Tooth decay, obesity and A&E admissions, report reveals issues for under 5s in Norfolk and Suffolk
PUBLISHED: 08:45 07 September 2015 | UPDATED: 09:42 07 September 2015
One in four five-year-olds in Norfolk has tooth decay, almost one in ten is classed as obese and hundreds of young children are needlessly ending up in A&E every year.
These are some of the stark findings of a new report which has issued a rallying cry for more to be done to prevent youngsters from experiencing a poor beginning in life.
The National Children’s Bureau (NCB) report has highlighted a postcode lottery of health and development for under 5s in the East of England, with those living in deprived areas more likely to suffer.
However, crucially, its Poor Beginnings report says the relationship between deprivation and health is not “inevitable”, with some of England’s poorest regions achieving better than average outcomes for their children,
Its report calls for more in-depth analysis to be carried out in the areas of deprivation that have managed to “buck the trend” to find out how this has been achieved.
And with local authorities taking over responsibility for public health of preschool children next month, the NCB also highlights the need for councils to be “championing children’s health” and for decision makers to be held to account.
Norfolk County Council is currently putting the final touches to its Healthy Child programme, which will be delivered by the Cambridgeshire Community Services NHS Trust (CCS) as part of an initial five-year contract.
It focuses on improving outcomes in 20 key areas and sees services such as health visiting, school nursing and healthy schools for anyone under 19 brought together for the first time.
Suzanne Meredith, a consultant in public health, said: “This will mean that if a scheme works in one part of the county, we will roll it out elsewhere.
“We have been busy working with parents and identifying the key issues we need to tackle with the new service, including those mentioned in this report.
“We would expect to see improvements in these areas over the next few years.
“It’s so important our children are ready for school and get a good start in life.”
Overall, Suffolk scores generally well under the various health measures.
However Suffolk’s percentage of children deemed by teachers to have reached good standards of development by the end of reception falls worryingly below the national average.
Nationally, 60% of reception-aged children are judged to have achieved good levels of “school readiness”, based on their personal, social and emotional development, reaching as high as 75% in some London boroughs, whereas in Suffolk the figure is just 58.9%.
Suffolk County Council is currently developing a health lifestyles service with schools to include a variety of ways to support young people to have a healthy diet and become more physically active.
Head of health improvement for children and young people, Sharon Jarrett also highlighted the Keep Suffolk Smiling project to tackle poor dental health, as well as its work with Public Health Suffolk and clinical commissioning groups to produce a “comprehensive guide to childhood illnesses”.
She added: “Our overall approach is to use our comprehensive health needs assessments to identify where there are health inequalities in the children and young people in Suffolk, for both physical and mental health and work together with health and care services to implement evidence based interventions to optimise the support given, address inequalities and improve outcomes for our population.”
Comparing the 30 most deprived local authorities in England with the 30 best-off, the report finds that children under five in poor areas are significantly more prone to obesity, tooth decay, accidental injuries and lower educational development.
While only 18.4% of children living in the 30 richest areas suffer from tooth decay, this rises substantially to 31.6% of four to five-year-olds in the 30 most deprived areas.
Anna Feuchtwang, chief executive of the National Children’s Bureau said: “It is shocking that two children growing up in neighbouring areas can expect such a wildly different quality of health.
“As these variations are closely linked to poverty, with those in areas with the highest levels of deprivation more likely to suffer from a range of health issues, we have to ask whether England is becoming a nation of two halves?
“The link between poverty and poor health is not inevitable. Work is urgently needed to understand how local health services can lessen the impact of living in a deprived area.
“We need local and national government to make the same efforts to narrow the gap in health outcomes across the country for under-fives as has been made to narrow the gap in achievement between poor and rich pupils in school.
“Government must make it a national mission over the next five years to ensure that the heath and development of the first five years of a child’s life is improved.”
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Of the five counties in the region, Norfolk was classed as the most deprived, a measure which is based on several factors including housing, employment and social class.
It was ranked as 98th out of 150 areas nationwide, so while not amongst the most deprived parts of the country, there are parts of Great Yarmouth and Norwich, in particular, where deprivation remains.
In April this year Norfolk County Council released a Child Poverty Needs Assessment report which found that 16.3% of Norfolk children live in low-income families, compared to 18.6% nationally, which equates to an
estimated 27,300 Norfolk children.
The report’s recommendations included bringing better paid job opportunities to poorer areas, increased support of families with complex needs and trying to improve early years education.
Suffolk was ranked 113 for deprivation and Cambridgeshire 136.
Dire warnings exist about obesity and the problems it could cause in the years to come.
