Health inequalities tool 4 - Advocate for change

Changing Government policy, reforming how funds are distributed for healthcare, and making new laws that protect children and young people are how sustained and meaningful change can happen. Prevention is better than cure. Inequalities cannot improve without repairing the inherent problems in society and within health services.

Although doctors are historically not taught how to advocate for change and influence thinking in strategic areas, we are hoping to address this as a College. We offer key principles.
Icon of unrolled scroll with megaphone - on background of repeated icon of family

The key principles are simple

  • Don’t worry about how to become an activist. Activists don’t need paediatricians to be an activist – they need us to be paediatricians. The expertise we bring to the table needs to be a combination of our experiences, and evidence. Healthcare leaders and policy-makers are keen to hear from clinicians about inequality. 
  • It is important to understand the landscape for local and national influence. “People know people know people” and talking is the best way to open doors and develop a network. Colleagues will often be linked in with different initiatives and leadership roles and may be able to get a foot in the door with the right person.
  • Stand firm. Compromise is fine (and healthy), but it is important to not be fobbed off. “Low hanging fruit” can be a good strategy for certain problems, but not for child poverty. Scratching around the surface compounds the problem. It often diverts from where the problems really lie. 
  • The key benefits of addressing child poverty cut across the board. There are financial, resource, moral, ethical, and environmental benefits if children do not live in poverty. It is useful to identify which of these is relevant to the people with whom we speak.
  • Use data and evidence as tools to support your case when advocating for change. (See Harnessing data and evidence below.) 
What do children and young people think?
  • Involve us in a project to help create awareness campaigns, materials, resources or presentations to professionals and local influencers. We know better than anyone what it is like to experience poverty or inequalities, so we want to work with you on it. We have a guide called Youth Social Action on how to work with young people on a project, which was created with a paediatrician.
  • Ask people to think about these questions:
    • What would be your top three suggestions for families who are struggling with the cost of living?
    • What can you do with your connections or links to make a difference?
    • How does your policy make a difference and what could be changes to make it even more of a difference?
    • If you had to choose between food, medicine/appointments or bills, what would you choose?
  • Play family misfortunes or the child poverty memory game in your teams and with decision makers to raise awareness of issues identified by children and young people in relation to poverty and the impact on their wellbeing.

If you’re based in England, you could consider becoming an RCPCH Ambassador, who are responsible for advocating for children in your local Integrated Care Systems (ICS), or approaching your local Ambassador for support with your advocacy work. Find out more about RCPCH Ambassadors

Paediatricians must ensure that people know that poverty increases the risk of childhood mortality, and that there is an urgency to improve the situation. There is ongoing work to enshrine the rights of children in UK law, which may help to address this.

Harnessing data and evidence

Here are sources of data and resources that will be useful to support you in making the case to address child health inequalities in your local area.  

UK-wide database
Office for National Statistics - This has excellent resources around many aspects of socioeconomic deprivation and child health
Northern Ireland
National audits

These can be used to assess clinical outcomes, process outcomes and service provision, and enable benchmarking with other centres. The data can be used to generate business cases for improved services.

National audits in infants, children and young people are conducted for asthma (with Royal College of Physicians), neonatal carediabetes and epilpesy.

Other resources

Various charities, third sector and grassroot organisations publish information and resources on child poverty in the UK to support you in advocating for improved child health outcomes: 

Paediatric organisation

The Wellbeing and Health Action Movement (WHAM) - To inform, empower and unite clinicians who fight child poverty and health inequality with tools and resources to help you do so

More from the health inequalities toolkit