Publication - Research publication

Child and adolescent health and wellbeing: evidence review

Published: 11 Sep 2018

Maps available national data on child health and wellbeing against the SHANNARI domains, to produce a full and detailed picture of ‘where we are now’ on child health and wellbeing in Scotland.

90 page PDF

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90 page PDF

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Contents
Child and adolescent health and wellbeing: evidence review
3. Healthy

90 page PDF

1.3 MB

3. Healthy

3.1 Elements within the Healthy domain

The Healthy domain is defined as 'Having the highest attainable standards of physical and mental health, access to suitable healthcare and support in learning to make healthy, safe choices' and is the most data rich of the SHANARRI domains. The key indicators identified here are partly measures of health outcomes and partly measures that are known to drive these longer term health outcomes. Drivers of health outcomes include maternal health during pregnancy; neonatal health; health behaviours during early years; and teenage pregnancy. Health outcomes are: children's general health; long term health conditions; children's mental health; and children's deaths.

Maternal health behaviours

Maternal health during pregnancy has a long term influence on health outcomes for the child. Specifically, maternal smoking and obesity are highlighted. Smoking during pregnancy can cause serious health problems for both mother and baby, including complications during labour, an increased risk of miscarriage, premature birth, stillbirth, low birthweight and sudden unexpected death in infancy ( xxi). Obesity in pregnancy is associated with an increased risk of a number of serious adverse outcomes, including miscarriage, birth defects, thromboembolism, gestational diabetes, pre-eclampsia, dysfunctional labour, postpartum haemorrhage, wound infections, stillbirth and neonatal death. There is a higher caesarean section rate and lower breastfeeding rate in this group of women compared with women with a healthy BMI ( xxii).

Neonatal health also has long term effects on child health. Babies born preterm can have multiple difficulties in the days and weeks following their birth and the consequences of being born preterm can affect health and development throughout childhood and adult life. In Scotland, premature birth is the single biggest reason babies require admission to neonatal care and the single biggest cause of death in early infancy. The more preterm a baby is, the higher the risks. Similarly, babies with a low birth weight (which may be due to their gestation) are at particular risk of short and long term health problems ( xxiii).

Maternal health behaviours in the early years, such as breastfeeding and smoking, are also important. Breastfeeding provides the best nutrition for babies and young children and supports children's health in the short and longer term. There is strong evidence that breastfeeding reduces children's risk of gut, chest, and ear infections and leads to a small but significant improvement in brain development and IQ. Growing evidence suggests that breastfeeding also protects against Sudden Infant Death Syndrome ( SIDS), promotes healthy weight in childhood and into adulthood, and reduces the risk of Type 1 and Type 2 diabetes and childhood leukaemia ( xxiv). Exposure to second hand smoke has similar negative effects as smoking and has been linked to asthma, lower respiratory tract infections, middle ear infections and SIDS in children ( xxv).

Child health behaviours

Overall health is also driven by health behaviours of the child. These are often driven by parental influence, particularly for the youngest children. Poor diet (alongside physical activity, which is discussed in the Active chapter) is linked to a risk of many non-communicable diseases, including cardiovascular disease, Type 2 diabetes and certain types of cancer, as well as the risk of obesity. Obesity is, in turn, linked to a number of negative outcomes such as heart disease, diabetes, osteoarthritis, back pain, increased risk of certain cancers, low self-esteem and depression. Evidence on the economic costs of risk factors for chronic disease suggests that poor diet is a greater burden on the NHS than smoking, alcohol consumption, being overweight and obesity or physical inactivity ( xxvi).

Specifically within diet measures, fruit and vegetable consumption has been identified as a protective measure against a large number of health issues including cancer, heart disease and diabetes ( xxvii). Breakfast consumption is widely seen as an important component of a healthy diet and lifestyle, and can positively impact on children's health and well-being ( xxviii), while skipping breakfast is associated with increased snacking ( xxix). Common snack foods amongst children include sugary drinks, crisps and sweets, which in turn are associated with increased risk of dental cavities and excess body weight ( xxx).

