From Dr Helen Stewart, Officer for Health Improvement
Since the last iteration... very little has improved and, on some indicators, the situation has deteriorated
Thank you for taking the time to read this updated State of Child Health report. It is the culmination of a huge amount of work, bringing together a wide range of data to help us better understand the health of children and young people in the UK and what we can do to improve it. It is especially exciting that children and young people were involved in this report, developing an indicator on emotional health and wellbeing using their insights, reflecting the importance of listening to their voices in shaping the policies that affect their lives.
In early 2024, the UK government promised to create the healthiest and happiest generation of children ever in Britain. It is a noble goal that governments of all colours across our nations should hold as a priority. 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. For example, fewer than 90% of children in all four nations are now receiving both doses of the MMR vaccine by age five, and in England this has fallen as low as 84%. Most measures of child health and wellbeing show a worsening picture, and where progress was once being made, it has stalled.
It is also clear that there remain significant inequalities which are impacting the health of children and young people, with those in the most deprived communities experiencing the worst outcomes. For instance, rates of both infant mortality and obesity were found in this report to be more than twice as high in the most deprived areas compared to the least deprived.
I became curious as to why so many of the patients coming to the [emergency] department were from the same areas of the city
This is unlikely to be a surprise to many of you. As a Consultant in Paediatric Emergency Medicine, I see patients every day who are impacted by their life circumstances: children with asthma exacerbations who live in polluted areas, those living with complications of excess weight, and those who have been unable to access vaccinations. In fact, it was my career in emergency medicine that inspired me to become the RCPCH Officer for Health Improvement. I became curious as to why so many of the patients coming to the department were from the same areas of the city, which took me on a journey to understand health inequalities, how little control children have over their own health and the extent to which the environments they grow up in are shaping their outcomes.
This report should be a wake-up call to the governments of all four nations that we need to act now. The recommendations need to be implemented as soon as possible. Every child in these nations has the right to the best possible health and to develop to their full potential under the UN Convention on the Rights of the Child, and currently they are being failed.
From Professor Steve Turner, RCPCH President
Collectively, we must do better, and we must do it sooner
I have been involved in State of Child Health since it was first published in 2017. Over that time, it has become the go-to resource for describing and comparing child health and wellbeing across the UK’s four nations, providing a clear and consistent picture of where progress is being made and where it is not.
The 2026 update is a timely and important reminder that we are not yet doing enough. While ambitions for children’s health have been set out repeatedly, the evidence in this report shows that too many children and young people, particularly those in our poorest communities, are still being left behind.
Collectively, we must do better, and we must do it sooner. Improving child health requires sustained focus, long-term investment, and a commitment to tackling the root causes of inequality. Getting it right first time matters, not only for children today, but for the health and prosperity of our society in the years to come.
[State of Child Health] presents an opportunity for ongoing engagement and collaboration with our membership and partners...
This is not just the publication of a dataset; it is a living, evolving resource that will be updated as new data become available. It is also a tool for our members providing them with information to make change locally. It presents an opportunity for ongoing engagement and collaboration with our membership and partners, supporting shared learning and real, sustained change in child health.
Ultimately, we hope that State of Child Health acts as a stark reminder to policy makers to go further and faster on child health. Children remain 25% of the population and 100% of our future.
Introduction
Our RCPCH vision is a world where every child is healthy and well. As signatories to the UN Convention on the Rights of the Child (UNCRC), UK governments have a responsibility to uphold every child’s right to the highest attainable standard of health, and current trends suggest this responsibility is not being fully met.
We have created this report to give a comprehensive overview of the current state of child health and wellbeing across each nation of the UK using a set of 12 indicators. Our report combines the insights of paediatricians and the voices of children and young people with analysis of the latest evidence to generate key actions for decision-makers to make progress towards achieving our vision.
Nearly 10 years on from our first State of Child Health report in 2017, successive government strategies have set out ambitions to improve the health and wellbeing of children and young people. However, the data presented here suggest that any progress has been slow, and as a result, highlights worrying trends for children and young people’s health. Most of the indicators of child health and wellbeing outcomes we have used reveal a worsening situation, and where improvements were previously seen, progress has stalled. Health inequalities persist and in some cases are widening, meaning the worst health and wellbeing is being experienced by those living in deprived areas and among ethnic minority communities.
The data clearly show that we will not achieve the ambition of raising the healthiest and happiest generation of children ever without significant change. Past government approaches have not been enough to see adequate improvement in children and young people’s health. The environment in which our children are growing up is causing them harm.
We are publishing this at a critical political moment in the UK, with Westminster Government pledging to raise the healthiest and happiest generation ever, and new governments being elected in Scotland and Wales in 2026 and in Northern Ireland in 2027. We are taking this window of opportunity to publish State of Child Health 2026 in order to influence policies on health improvement, inequalities, and the child health workforce across the UK.
We want to see UK governments adopt the preventative strategies and recommendations set out across State of Child Health 2026, and to measure progress on meeting their ambitions by tracking child health and wellbeing improvements across our 12 indicators.
We must invest on our children; they are 25% of the population but 100% of our future. Failure to improve child health today risks lifelong health problems, poorer educational outcomes, and entrenched inequalities. Without urgent action, paediatricians are clear that we risk raising one of the unhealthiest generations of children ever.
Methodology
State of Child Health 2026 provides a comprehensive overview of children and young people’s health and wellbeing across the UK. The report brings together the latest available data across 12 key indicators to assess trends over time, identify inequalities, and highlight priorities for action.
It is designed as both an evidence-based data tool and an advocacy resource, supporting governments to improve outcomes and reduce health inequalities for children and young people.
