Presentation at the Faculty of Public Health annual conference 2016

1. FPH Annual Conference Brighton
15 June 2016

2. Giving children a good start plenary
Alison Garnham
Chief Executive, Child Poverty Action Group

4. Child Poverty Action Group
Who are we?
• Founder members credited with rediscovery of poverty in 1965
• Campaigning to prevent and end child poverty
• Hosts the End Child Poverty Campaign
• Experts’ expert in social security law
• Instigated the UK welfare rights movement
• Won Child Benefit
• Significant strategic litigation history
• Social enterprise
• £3m turnover and 49 staff – offices in London and Glasgow

5. What has happened to child poverty?
Some evidence

6. Child poverty - historical trend since 1970
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7. Child poverty is policy responsive
• Largest reductions in child poverty in OECD between mid-1990s
and 2008 (Bradshaw 2012)
• Child wellbeing improved on 36 out of 48 indicators between
1997 – 2010 (Bradshaw, 2012)
• Deprivation levels fell as did money worries (FACS)
• Extra money led to increased spending on fruit and vegetables,
children’s clothes and books – spending on alcohol and
cigarettes fell (Stewart, 2012)

8. Compared with the EU
SUB TITLE

10. Would have hit target in early 2020s

11. Targets, progress and projections UKSources: DWP (2015) HBAI 1994/95-2013/14; IFS (2016) Living standards, poverty and inequality
in the UK: 2015/16 to 2020/21, London: IFS
Before housing costs After housing costs
Baseline year 98/99 3.4 million
(26%)
4.4 million
(34%)
10-year actual 2010/11 2.3 million
(18%)
3.6 million
(27%)
IFS estimate 20/21 3.6 million
(25.7%)
Gov’t target 20/21
(Based on 10/11 population)
1.3 million
(10%)
n/a

12. Rising proportion of poor children live
with working parents
In-work poverty (2013/14) - below 60% median (BHC)
2000/01 2013/14
% poor children in working
households 52 64
% poor children in workless
households 48 36
No. poor children in working
households (million) 1.6 1.5
No. poor children in workless
households (million) 1.5 0.8

13. Government claim - whoops!

14. Ending child poverty by 2020?
Reasons why not:
• High cost of living
• Rising cost of a child
• Low wages, slow to rise
• Benefit and tax credit cuts - £21bn per year, plus £12bn more
• 70% hit families with children
• 60% hit working people

15. Where the cuts fell
House of Commons Library

16. More devastating cuts this year
• Child benefit, tax credits and universal credit frozen for 4 years
• Next April – two-child limit on tax credits or universal credit – no
exception disabled children or children who have lost a parent
• Benefits reduced to £20,000 a year (£23,000 in London) under benefit
cap (even if no work because of disability or the need to care for young
children)
• Over 60% contain a child under 5
• Children of single parents, larger families (more than two) and disabled
children will be hardest hit
• support for housing costs cut dramatically, while rents soar

17. We’re facing a child poverty crisis
• IFS latest projections:
• relative child poverty will rise 1.2m between 2015-2020
• Absolute poverty will rise by 600k
• Resolution Foundation:
• July 2015 budget increased child poverty by 300-600,000
• 1.5m more children in poverty by 2020
• Lone-parent poverty rising steeply by 18.4 percentage points
(compared to 4.3 percentage points for couples) - IFS
• Most of the increase in absolute poverty will be among large
families (3 or more children) – IFS
• 3.6m children = 9 in every classroom of 30 kids
Government response?

18. Moving the goal posts
SUB TITLE

19. Did those with the broadest shoulders bear the greatest burden?
The results are in:

22. Necessity or choice?
• LSE. Manchester & York universities published this major analysis
http://sticerd.lse.ac.uk/dps/case/spcc/rr04.pdf
• Fig 9 – the whole of the poorest half of the income distribution is
worse off and the richest half is better off
• Cuts for low income groups in effect, funded tax cuts for richer
groups
• Reflects cost of raising the personal tax allowance (£12bn)

24. Why does income matter?
• Family income makes a significant difference to children’s
outcomes: poorer children have worse:
• Cognitive
• social-behavioural and
• health outcomes
• This relationship is independent of other factors that have been
found to be correlated with child poverty (e.g. household and
parental characteristics)
• Income has a causal relationship with poor child outcomes
• Most likely mediated by parental stress and anxiety
Cooper K & Stewart K (2013) Does money affect children’s outcomes? York: JRF
https://www.jrf.org.uk/report/does-money-affect-children%E2%80%99s-outcomes

25. Stealing away children’s life chances
• Education divide – poorer children 9 months behind (Hirsch D,
2007)
• Health divide – socio-economic conditions mean greater risk
heart disease, death by stroke, disability, poor mental health
(Spencer N, 2008)
• Wellbeing divide – neg. impact relationship with parents,
educational orientation, self-worth and risky behaviour
(Tomlinson and Walker, 2009)
• Costs £29 billion a year in public spending (CPAG/Hirsch, D, 2013
building on JRF, 2008 ) – if poverty rises will be £35bn

