1. Child Public Health The importance of early years 7 th October 2014 Julia Yelloly, Child and Maternal Health (ChiMat) Intelligence Network and Knowledge and Intelligence Team (KIT) East

2. 2 Child and Maternal (ChiMat) Health Intelligence Network Contents 1. PHE: who we are and what we do 2. Overview of the evidence, and inequalities 3. Focus on educational attainment and inequalities 4. Options for action

3. 3Child and Maternal Health Intelligence Network Public Health England PHE exists to protect and improve the nation's health and wellbeing, and reduce health inequalities. It does this through advocacy, partnerships, world-class science, knowledge and intelligence, and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health

4. Foetal Programming Prof David Barker ‘events early in life might be linked to chronic degenerative diseases such as non-insulin dependent diabetes mellitus and cardiovascular disease which do not usually appear until mid-life or later’. Previously know as ‘the Barker Hypothesis’. Events before birth and early life Altered vulnerability to developing disease in later life

5. 5Child and Maternal Health Intelligence Network Some evidence in support of foetal programming: the Dutch Hunger Winter 1944-45 German food blockade plus harsh winter led to widespread famine Food supplies not restored until liberation 5 May 1945 Women who were pregnant during the Hunger Winter suffered under-nutrition

6. 6Child and Maternal Health Intelligence Network The Dutch children were followed up as teenagers... Source: Obesity in young men after famine exposure in utero and early infancy. Ravelli et al. N Eng J Med 295;349-53, 1976. http://www.lorentzcenter.nl/lc/web/2008/319/CD%20LORENTZ%20CENTER%20WORKSHOP/Dutch%20Recruits%20Obesity%20Ravelli%20NEJM %201976.pdf http://www.lorentzcenter.nl/lc/web/2008/319/CD%20LORENTZ%20CENTER%20WORKSHOP/Dutch%20Recruits%20Obesity%20Ravelli%20NEJM %201976.pdf Mothers in the late stages of pregnancy during the Hunger Winter had children who were born small and had lower levels of obesity as teenagers. Mothers in the early stages of pregnancy during the Hunger Winter had children who had higher levels of obesity as teenagers.

7. http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review

8. 8Child and Maternal Health Intelligence Network http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review

9. 9 Child and Maternal Health Intelligence NetworkChild and Maternal (ChiMat) Health Intelligence Network http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/improving-the-publics-health-kingsfund-dec13.pdf

10. 10Child and Maternal Health Intelligence Network http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review

11. Child and Maternal (ChiMat) Health Intelligence Network 11 http://fingertips.phe.org.uk/profile/cyphof/data

12. 12 Child and Maternal Health Intelligence Network http://fingertips.phe.org.uk/profile/cyphof/data

13. 13Child and Maternal Health Intelligence Network Difference in achievement between the average and those with FSM status 2012/3 % pupils achieving a good level of development at the end of reception average pupils with FSM statusDifference Hertfordshire61.240.620.6 Central Bedfordshire49.128.720.5 Cambridgeshire50.830.919.8 Southend-on-Sea44.926.019.0 Essex52.534.717.8 Suffolk49.032.916.1 Bedford47.832.215.6 Norfolk45.631.314.3 Peterborough46.734.412.4 Thurrock53.041.711.3 Luton47.139.77.4

14. 14 Child and Maternal (ChiMat) Health Intelligence Network http://www.england.nhs.uk/wp-content/uploads/2013/06/nati-hlth-vis-pln.pdf

15. Early years profiles Early years profiles (county)

16. 16Child and Maternal Health Intelligence Network Options for action locally Child and Maternal Health Intelligence Network http://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

17. 17Child and Maternal Health Intelligence Network Child and Maternal Health Intelligence Network http://www.england.nhs.uk/wp- content/uploads/2014/03/hv-ey-hlth- prof.pdf

18. 18 Child and Maternal (ChiMat) Health Intelligence Network http://www.england.nhs.uk/wp-content/uploads/2014/03/hv-ey-hlth-prof.pdf

19. 19 Child and Maternal Health Intelligence Network Summary 1. Evidence of the importance of early years 2. Evidence of inequalities in outcomes 3. Evidence based options for action You collect some of this data, you can use it for: - for targeting resources where most needed - business cases - to show where improvements are being made To help improve outcomes for mothers, infants and children -> society Maternity and children’s dataset, from CHIS data, due 2015 http://www.hscic.gov.uk/maternityandchildren http://www.hscic.gov.uk/maternityandchildren

20. 20 Child and Maternal (ChiMat) Health Intelligence Network Child Health Profiles in CYP’s health benchmarking tool datagateway.phe.org.uk -> Child and maternal health Children and young people’s health Benchmarking tool… or Early Years Profile Then select …

21. 21Child and Maternal Health Intelligence Network Visit the PHE stand for demonstrations and come to our workshop Thank you On the web: www.chimat.org.uk datagateway.phe.org.uk www.erpho.org.ukwww.erpho.org.uk –> child health -> recent By email: Julia.yelloly@phe.gov.uk On twitter: @PHE_Children @PHE_UK @PHE_obesity