UK Child Poverty and Health

Introduction

The proposed research project engages with what appears to be the rising incidence level of poverty among the children in the UK, and the health implications of it, with a specific focus on the ramifications of different definitions of poverty. The first chapter examines the background and rationale for the project, through a brief literature review, the second substantive chapter provides a methodology for the proposed research, and then the final sections specify the structure of the chapter and proposed timetable.

Background and Rationale

There are many different ways of defining childhood poverty, all of them have implications for prevalence rates and scaling poverty, and this research would be considering some of the headline statistics. Most of the measures of childhood poverty are based on relative income levels. Combined work from the World Bank and UNICEF notes that, it is estimated that, 385 million children living in poverty around the world, which is 19.5% of the total population, compared to 9.2% of adults, with the bulk of these people are located in developing nations (World Bank, 2016). In this case, childhood poverty is defined as an income below $1.25 a day (though the World Bank uses this interchangeably with a $1.50 a day rate), as this is the rate defined initially in the Millennium Development Goals (MDGs) and later in the Sustainable Development Goals (SDG), and represent a target for eradicating poverty (World Bank, 2016). However, UNICEF stated that, this is not a true indicator of poverty, since poverty is a multidimensional issue and an essentially arbitrary income rate is not simply pointless, but it is likely to be actively damaging to efforts to reduce or eradicate poverty. Part of their work or the foreseeable future and contained within the SDG process is to develop a holistic definition of poverty, which is difficult to do (UNICEF, 2015).

As these statistical levels of poverty are effectively meaningless, explanations for poverty attached to them are rendered similarly meaningless; they have generally revolved around exploitation, economic inequality, gender-based discrimination and increasing arguments around climate change. Poverty as a global concept and especially as it relates to childhood development, is defined differently in different parts of the world including the extent, the duration and the impact as well as the period of history within which it occurred (Maholmes et al, 2012). The world as at today is full of children from families with varying state of poverty where half of them are living below the poverty line of $2 a day (Ortiz et al, 2012). These inequalities include low income, minimal or no access to food, water, health, education, housing, or employment for their families, leading to over 22,000 children dying daily (Ortiz et al, 2012) Child poverty is so widespread within each community or nation in the world and it is one of the most severe problems with its impact on quality of life generally to the extent that, it becomes a vital issue under the Millennium Goals post-2015, which is included in the Europe 2020 strategy of the European Union and other nations to reduce the poverty rates (Schweiger and Graf, 2015).

Childhood poverty in the UK

In the context of the UK, the most recent data from the Social Metrics Commission (SMC) (2018) suggests that, there are 4.5m children living in poverty, though their definition of poverty is completely different to that of UNCEF, the World Bank or the SDG. Moreover, their method of forecasting suggests that, rises of 20% over the next 24 months are to be expected, which would be unprecedented in modern history. SMC (2018) also suggests that, there are 14m people in the UK, living below ‘the breadline’, of which there are 4.5m children; however, the report sounds a warning that, fully 12% of the population are in ‘persistent’ poverty, which is four consecutive years or more in poverty. Moreover, the Institute for Fiscal Studies (IFS) has published the research which demonstrates that, the number of children in poverty might rise to as high as 5.2m by 2020, which would be an unprecedented rate of growth (Hood & Waters, 2017).

However, the total number of children in poverty is calculated, the recent revelations around children suffering from rickets, malnutrition and re-feeding conditions suggests that, there is a serious health issue at play (Spencer, 2018). The politics of child poverty makes it difficult to know what health professionals can do to improve the outcomes for children and young people (Spencer, 2018; Kleinman, 2000; Brady, 2009). About 25% of children under poverty are suffering from rickets and malnutrition due to lack of nutrition available for them where the parents are unable to provide good food and meet the basic needs of the children due to low income. The news media mainly reports on absolute number of people living in poverty is quoted, alongside analysis as to whether this number is growing or declining (Brady, 2009; Kleinman, 2000). There is no absolute figure in pounds and pence below which is poverty, but poverty is considered to be dependent on the time and place in which people live (Social Metrics Commission, 2018; Brady, 2009). In the 1970s and 1980s, a different model of poverty was suggested, whereby the objective was not to look at income as a single measure, but to add in assorted measures of deprivation that could help in offering a more nuanced understanding of poverty, and particularly to understand how this varies between time and place (Bourguignon & Chakravarty, 2003). Of critical importance in this approach there was the idea that poverty, particularly for children, is not simply about a lack of funds in an absolute sense, but the resultant exclusion from the patterns and institutions of everyday life; in short, poverty of opportunity.

