JSNA – Places
Creating a Family Friendly Barnet, enabling opportunities for our children and young people to achieve their best.
Infant mortality is an indicator of the general health of an entire population. It reflects the relationship between causes of infant mortality and upstream determinants of population health such as economic, social and environmental conditions. Infant mortality is defined as the number of deaths in children aged less than 1 as a rate of all liveborn births.
In Barnet there were 4618 babies born in 2019. This number is slowly declining – it’s 1.6% lower than 2018 and 4.2% lower than 2017.
Barnet has 8th lowest Infant mortality of London’s 32 boroughs with 2.7 deaths per 1000 live births in 2017-2019. The London and England average rates for the same period were 3.4 and 3.9 respectively.
Childhood Vaccination Uptake
Vaccination coverage is the best indicator of the level of protection a population will have against vaccine preventable communicable diseases. Higher levels of uptake are closely associated with lowers levels of disease. Monitoring uptake identifies possible drops in immunity before levels of disease rise.
MMR is the combined vaccine that protects against measles, mumps and rubella which are previously common conditions that can have serious complications, including meningitis, swelling of the brain (encephalitis) and deafness. They can also lead to complications in pregnancy that affect the unborn baby and can lead to miscarriage.
One dose of the MMR vaccine is approximately 90 to 95% effective at preventing measles. After a second dose, the level of protection increases to around 99%, as measles is a highly infectious disease around 95% uptake is required to provide herd immunity. Barnet has a consistently lower uptake of MMR 1st dose @ 24 months old. In 2017/18 the rate was 83.8% compared to the overall average for London at 85.1% and 91.2% for England. This number has further decreased in 2018/19 to 81.9% but increased to 83.4% in 2019/20 which is similar to 83.6% London average but significantly lower than 90.6% for England.
The combined DTaP/IPV/Hib is the first in a course of vaccines offered to babies to protect them against diphtheria, pertussis (whooping cough), tetanus, Haemophilus influenzae type b (a leading cause of childhood meningitis and pneumonia) and polio (IPV is inactivated polio vaccine). In the current year this has been updated to the hexavalent vaccine which also includes protection against Hepatitis B which will be reported in future years.
For 2017/18 Barnet rates (88.4%) are lower than London (91.7%) and substantially lower than England (95.1%). The trend for Barnet DTaP/IPV/Hib vaccination uptake has been increasing in 2018/19 to 90.3% and 2019/20 to 90.8% which is above London’s overall average of 90.1%. However, this remains lower than England average of 93.8%.
School Readiness & Achievements
Children’s education and development of skills are important for their own wellbeing and for that of the nation as a whole. Learning ensures that children develop the knowledge and understanding, skills, capabilities and attributes that they need for mental, emotional, social and physical wellbeing now and in the future.
School Readiness is a key measure of early years development across a wide range of developmental areas. Children from socio-economically disadvantaged backgrounds are less likely to achieve good development and the evidence shows that differences by social background emerge early in life.
Within Barnet in 2018/19, 74.3% of children achieved a good level of development at the end of Reception. This is above the overall average for London (74.1%) and England (71.8%)
For the same period, 63.3% of children who receive free school meals achieved a good level of development at the end of reception in Barnet. This is slightly lower than the overall London rate, (64.1%) but significantly higher than the rate for England (56.5%).
Barnet Public Health supports all educational settings to be healthy environments and communities through promoting the Healthy Early Years London and Healthy Schools London award schemes. 118 schools and 96 early years settings have registered for the scheme, with many of which having received awards.
Children with poorer mental health are more likely to have lower educational attainment and there is some evidence to suggest that the highest level of educational qualifications is a significant predictor of wellbeing in adult life; educational qualifications are a determinant of an individual’s labour market position, which in turn influences income, housing and other material resources.
Educational attainment is influenced by a range of factors including the quality of education children receive and their family socio-economic circumstances.
In 2020, Barnet 2.61% of school pupils were identified as having social, emotional, and mental health needs. This is marginally higher than the overall rate for London (2.49%), and slightly lower than for England (2.7%)
For primary school age children in Barnet, 2.54 % had social, emotional, and mental health needs in 2020. This is slightly higher than the comparable rates for London (2.24%) and England (2.45%)
In Barnet’s secondary school age pupils in 2020, 2.6% had social, emotional, and mental health needs. This is slightly lower than the rates for London (2.63%) and England (2.67%) for the same period.
Under 18 conceptions
Most teenage pregnancies are unplanned and around half end in an abortion. As well as it being an avoidable experience for the young woman, abortions represent an avoidable cost to the NHS. And while for some young women having a child when young can represent a positive turning point in their lives, for many more teenagers bringing up a child is extremely difficult and often results in poor outcomes for both the teenage parent and the child, in terms of the baby’s health, the mother’s emotional health and well-being and the likelihood of both the parent and child living in long-term poverty.
Barnet has 5th lowest under 18 conceptions rate in London as of 2018. At 8.2 per 1000 it is significantly lower than the overall London rate of 13.9 and less than half of the average rate of 16.7 for England. Barnet has a comprehensive sexual health strategy framing a holistic approach to improving the sexual health of residents and empowering young people to take responsibility for their sexual health and wellbeing.
National Childhood Measurement Programme
There is concern about the rise of childhood obesity and the implications of such obesity persisting into adulthood. The risk of obesity in adulthood and risk of future obesity-related ill health are greater as children get older. The health consequences of childhood obesity include increased blood lipids, glucose intolerance, Type 2 diabetes, hypertension, increases in liver enzymes associated with fatty liver, exacerbation of conditions such as asthma and psychological problems such as social isolation, low self-esteem, teasing and bullying.