Adolescence is a critical period in the development of good eating habits as eating habits formed at this time can persist into adulthood, influencing the risk of major chronic diseases. As children move into adolescence, they tend to be given greater control over eating choices, in particular through increased opportunity to buy their own food and drink outside the home and without adult supervision, which may lead to increased consumption of unhealthy foods. However, parents can have a strong impact on adolescent eating habits ( xxxi). Regularly eating together as a family during childhood has been linked to many benefits related to eating habits and emotional well-being in childhood and later in life. Family meals encourage regularity in eating patterns, which is associated with both better health and wellbeing, and also reduced risk of unhealthy weight control methods ( xxxii), ( xxxiii).

Other positive health behaviours include uptake of immunisations, which protect against various diseases and tooth brushing, preventing tooth decay. Child behaviours relating to substance use (smoking, alcohol and drugs) have been included in the Responsible chapter.

Child health outcomes

Self-reported health is a general indicator of the burden of disease on society. It can reflect subjective experiences of both diagnosed and undiagnosed illnesses, and their severity, which more objective measures for the whole population can sometimes overlook. For the measure used here, young people aged 13 to 15 were asked to rate their own health, while for children under the age of 13 the question was answered by the parent or guardian completing the interview on their behalf.

Self-assessed general health is often a reflection of the presence or absence of long-term conditions, both physical and mental. People with a long-term condition, defined as any physical or mental health condition or illness lasting - or likely to last - for twelve months or more, are twice as likely as those without to be admitted to hospital and stay in hospital disproportionately longer ( xxxiv).

Together with physical health, mental wellbeing is a central aspect of overall wellbeing. It is important as an indicator of quality of life and a population's overall health status. Mental ill health often co-exists with other diseases, including cancers and cardiovascular diseases ( xxxv). Many risk factors, such as obesity, excessive alcohol consumption, and low levels of physical activity, are common to both mental health conditions and other non-communicable diseases. Adolescence is the peak age of onset for mental ill-health and the period when initial care is required ( xxxvi). Those with mental health conditions have disproportionately higher disability and mortality than the general population, dying on average more than 10 years earlier ( xxxvii).

In Scotland, children and young people's mental health is widely measured through two tools, the Warwick Edinburgh Mental Wellbeing Scale ( WEMWBS) and the Strength and Difficulties Questionnaire ( SDQ). WEMWBS is a tool for measuring positive mental wellbeing at a population level. The scale has 14 items designed to assess: positive affect (optimism, cheerfulness, relaxation) and satisfying interpersonal relationships and positive functioning (energy, clear thinking, self-acceptance, personal development, mastery and autonomy). The scale uses positively worded statements with a five-item scale ranging from '1 - none of the time' to '5 - all of the time'. The lowest score possible is therefore 14 and the highest score possible is 70; the measure presented here is the mean score. The scale was not designed to identify individuals with exceptionally high or low levels of positive mental health, although some analyses have grouped scores into categories.

The SDQ is a measure of emotional and behavioural problems. A total difficulties score is calculated by summing the scores for emotional problems, conduct problems, hyperactivity and peer problems, and scores are grouped into categories to identify different categories of children at risk. Please note that SDQ is currently being replaced by the Ages and Stages Questionnaire ( ASQ) as part of the Universal Health Visiting Pathway, but SDQ will continue to be collected at national level through surveys. ASQ data is presented in the Achieving chapter. An additional ASQ module on social and emotional development ( ASQ: SE) is used by some Health Boards, but this is not mandatory and there are currently no published national statistics available.

Additionally, measures of life satisfaction and confidence have been included as more general indicators of young people's mental wellbeing.

Hospitalisations for drug or alcohol misuse have been included in this chapter although as noted in the previous section, child behaviours related to substance use variables are reported in the Responsible chapter.