26. The cost of child poverty

27. Conclusion
• National and comparative evidence shows child poverty
and child health and well-being were improving until 2010
• Austerity measures have hit families with children hardest
• Child poverty will increase – all gains swept away
• 2020 targets missed
• Child health and well-being bound to suffer
• Evidence will just keep coming
• All Party Parliamentary Group on Health in All Policies Inquiry launch:
Child Poverty and Health – the Impact of the Welfare Reform and Work
Bill 2015-2016
• Sophie Wickham, Elspeth Anwar, Ben Barr , Catherine Law, David
Taylor-Robinson, Child poverty: Using evidence for action, Arch. Child.
Diseases

28. We’re all in it together?

29. What now for health?

30. Poor children face significant health risks
• Babies born in deprived areas – weigh 200g less at birth
• Stillbirth and mortality twice as likely for poorest
• 10 times more likely to die suddenly in infancy
• Twice as likely chronic illnesses like asthma, cerebral palsy,
infectious illnesses, poor dental health
• More likely to get arthritis, heart disease or diabetes
• More likely to die or be injured in accidents
• Increased risk mental ill-health
• Poor, young men twice as likely to commit suicide
• Shame, isolation, stress on parents – affects interaction with
children

31. Taylor-Robinson et al BMJ 2013;347:f7157

32. Causes of food poverty
•Not enough money after paying for essentials (fuel,
rent, arrears)
•Range of foodstuffs local shops limited
•Pay higher prices for food locally
•School food inadequate (working poor, stigma,
quality)
•Now, cuts mean even less money, sanctions, etc.
(Dowler E, Turner S and Dobson B (2001) Poverty
Bites, CPAG)

33. How does food poverty affect families?
•Less variety dietary patterns
•Less fresh fruit, wholemeal bread, meat oily fish,
•Lower nutrient intakes than richer households
•Pregnant women have very poor diets – more low
birthweight babies and less likely to be breastfed
•Children grow less well, more likely to be obese
•Children come to school hungry, less able to learn
and benefit from school
(based on national and local surveys of food and
dietary intake – Dowler, et al)

34. How do families manage food poverty?
•Adopt careful strategies so there is food on the table
•Few, very limited foodstuffs
•Parents go without food themselves
•Don’t invite friends or family for meals, to celebrate events, or
to socialise
•Homeless people in bed and breakfast – severe problems
storing, preparing and eating food
•Lack of ready cash a severe problem – prepayment, key
meters, catalogues, door to door loans – mean no food money

35. The food bank response
•Trussell Trust foodbank parcels:
•2011/12 – 128,697
•2012/13 – 346,992
•2013/14 – 913,138
•2014/15 – over 1 million
•50-55% due to benefit problems
•Last resort after an acute income crisis
(Perry J, Williams M, Sefton T, Haddad M (2014) Emergency Use Only:
Understanding and reducing the use of food banks in the UK)

36. Multiple drivers
One or more of:
•Sanctions, waiting for benefits, ESA stopped (50-55%)
•Plus bedroom tax/benefit cap (59-63%)
•Plus benefit change or delay (67-78%)
(Perry J, Williams M, Sefton T, Haddad M (2014)
Emergency Use Only: Understanding and reducing the
use of food banks in the UK)

37. What now for children’s health outcomes?
What can we do?

38. Child poverty and health
• Eliminating child poverty in the UK
would save the lives of 1,400 children
under 15 years of age annually
• Pillas D, Marmot M, Naicker K, et al. Social inequalities in early childhood health
and development: A European-wide systematic review. Pediatric Research
2014;76:418–24. doi:10.1038/pr.2014.122

39. Advocate anti-poverty measures
• Include in health and wellbeing plans
• Publicise local welfare assistance schemes
• Work with JC+ so families don’t end up at food banks
• LAs can work with employers and FE to help parents
into work
• Become Living Wage employers and contractors
• Work to improve local childcare – atypical hours

40. Some policies to focus on
•Advice and support – welfare rights advice is early
intervention
•FSMs
•Extended schools and holiday childcare
•Food poverty - food deserts & food banks
•Planning - Fast food near schools
•Debt and credit
•Community transport
•Unlock sports facilities and community assets
•Social prescribing
•Traffic calming
•Green spaces – community orchards – community growing

41. Implications for education
• We are already seeing children finding it hard to participate in
school activities because of the costs involved
• Our work on the cost of the school day shows children choose
subjects to avoid those that involve cost
• In addition, many are arriving at school hungry and cannot
participate in the same activities as their peers – trips, school
uniforms, school meals and so on
• Positive results when this is tackled – attendance, participation
• This can only get worse unless tackled

42. What works?
• High quality early childhood education and
care
• Extended schools – breakfast, after school,
school holidays
• Poverty proofing the school day
• Pupil Premium (including in early years)
• Focus on disadvantaged children
• Parental employment

43. Some more conclusions
• We know child poverty is policy responsive
• Failure to act is hugely expensive
• If Governments do the right thing – it comes down
• If they do the wrong thing…
• It seems children today are being sacrificed
• Children are an end in themselves, not a means to an
end
• Listen to parents, children and young people and
include them in decision-making

44. Rising public concern:
Ipsos Mori Issues Index, March 2015