Starting and growing well

It is vital to ensure that children have the best start in life. Not only does this provide the foundations for optimal health and wellbeing in the future, it helps to address health inequalities at the earliest opportunity.

In the 2021 Census, 31.8% of the total resident population in York is aged 0 to 24 years total resident population of 32.4% compared with 29.1% in England. Children and teenagers from 0 to 15 years comprise 15.2% locally against 17.4% making this cohort smaller than the national average. However, the percentage of 16 to 24 year olds is significantly higher than the national average: 16.6% compared with 11.7%. One considerable factor for this is the provision of further and higher education. York has a large Further Education college which provides traditional and vocational courses as well as a number of State and Independent schools, and academies. It is also home to two reputable Universities and a Higher Education agricultural college.

Across the Wards, the most deprived has the highest number of children and teenagers 0 to 15; the lowest rates are seen in those Wards in close proximity to the Universities. The 16 to 24 years cohort is therefore understandably seen to have the highest representation in such Wards.

Below, are narrative and data concerning the different elements that make up starting and growing well in York.

A

Alcohol Consumption

A greater proportion of young people aged 15 years in York report having ever consumed an alcoholic drink than the national average (however this has only been measured once in 2014/2015). Guidance from the Chief Medical Officer for England recommends that young people under 15 should not drink alcohol at all. This is an important indicator because drinking in early teenage years can be particularly harmful to health. Additionally, young people who start drinking alcohol at an earlier age tend to drink more frequently and more overall as they grow up than their peers who started drinking at an older age.

B

Breastfeeding

Breastfeeding has many known benefits to babies: it protects them from infections and diseases, helps with bonding, and can protect against adulthood conditions such as cardiovascular disease. 4 year aggregated data in York indicates that fewer than half of babies are breastfed at 6 to 8 weeks (44.8%). However, 73% of York babies were breastfed at time of delivery which is similar to the national average (71.7%).

C

Childhood obesity

Children living in the most deprived wards in York are twice as likely to be obese at reception as those living in the least deprived ward. Similarly, black reception age children in York are significantly more likely to be obese than their peers.

D

Dental health

The picture of childhood dental health in York is mixed. York has a larger proportion of five-year-olds without any dental decay than both the regional and national averages. However, York has a very high proportion of children aged 0 to 4 admitted to hospital for dental decay among York's statistical neighbours. It is possible this a refection of York's local admissions practices, rather than a reflection of high levels of dental decay.

G

Attainment 8 Score

Attainment 8 is a key stage 4 measure of performance that replaced GCSE examinations. In York overall, the average attainment 8 score achieved by young people was higher than the national average. This reflects the GCSE attainment scores from the previous year. York has a higher GCSE attainment rate for children in care compared with the average for England and its statistical neighbours.

I

Infant Mortality Rate

The infant mortality rate is the number of infant deaths (babies under 1 year old) for every 1,000 live births. It is an important marker of not only maternal and infant health but the overall health in the local area. Current data is a 3 year aggregate from 2019 to 2021 and records a rate of 2.8 infant deaths per 1000 live births. This is similar to the England average of 3.9 per 1,000 live births.

L

Looked After Children

Looked after children are those that have in the care of their local authority for more than 24 hours.

O

Obesity

Nationally, children’s weight is measured in reception year (4 to 5 year olds) and in Year 6 (10 to 11 year olds), Nationally, the proportion of 4 to 5 year olds at healthy weight is stable, but the proportion of 10 to 11 year olds at healthy weight is still falling slightly, and as a result the proportion of children with excess weight is rising slightly. In York, the data for both age groups has been similar to or slightly better than the national average, and York is in the middle of the statistical neighbour group for this indicator.

Despite this, it is important to recognise that the absolute numbers of obese children for both age groups in York are high. This means that whilst York is doing well in comparison to other areas of England, obesity is still impacting on the health of children in York.

S

School attainment

By the end of key stage 2, disadvantaged pupils are less likely to be assessed as having a good level of reading, writing, and maths. This is also true for pupils with special educational needs.

Starting and Growing Well Inequality Report published in August 2018, this inequality report takes a deeper look into differences of experience for children and young people growing up in York. The report focuses on three interlinking themes, childhood obesity, self-harm in young people, and childhood poverty.

School Readiness

A good level of development measures how ready a child is to start school. It considers whether a child has the baseline social, physical, and intellectual skills necessary to engage and learn, but also considers the responsibilities of families and teachers in ensuring children are ready to commence learning.

York has the highest level of school readiness in Yorkshire and Humber with 70.9% of children (2021/2022) meeting the desired skillset for key stage 1. This is compared with 61% in the lowest-performing local authority in Yorkshire and Humber. York is ranked 13th nationally and is significantly higher than the average of 65.2%. School readiness is an important measure of population health and inequalities; this is because children who achieve a 'good level of development' are more likely to do better in later education. A good education is also linked to better health outcomes in later life.

Smoking

Smoking is a major cause of preventable early death and ill health. York has an ambition for all young people in York to be part of a 'smoke free generation'. The proportion of 15 year olds in York who report smoking either occasionally or regularly is similar to the national average. However, this has only been measured once in 2014/2015.

Special Educational Needs

‘Special educational needs’ is a legal definition and refers to children with learning problems or disabilities that make it harder for them to learn than other children of the same age. Additional support may be needed with schoolwork, behaviour, expressing themselves and understanding information. There may also be sensory of physical needs that need to be taken into account. Unmet needs can have far-reaching impacts on the emotional and physical health that can extend into adulthood. In York, 2022/2023 data record 14.3% of children as having special educational needs. This is much lower than the national value of 17.3%. This does not necessarily give a true indication of the prevalence as diagnostic rate is currently unknown. An updated health needs assessment is currently in progress due to be published in March 2024.

T

Teenage Conception

Teenage pregnancy is an important indicator of population health. Younger mothers are more likely to experience unemployment and poverty with an increased likelihood also seen in mental ill health. Nationally, the trend for teenage conception rates among under 18’s has been falling each year since 1998 which generally mirrors the trend in York. There has been a steady levelling of annual rates from 2016 with the latest data for 2021 showing York's count as being 10.2 cases per 1,000 people. Nationally, the figure is 13.1 per 1,000.

Teenage pregnancy

5-year pooled data from 2017 to 2021 records 75 births to teenage mothers or fewer than 1% of all births in York. Nonetheless, this figure is higher than the national rate.

V

Vaccination

There are a large number of vaccinations offered to children in the first few years of life, and throughout childhood. The data for York varies by vaccination type, but broadly York appears to be similar to or slightly above the national average for vaccination rates. However, this is almost always below the 95% coverage that is estimated to be necessary to protect the population. This remains an important opportunity to improve health protection for York and the region.

Y

Young people not in employment, education, and training (NEET)

Young people who are not in employment, education, or training after leaving secondary school are more likely to experience further unemployment and ill health later in their lives. York has one of the lowest rates of young people who are NEET regionally and this is reflected nationally. Recent trend data suggests there has been no significant changes in numbers. Despite this, some groups of young people continue to struggle to find employment, education, or training. This includes people from deprived areas or with few qualifications.

Youth Justice System

The youth justice system is part of the criminal justice system that only deals with children. Its main aim is the prevention of offending by children and young people. At all times, the police and courts must consider the welfare of the offender including measures that do not resort to judicial proceedings. In York, fewer children are entering the youth justice system than nationally and this number has reduced a lot since 2013.