Southwark is ranked within the 10 per cent most deprived local authority areas in the country. Poor health outcomes across the age range are associated with social determinants of health, such as poverty, isolation and lack of social support, social exclusion generally and poor access to health services specifically, there is increasing evidence that social adversity has detectable effects from early in development, in childhood and already in utero. Factors in early development known to raise risk of poor health in infancy and through the life course include maternal stress, smoking, poor diet, poor access to healthcare and parental conflict, while conversely many factors enhance infant development such as parental well-being, sensitive, warm and consistent care and health literacy. Health outcomes affected include birth weight and early growth trajectories, emotional, behavioural and cognitive development, and childhood obesity. Consistent with this in Southwark children have poor health indices across the age rangeincluding some beginning in childhood or which are affected by early development, such as obesity. Childhood obesity is a big problem in Southwark: the UK national average of children obese in year 6 is internationally recognized to be concerning at 19%, in Southwark it is significantly worse at 26%.
National and health and social care policy has focused on the need for prevention to improve the health of the more deprived populations in the country by improving the social determinants of health, including lack of social support, social exclusion and poor access to health services.
Many mothers in Southwark may not be classed as ‘high risk’ and do not receive specialist services, but nonetheless experience cultural dislocation and are isolated with poor social support. If English is not their first language, this can often inhibit communication, both social and relating to health.