- Indicator selection
The report is structured around 12 child health indicators, selected to provide a broad and meaningful picture of children’s health across the life course.
Indicators were selected using agreed criteria. Each indicator:
- Focuses on outcomes impacting children’s health and wellbeing, rather than service inputs
- Represents a priority issue for children and young people and RCPCH members
- Has robust, regularly updated and comparable national data available for at least two UK nations where available
- Is an area where the College has clinical expertise and a clear role in policy development
- Reflects issues where paediatricians have a direct role in care or influence outcomes
- Is an area where Government action to tackle health inequalities and improve the wider determinants of health can improve child health.
One indicator (emotional health and wellbeing) was co-developed with children and young people using a mixed-methods, engagement-led approach, reflecting their priorities and lived experience alongside quantitative data.
Where possible, indicators have been retained from previous State of Child Health reports to allow comparison over time.
- Data sources and analysis
Data for each indicator were drawn from national datasets and official statistics across England, Scotland, Wales and Northern Ireland.
For each indicator, the report:
- Analyses current data and trends over time
- Compares outcomes across nations where possible
- Examines variation by key factors such as deprivation and, where available, ethnicity
- Identifies drivers of poor outcomes and inequalities.
Due to differences in data collection and reporting across the UK, full comparability is not always possible. These limitations are highlighted throughout.
While most indicators draw on national datasets, the emotional health and wellbeing indicator incorporates qualitative insights from children and young people to address gaps in routinely collected data.
- Research partnership and analytical support
State of Child Health 2026 was developed in partnership with Born in Bradford (BiB), an internationally recognised child health research programme. Through this collaboration, BiB provided dedicated research capacity and analytical expertise to support the development of the report.
BiB's contribution included:
- Supporting the curation and validation of national data on prevalence, incidence and health inequalities across the report indicators
- Analysing trends over time and advising on interpretation of findings
- Supporting the development of UK-wide analyses where data required extrapolation or synthesis across nations
- Contributing expertise in health economics modelling and economic analysis where appropriate
- Providing methodological advice on the interpretation of evidence and health inequalities.
The partnership brought together RCPCH expertise in child health policy, clinical practice and advocacy with BiB's strengths in population health research, epidemiology, health inequalities and knowledge mobilisation to strengthen the evidence base underpinning the report.
- Approach to inequalities
A central aim of the report is to understand and address health inequalities.
Each indicator explores how outcomes vary by deprivation and other factors, highlighting:
- Differences between the most and least deprived groups
- Inequalities across population groups
- Key drivers, including poverty, ethnicity and wider determinants of health.
This approach ensures inequalities are consistently considered across all indicators, rather than treated as a standalone issue.
- Content for each indicator
Each indicator includes a structured analysis combining quantitative data, clinical insight, and policy recommendations. Specifically, each section includes:
- Analysis of data and trends over time
- Identification of health inequalities and key drivers
- Clinical insight from paediatricians
- Voices of children and young people
- Nation-specific policy recommendations
- Where possible, reference to the economic impact of action or inaction.
- Clinical insight and interpretation
Quantitative data is supported by insight from paediatricians and clinicians across the UK. These contributions:
- Provide context on trends and system pressures
- Highlight barriers to access and delivery
- Illustrate the real-world impact on children and families.
This ensures findings reflect both national data and frontline clinical experience.
- Engagement with children and young people
Children and young people have been actively involved in shaping the report, including contributing to indicator development and highlighting priority issues.
Their input ensures the report reflects:
- Lived experience alongside quantitative data
- Issues most important to children and young people
- Practical insights into how services and systems are experienced.
- Limitations
The report is subject to several limitations:
- Variation in data availability and definitions across UK nations
- Incomplete or inconsistent data in some areas
- Time lags in published datasets
- Inability to capture all aspects of child health within a single framework
Addressing these data challenges is itself a key recommendation of the report.
- Role of the report
By bringing together 12 indicators into a single framework, State of Child Health 2026:
- Provides a clear overview of the state of children’s health
- Enables tracking of progress over time
- Identifies key inequalities and drivers
- Supports evidence-based policymaking
Together, this approach provides a practical foundation for improving outcomes and delivering the ambition of the healthiest generation of children ever.
Acknowledgements
This work was authored by:
- Dr Helen Stewart, Officer for Health Improvement, RCPCH
- Olivia Lam, Policy Manager, RCPCH
- Jamie Inkles, Policy Manager, RCPCH
- Alison Firth, Head of Health Policy, RCPCH
- Louise Dyer, Policy Officer, RCPCH
- Eliott Thompson, Health Policy Assistant, RCPCH
- Sara Ahern, BiBBS Programme Manager, Born in Bradford
- Mariya Geneshka, Research Fellow, Born in Bradford
- Sarah Byrne, Knowledge Mobilisation Fellow, Born in Bradford
- Aimee, Amanda, Eva, Lewis, Poppy, Rebecca, Taegan from RCPCH &Us, Youth Link Scotland and Insulin Avengers Stoke
- Allison Guiton, Engagement Academy Manager, RCPCH
- Emma Sparrow, Head of Children, Young People and Engagement, RCPCH
We are also grateful to the following for their significant contributions:
- Professor Steve Turner, President, RCPCH
- Dr Mike McKean, Vice President for Policy, RCPCH
- Dr Sunil Bhopal, Director of Child Health Research, Born in Bradford
- RCPCH Policy and Public Affairs (Devolved Nations) team
- RCPCH Health Improvement Committee
- RCPCH Policy and Advocacy Executive
- RCPCH &Us Network – children and young people across the UK who contributed their views
- RCPCH members who contributed a paediatrician’s insight piece (named throughout the report)