State of Child Health 5 - Family and social environment indicators

This chapter looks at poverty, the child protection system and counselling sessions by Childline.
Last modified
11 September 2018

Child poverty

Proportion of children living in households with income less than 60% of the median

Key messages

  • Poverty is associated with adverse health, developmental, educational and long-term social outcomes.
  • Nearly one in five children in the UK is living in poverty. This is predicted to increase. Therefore strategies are urgently needed to reduce poverty and to mitigate its impact on child health outcomes.
  • Improving the health outcomes of children living in poverty requires provision of good-quality, effective and universal prevention and health care services. 
  • All professionals caring for children should advocate for and support policies that reduce child poverty.

Key actions

  • Governments must introduce comprehensive programmes to reduce child poverty.
  • Increase awareness among health professionals of the impact of poverty on health and support all professionals working with children to become advocates for their patients experiencing poverty.
  • Ensure universal early years’ public health services are prioritised and supported, with targeted supports for children and families experiencing poverty.
  • Provide good quality, safe and effective prevention and care throughout the public health and healthcare service with a particular focus on primary care in order to mediate the adverse health effects of poverty.
  • Support research that examines the relationship between social and financial disadvantage and children’s health. 
  • Support the continued recording of income-based measures of poverty so that trends and impacts of service provision can be meaningfully assessed, with a focus on achieving a target of less than 10% of children experiencing relative low income poverty.

Children in the child protection system

Number of children subject to child protection plans or on the child protection register

Key messages

  • The number of children subject to a child protection plan (CPP) or on the child protection register (CPR) is one of several measures used to monitor children in the child protection system. 
  • Between 2004 and 2015, the number of children in the child protection system increased in all four nations; the greatest increase took place in England, where the rate increased from 24 to 43 per 10,000. For 2015, Wales recorded the highest rate: 47 per 10,000. 
  • Children in the child protection system are more likely to experience a range of physical and mental health issues. Better data are needed to support effective service delivery and improve health outcomes of these particularly vulnerable infants, children and young people.

Key actions

  • Protect and continue to support the provision of early help services.
  • Invest in a well-trained multi-disciplinary workforce that can respond to children and families at risk of or who experience harm.
  • Strengthen knowledge and skills for those working in primary care, education and community settings who are well placed to spot the signs of harm.
  • Ensure children and young people are educated to understand respectful relationships and provide them with information on seeking help through statutory health education. 
  • Increase therapeutic support for children and young people who have experienced harm.
  • Strengthen evidence to inform demand, provision and best practice.
  • Improve research, evaluation and monitoring to accurately identify the number of children experiencing abuse and the different types of abuse. 
  • Evaluate the services available to children experiencing harm so that these services are doing enough to support children and young people.

Counselling sessions by Childline

Percentage of Childline counselling sessions by primary concern across UK

Key messages

  • Childline is a free 24-hour helpline providing counselling for children and young people across the UK.
  • Latest figures show that nearly half of all Childline contacts were with children who were concerned about low mood or unhappiness, bullying and family relationships.
  • When a child or young person is in a life-threatening situation, or when they are requesting direct help, Childline will make the decision to make a referral to another agency on their behalf. In 2015-16, Childline made 4,005 referrals to external agencies; 2,204 – more than half – were on behalf of children with suicidal concerns.

Key actions

  • Maintain ongoing monitoring of Childline contacts to inform policy and practice.
  • Ensure training of all professionals working with children and young people enable them to support children and young people who contact Childline, as appropriate to their need and in line with demand.
  • Further recommendations are outlined in the Indicator on suicide