7

Child Maltreatment and Child Mortality

Joanna Mack

In the summer of 2016, the United Nations issued their latest report on the UK’s progress in meeting the internationally agreed targets on the Rights of the Child. Concentrating on the period since 2008, the report provides an independent assessment of the impact of the financial crash and, in particular, the first stage of the austerity policies that followed. Its verdict is damning. ‘Recent fiscal policies and allocation of resources’, the report concluded, were ‘disproportionately affecting children in disadvantaged situations’.1 Policies such as the ‘household benefit cap’, ‘the bedroom tax’ and limitations to entitlements to child tax credits were highlighted as particularly damaging. The high rates of child poverty were seen as a matter of ‘serious concern’. In conclusion, the UN Committee on the Rights of the Child called for the re-establishment of the child poverty reduction targets, which the government repealed in 2016, the provision for ‘clear and accountable mechanisms for the eradication of child poverty’ and the revision of recent benefit reforms.

This is a powerful condemnation of the violence inherent in the politics of austerity. Under the guise of deficit reduction, and with little political opposition, the government promoted an aggressive programme of welfare cuts. While the government presented these policies as fair and evenly spread, that we were ‘all in it together’,2 the outcomes – increased levels of child deprivation and the accompanying higher likelihood of ill health and diminished life chances – were entirely predictable. The policies were designed3 to hit the incomes and housing security of families who already had a hand to mouth existence, missing out on the most basic of contemporary needs.

In 2012, before the impact of current changes to the benefit system, the Poverty and Social Exclusion survey4 found that over two and a half million children, around one in five, live in a home that is cold or damp (see Chapter 9 by Ruth London). Over a million children, just under one in ten, do not have an essential item of clothing. One in 20 households cannot afford to feed their children adequately, resulting in 600,000 children missing out on one or more of three meals a day, fresh fruit and vegetables each day, or meat, fish, or the equivalent, while 300,000 children go without two or more of these essential food items (see Chapter 8 by Rebecca O’Connell and Laura Hamilton).5

It is against this background that the Coalition government opted for a programme of progressively harsher cuts to welfare spending. On taking office, they froze the rate of child benefit and changed the inflation rate for upgrading benefits to the lower Consumer Price Index (rather than Retail Price Index). In 2013, a ‘big bang’ of benefit reforms – which, among other cuts, set working-age benefit increases to a maximum of 1 per cent, brought in a cap to individual benefit payments and introduced the ‘bedroom tax’ – was passed, with the target to cut around £20 billion a year by 2015/16 from working-age benefits. At the same time, council tax benefit was effectively strangled by passing responsibility to local councils, which – already facing slashed budgets – had no money spare to take it on.6

Including tax changes – which gave away money through increases to the personal allowance but took it through increases to VAT – the Coalition government took around £30 billion overall from household incomes. And the poorest families were the hardest hit.

Figure 7.1 shows that while middle income households without children saw an increase to their incomes as a result of these changes, households with children saw a decrease and of these households, those on low incomes fared the worst.7 Prior to these cuts, adults in households with children were already over twice as likely to be in poverty as adults without children.8

Lone parents – of whom, prior to the cuts, two thirds were in poverty9 – saw the severest percentage reductions with close to 10 per cent (around £2000) for those out of work and nearly 7 per cent for those in work.10 These reductions in the incomes of the poorest families are a direct result of the government’s benefit changes.

illustration

Figure 7.1 The impact of the tax and benefit reforms, May 2010 to April 2015

Existing on meagre incomes, such families already had nothing left to spare at the end of each week. As one lone parent from Birmingham explains:

It’s a struggle. It’s an effort. I get up in the morning and it [money] is the first thing I think of and I go to bed at night and it is the last thing I think of. That’s the impact it has.11

The consequence of such reductions in income is that the UK, which has long had a poor record on child poverty compared to many other nations with similar levels of economic development, has slipped further behind. Eurostat, which gathers comprehensive data from across Europe, reports that in 2014 over 22 per cent of children in the UK lived in deprived households, taken as being unable to afford three or more of a range of household items,12 compared to 14 per cent in France, around 12 per cent in Germany and a mere 4 per cent in Norway and Sweden.13 In 2007, before the austerity years, the UK’s rate was 15 per cent well below the EU average – now it is above.

