Health inequalities refer to the systematic, avoidable, and unfair differences in health outcomes between different groups of people – and they often take root in the earliest years of life.
We are fortunate to live at a time when we have more evidence than any other generation on the importance of the earliest years of life. It is during this time of rapid growth that babies’ brains are shaped, and the foundations for lifelong health are laid. Where children are born and live, whether they are rich or poor, their exposure to environmental risks, and the support that they receive from their families, communities and the services around them, can all make a big difference to their health and life chances (Marmot et. al., 2020).
Investing in the earliest years of life is not only the right thing to do, it also makes sound economic sense. Health economists have estimated that the cost of “lost opportunity” from failing to intervene with preventative action in early childhood is £16.13 billion per year in England (The Royal Foundation, 2021). This amount is conservative and does not include the significant lifetime costs for the full range of preventable health conditions that have their roots in early childhood and can be mitigated through early intervention.
Inequalities are not inevitable. Improving health and reducing inequalities requires a whole system response with action to address the wider determinants of health, like poverty and environmental factors. There is also good evidence that prevention and early intervention at an individual level, with services based on the principles of proportionate universalism, can improve outcomes. Health visitors have a crucial role to play in tackling inequalities, with a growing body of research and resources available in this area.
External resources
Marmot, M., Allen, J., Boyce, T., Goldblatt, P., Morrison J., (2020) Health equity in England: The Marmot Review 10 years on. London: Institute of Health Equity. https://bit.ly/48vsR6i
The Royal Foundation Centre for Early Childhood (2021) Big Change Starts Small. https://assets.ctfassets.net/qwnplnakca8g/2iLCWZESD2RLu24m443HUf/1c802df74c44ac6bc94d4338ff7ac53d/RFCEC_BCCS_Report_and_Appendices.pdf
Minnis H, Pollard A. (2024) Prioritising early childhood to promote the nation’s health, wellbeing and prosperity. The Academy of Medical Sciences. https://acmedsci.ac.uk/child-health-report
A collection of educational resources on critical health topics for people who work in the health and care sector and the extended public health workforce:
