Life chances before birth
This piece of research on inequalities at the start of life by the Fabian Society is part of their Life Chances and Child Poverty Commission Report. It is an important contribution to the debate about tackling inequality.
I was particularly pleased when Louise and Sunder asked me to this seminar because as it happens, my daughter and I are part of an intergenerational study being undertaken by the Inst of child health at UCH on the genetic and environment determinants of child health. This began with an assessment of my health in pregnancy and now they are measuring us again and even contacting both her grandmothers.
Over the past 9 years the government has done a great deal to tackle disadvantage and help narrowing the gap through interventions – early childhood – most notably via the Sure Start programme and if experience in other countries is anything to go by, we will see the benefits of this over the next 20 years. Already I can see the benefits in my constituency in County Durham.
The Fabian Society looked at the evidence of low birth weight babies because they suffer significant disadvantages from the beginning of their life:
- they are 40 times more likely to die in their first year
- they are more likely to have a low IQ and learning disabilities
- they are more likely to have behavioural problems at school
- and their future life chances in terms of educational achievement, low earnings and unemployment are measurably worse.
Low birth weight at birth is caused by poor maternal health particularly poor maternal nutrition and smoking during pregnancy.
Studies have shown that a mother’s poor diet in terms of calories and iron means a child with greater risk of diabetes and high blood pressure. Inadequate nutrition can mean stunting at birth and early symptoms of heart disease.
Pregnant women who smoke are more likely to miscarry, have early births and are twice as likely to have low birth weight babies.
And of course these health problems are strongly correlated with social class and ethnicity. Mothers in class IV or V are 50% more likely to have low birth weight babies. Lone mothers and teenage mothers are particularly as risk and lone mothers are 9 times more likely to have a still born baby.
Asian mothers are 2-3 times more likely than white mothers to have small babies. And unemployment and low educational achievement also have an impact.
This is hardly surprising. But it is shocking to learn that a 20 year old pregnant woman on Income Support lives off £44/week. This matters because 74% of lone mothers are on Income Support, and 80% of lone mothers under 18 are on Income Support.
So what is to be done?
First of all there is a role for public health education – showing mothers at risk that they can make a difference to their children’s health through what they eat and giving up smoking. I know this from my own constituency. A few years ago Wear Valley had the highest rate of teenage pregnancy in West Europe. This is now down by 50 % because of interventions across the board – from GPs, health centres, pharmacies and also in schools.
Secondly, we need to improve financial support. There are 2 options currently (well, 3 if you count some ways proposed to use tax credits).
- paying child benefit during pregnancy and I think Kate is going to talk about this
- secondly, raising Income Support for pregnant women under 25.
There is of course a case for ending all the age differentials in Income Support and HB and giving mothers under 16 benefit entitlements.
All the arguments with which we are familiar on the costs and benefits of targeting versus universal support come into play. I think it would be helpful to have the options costed and possibly go for a phased approach first: raising Income Support and then Child Benefit. Given the concentration of poverty in certain parts of the country – the North and inner cities, these findings also emphasise the importance of redistributing our NHS resources as the DH are now doing.
Speech to a Fabian Society event ‘Life Chances Before Birth’, House of Commons, 24 July 2006