Many on low incomes report feeling ‘stressed’ or ‘anxious’ and for some the cumulative effect is that they end up suffering from depression.14 Lone parents, in particular, were already facing additional levels of stress. Prior to 2008, lone parents whose youngest child was under sixteen didn’t have to work and could claim Income Support but the then Labour government reduced that age to seven, forcing lone parents on to Job Seeker’s Allowance with all the added pressure of benefits being conditional on having to look for work and suitable child care – and with the threat of sanctions for ‘failing’ to do so. Subsequently, the Coalition government reduced this to lone parents with five-year-olds and in 2014 sanctions were introduced for those with three- and four-year-olds on Income Support who failed to undertake ‘work-related activities’.

As well as the sharp reduction in benefit levels, the Coalition government introduced a far more punitive regime with more restrictive conditions for the receipt of benefits and tougher sanctions (see Chapter 3 by John Pring and Chapter 4 by Jon Burnett and David Whyte). From 2012, penalties for claimants on Job Seeker’s Allowance and for disabled people on Employment and Support Allowance were introduced for a wide range of supposed failures. These included missing an interview, non-attendance in a training scheme and not applying for as many jobs as specified. These sanctions came with a new set of fixed-period suspensions of benefits ranging from four weeks to three years. Claimants are not allowed to appeal until two weeks after the decision, leaving many penniless in the meantime.

Between October 2012 and the end of 2015, there were over 1.9 million decisions to sanction claimants.15 More people suffer financial penalties through benefit sanctions than fines in the magistrate courts. It is a state administered penal system without any transparency or accountability.16 This is institutional violence aimed at the poorest. Combined with administrative delays in processing applications through over-loaded benefit offices many people have been left desperate.

Gemma was four days away from giving birth when she ended up in a food bank in Stockton-on-Tees, dependent on an emergency food parcel for the next meal. She and her partner had had no money for three weeks as they waited for the Department of Work and Pensions (DWP) to process their Job Seeker’s Allowance claim:

I was crying on the phone to them [the DWP] telling them I am pregnant. I don’t want my baby coming home to a house with no gas or electric. We have laminated floor and it’s so cold.17

The UK infant (0 to 1 years) mortality rate, at around four deaths per 1000 births in 2014, is higher than all but two of the nineteen Euro area member states.18 About half of these deaths are linked to short gestation and low birth weight, both of which are highly associated with deprivation.19 The result is that babies born into poorer families in deprived neighbourhoods are more likely to die than children from richer families.20

Allowing a pregnant woman to go without food in a cold, unheated home is to compromise her baby’s life chances. The World Health Organization defines ‘child maltreatment’ as an action that in the context of a relationship of power results in ‘actual or potential harm to the child’s health, survival, development or dignity’.21 If an individual takes such actions then they may be liable to prosecution. Yet if a political system results in such actions, it is seen as an inevitable, if unfortunate, by-product of economic necessity. This is not covert violence but overt violence.

Throughout childhood, poverty raises the risk of premature death. The progress that had been made in the 1980s and 1990s in reducing child mortality rates shuddered to a halt in this millennium with the result that the UK has fallen behind other European countries with similar levels of development. If the UK had the same all-cause death rate as Sweden, around 1900 children’s lives could be saved each year.22

Poverty in childhood also leads to poor health. Children who live in damp and mouldy homes are up to three times more likely than those in dry homes to suffer from coughing, wheezing and respiratory illness.23 Children living in overcrowded conditions – the numbers of which had risen sharply between 1999 and 2012 from 3 per cent of children to 11 per cent24 – are more likely to catch infectious diseases.25

Children born in poor areas have, as is well and long established, a shorter life expectancy than those born in rich areas and a much shorter period of a life free of the limiting effects of illness and disability – inequalities that are increasing.26 Much of this increased risk is the result of cumulative disadvantages across the adult years. Children from deprived backgrounds are more likely to have lower educational qualifications with lower long-term earnings and therefore to be deprived as adults (see Chapter 6 by Emma Bond and Simon Hallsworth). But there is growing scientific evidence that during the early years (and in the womb) there is a biological embedding of metabolic processes in the body that increases the risk of long-term illness and, with this, premature death – risks that are not completely removed even if there is subsequent upward social mobility.27

