Early childhood experiences are powerful predictors of good or poor outcomes in later life. The recent GCPH report, Health and early years, children and young people: a GCPH synthesis, is an important resource for public policy makers as a reminder of the policy areas we need to focus on for every child to have the best start in life.

The impact that poverty has on children’s opportunities and development appears again and again in this report and others. We need to address child poverty if we want to work towards an equal distribution of good health and wellbeing across the population.

Absolute poverty blocks access to the resources families need for healthy, growing children. The stigma and discrimination experienced as a result of relative poverty further entrenches inequality in later life. Of course we know that many people show steely resilience to the toxic stress of early poverty and adversity, working through their circumstances to achieve success in later life, but at what cost?  

The Adverse Childhood Experiences (ACEs) research explored recently by ScotPHN demonstrates a higher risk of poor outcomes and damaging behaviours resulting from difficult circumstances in childhood. While child poverty was not included in the original ACEs research, it is clear that poverty increases the risk of experiencing stress in family relationships and challenging environments. Adverse childhood circumstances underpinned by poverty can be deeply damaging throughout life.

Much of the evidence presented and the actions proposed in the GCPH synthesis will already be familiar to those of us with an interest in children and inequality (although perhaps rarely in such a digestible form).

Data from elsewhere backs up the report’s emphasis on poverty and adversity. The Child Poverty Action Group (CPAG) recently reported that child poverty is forecast to be on an upward trend. ScotPHO found that emotional health might be deteriorating in secondary school pupils. ScotPHO also report that health inequalities in the population are increasing. There is no question that childhood adversity is damaging throughout the life course and has to be addressed as a priority.

At NHS Health Scotland we welcome the Scottish Government’s willingness to retain a focus on child poverty and its measurement. We aim to strengthen the potential for public services to mitigate the impact of poverty and adversity in childhood in a number of ways including: producing profiles and research reviews; helping to implement across Scotland findings from Healthier Wealthier Children and Cost of the School Day; informing development of the Child Poverty Bill; focusing action for lone parents; and promoting rights based approaches to person-centred and inequalities sensitive services.

As part of this, we are working across the health and social care system and beyond to stimulate a Scottish societal response to adversity in childhood. We will agree immediate priorities following our ACEs event in Edinburgh on 28^th November 2016.

The GCPH synthesis offers examples in policy and practice of joined up working and more attention being paid to the impact of poverty and adversity in childhood. This will help us strengthen our work to mitigate the impact of poverty and adversity on children, build resilience in families and prevent long lasting damage from difficult childhood circumstances as children develop into young people and on through their life-course.

Focusing on children in difficulties now will reduce inequalities between tomorrow’s adults. A whole system approach is needed where no child is left in need of the love, nurture, materials and environment they need for a good start in life.