The individuals, families and groups in the population can be said to be in poverty, when they lack the resources to obtain the types of diet, participate in the activities, and have the living conditions and amenities which are customary, or at least widely encouraged or approved, in the societies to which they belong. Their resources are below those commanded by the average individual or family, that they are, in effect, excluded from ordinary patterns, customs and activities (Townsend, 1979: 12). These conditions and amenities can be almost limitless, and there is a considerable amount of academic discussion about the types of things, which might be included in such a scheme of deprivation, and how they could be weighted to represent the fact that, some could be more important than others (Tinson et al., 2016). However, it has been argued that, this allows for a much greater degree of correlation between a robust measure of poverty which can inform existing policy and the actual experiences of people in poverty; whereas, a simple income metric may not represent their experience of poverty at all, for example, in London, there are many people who would not be in poverty under a 60% of median income model because they have a good income, but the costs of housing mean there is a functional sense. According to Joseph Rowntree Foundation, it indicated that almost one in four Children which is about a quarter of a million, are living in poverty in Scotland and a total of, 230,000 are in relative poverty regarding housing prices (JRF poverty in Scotland 2018). while in Wales, current information, highlighted that 710,000 people in Wales live in poverty. This number comprises of 185,000 children, 405,000 working-age adults and 120,000 pensioners (JRF poverty in Wales 2018). Fur than more, Northern Ireland has 370,000 people live in poverty. The figure entails 110,000 children, 220,000 working-age adults and 40,000 (JRF poverty in Northern Ireland 2018).

The graph below shows the relative child poverty across the UK, after housing costs, 1995–2017, and projections for 2020/21,

Furthermore, the Labour Government, pledged in 1999 to eradicate childhood poverty by 2020/21. This concept led to the introduction of Child Poverty Act 2010 and with cross party support and requires the UK government to publish child poverty approach on a regular basis, which also pave way for a Child Poverty Commission to provide advice and set new duties and responsibilities on local authorities, including their partners to work in partnership for getting rid of child poverty in the UK. (Child Poverty Act 2010: a short guide). In addition, 2017 Scottish Parliament passed the Child Poverty (Scotland) Act (2017), set out four statutory targets for child poverty. The Act enables poverty to tackle in a way that it can be measured by the low income (Scottish Government, 2018).

Health impact of poverty

Historically, the health impacts of poverty on children have been focused on physical health. There is a broadly supported conclusion that children that experience extreme poverty will have a much shorter life expectancy than other children where the children living under poverty have 9.2 years shorter life expectancy as compared to the children who are not living under poverty (Spender, 2018). There is similar evidence that suggests that children who experience sustained poverty experience stunted growth in various forms, which is argued to come from poor quality diets in the main, and particularly where that extends to malnutrition (Spencer, 2018). For example, the child who are born in the family who are suffering from poverty, have 200 grams less weight as compared to the child born in the rich family. due to poverty, the parents fail to provide education and proper care to the children which deteriorates the growth of the children living in poverty. Further research argues that children in poverty exhibit weaker brain development, particularly in the early year, to three years of age; however, the cause of this is often argued to be about a lack of play and stimulation rather than diet. (Hill & Tisdall, 2014). In terms of determining health and health outcomes, the World Health Organization (WHO) note that a person’s health has a very wide number of factors that influence it, and many of these are outside of their immediate control; therefore, there needs to be a structured way of thinking through these factors (Bartley, Blane & Smith, 1998). This has led to the idea of the determinants of health, only one of which is the personal behaviour, choices and actions of the individual; the social and economic environment and the physical environment also play a role (Bartley, Blane & Smith, 1998). The economic environment is the subject of the proposed topic, but in terms of the physical environment there has been work on such things as whether there is a health penalty associated with the urban landscape, for example (Bambra et al., 2009). Low income, poor quality of housing further deteriorates the physical and mental health of the children, and hereby, it can be stated that, poverty has negative impacts on the physical and mental health of the children.