Finally, death rates are recorded for children and young people. Deaths may be due to a variety of reasons, both preventable and non-preventable. Suicide rates are given separately.

3.2 Current position

Indicator

Headline figure

Date

Data source

Next data

Time trend

Key inequalities

International comparisons

Mothers' health during pregnancy

Percentage of all women recorded as 'current smoker' at first antenatal booking appointment

14.8%

2017

ISD

2018

Steady year on year decrease since 1998 (28.7%)

* SIMD Percentages vary very substantially by area deprivation, from 26.5% in SIMD1 to 3.4% in SIMD5. However, the gap between the most and least deprived has reduced over time

* Age smoking is common in younger than older women, declining from 33.1% among those aged under 20, to 8.8% among those aged 40 or above

In 2010, Scotland reported higher rates of smoking during pregnancy than other European countries (Euro-Peristat Perinatal Health Report).

In (2015/16) UK comparison, the rate was slightly higher in Scotland (16%) than in England (14%) and slightly lower than in Wales (14%).

Percentage of all women recorded as 'current smoker' at Health Visitor's first visit (10 days after birth)

17.2%

2016/17

ISD

12017/18

Steady year on year decrease between 2001/02 (24.6%) and 2015/16 (14.0%) before increasing in 2016/17. There was a substantial reduction in the percentage with an unknown smoking status between 2015/16 and 2016/17 (from 6.5% to less than 1%)

* SIMD In 2015/16, percentages ranged from 23.7% in SIMD1 to 3.9% in SIMD5

* Age In 2015/16, smoking was more common in younger than older women, declining from 29.2% among those aged under 20, to 8.4% among those aged 40 or above (sub group analysis not available for 2016/17)

/

Percentage of pregnant women recorded as obese at antenatal booking

23%

2017

ISD

2018

The percentage has increased year on year since first recorded in 2011 (17.6%)

* SIMD The percentage overweight or obese ranged from 44% in SIMD5 to 56% in SIMD1. The percentage has increased in all deprivation categories since 2014, but the increase has been steeper in women from SIMD1 leading to a widening of the deprivation gap over time

* Age The percentage increased with age, from 36% in women under 20 years old to 59% in women aged 40 or above. There has been a consistent increase in the percentage in all the age groups under 40

In 2010, the percentage of overweight or obese women in European countries was typically about 30-37% but it was much higher in Scotland at 48% (2010 Euro-Peristat Perinatal Health Report).

Neonatal health

Perinatal mortality rate per 1000 births

5.7/1000

2017

NRS

2018

The rate has fluctuated year on year, but a general downwards trend is evident ( e.g. 9.0 in 1992, 7.6 in 2002 and 6.5 in 2012)

/

/

Percentage of all singleton live births before 37 weeks' gestation

6.4%

2016/17

ISD

2017/18

The rate increased steadily from around 4.5% in the mid-1970s to 6.4% in the mid-2000s and has shown little change since.

* Age Preterm birth rates were highest among mothers in the youngest (under 20) and oldest (40 or above) age groups.

* SIMD Rates were higher in mothers in SIMD1 (7.8%) than among those in SIMD5 (4.8%)

Scotland's rate is similar to that seen elsewhere in the UK and lies midway between that seen in other Western and Northern European countries

Percentage of all live singleton births with low birthweight

5.4%

2016/17

ISD

2017/18

The percentage with low birthweight has shown little change since records began in the mid-1970s. This is the result of the increase in preterm births combined with the fact that babies born at any given gestation have got, on average, slightly heavier over time.

