Above average rates of second-hand smoking, smoking during pregnancy and childhood poverty are highlighted in the child health report for 2022 from NHS Ayrshire & Arran’s Director of Public Health, Lynn McNiven.

In this first chapter of the annual report, Director of Public Health (DPH) Lynn McNiven introduces key areas of development and concerns in child health for NHS Ayrshire and Arran. She says that the aim of this report is to “set the scene” on the range of child health work the Public Health Department is involved in.

Ms McNiven explains that existing issues across healthcare have been exacerbated by the pressures brought by covid-19, adding:

“In Ayrshire and Arran, we are passionate about improving the health and social outcomes for infants, children, and young people.

“This report is open and transparent and, at times, makes challenging reading. However, it also highlights the tremendous amount of work being done in so many important areas.”

As services are “remobilised” following the shift during the height of the pandemic, one key aspect outlined where work is needed is to address the higher rates of poverty among children in NHS Ayrshire and Arran. Ms McNiven says the pandemic’s impact on children “will not have been equal”, covid-19 having had a worse impact for those experiencing poverty or other difficulties.

On average, the percentage of children in relative poverty in Scotland has been increasing over the past five years, reaching 24.3% in 2019/20, but all Ayrshire areas reported higher percentages.

In North and East Ayrshire, the proportion of children living in relative poverty was 27.8% and 27.3% for 2019/20 and the lowest level recorded was for South Ayrshire, just 0.5% more than the Scottish average.

Another contributor to the report, Consultant in Public Health Ruth Mellor, added that children from families with a single parent, minority ethnic backgrounds, or a child under 1 year old are among those at a higher risk of poverty.

Ms Mellor outlines local work being done addressing these higher rates of childhood poverty across Ayrshire and Arran, including workshops on financial inclusion services and training healthcare staff to refer patients to support services.

Poverty, deprivation, and social exclusion among young people are outlined in the report as factors contributing to elevated risk of suicide – which have been increasing since 2018 across Ayrshire and Arran. Moreover, poverty is a concern for babies as maternal poverty is linked to an increased risk of premature birth.

Previous research from the University of Aberdeen has found that poverty impacts foetus development from 20 weeks into pregnancy. NHS Ayrshire and Arran’s child health report states:

‘Babies born prematurely can have multiple difficulties in the days and weeks following birth, and the consequences of being born too early can continue to affect health and development throughout childhood and adult life.’

Public Health Scotland reported in 2021 that premature delivery is the biggest cause of admission to neonatal care and cause of death in early infancy for children in Scotland.

For Ayrshire and Arran, local rates of pre-term births were ‘not significantly different’ from Scotland’s average of 8.4%, but local action including maternal nutrition and ‘Quit Your Way’ smoking cessation initiatives are outlined.

Second-hand smoking is another concerning area, with the percentage of babies exposed to second-hand smoke at their 6-8 week review higher in East and North Ayrshire than Scotland’s average.

Ms McNiven says in the report:

“Children are particularly vulnerable to the effects of second-hand smoke and exposure increases the risk of cot death, glue ear, asthma and other respiratory disorders, including emphysema later in life.

“Local action to address this includes work with paediatric staff, health visitors and early years workers.”

In Scotland, the average percentage of maternal smoking is 13.9%, while it sits at 17.3% for East and South Ayrshire, reaching 21.6% of women in North Ayrshire smoking during pregnancy.

A final concern is the number of children in the care of the local authority which has been higher in Ayrshire and Arran than the national average for the past decade. In 2020/21, the health board was considered “corporate parents” to 1,149 children from across Ayrshire and Arran. This recent child health report states:

‘We must keep the health and social needs of our care experienced population at the forefront of our considerations and ensure there are adequate resources to meet their needs, or we risk widening inequalities in multiple areas of their lives.’

Alongside individual actions groups, the health board has a Corporate Parenting Taskforce, integrating individual workstreams to ensure “cohesive progress” for children in their care.

Beyond specific local actions, Ms McNiven explains developments are being made across broad areas impacting children and their future, by addressing the climate crisis and adopting trauma-informed care approaches.

She is hopeful that the innovation and “excellent relationships” with local partners will help NHS Ayrshire and Arran to improve and protect their children’s health.

Read more: Insight: Early childhood development inequalities;Virtual care worsens outcome for disadvantaged mothers;Health poverty hits children halfway through pregnancy

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