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Physical and mental health for young children
Physical and mental health for young children

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2.2 Case studies of child-health promotion work in Birmingham

You will now look at two local case studies of past work to support young children’s health, plus that of the wider community. One of the authors of this course, Professor Jane Payler, was involved in both cases.

Central Birmingham community health council 1982

In the video in Section 2, you saw Jane talking about the work she did at Central Birmingham Community Health Council (CHC) from 1982–83. CHCs were set up to provide a voice for the public in the National Health Service. At this time, a new health authority, Central Birmingham Health District led by Edwina Currie (who went on to become a health minister in the Conservative government), had been set up to run the health services in the central parts of the city. The CHC wanted to give the new health authority an overview of the population of the electoral wards in the Central area and to make them aware of factors relevant to planning health services. The population’s age structure and ethnic mix, the environmental conditions and indicators of relative affluence or poverty were all included.

It was clear that Central Birmingham at that time had electoral wards that were wealthier to the west, south and further out from the centre, whereas areas nearer to the centre – the inner-city areas - were poorer. Indicators showed that in the inner-city areas (Sparkbrook, Sparkhill and Nechells) over 45 per cent of households either had to share or did not have access to an inside toilet. Over 8 per cent of the households also did not have access to, or had to share, a fixed bath or shower (see Table 3) (Harding, 1982).

Table 3 Percentage of households with exclusive use of fixed bath, inside WC and hot water supply in 1971 in electoral wards in Central Birmingham. (Harding, 1982)
Quinton 81–95%
Harborne 81–95%
Hall Green 81–95%
Edgbaston 66–80%
Fox Hollies 66–80%
Sparkhill 50–65%
Sparkbrook 50–65%
Nechells 50–65%

Some of the indicators of child health from that time show the pattern of inequalities replicated. In the poorer areas, babies were more likely to be born at low birth weight and were more likely to die in the perinatal period (deaths from birth to age six days), than in the wealthier areas. The rates of paediatric deaths and discharges for children aged 2–13 years were also highest in the poorest area, at that time Sparkhill, but lowest in the wealthier areas of Harborne, Hall Green and Fox Hollies.

Action by the Central Birmingham Community Health Council helped to highlight the needs of children and babies living in the poorest areas in Central Birmingham at that time.

East Birmingham patterns of health mid-1980s

From 1985, Jane worked in the health education service at East Birmingham Community Health Authority. The health education service worked closely with local community leaders, health visitors, school nurses and the East Birmingham Community Health Council to address difficulties faced by families, babies and children in the area. In electoral wards now known as Bordesley Green, Small Heath and Heartlands in the west of East Birmingham, child health statistics at that time demonstrated a strong link between higher rates of infant and child illness and death and families living in disadvantage. The health education team worked with local people to produce culturally sensitive infant weaning leaflets in a variety of community languages. It made pregnancy, baby and child health advice videos and leaflets in community languages available to health professionals and community leaders to use widely in the community. The team also went into primary schools to talk with teachers and children about health promotion.

Sadly, recent statistics from Birmingham Public Health (2019, p. 7) tell us that the health of babies and children is still worse than it should be in these areas. For example, Birmingham has the worst infant mortality rate of all local authorities in the country. The wards of Bordesley Green and Heartlands have infant mortality rates that are even higher than the Birmingham average.

A map of Birmingham showing infant mortality rates
Figure 4 Infant mortality rates in Birmingham, 2014–2016