A January Norfolk Public Health report predicted that if obesity levels carry on at the current rate, by 2020 adult obesity in Norfolk could see an increase from 174,629 to 253,762, a rise of 31% for which Norfolk will subsequently be spending more than £26m on treating weight related diabetes alone.
The study found that almost one in ten (8.6pc) of four to five years olds in Norfolk are classed as obese, compared to 8.9pc in Suffolk and 8pc in Cambridgeshire.
This is broadly in line with the national average and the worst places in the country are mainly in London.
The recommendations to resolve the issues include targeting and working with whole families where obesity is a problem and encouraging other agencies, such as schools, to take more responsibility for spreading awareness of the issue.
One in four (25pc) five year olds in Norfolk was found to be suffering from tooth decay, a figure that was much higher than Suffolk (15pc) and Cambridgeshire (12pc).
Nationally, this is a growing problem and earlier this month Professor Nigel Hunt, dean of the Royal College of Surgeons’ dental faculty, warned Britain was facing a tooth decay crisis if things didn’t improve.
Put simply, experts believe parents need to be more aware of the heath of their children’s teeth, especially at a time when sugary drinks are more common.
Nick Stolls, a south Norfolk dentist, and secretary of the Norfolk Local Dental Committee, said: “Tooth decay is totally preventable and parents need to do their bit to make it normal that their child sees a dentist. There is also work going on to change dentists’ contracts to focus more on preventative measures, rather than simply treating people when they have a problem.”
Top tips for Parents
1. Limit sugar intake: In the mouth, the bacteria living on the teeth rapidly convert sugar into acid and it is this acid that dissolves the tooth enamel. The risk of developing decay increases as the amount and frequency of sugar consumption rises: so try to limit the amount of sugar you eat during mealtimes.
2. Brush regularly: Keeping teeth clean by regular brushing helps prevent decay as the amount of acid generated is dependent on the quantity of dental plaque on the teeth. All children up to three years old should use a toothpaste with a fluoride level of at least 1000ppm, both morning and night. After the age of three, toothpaste should contain 1350ppm-1500ppm. Children’s brushing should be supervised until the age of 7.
3. Don’t miss your check-ups: Dentists should encourage their patients to ensure their children come in for regular dental check-ups, so any oral health problems can be spotted early.
4. Put a lid on unhealthy snacks: The problem is made worse by the trend for sweets, which tend to be eaten between meals, to contain increasingly acid ingredients. Breadsticks, nuts and raw vegetables are far better alternatives to sugary snacks. Even if carbonated drinks are sugar-free, their acid properties will still lead to tooth damage, by erosion rather than decay. Look out for raisins too, these tend to stick to teeth and attack enamel and so should be consumed after meals, rather than as a snack.
5. Watch out for ‘hidden’ sugars: Pure fruit juices can be a healthy choice, but the natural sugars these contain can still damage teeth, so fruit juice should be consumed with a meal and only one glass (150ml) a day. Sugars in whole pieces of fruit are less likely to cause tooth decay because they are combined with fibre.
A high number of children aged 0-4 being admitted to hospital is also classed as an indicator of worrying levels of deprivation.
Todays report found that home is the most common place for preschool children to be injured, with falls, burns and poisoning some of the causes, as well as admissions linked to general poor health.
Norfolk’s admission rate of 153 per 10,000 children aged four and under was the 50th worst out of 150 in the country, while Cambridgeshire’s rate was 127 and Suffolk 110.
A 2014 report was commissioned to look into Norfolk’s high rates of admissions and it concluded: “There is a need to ensure that health visitors, children’s centres, GPs, social workers and other early years’ services are appropriately equipped to give parents advice on preventing accidents in the home and ensuring children are safe and protected.
“Many Children’s Centres in Norfolk offer “Save a baby’s life” courses as well as road safety awareness and car seat safety checks. Some are also offering home safety checks to more vulnerable families and all use their ‘hardship funding’ to support purchases of safety equipment e.g. stairgates.”
Norfolk’s struggles around education and development at all ages is well documented and the report fund that 58pc have what is classed as a good level of development at the end of reception year, which is normally at four-years-old. The best in the country was Lewisham (75pc) and the worst Leicester (41pc).
Suffolk fared only slightly better (59pc) and Cambridgeshire (61pc).
This level is measured by wether that child is classed as ready for school or not, with factors including communication skills, literacy levels and emotional and physical development.
THE REPORT RECOMMENDATIONS
- Government needs to set out a new strategy to support families in the early years that focuses on children’s health and development.
- Encourage authorities to follow lead set by Greater Manchester where bodies have come together to coordinate activity with a clear focus.
- Government should closely monitor new way of working and ensure sufficient resources are available.
- Local authorities to put in place plans to improve health and development in poorly performing areas.
- A review at local level of all provision for children under 5 for health, education and early years.