* Age The percentage was highest in women under 20, although rates by age have fluctuated substantially over time

* SIMD Rates were higher in mothers in SIMD1 (7.2%) than among those in SIMD5 (3.7%)

/

Parental health behaviours during early years

Number of babies reported by parent as being breastfed at 6-8 week review

41%;

30% exclusive

2016/17

ISD

2017/18

Since 2001/02, the percentage has increased slightly. This is due to small increases in the proportion of babies receiving exclusive and mixed breastfeeding, most markedly since 2014/15

* Age 56% of babies born to mothers aged 40 or above were breastfed compared with 12% of babies born to mothers aged under 20

* SIMD Breastfeeding is much more common among mothers living in SIMD5 (60%) than SIMD1 (26%)

* Ethnicity Babies from minority ethnic groups are more likely to be breastfed than White Scottish babies

Comparative data by the WHO shows that UK breastfeeding rates are lower than in other Western European countries. The 2010 Infant Feeding Survey also found that the proportion of babies ever breastfed in Scotland (74%) was consistently and substantially lower than in England (83%), although it was higher than Wales (71%) and Northern Ireland (64%).

Percentage of babies reported by parent as being exposed to second-hand smoke at the 6-8 week review

8.2%

2016/17

ISD

2017/18

The percentage decreased substantially between 2007/08 (21.5%) to 2008/09 (14.7%), followed by a slower consistent reduction since then

* SIMD The percentage was higher among mothers living in SIMD1 (14%) than SIMD5 (2.9%)

* Age The percentage was higher among the younger age groups - 20.8% with mothers under 20, and 14.2% with mothers aged 20-24; compared with 4.9% among mothers aged over 35

* Ethnicity Exposure was lowest among Asian and Black, Caribbean or African groups

/

Immunisations

Percentage of children taking up immunisation at 24 months for 5-in-1 vaccination

97.6%

2017

ISD

2016

Uptake rates were consistently high, although there was slight decrease for the third year in a row

/

/

General health

Percentage of children aged 0-15 who are in good or very good general health

95%

2015-16 combined

SHeS

2016-17 combined

Little change over time

* Gender Girls were more likely than boys to report good health (97% and 94% respectively)

* Age Percentage lowest among children aged 14-15 (91%), compared with 95-98% for children aged 0-13. This finding could in part be explained by the survey design asking parents of children aged 0-12 about their child's health status, and asking children aged 13-15 directly

/

Percentage of children aged 0-15 with at least one long term health condition

16%

2016

SHeS

2017

/

* Gender Boys were significantly more likely than girls to have a condition (18% and 14% respectively)

/

Childhood obesity

Percentage of primary 1 children whose BMI is within the top 5% of the 1990 UK reference range for their age and sex ("at risk of obesity")

10.5%

2016/17

ISD

2017/18

The percentage has increased slightly from 9.2% in 2007/08

* SIMD Children in SIMD1 were almost twice as likely to be at risk of obesity than those in SIMD5 (13.2% vs 7.1%). The inequality has widened over time as rates in deprived areas have increased, while rates in the least deprived areas have fallen

* Gender The percentage was similar among boys (10.7%) and girls (10.2%)

/

Tooth decay

Percentage of children receiving a letter 'C' (no obvious decay experience) at basic inspection

P1 70.9%;

P7 69.4%

2016/17

ISD

2017/18

The percentage of P7 children with no obvious decay experience at detailed inspection has increased markedly since 2005 (53%) to 77% in 2017 (information from detailed inspection)

* SIMD The percentage with no decay experience at detailed inspection among P7s was 65.6% in SIMD1, compared with 86.5% in SIMD5. The gap between the most and least deprived dropped from 27 percentage points in 2010/11 to 21 percentage points in 2012/13 and has stayed stable since. (information from detailed inspection)

/

Mental health

Mean score for S2 and S4 pupils on the Warwick-Edinburgh Mental Wellbeing Scale ( WEMWBS)

48.4

2015

SALSUS

2018

The average WEMWBS score for all pupils decreased slightly between 2010 and 2013 from 50.0 to 48.7. Between 2013 and 2015, there was only a minor decrease

There was little change among boys, but girls showed a decrease in WEMWBS scores, particularly among S4 girls (from 45.1 to 44.4) but also S2 girls (from 48.7 to 48.2)

* Age/gender Mean scores were lowest among S4 girls (44.4) and slightly lower among S2 girls (48.2) than S4 boys (50.1) and S2 boys (51.4)

* SIMD Pupils who in SIMD1 had a lower mean WEMWBS score than those in SIMD5 across all age/gender groups

* Family structure

Pupils who live with both parents had higher mean WEMWBS scores

* Caring responsibilities

Pupils who had caring responsibilities had lower mean WEMWBS scores

* Relationship with parents

Pupils who thought their parents knew more about their activities had higher WEMWBS scores.

