Nursery rhymes

The Department for Education has just released some analysis of take-up of early years provision by disadvantaged families which uses data from the 2008 and 2009 Childcare and Early Years Survey of Parents series to look at the effectiveness of government policies designed to improve early years provision for disadvantaged families. Unsurprisingly, the report shows that children from disadvantaged backgrounds are less likely to access free early years provision. Again, unsurprisingly, one of the key factors in low take-up is lack of information. Overall take-up of early years provision amongst 3-4 year olds is high (92%), although largely because reception classes in primary schools are the main provider for 4 year olds. The significant gap appears amongst disadvantaged children at 3 years old, where only 24% of children received early years provision, in contrast to 95% of disadvantaged 4 year olds.

Poverty index

Child poverty amongst families who are in work is at a record high, the Joseph Rowntree Foundation reports. In its 13th Monitoring Poverty and Social Exclusion Report, national figures for child poverty have dropped to 3.7m, but poverty amongst children living in working households has increased to 2.1m. out of the 13m people living in poverty in the UK in 2008-9, 5.8m are described as living in "deep poverty". The report looks at the wider context of social exclusion and, amongst its health indicators, covers low birthweigh babies, child and young adult deaths, under-age pregnancy, mental health and limiting long-term illness.

Out to lunch

SMART lunchboxes may conjure up images of plastic containers decorated with your toy or TV character of choice, but seemingly this is not the case. A recent RCT published in the Journal of Epidemiology and Community Health records an intervention designed to improve the nutritional contents of children's packed lunches. The team used SMART lunch boxes, which consisted of a cooler bag and a variety of SMART plastic boxes for specific food items, along with advice on creating healthy lunches and child friendly incentives (including jokes and stickers). The same team also looked at nutritional standards for lunch box contents amongst primary school children in the UK, which was covered widely in the press earlier this year. Press reports were, in turn, deconstructed by NHS Choices.

Counting the cost

The National Obesity Observatory has published a report on the economic burden of obesity, surveying research done since the publication of the Foresight report in 2007.
A recent survey from the OECD also considers economic issues: Obesity and the economics of prevention examines the role of markets and governments in tackling obesity, as well as considering which interventions work. There’s a special focus also on regulating food advertising. Latest briefings from the National Obesity Observatory provide data on adult and child obesity, linked to socioeconomic status.

Widening gap

Smoking breeds inequalities, according to the Faculty of Public Health. Showcasing the new Local Tobacco Control Profiles for England, FPH Vice-President John Middleton notes that the gap between rich and poor (and north and south) means that there is a “need to do much more to help vulnerable groups to access stop smoking services, information and any other support that is available.” The Tobacco Profiles offer data at local authority and PCT level, providing comparisons for key indicators with regional and national averages.

Visiting Hours

The government's earlier promise to create 4 200 new health visitor posts is affirmed in the Public Health White Paper and there is good news for the Family Nurse Partnership programme, which is namechecked as an evidence-based intervention that works. The Healthy Child Programme and the Change4Life Convenience Store Programme also receive honourable mention.

White out

After nearly five months of waiting, the Public Health White Paper (Healthy Lives, Health People) has arrived. And, as well as filling in the public health elements of Liberating the NHS, this document also very explicitly offers itself as a response to the Marmot report on inequalities. However, its main task is to usher in more of the localism already seen in previous consultation papers. Devolving the public health function largely to local authorities is the most substantive move. Yet, once again, the devil’s in the detail and the detail is in a further consultation document, to be published next year. The same goes for the Local Health and Wellbeing Boards, the role of Public Health England in funding and commissioning, the Public Health Responsibility Deal and others. A less than considered but considerably impassioned response can be found at Health Policy Insight. More measured tones at the King’s Fund, with the HSJ and the Guardian focusing on funding and timing of transfer.