Widening inequalities in child health revealed

Children's health in England is "stagnating or declining" across almost every major measure, according to a new report from the Royal College of Paediatrics and Child Health (RCPCH). 

The State of Child Health 2026: England reveals that nearly a decade after the first national review, outcomes have worsened or stalled across almost all 12 key child health indicators. 

Widening inequalities are leaving the poorest children at greatest risk of poor health, and the report identifies three drivers of declining outcomes: gaps in child health data, widening inequalities and chronic underinvestment in the child health workforce.

Doctors warn that urgent government action is needed to prevent a generation of young people experiencing poorer health than their parents.

Key findings

The proportion of eight to 16-year-olds diagnosed with a probable mental health disorder has nearly doubled in four years, rising from 12.5 per cent in 2019 to 20.3 per cent in 2023. 

At the same time, the proportion of young people able to access help through school has fallen from 59.8 per cent in 2022 to 53.1 per cent in 2023. 

Report authors state: "Children and young people consistently identify limited access to emotional health support as a major concern, with support often difficult to access, inconsistent, and typically only available at crisis point despite widespread everyday need."

Childhood obesity also remains a significant concern, with rates rising sharply as children get older. 

Almost one in four (23.5 per cent) children aged four to five are overweight or living with obesity, increasing to more than one in three (36.2 per cent) by the time they reach 11-years-old. 

Obesity among ten to 11-year-olds is 30.8 per cent among Black Caribbean children and 31.4 per cent among children from other Black backgrounds, compared with 13.6 per cent among children from Chinese backgrounds. 

The report says children living in the most deprived areas are around twice as likely to be overweight or living with obesity as those in the least deprived communities.

A separate analysis published this week by the Education Policy Institute through its Early Years Observatory found nearly a quarter (24 per cent) of households with children under the age of five experience food poverty.

Emergency admissions for childhood asthma have risen to 147.9 per 100,000 children, with those from deprived backgrounds four times more likely to die from asthma than their wealthier peers. 

Tooth decay remains widespread, affecting 22 per cent of five-year-olds and costing the NHS an estimated £74.8 million for extractions among under-20s in 2024. 

Meanwhile, although early childhood development has improved since the pandemic, only 68.3 per cent of children achieved a good level of development in 2024, below the government's 75 per cent target. This fell to 51.3 per cent of children eligible for free school meals.

The RCPCH says England is at a “critical political moment” and is urging ministers to place child health at the centre of national policy. It argues that investment in prevention, rather than simply treating illness, will be essential to reversing current trends.

Dr Helen Stewart, RCPCH officer for health improvement, said: "This report is a stark reminder to policymakers that, to achieve that goal, there is a huge amount of work to do. Since the last iteration of State of Child Health (published in 2020), very little has improved and, on some indicators, the situation has deteriorated.”

Solutions

The RCPCH is calling for:

• Better collection and sharing of child health data to monitor progress
• The introduction of clear national targets to improve children's health and reduce inequalities
• Greater long-term investment in child health services and the workforce

The report argues that stronger accountability is needed to ensure governments deliver on promises. 

Consistent national targets would allow progress to be measured across areas including immunisation, obesity, mental health and child mortality.

Reaction

Children’s charity, local government and health leaders have expressed alarm at the findings, and backed the recommendations in the report.

The Local Government Association said: "This report is a stark reminder of the realities facing children across the country: widening health inequalities, stalling vaccination rates and rising mental ill-health among them." 

Dr Heather Grimbaldeston, chair of the BMA public health medicine committee, said: "This report paints a worrying picture of children's health in the UK, and all signs indicate that things are heading in the wrong direction.

"Whether it is falling vaccination rates, rising obesity, worsening mental health or higher infant mortality, these are not isolated problems – they are symptoms of a system that has failed to invest in public health systems, prevention and in the services families rely on." 

Rukshana Kapasi, director of Health at Barnardo’s, said: “Children’s health is in crisis and should be treated as such. Through our Barnardo's’ services, we see this crisis play out every day. We know that without a stronger focus on preventing the drivers of poor health, we risk worse educational outcomes and widening health inequalities for an entire generation.”