On winning the 2015 election, the Conservatives announced a further £12 billion cuts which included limiting tax credits to two children, a continued freezing of working-age benefits and a lowering of the level of the benefits cap. As Figure 7.2 shows, the poorest households are, again, the hardest hit and, in particular, poor households with children – who are set to lose up to 12 per cent of their income.28

illustration

Figure 7.2 The projected impact of tax and benefit reforms, May 2015 to April 2019

Since 2010, the government – both Coalition and Conservative – have consistently downplayed the importance of lack of income as a cause of poverty. Instead, blame has been laid on the lifestyles of individual families and their parenting practice. David Cameron cast the problem as: ‘Drug addiction. Alcohol abuse. Crime. A culture of disruption and irresponsibility that cascades through generations.’29 A focus on personal inadequacies fitted much better the aim, for which austerity was providing cover, of rolling back welfare provision.

On becoming Prime Minister in July 2016, Theresa May tried to set a new tone, making bold promises about ‘a country that works for everyone’ and fighting the ‘burning injustice’ of those born poor dying earlier than others.30 Yet for all the talk of an end to austerity, all of the planned benefits cuts will go ahead.31 Largely as a direct result of these planned cuts, over half a million more children are set to fall below the 2010/11 poverty line in 2020/21 than did in 2015/16 while the percentage of children in relative income poverty32 is predicted to rise from 18 per cent in 2015/16 to 26 per cent in 2020/21.33 And these projections could prove optimistic given the economic uncertainties surrounding Brexit and the threats to turn the UK into a low-tax haven with its inevitable consequence of a further rolling back of the welfare state. There are warnings of sharp falls to come to the real-terms incomes of the poorest, particularly those with children.34

This makes a mockery of promises to fight the injustice of poverty. To do this, there would need to be a real commitment to the transfer of income and wealth from the rich to the poor. And that would challenge the very basis of the neoliberal ideology still underpinning the government – an ideology that embeds within it the violence of child poverty.

NOTES

Websites were last accessed 15 July 2016.

1.   United Nations Committee on the Rights of the Child, Concluding Observations on the Fifth Periodic Report of the United Kingdom of Great Britain and Northern Ireland, CRC/C/GBR/CO/5, Geneva, 2016.

2.   Full speech available at: www.theguardian.com/politics/2009/oct/08/david-cameron-speech-in-full

3.   As admitted by the then deputy prime minister. See A. Asthana and S. Hattenstone, ‘Clegg: Osborne casually cut welfare for poorest to boost Tory popularity’, Guardian, 2 September 2016, available at: www.theguardian.com/politics/2016/sep/02/nick-clegg-george-osborne-cut-welfare-poorest-boost-tory-popularity

4.   www.poverty.ac.uk

5.   Stewart Lansley and Joanna Mack, Breadline Britain: The Rise of Mass Poverty, London, Oneworld, 2015.

6.   www.theguardian.com/society/2016/aug/06/benefits-council-tax-poverty-families-liverpool

7.   J. Browne and W. Elming, The Effect of the Coalition’s Tax and Benefit Changes on Household Incomes and Work Incentives, BN 159, London: Institute for Fiscal Studies, 2015, available at: www.ifs.org.uk/uploads/publications/bns/BN159.pdf

8.   G. Main and J. Bradshaw, Child Poverty and Social Exclusion: Final Report of 2012 PSE Study, 2014, available at: www.poverty.ac.uk/sites/default/files/attachments/PSE-Child-poverty-and-exclusion-final-report-2014.pdf

9.   Lansley and Mack, Breadline Britain, p. 85.

10. Browne and Elming, The Effect of the Coalition’s Tax and Benefit Changes.

11. S. Pemberton, E. Sutton, E. Fahmy and K. Bell, Life on a Low Income in Austere Times, Report published by Poverty and Social Exclusion in the UK, 2014, available at: www.poverty.ac.uk/sites/default/files/attachments/Life%20on%20a%20low%20income%20in%20austere%20times_final_report.pdf

12. The household items covered are available at: http://ec.europa.eu/eurostat/statistics-explained/index.php/Glossary:Material_deprivation

13. These figures are taken from Eurostat data tables, available at: http://ec.europa.eu/eurostat/web/income-and-living-conditions/data/database

