Health inequality in Scotland's poorest children branded national problem by University of Glasgow expert

Growing health inequalities across Scotland are resulting in a “national problem” leaving children in the poorest areas to suffer obesity and a greater risk of infant mortality, researchers have warned.

The “widening of inequality” in some areas of children’s health was “worrying”, particularly during the cost of living crisis, Dr Anna Pearce, an expert at the University of Glasgow has said.

Her comments came as a study carried out by the MRC/CSO Social and Public Health Sciences Unit at the University of Glasgow revealed “stark and concerning data” – including that children living in deprived areas are 2.6 times as likely to die before their first birthday as children in less deprived areas.

While overall infant mortality has declined since 2000, the research showed a rise after 2014 in the most deprived fifth of areas.

With infant mortality continuing to fall in the least deprived 60% of areas, inequalities have widened.

Meanwhile over the the past decade, the number of youngsters at risk of childhood obesity has been rising in more deprived areas and falling in the least deprived.

At an overall population level, the proportion of children at risk of this has remained fairly stable over the past 20 years in Scotland.

But researchers said this situation “disguises potentially worrying differences across areas” – with risk of childhood obesity having fallen slightly in the least deprived areas and increased slightly in the most deprived areas, resulting in a widening of inequalities.

By 2018-19 children living in the most deprived fifth of areas were twice as likely to be at risk of obesity, the research found, with an absolute gap of 7%.

The full report is due to be published before the end of the year but the interim findings also showed increases in the proportion of two-year-olds who had not been immunised against measles, mumps and rubella in three of the five most deprived areas in Scotland.

Here the absolute gap between the most and least deprived areas had increased from 0.8% in 2014 to 4.5% in 2021, with relative inequalities doubling.

Since 2016 Scotland has not met the World Health Organisation target of having 95% of children immunised with the MMR vaccine by the age of two – with this currently only achieved in the least deprived 40% of areas.

Speaking about the findings, Dr Pearce, Wellcome Trust senior research fellow at the MRC/CSO Social and Public Health Sciences Unit, said: “This widening of inequality in some areas of children’s health, including the risk of childhood obesity, is worrying, especially with families’ financial circumstances expected to worsen.”

She added: “We know that these inequalities are not going to be resolved by solely targeting people’s behaviours. For example, inequalities in childhood obesity are likely to be driven not by differences in children’s physical activity levels (which do not vary by deprivation), but by differences in diet and a healthy balanced diet is considerably more expensive calorie for calorie and therefore increasingly inaccessible to those on the lowest incomes.

“This is a national problem for Scotland, and the data show a growing inequality gap.”

The research is part of an independent review being undertaken by the UK-focused charity the Health Foundation, working with Scottish research partners and an expert advisory group.

It hopes to produce evidence that will influence policy in a bid to improve long-term health and close the gap between the richest and poorest.

David Finch, assistant director with the Health Foundation, stated: “Our review aims to fully understand all the factors which cause health inequality in Scotland, and to provide policy makers with a foundation to improve the outcomes for the sections of the population who are struggling the most.

“This stark and concerning data on childhood obesity and other childhood inequalities – shows the importance of supporting good health and tackling inequalities for children from the youngest ages and for their families.”

He continued: “The evidence pointing to nutrition as the driver, rather than physical activity, requires us to examine the links between the health of our children and cost of living, including access to healthy food – a particular concern with food prices rising by 13% in the year to August.

“We hope our review will create a foundation for improving the health of people across Scotland.”