In one sense the purpose of this work is simply to reveal that a person’s health cannot be separated from the context of their life; therefore, behavioural models of health are not the single solution. More interestingly, this work is developed into a body of work on health inequalities; this is the proposition that access to the determinants of health is not distributed equally across society, and there are clear structural issues that effectively leave some people disadvantaged compared to others (Graham, 2009).As per the behavioural model, the low income and poverty is linked with inconsistent, uninvolved and unsupportive parenting style which mislead the children who are suffering from poverty. Lack of access of health and social care, poor parenting and lack of education deteriorates the mental and physical health of the children. Apart from that, the parents under poverty also fail to meet the basic needs of their children including foods, managing hygienic factors at home, providing suitable environment for child growth, shelter, water and safety of the children. More contemporary research has focused on the mental health implications of poverty. Efforts to gather statistical data on childhood mental health are only relatively recent on a national scale, but there is an emerging body of evidence that would indicate that childhood poverty is associated with increased incidence of anxiety and depression, not just in childhood but throughout adult life (Bradshaw, 2016; NHS Digital, 2017). There is evidence around stress, anxiety and fear in children in poverty, though it is acknowledged that this is a research cohort that is extremely difficult to engage with (Fitzsimmons et al., 2017). As per the graph below, the percentage of depression, anxiety and the behavioural problems among the children who are living under poverty are increasing by their age from 0 to 17 years, 1 in 5 children below poverty line have mental, developmental and behavioural disorders. About 11% children under poverty are suffering from anxiety due to unfulfillment of their basic needs. The number of children under below poverty line suffering from depression and behavioural disorders are also increasing day by day due to lack of getting the basic needs, suitable environment and poor mental and physical health of the children due to lack of getting adequate health and social care service in the society.

In addition, the impacts of poverty on childhood health and wellbeing have been a persistent matter for over 150 years. Some improvement was achieved for a certain aspect of the public during the19th and mid-20th century. However, there were noteworthy upsurge of poverty in the late 1970s among Children despite some genuine endeavours by open-minded governments, especially in the early Labour era, to lessen the rate of child poverty (Wickham, et al, 2016). However, some of the cause of childhood poverty has been attributed to austerity and welfare reform in the UK making some families to struggle with poverty as they can no longer afford food items which has led to some families turning to food bank for support. (Austerity and welfare reform 2010). In terms of determining health and health outcomes, the World Health Organisation (WHO) note that, there are wide numbers of factors that influence a person’s health, and many of these are outside of their immediate control; therefore, there needs to be a structured way of thinking through these factors (Bartley, Blane & Smith, 1998). This has led to the idea of the determinants of health, only one of which is the personal behaviour, choices and actions of the individual; the social and economic environment and the physical environment also play a role (Bartley, Blane & Smith, 1998). The economic environment is the subject of the proposed thesis, but in terms of the physical environment there has been work on such things as whether there is a health penalty associated with the urban landscape, for example (Bambra et al., 2009; Graham, 2009).

Aim and Objectives

The main aim of this research is to investigate how poverty affects the health and well-being of children aged 0-17 years in the UK.

To accomplish this, the research would include the following objectives:

To examine the prevalence of childhood poverty in the UK.

To explore the factors contributing to poverty among children between the ages 0-17 years in the UK.

To explore the health and wellbeing implications of childhood poverty in the UK.

To assess the impact of government strategies in tackling poverty among children in the UK.

