Executive Summary

Introduction

Bedford Borough is focused on tackling local health inequalities that start before birth and accumulate throughout life. It understands that these inequalities are preventable and to achieve the best outcomes it is necessary to focus on the complex influences affecting children and young people’s health, including their family, environment, life skills, knowledge and experience. Preventing or minimising the impact of risk factors, including adverse childhood experiences, is vital. It is equally important to strengthen the protective factors, particularly the resilience (ability to cope) of your children, young people, and their families.

Role of deprivation

Deprivation, which is measured by a combination of income, employment, education, health, housing and services, living environment and crime factors, is recognised as a major contributing factor to inequalities to health outcomes. Indeed, a report by the National Children’s Bureau into health inequalities in England found that children and young people growing up in more deprived areas tend to have worse health outcomes, but also found that this was not inevitable.¹ 

The health and wellbeing of children and young people in Bedford Borough are generally similar to other local authority areas with similar levels of deprivation.² However, there is significant variation in outcomes within Bedford Borough; some groups of children and young people have significantly worse health outcomes than others. To find out more, please see the detailed Local Insight dashboards and select deprivation indices.

Activities and actions

The Healthy Child Programme (HCP) offers a range of interventions for all children, young people and their families in Bedford Borough from pre-birth to 19 years.³ There may be times in childhood and adolescence when additional help and support is needed. Earlier identification enables a timely and effective response before issues escalate. The case for early help and intervention is well evidenced, as is the need for a skilled, multi-agency workforce that communicates well and works together. No single agency can provide support on its own.⁴

The pandemic caused unprecedented challenges for the health and wellbeing of children and young people – schools were partially closed and remote learning implemented, many non-essential services were closed, and social distancing strategies meant alternative ways of delivering health care were necessary. In addition, although many of social changes were universal there has been a disproportionate impact on children and families, exacerbating pre-existing inequalities.

The COVID-19 pandemic caused unprecedented disruption to children, young people and their families. Partial school closures, social distancing strategies, closure of non-essential services, and changes in the delivery of health care are having a continued impact on outcomes for children of all ages and their families. The COVID-19 pandemic exposed and deepened pre-existing inequalities among children, young people and expectant mothers.⁵

The Covid recovery period is seeing the gradual return to face-to-face service delivery alongside hybrid ways of working, learning from what worked well digitally during the pandemic.

Snapshot of the children and young adults in Bedford

1. Healthy Pregnancy

The circumstances and behaviours of parents and the wider family before the baby is conceived, during pregnancy, and once the baby is born, can either have a positive or negative effect on the health outcomes of their child. For example, babies born to parents with disadvantageous circumstances and unhealthy behaviours have an increased risk of low birth weight, early illness and even early death. Intervening early will have an impact on a child’s resilience and their physical, mental and socioeconomic outcomes in later life.

2. Healthy Birth and Early Years

Families are the most important influence on a child during these years, and early identification of families who need help combined with evidence-based interventions is key to improving outcomes. We are aiming for parents and carers to feel supported to make decisions to improve their child’s health outcomes and life chances, be their child’s first educator, and feel confident to manage their
child’s minor illnesses and health issues.

3. The School-Aged Years

The Chief Medical Officer and Professor Sir Michael Marmot have highlighted the importance of giving every child the best start and reducing health inequalities throughout life. They recognise the importance of building on the support in the early years, and sustaining this across the life course for school-aged children and young people to improve outcomes and reduce inequalities through universal provision and targeted support.

References

1. Public Health England. 2019. Healthy Beginnings: Applying All Our Health. Available at: https://www.gov.uk/government/publications/healthy-beginnings-applying-all-our-health/healthy-beginnings-applying-all-our-health [Accessed 16 December 2020].
2. Ministry of Housing, Communities & Local Government. 2019. The English indices of deprivation 2019 – Frequently asked questions 2019. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/853811/IoD20
3. National Children’s Bureau. 2015. Poor Beginnings: Health Inequalities among Young Children across England. Available at: http://www.ncb.org.uk/sites/default/files/uploads/files/Poor%2520Beginnings.pdf [Accessed 16 D
4. Public Health England. 2020. Rapid Review to Update Evidence for the Healthy Child Programme 0–5. Available at: http://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/429740/150520RapidReviewHealthyChildProg_UPDATE_poisons_final.pdf [Accessed 16 December 2020].
5. December 2020].The Impact of the COVID-19 upon Children, Young People & Expectant Mothers: Phase 1, Hasna Dulfeker, Bedford, 2020.
6. Office for National Statistics- Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2021. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2021 [Published 21 December 2022].[Accessed 27 December 2023].
7. Office for National Statistics- Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2021. Available at:  https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/populationestimates/bulletins/annualmidyearpopulationestimates/mid2021 [Published 21 December 2022].[Accessed 27 December 2023].
8. Fingertips
9. GOV.UK. 2020. English Indices of Deprivation 2019. Available at: https://www.gov.uk/government/statistics/english-indices-of-deprivation-2019 [Accessed 27 December 2023].
10. Office for National Statistics – Birth characteristics 2021. Available at:
11. https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/datasets/birthcharacteristicsinenglandandwales [Published 19 January 2023].[Accessed 27 December 2023]
12. Government Statistics: Children looked after in England including adoptions. Available at: https://explore-education-statistics.service.gov.uk/find-statistics/children-looked-after-in-england-including-adoptions [Published 17 November 2022].[Accessed 27 December 2023]
13. Government Statistics: Children in low income families: local area statistics 2014 to 2022. Available at: https://www.gov.uk/government/statistics/children-in-low-income-families-local-area-statistics-2014-to-2022 [Published 23 March 2023] [Accessed 27 December 2023]

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