United Kingdom: A generation of children in poor health, warn pediatricians

In a report Published on July 14, 2026, the Royal College of Paediatrics and Child Health (RCPCH) is sounding the alarm: of the twelve child health indicators it has been monitoring for nearly ten years, almost all results have worsened or remained stable in England, with marked territorial and social inequalities. Pediatricians consider this finding alarming, leading them to call on the British government, currently in the midst of a political transition, to implement structural changes.[1].

A detailed overview of the twelve child health indicators

The RCPCH bases its analysis on twelve internationally recognized indicators. Regarding early childhood development, the rate of children reaching a good developmental level at age five is improving (68.3 per 100,000 children in 2024, compared to 65.2 per 100,000 children in 2021), but it remains below the target of 75 per 100,000 children and below its pre-pandemic level. The gap is particularly pronounced in more disadvantaged communities: 51.3 per 100,000 children eligible for free school meals reach this level, compared to 72.5 per 100,000 children for other children. Vaccination coverage remains insufficient, with only 84 per 100,000 children having received both doses of the MMR (measles-mumps-rubella) vaccine by age five, far from the World Health Organization's target of 95 per 100,000 children.

Infant mortality (3.9 per 1,000 live births in 2023) and mortality among children aged 1 to 17 have improved only slightly in recent years, with suicide remaining a significant cause of death among 10- to 17-year-olds. Both indicators remain marked by stark social inequalities, with rates nearly twice as high in the most disadvantaged areas. Regarding mental health, the proportion of children aged 8 to 16 with a probable disorder increased from 12.5 per 1,000 live births in 2019 to 20.3 per 1,000 live births in 2023, while access to support through schools deteriorated over the same period. Young people themselves report difficulties accessing emotional health support, which is often contingent on a crisis situation.

Obesity affects 23.5 per 1,000 children aged 4 to 5, a proportion that rises to 36.2 per 1,000 children aged 10 to 11, with marked variations depending on socioeconomic status and ethnic origin. Oral health remains a concern, with 22 per 1,000 children aged 5 affected by cavities in 2024, representing an estimated cost of £74.8 million for dental extractions that same year. Emergency hospitalizations for injuries remain more frequent among younger children and in disadvantaged areas. Regarding the use of toxic and addictive substances, while cannabis use has declined slightly, alcohol consumption is increasing among 11- to 15-year-olds. 46 girls and 41 boys reported having been drunk in 2023, compared to 39 and 28 respectively in 2016. Smoking rates remain low (3 girls and 28 boys in this age group in 2023), unlike e-cigarette use, which continues to rise (27 girls and 22 boys reported having used e-cigarettes, compared to 25 and 19 in 2021). Finally, emergency hospitalizations for asthma have increased again after several years of decline, with children from disadvantaged backgrounds having a four times higher risk of death than their more privileged peers.

Structural recommendations in response to a political response deemed insufficient

In light of this situation, the RCPCH makes three priority recommendations to the UK government: strengthen the quality, collection, and sharing of child health data; set explicit and binding national targets to reduce inequalities across all twelve indicators; and introduce a dedicated investment standard for child health, accompanied by a long-term strategy for the staff involved. A YouGov poll associated with this work shows that only 12% of parents believe their children's health has improved over the past ten years.

This publication comes just days before Andy Burnham takes office as British Prime Minister, following Keir Starmer's resignation in early July 2026. The government responded by highlighting several measures already underway: removing the two-child cap on benefits, expanding mental health support in schools, opening local health centers, strengthening regulations on tobacco, vaping, and junk food advertising, as well as providing free breakfasts and school meals for children from the lowest-income families. For Dr. Helen Stewart, head of health improvement at the RCPCH, who described the UK's record as a "national embarrassment," these announcements alone are insufficient to address the scale of the identified inequalities. The analysis also points to persistent gaps in data collection and chronic underinvestment in child health services.

An opportunity for more ambitious prevention policies

While the work of the RCPCH (Regional Committee on Consumer Health) does not explicitly fall under the umbrella of the commercial determinants of health, several of the indicators it documents—vaping, obesity, and alcohol consumption—concern products whose design, promotion, and accessibility influence the behavior of young people. Regarding tobacco and vaping in particular, the continued decline in smoking among 11- to 15-year-olds contrasts with the increase in e-cigarette use in the same age group. The United Kingdom already has a legislative framework on this subject, with the Tobacco and Vapes Act, enacted on April 29, 2026, which establishes a generational ban on tobacco sales from January 1, 2027, and grants the government the power to regulate the flavors, packaging, and advertising of vaping products. However, these provisions still need to be clarified by regulation, as a public consultation on the subject, which opened on July 10, 2026, will not close until October 2. This publication on the evolution of children's health can therefore provide a basis for British public authorities, both to finalize an ambitious strategy within the framework of these implementing texts, and more broadly to take strong measures on the other products identified.

©Generation Without Tobacco

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[1] Tobi Thomas, UK children will be one of the unhealthiest generations in decades, "Doctors say," The Guardian, published July 14, 2026, accessed the same day