In 2019/20 Barnet was 7th lowest London borough for overweight including obesity prevalence in Reception aged children with a rate of 19.1%. This is lower than the overall rate for London (21.6%) and significantly below the rate for England (23%).
For the same period and measurement for Y6 children, Barnet was the 4th lowest London borough with prevalence rate of 34.2%. The comparable rate for London and England was 38.2% and 35.2% respectively.
The 2020-21 measurement year was impacted by school closures in response to the COVID-19 pandemic, as a result a sample of schools were measured rather than all schools and consequently the results for this year may be different to previous years.
Barnet has a comprehensive programme of action supporting healthy weight management from early years, through school ages to adolescents. Middlesex University is working with Barnet Public Health to research how we can improve physical literacy within primary school children; and the Mayor’s Golden Kilometre scheme encourages physical activity within the school day. Barnet has a Healthy Weight Strategy with an intervention pathway from birth to adulthood for those who need additional support.
A&E Attendances & Admissions for Accidents & Injuries
Injuries are a leading cause of hospitalisation and represent a major cause of premature mortality for children and young people. They are also a source of long-term health issues, including mental health related to experience(s).
Hospital admissions caused by unintentional and deliberate injuries in Barnet’s children (aged 0-14 years) in 2019/20 was significantly lower at 60.1 per 10,000 in comparison to the averages for London 67.3 and England 91.2. Barnet’s is positioned as the 8th lowest of the London boroughs for this measure.
For children aged between 0 and 4 years, in 2019/20 the A&E attendance rate was 810 per 1,000. This is higher than the overall London rate of 755.2 and significantly higher than the average in England of 655.3. Moreover, on average 13.8% more boys than girls who attended A&E in Barnet.
Children in Need
A child in need is defined under the Children Act 1989 as a child who is unlikely to reach or maintain a satisfactory level of health or development, or their health or development will be significantly impaired without the provision of children’s social care services, or the child is disabled.
The rate of Children in Need in Barnet is variable, but generally lower than the England and London averages. The number of children in need in Barnet was around 2,000 in 2020.
Children Living in Poverty
There is evidence that childhood poverty leads to premature mortality and poor health outcomes for adults. Reducing the numbers of children who experience poverty should improve these adult health outcomes and increase healthy life expectancy. There is also a wide variety of evidence to show that children who live in poverty are exposed to a range of risks that can have a serious impact on their mental health.
Absolute low income takes the 60 per cent of median income threshold from 2010/11 and then fixes this in real terms (i.e. the line moves with inflation). This is designed to assess how low incomes are faring with reference to inflation. It measures the number and proportion of individuals who have incomes below this threshold. The percentage of individuals in absolute low income will decrease if individuals with lower incomes see their incomes rise by more than inflation
Relative low income sets a threshold as 60% of the UK average (median) income and moves each year as average income changes. It is used to measure the number and proportion of individuals who have income below this threshold.
In Barnet in 2018, 12.6% of children were living in relative poverty. This was significantly lower than the comparable rates for London (16.9%) and England (18.2%)
For the same period, 10.7% of children were living in absolute poverty in Barnet. Again, this is considerably lower than comparable rates for London (14.1%) and England (15.1%).
The Barnet Public Health team addresses health inequalities as part of all the work it undertakes and targets actions to those children, young people and their families in greatest need where appropriate through localised programmes for support and action.
6-8 Weeks Breastfeeding
Breast milk provides the ideal nutrition for infants in the first stages of life. There is evidence that babies who are breast fed experience lower levels of gastro-intestinal and respiratory infection. Observational studies have shown that breastfeeding is associated with lower levels of child obesity. Mothers who do not breastfeed have an increased risk of breast and ovarian cancers and may find it more difficult to return to their pre-pregnancy weight.
The proportion of women receiving a 6–8-week health visitor review in Barnet was low prior to 2020/21 and therefore breastfeeding data was unreliable; based on the locally available data the proportion of mothers who continue with breastfeeding are higher in Barnet than the England average, although the England average is likely to underrepresent the true figure. There is variation in breastfeeding continuation by ward with Brunswick Park the lowest at around 37% and East Finchley the highest at around 69%.
A new infant feeding strategy, co-produced with LBB’s partners, is in development and aims to increase breastfeeding rates across the borough.
Chlamydia Detection Rate (Ages 15-24)
Chlamydia is the most commonly diagnosed bacterial sexually transmitted infection in England, with rates substantially higher in young adults than any other age group. It causes avoidable sexual and reproductive ill-health, including symptomatic acute infections and complications such as pelvic inflammatory disease (PID), ectopic pregnancy and tubal-factor infertility. The National Chlamydia Screening Programme (NCSP) recommends screening for all sexually active young people under 25 annually or on change of partner (whichever is more frequent). The chlamydia detection rate among under 25-year-olds is a measure of chlamydia control activity, aimed at reducing the incidence of chlamydia infection and interrupting transmission onto others. An increased detection rate is indicative of increased control activity.
The chlamydia detection rate in Barnet has been increasing in recent years but remains lower than the England and London averages. Barnet’s Sexual Health Education and Relationship service aims to improve the sexual health and wellbeing of young people under 25 years. Education and outreach enables young people to be better equipped with knowledge and understanding about the importance of screening for Chlamydia and other STIs.
Text Last Updated: 09.09.21