Pupils who were unlikely to talk to their parents about something that was worrying them had lower WEMWBS scores

/

Percentage of S2 and S4 pupils with a slightly raised (previously "borderline") or high or very high (previously, "abnormal") SDQ Total Difficulties score

31% (15% slightly raised, 16% high or very high)

2015

SALSUS

2018

The proportion of all pupils with a slightly raised or high difficulties score has increased slightly between 2006 and 2015 (from 27% in 2006 to 31% in 2015).

The percentage increased substantially among girls between 2010 and 2013, with little change among boys, and stayed stable between 2013 and 2015.

* Age/gender The percentage was substantially higher among S4 girls (39%) than other S4 boys and S2 pupils (15-30%). The gender difference is largely driven by the emotional symptoms subscale. S4 girls were three times as likely to have a slightly raised or high score on this scale than S4 boys. On other subscales, there was either no gender difference or boys scored worse than girls

* SIMD The percentage was higher in SIMD1 (34%) than SIMD5 (26%). However, the gap between pupils living in the most and least deprived areas has narrowed over time as the increase was slightly greater among those in SIMD5

* Family structure

Pupils who lived with both parents were less likely than those in other family situations to have a slightly raised or high score

* Caring responsibilities

Pupils who had caring responsibilities were more likely to have a slightly raised or high score

* Relationship with parents

Pupils who thought their parents knew more about their activities were less likely to have a slightly raised or high score.

Pupils who were unlikely to talk to their parents about something that was worrying them were more likely to have a slightly raised or high score.

/

General wellbeing

Percentage of 11,13 and 15 year olds who report high life satisfaction

87%

2014

HBSC

2018

No change in life satisfaction since it was first recorded in 2002

* Gender The percentage was higher among boys (90%) than girls (84%). There was a gender difference at 13 and 15, but at not at 11

* Age There was a decrease in life satisfaction with age. Among girls, life satisfaction decreased from 92% at 11, to 84% at 13 and 76% at 15. Among boys, there was no difference between ages 11 and 13, but rates were slightly lower among 15-year olds than 11-year olds (88% vs 92%)

Scotland performed average in international comparison

Percentage of 11,13 and 15 year olds who always feel confident in themselves

16%

2014

HBSC

2018

There was a peak in confidence amongst boys in 2006 (27%), and girls in 2002 (16%) and rates have fallen since. In 2014 the percentage was similar to that seen in the early 1990s

* Gender Boys were more likely to feel confident than girls (21% vs 11%). The gender difference was widest at age 13

* Age Confidence decreased with age. Among 11-year olds, 25% felt confident, compared with 9% of 15-year olds

Scotland only question

Eating behaviours

Percentage of children aged 2-15 who had the recommended 5 portions of fruit and vegetables the previous day

13%

2016

SHeS

2017

The percentage has fluctuated between 12-15% since the start of the time series in 2008.

* Gender the percentage was higher among girls (15%) than boys (11%)

* Age There was no clear pattern by age group. However, the percentage of children who had eaten no fruit or vegetables the previous day increased with age.

* SIMD The percentage was lower in SIMD1 (10%) than SIMD5 (18%)

* Household income There was no clear relationship. The percentage was highest in households in the highest income quintile (18%) but lowest in the second lowest income quintile (9%)

/

Percentage of 11, 13 and 15 year olds who consume fruit daily

38%

2014

HBSC

2018

There was a slight increase in fruit consumption since 2002

* Gender the percentage was higher among girls (42%) than boys (35%).