Methodology and Justification

There are two basic forms of research, primary or secondary, based on the data collection process used in the research (Hucker, 2001). The primary research method involves designing of questionnaire, administration of the questionnaire, collation, analysis and report writing, or the researcher may use focus group, observation and interviews. Whereas secondary research is mainly based on reviewing the existing literature reflecting views or findings of all related schools of thought on the subject, collate, analyse and report. While primary method requires good interview skill by the researcher (Hickson, 2008). The secondary method is more affordable, fast and makes use of wider range of existing data (Smith, et al, 2011) however it has limitations of questions that can be researched (Tayie, 2005) The proposed research would be based on secondary research methodology to investigate the effect of childhood poverty on the general development and wellbeing of the children, irrespective of their location in the United Kingdom. Thus, data would be collected, collated, analysed and findings reported as appropriate in order required to accomplish the research aim (Divakaran, 2014). A secondary research project can be a very valuable tool in taking-stock of where a discipline is in a certain area, and to provide renewed focus and direction for under-researched areas. The technical application of different measures of poverty for the case of children would certainly be in that category, and a secondary research approach can be justified on the basis that an original synthesis of existing work at this juncture may yield a range of new insights.

Literature Search Strategy

The literature search strategy for this project will be slightly more involved than usual, because of the location of much of the literature. In the first stage, the literature search will follow a traditional search strategy based on academic journal searches and the like; the particular search engines that will be used include the Social Work Abstracts database, the Social Policy database, the ProQuest series of databases and generalist search engines such as IngentaConnect. In addition, Google Scholar will be used as a means of acquiring journals not found within the main database searchers (Bowling, 2014).

However, because of the political interest in the area of child poverty, some of the most interesting – and indeed, the worst – material is produced by various third sector organizations, and a range of ‘think-tanks’ such as the IFS mentioned in the introductory paragraphs (Mukherji & Albon, 2010). Therefore, a secondary literature search process will take place, whereby there is a search through regular Google, the news media and through the bibliographies of academic papers for this type of report, going back over a five-year time horizon (Mukherji & Albon, 2010).

Exclusions and Operators

One of the challenges with executing the search strategy described is that the database journals utilize a keyword search function, and some of these are not particularly accurate; it is likely that phrases around child poverty and health that will throw up and array of responses related to those three words independently or otherwise out of context (Padgett, 2016). Therefore, a range of operators will be used to create a set of exclusion categories, as follows:

To exclude work that does not focus on the specific context of the UK.

To exclude work published before 2004.

To exclude work that is obviously political or ideological in nature, rather than analytical.

To exclude work that is focused on the economics of poverty rather than health and social care aspects.

These exclusions will be performed by means of using the operators allowable on the search engines, which generally involve the use of symbols like +- “” and date parameters to specify exact phrase, words to be excluded or combinations thereof.

Data Analysis

The presentation element of this research will be accomplished by means of a narrative literature review, whereby the intention is to review a large amount of research in a thematic manner, rather than a structured comparison of individual papers (Bowling, 2014). In this case, there is a large amount of material to be reviewed thematically on differing methodologies of measuring poverty and its health impacts upon children within the target age range. Thematic analysis is hereby beneficial to conduct the research and identify the impacts of poverty among the children on their health and wellbeing in the UK, where different statement and themes will be discussed to meet the above-mentioned research objectives.

Ethical consideration

In one sense, the ethical dimensions of this research project are quite simplistic, because the project is entirely secondary in nature, and therefore all of the information to be used is already in the public domain, and there is no issue with regard to privacy and confidentiality. Similarly, as no primary research is to be undertaken, there is no concern about the potential for harm to come to either research participants or the researcher, which is a common consideration in health research (Bowling, 2014). However, because the entire research project is effectively based on the work of others, there is a particular ethical burden to ensure that, the researcher is assiduous with regard to referencing and acknowledging the work of others. This is not just the case, where a direct quotation is presented, or where a specific data set is used, but any point, where the work of others has influenced the writing of the proposed project. This will ensure that, the researcher cannot be accused of plagiarism or otherwise abusing the published work of others, which is important as a matter of academic integrity.

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