Poorest children have worse health and educational outcomes in adolescence

Generation Z children born into the poorest fifth of families in the UK are 12 times more likely to experience a raft of poor health and educational outcomes by the age of 17 compared to more affluent peers, finds a new report led by UCL researchers.

Published in The Lancet Public Health, the research used data from the Millennium Cohort Study, a major study of 19,000 children born across the UK at the turn of the century, who are now in their early 20s.

The researchers analysed information on more than 15,000 adolescents at age 17 to examine links between their socioeconomic background and adverse health and social outcomes which are known to limit life chances, including educational achievement, smoking, poor health, obesity and psychological distress.

Children who were most disadvantaged between the ages of 0-5 were four and a half times more likely to do worse at school at the age of 17 compared to those in the highest income group. And they were three and a half times more likely to start smoking.

Those born in the lowest income quintile group were also more likely to have a harmful cluster of vulnerabilities at age 17 and were 12 times more likely to experience all – or all but one – of the five adverse health and social outcomes examined by researchers, compared to those born in the highest income quintile.

However, lifting families with children from the poorest income quintile group to the next poorest group would only result in a modest reduction in the clustering of multiple adolescent adversities (4.9% according to the scenario model).

Consequently, the researchers advocate coordinated action on childhood disadvantage across health, education, social care and other public services, across the social spectrum.

The researchers suggest that policymakers should, as a minimum, aim to prevent absolute poverty in childhood, characterised today by widespread food and fuel poverty. They argue this is a necessary step but insufficient without a concerted effort to deliver coordinated public services to disadvantaged communities.

Professor Eric Brunner (UCL Institute of Epidemiology & Health) said: “Almost a third of children in the UK lived below the poverty line in 2019-20, as housing costs and childhood poverty continued to rise. The consequences in relation to future health inequalities (in diabetes, heart attack, cancer, and multimorbidity) are evident in stark terms in the experience of those taking part in the Millennium Cohort Study. Social fragmentation on the scale we see it today is not a good plan in any sense.”

Professor Richard Cookson (Centre for Health Economics, University of York), said: “To improve life chances, reduce inequality and unleash human potential, the UK government needs to find imaginative ways of providing support to the pre-school population right across the social spectrum – not only through the tax and benefit system but also through coordinated public service delivery across organisations together with employment and housing reform.”

The research comes shortly after the Spring Budget, which includes changes such as a freeze on income tax thresholds, abolishing the lifetime allowance (the maximum amount you can draw from your pension without paying more tax) and increasing the annual allowance (which limits the total amount a person can contribute to a pension in one year without paying a tax charge), which the study authors say could benefit high earners at the expense of those lower down the income distribution.

Further information

Clustering of adverse health and educational outcomes in adolescence following early childhood disadvantage: population-based retrospective UK cohort study, by Aase Villadsen, Miqdad Asaria, Leva Skarda, George B Ploubidis, Mark Mon Williams, Eric Brunner, Richard Cookson, is available on The Lancet Public Health website.