* Age Fruit consumption decreased with age among both boys (from 41% at 11 to 29% at 15) and girls (from 50% to 36%)

Scotland performed average in international comparison

Percentage of 11, 13 and 15 year olds who consume vegetables daily

38%

2014

HBSC

2018

There was a slight increase in vegetable consumption since 2002

* Gender the percentage was higher among girls (42%) than boys (34%)

* Age there was little difference between age groups

Scotland performed average in international comparison

Percentage of children aged 2-15 who ate sweets or chocolates once a day or more in the last week

51%

2015/2016 combined

SHeS

2016/2017 combined

/

* Household income The percentage was highest in households in the lowest income quintile (53%), but similar in all other quintiles (42% - 47%)

* Gender no gender difference

* Age No clear age difference

* SIMD No clear relationship

/

Percentage of 11, 13 and 15 year olds who consume sugary soft drinks daily

24%

2014

HBSC

2018

The percentage decreased between 2006 and 2010 (from 32% to 25% of boys and from 25% to 18% of girls), but has not changed significantly since 2010

* Gender The percentage was higher boys (27%) than girls (20%), although there was no gender difference at age 11

* Age Consumption increased with age, most markedly for boys between ages 11 (20%) and 13 (29%). For girls, the increase was less marked

Scotland performed worse in international comparison for 13 and 15 year olds:

* 20% Scotland, 16% HBSC average among girls aged 13;

* 29% Scotland, 21% HBSC average among boys aged 13;

* 24% Scotland, 16% HBSC average among girls aged 15;

* 31% Scotland, 22% HBSC average among boys aged 15.

It performed average for 11 year olds.

Percentage of 11, 13 and 15 year olds who eat breakfast every weekday

62%

2014

HBSC

2018

Between 2002 and 2014, there was little change among boys, whereas for girls there has been an increase (from 51% to 56%).

* Age Younger adolescents were more likely to eat breakfast; 76% of 11-year olds did so compared with 50% of 15-year olds

* Gender At ages 13 and 15 girls were less likely than boys to eat breakfast. There was no gender difference at age 11

Scotland performed better than average for 11 year olds: (79% Scotland, 73% HBSC average for boys; 75% Scotland, 70% HBSC average for girls).

It performed worse than average for 13 year old girls (53% Scotland, 58% HBSC average) and

15 year olds (43% Scotland, 52% HBSC average boys, 57% Scotland, 62% HBSC average girls).

Scotland performed average in international comparison for 13 year old boys.

Substance misuse

General acute hospital stays in young people aged 15-24 years with a diagnosis of alcohol misuse; rate per 100,000 population

303.8/100,000

2016/17

ISD

2017/18

The rate has fallen steadily from a peak of 638.4 in 2007/08

* Gender The rate was higher among males (366.9) than females (240.7).

* SIMD Alcohol related stays displayed a strong gradient by SIMD, being highest in the most deprived decile (data for all ages)

/

General acute inpatient and day case stays in young people aged 15-24 years with a diagnosis of drug misuse; rate per 100,000 population

131.52/100,000

2016/17

ISD

2017/18

The rate has fluctuated but broadly fell from a peak in 2002/03 (199.32) to a low in 2012/13 (104.20) before increasing to current levels.

