Child health gaps unacceptable, says chief medical officer

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Media captionDr Frank Atherton said those in the most deprived areas need to benefit from improving health

The difference in infant mortality rates between the richest and poorest areas is "shocking", the new chief medical officer for Wales has said.

In his first annual report, Dr Frank Atherton has focused on health inequalities between the most deprived and least deprived areas.

The rates of baby deaths aged under one year are almost 50% higher in the poorest parts.

He called it an "unacceptable difference".

Dr Atherton said the NHS has to really think about how it focuses services to the most deprived areas.

The latest infant mortality figures for Wales stand at 3.7 deaths per 1,000 on average, compared to 4.4 between 2002 and 2011.

But it was 5.6 deaths per 1,000 in the most deprived areas of Wales, compared to 3.8 in the least deprived parts. Most deaths are for conditions related to pregnancy and birth.

"It's shocking and it's unfair and it's preventable. We can do better than that here in Wales," Dr Atherton said.

"Infant mortality rates are improving but we need to ensure they improve for everybody."

On childhood obesity, there was a "clear correlation" between levels of deprivation and rates of being overweight or obese - ranging from 28.4% of children living in the most deprived areas to 20.9% in the least deprived.

The report found one in seven children (14.7%) living in Merthyr Tydfil was obese, compared with just one in 14 children (7.3%) living in the Vale of Glamorgan.

Image copyright Hulton Archive
Image caption Slum clearance in Cardiff 80 years ago - close to where the Principality Stadium is now - and when the infant mortality rate was 58 deaths in 1,000


  • In 1900, nearly 500 children under five died in Cardiff in a three month period alone
  • Causes ranged from diarrhoea, diphtheria to scarlet fever and typhoid
  • In 1921, the rate of baby deaths aged under one year was 82.8 deaths per 1,000 for Wales and England
  • Dropped to about 50 by World War Two and moved into single figures in 1984
  • Improvements put down to better living conditions and sanitation, diet and medical advances
  • Still issues in deprived areas - neighbourhoods in parts of Newport, Cardiff and the Rhondda as well as Moelfre on Anglesey rank in a top 10 for low birth weight


  • In the Cardiff and Vale health board area, there were 25 infant deaths in 2014
  • The Flying Start programme works in some of the most deprived areas of Cardiff, including Tremorfa and Adamsdown, where Dr Atherton is launching his report
  • Support offered to all known expectant mothers from 28 weeks of pregnancy
  • Children receive regular visits until the age of four
  • Various classes are offered including baby massage, parenting programmes and healthy cooking lessons
  • Health visitors can signpost clients to other agencies such as housing or charities such as Barnardo's
Image copyright Flying Start Cardiff
Image caption A Get Cooking course run by Flying Start in Cardiff teaches parents how to cook healthy family meals

Jane Imperato, a team leader with Cardiff Flying Start and health visitor of almost 30 years, said: "We try to make sure that parents understand what their babies are trying to communicate to them, so we can give them the best possible start in life.

"We provide some outreach programmes with the homeless team and also with Gypsy travellers."

In the future, the programme is looking to introduce baby boxes - a Finnish idea which has just been given the go ahead in Scotland - which include about 80 useful items for new-born babies and which have been credited with cutting infant mortality rates.

Image copyright Flying Start Cardiff

Dr Atherton wants public services to work together to better target people who are disadvantaged.

"Our social circumstances and environmental factors are a significant influence on our health. So improving the health of the nation and reducing health inequalities means we must look at these wider influences," he said.

Dr Mair Parry, of the Royal College of Paediatrics and Child Health in Wales, said personal social health education was "desperately needed" in all schools to help tackle the effects of poverty, which "sadly often runs in family cycles".

"Through classes on sex education and relationships, the effects of smoking, drug and alcohol abuse and health and wellbeing, when taught early, has a real opportunity to influence young peoples' lives," she said.

"It's only then can these cycles be broken."

Welsh Local Government Association chief executive Steve Thomas said there was joint working going on between councils and health and social care bodies but it was important to keep the pressure on.

"It's tough in terms of budget constraints, it's tough in terms of making sure that we deal with the most disadvantaged communities out there, particularly in terms of health inequalities but that is assisted by the fact that public sector organisations can work together and do work together," he said.

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