State of Child Health 3 - Early years indicators

This chapter looks at indicators important for early childhood, including weight when starting school, healthy teeth and gums and hospital admissions due to non-intentional injury.
Last modified
11 September 2018

Healthy weight when starting school

Proportion of children at a healthy weight during their first year of primary school

Key messages

  • Weight status at the commencement of primary school is an important predictor of health outcomes later in life.
  • Across England, Scotland and Wales more than one in five children during their first year of primary school are overweight or obese.
  • There has been minimal overall improvement in the proportion of children at a healthy weight in the past decade in any country.
  • Children living in the most deprived areas are much more likely to be overweight or obese compared to children in the least deprived areas. 
  • The promotion of healthy weight in children requires a range of interventions to both reduce the obesogenic environment and target critical periods in the life course.

Key actions

  • Enact cross-government childhood obesity strategies across all countries, including rigorous evaluation and quality improvement plans.
  • Robust evaluation to monitor the effectiveness of the proposed sugar levy and other sugar-reduction initiatives on sugar-sweetened beverages in all countries.
  • Expand nutritional standards to all schools. Make school-based health education a statutory subject in all schools, with schools focusing on the importance of both physical activity and nutrition.
  • Introduce a ban across the UK on the advertising of foods high in saturated fats, sugar and salt before 9pm, and evaluate the impact of online food marketing on children. 
  • Extend the reach and effectiveness of universal measurement programmes in different countries to include an increase in the number of measurement points and longitudinal tracking of children, starting much earlier in childhood. There should be sharing of data with general practitioners, school nurses and parents. Introduce Year 6 and P6 cohorts in child measurement programmes in Scotland, Wales and Northern Ireland.
  • Support a research environment that enables sustained, long-term expansion of basic science and applied research to identify the causes of obesity and effective interventions to tackle it. 
  • Ensure that overweight and obese children have timely access and support to attend evidence-based programmes, via prescriptions or referrals by their GP.
  • Ensure children with significant underweight have timely access to specialist child health services 

Healthy teeth and gums

Proportion of children with no obvious tooth decay at age five

Key messages

  • Good oral health is essential for children’s overall health and wellbeing.
  • Despite tooth decay being almost entirely preventable, 31 to 41% of 5-year-old children across the UK have evidence of tooth decay, with rates higher for those in deprived populations. 
  • Tooth decay is the most common single reason why children aged five to nine require admission to hospital.
  • Good oral hygiene and reduced sugar consumption, coupled with access to timely primary dental care, are important for reducing tooth decay in children.

Key actions

  • Ongoing development, implementation and evaluation of national oral health programmes for children and young people across the UK, building on existing initiatives, including Childsmile (Scotland) and Designed to Smile (Wales). 
  • All children in the UK should receive their first check-up as soon as their first teeth come through, and by their first birthday, and have timely access to dental services for preventative advice and early diagnosis of dental caries, with targeted access for vulnerable groups.
  • Fluoridation of public water supplies, particularly in areas where there is a high prevalence of tooth decay. 

Hospital admissions due to non-intentional injury

Rate of hospital admissions for non-intentional injuries in children under five years

Key messages

  • In 2014-15 there were 45,168 non-intentional injury-related hospital admissions across England, Scotland and Wales for children under five years.
  • Injuries are non-random, preventable events. Yet non-intentional injuries remain a major cause of ill health and serious disability in children that require continued focus on safety improvements.
  • Around 72% of non-intentional injuries in children occur in the home.
  • Injury reductions can be achieved at low cost, particularly through parent education and local coordination.

Key actions

  • Ensure co-ordinated cross-sectorial action to reduce non-intentional injuries through improved home safety education for parents and health and other early years’ professionals.
  • Ensure that technological and engineering interventions are combined with education and inspection for maximum efficacy.
  • Reduce inequalities relating to admission rates for children and their families in the most deprived areas compared to those in the least deprived areas. 
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