For 15-19 year olds, the rate fell between 1999/2000 (119.5) to 2012/13 (65.4) but then increased back to the previous level. For 20-24 year olds, the rate fell from 2002/03 (282.5)

* Age Rates were higher among the older age group 20-24 (143.8) than 15-19 year olds (118.1)

* Gender Rates were very substantially higher among males (192.79) than females (70.24)

/

Deaths

Deaths in children aged up to 1 year per 1,000 live births

3.3/1000

2017

NRS

2018

Substantial drop over longer-term, little change recently ( e.g. averaged 32.9 for 1951-55, 18.8 for 1971-75, 6.6 for 1991-95 and 3.6 for 2011-15)

/

/

Deaths in children aged 1-4 years rate per 1,000 people

0.1/1000

2017

NRS

2018

Rates have fallen over longer-term, little change recently ( e.g. averaged 1.4 for 1951-55, 0.8 for 1971-75, 0.3 for 1991-95 and 0.2 for 2011-15)

/

/

Deaths in children aged 5-9 years rate per 1,000 people

0.1/1000

2017

NRS

2018

Rates have fallen over longer-term, little change recently ( e.g. averaged 0.6 for 1951-55, 0.4 for 1971-75, 0.2 for 1991-95 and 0.1 for 2011-15)

/

/

Deaths in children aged 10-14 years rate per 1,000 people

0.1/1000

2017

NRS

2018

Rates have fallen over longer-term, little change recently ( e.g. averaged 0.5 for 1951-55, 0.3 for 1971-75, 0.2 for 1991-95 and 0.1 for 2011-15)

/

/

Deaths in young people aged 15-24 years rate per 1,000 people

0.3/1000

2017

NRS

2018

Rates have fallen over longer-term, little change recently ( e.g. averaged 1.0 for 1951-55, 0.7 for 1971-75, 0.7 for 1991-95 and 0.4 for 2011-15). Latterly rates have fallen for men (averaged 0.9 for 2001-05; 0.6 for 2011-15); less change for women (averaged 0.4 and 0.3).

* Gender The rate was lower among females (0.2) than males (0.5)

/

Suicide

Deaths with underlying cause of 'intentional self-harm' or 'event of undetermined intent' (probable suicides), age 15-24, rate per 100,000 population, using the old coding rules

9.9/100,000

2017

ScotPHO (calculated from NRS figures)

2018

General downward trend from a peak in 2000 (22.8), but with some year-to-year fluctuations. 2017 is a slight decrease on 2016.

* Gender majority of suicides in this age group were male. Rates were much higher for men (16.2) than women (3.4)

/

3.3 Key points

  • There are a number of positive developments within the health domain. Maternal smoking during pregnancy and babies' exposure to second hand smoke at 6-8 weeks have dropped substantially over time. Tooth decay has also reduced over time.
  • Breastfeeding rates have increased over time, although they remain low in international comparison.
  • The gap between individuals in the most and least deprived areas continues to be substantial for the four measures above, although it has reduced over time. Positive parental health behaviours were also more common among older mothers, who were also more likely to come from the least deprived areas.
  • Mental wellbeing is emerging as a concern. Average WEMWBS scores have dropped over time, indicating a decline in positive mental health, while the percentage of children with a slightly raised, high or very high SDQ score has increased, indicating an increase in emotional and behavioural problems. The percentage of young people feeling confident in themselves has also fallen slightly.
  • This overall trend is driven by a change among girls. Girls displayed lower levels of wellbeing than boys on all measures, with a larger gap at older ages. Girls' wellbeing in recent years in terms of WEMWBS and SDQ also declined in recent years, with little change among boys.
  • Mental wellbeing decreased with age across childhood and adolescence, highlighting the importance of the teenage years. It was also lower in areas of higher deprivation.
  • In terms of obesity, almost a quarter of pregnant women were recorded as obese at antenatal booking. The percentage has increased year on year since it was first recorded in 2011.
  • This increase in obesity has been largest among women from the most deprived areas, leading to a further widening of the area deprivation gap.
  • More than one in ten Primary 1 school children were at risk of obesity. The percentage has increased slightly over the last decade. Children from the most deprived areas were substantially more likely to be at risk of obesity.
  • On diet, only 13% of children ate the recommended five portions of fruit and vegetables, and less than two thirds ate breakfast every weekday.
  • Deaths in children aged under 1, and young people aged 15-24, including suicides, have fallen substantially over the last decade.

Contact

Franca Macleod