14. Pemberton et al., Life on a Low Income.

15. Department for Work and Pensions, Quarterly Statistical Summary, May 2016, Newcastle-Upon Tyne, 2016, available at: www.gov.uk/government/statistics/dwp-statistical-summaries-2016

16. D. Webster, ‘Benefit sanctions: Britain’s secret penal system’, Centre for Crime and Justice, 26 January 2015, available at: www.crimeandjustice.org.uk/resources/benefit-sanctions-britains-secret-penal-system; also see D. Webster, ‘Benefit sanctions have failed: a comprehensive review is needed’, London School of Economics, 5 January 2016, available at: http://blogs.lse.ac.uk/politicsandpolicy/benefit-sanctions-have-failed-a-comprehensive-review-is-needed/

17. Quoted in K. Garthwaite, Hunger Pains – Life Inside Foodbank Britain, Bristol: Policy Press, 2016, p. 1.

18. These figures are taken from Eurostat data tables, available at: http://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=demo_minfind&lang=en

19. E. Rough, P. Goldblatt, M. Marmot and V. Nathanson, ‘Inequalities in child health’, in British Medical Association (ed.), Growing up in the UK, London: BMA Board of Science, 2013, pp. 37–55.

20. J. Roberts and R. Bell, Social Inequalities in the Leading Causes of Early Death, London: Institute of Health Equity, University College London, 2015.

21. World Health Organization, ‘Child maltreatment’, September 2016, available at: www.who.int/mediacentre/factsheets/fs150/en/

22. Ingrid Woolfe, ‘Setting the scene’, in British Medical Association (ed.), Growing up in the UK, London: BMA Board of Science, 2013, pp. 13–36.

23. The Marmot Review Team, The Health Impacts of Cold Homes and Fuel Poverty, London: Friends of the Earth, 2011.

24. Lansley and Mack, Breadline Britain, p. 45.

25. L. Harker, Chance of a Lifetime: The Impact of Bad Housing on Children’s Lives, London: Shelter, 2006.

26. M. Marmot, Fairer Society, Healthy Lives, London: Institute of Health Equity, University College London, Marmot Review, 2010. Office for National Statistics, Life Expectancy at Birth and at Age 65 by Local Areas in England and Wales: 2012 to 2014, 2016, available at: www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/lifeexpectancies/bulletins/lifeexpectancyatbirthandatage65bylocalareasinenglandandwales/2015-11-04#local-area-life-expectancy-at-birth

27. Gary Evans, E. Chen, G. Miller and T, Seeman, ‘How poverty gets under the skin’, in V. Maholmes and R.B. King (eds), The Oxford Handbook of Poverty and Child Development, Oxford: Oxford University Press, 2012, pp.13–36. Also see D. Barker, ‘Fetal origins of adult diseases’, in British Medical Association (ed.), Growing up in the UK, London: BMA Board of Science, 2013, pp. 149–81.

28. W. Elming and A. Hood, Distributional Analysis, London: Institute for Fiscal Studies, 2016, available at: www.ifs.org.uk/publications/8206

29. Full speech is available at: www.gov.uk/government/speeches/troubled-families-speech

30. Full speech is available at: www.gov.uk/government/speeches/statement-from-the-new-prime-minister-theresa-may

31. J. Elgot, ‘No more welfare cuts to come under Theresa May, says minister’, Guardian, 18 September 2016, available at: www.theguardian.com/politics/2016/sep/18/no-more-welfare-cuts-under-theresa-may-says-minister-damian-green-end-to-austerity

32. The percentage falling below 60 per cent of median household income before housing costs.

33. James Browne and Andrew Hood, Living Standards, Poverty and Inequality in the UK: 2015–16 to 2020–21, R114, London: Institute for Fiscal Studies, February 2016 available at: www.ifs.org.uk/uploads/publications/comms/R114.pdf. These projections, made pre-Brexit, use the Office for Budget Responsibility’s forecast for earnings and employment as well as incorporating the planned tax and benefit changes.

34. Adam Corlett and Stephen Clarke, Living Standards 2017, London: The Resolution Foundation, February 2017 available at: www.resolutionfoundation.org/app/uploads/2017/01/Audit-2017.pdf