Childhood health & wellbeing

Childhood health and wellbeing encompasses a range of topics from education, physical and mental health to behaviours, safeguarding and care responsibilities. The percentage of children achieving a good level of development at the end of the Reception year in Norfolk in 2023/24 was 67.3%, similar to the figure for England of 67.7%.^[1]

In terms of overall educational attainment, in 2022/23, the average attainment 8 score (which measures pupil achievement across 8 qualifications at Key Stage 4, i.e. GCSEs) in Norfolk was 44.6. This score is lower than that for England as a whole of 46.2 and places Norfolk in the bottom 40% of counties and unitary authorities nationally.^[2]

Turning to childrens’ health, hospital admissions for injuries to children (aged 0-14 years) have declined in Norfolk between 2019/20 and 2023/24.^[3] The three year average rate of under 18’s admitted to hospital for alcohol specific conditions up to 2023/24 was 22.0 per 100,000 in Norfolk. This figure is similar to the rate for England as a whole over the same time period of 22.6 admissions per 100,000.^[4]

1. fingertips.phe.org.uk/search/development#page/4/gid/1/pat/15/ati/502/are/E10000020/iid/90631/age/34/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1
2. fingertips.phe.org.uk/search/attainment#page/4/gid/1/pat/15/ati/502/are/E10000020/iid/93378/age/175/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1
3. fingertips.phe.org.uk/search/injuries#page/4/gid/1/pat/15/ati/502/are/E10000020/iid/90284/age/26/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1
4. fingertips.phe.org.uk/profile/child-health-profiles/data#page/3/gid/1938133228/pat/6/ati/502/are/E10000020/iid/92904/age/173/sex/4/cat/-1/ctp/-1/yrr/3/cid/4/tbm/1/page-options/car-do-0

Good mental health allows children and young people to develop resilience and grow into well-rounded, healthy adults. Children’s social and emotional wellbeing is important in its own right, but also because it affects their physical health (both as a child and as an adult) and can determine how well they do at school. Good social, emotional and psychological health helps protect children against emotional and behavioural problems, violence and crime, teenage pregnancy and the misuse of drugs and alcohol.

The proportion of school pupils with social, emotional and mental health needs in Norfolk in 2022/23 was 4.2%, higher than the rate for England as a whole of 3.3%. Both of these rates steadily increased in the 5 years up to 2022/23.^[5]

When children are unhealthy it affects their ability to learn, thrive and develop. Most ill-health will be short-lived and episodic, as children are particularly susceptible to respiratory and digestive conditions, and they are more likely than older age groups to injure themselves through accidents. The most common long-term condition in childhood is asthma, while epilepsy is most common long-term neurological condition and diabetes is increasingly common.^[6]

Hospital admissions for injuries in children (aged 0-14 years) in Norfolk declined substantially between 2016/17 and 2023/24. In 2023/24 there were 61.5 admissions per 10,000 children, lower than the 72.4 per 10,000 children for England as a whole.^[7] Being overweight or obese is also a key general health issue for children and is discussed in the ‘Healthy Weights’ section.

Tooth decay is the most common oral disease affecting children in England, yet it is largely preventable.^[8] Poor oral health can impact upon a child’s ability to sleep, eat, speak, play and socialise with other children; it causes pain, infections and is a leading cause of hospital admissions for children. Oral health is therefore a fundamental part of the overall health and wellbeing of children. In Norfolk in 2023/24 21.3% of five-year olds showed visible signs of dental decay, similar to the English average of 22.4%.^[9]

Child weight is monitored through the national child measurement programme which measures child height and weight in the Reception year of school (ages 4 and 5) and Year 6 (ages 10 and 11). Being overweight or obese is a primary concern due to its high prevalence and implications that persist into adulthood. In Norfolk in 2023/24, 22.1.% of reception children were overweight or obese with this figure rising to 35.1% in Year 6.^[10] In Year 6, the proportion of children identified as overweight or obese appears to have increased since the before the pandemic in both Norfolk and England more widely.^[11] There are clear inequalities in terms of weight with children in most deprived areas having significantly higher rates of obesity than those in the least deprived areas.^[12]

Engaging in regular moderate to vigorous physical activity offers a wide range of benefits for children and young people. It helps maintain a healthy body weight, reduces the risk of obesity, and supports emotional wellbeing.^[13] Additionally, it plays a crucial role in the development of essential motor skills and supports healthy growth and development. The Chief Medical Officer’s guidelines recommend children and young people should aim for at least 60 minutes of physical activity each day to achieve health benefits.^[14]

In 2023/24, 49.4% of children and young people in Norfolk met this recommended level of physical activity. This is similar to the East of England average (49.8%) and the national average for England (47.8%).^[15]

In Norfolk the Early Childhood and Family Service (ECFS) offers a range of support services for families with children aged 0 to 5 years old, particularly those facing challenges such as developmental concerns, isolation, difficulties with behaviour or financial hardship.^[16] Services include free “Stay and Play” sessions for children to attend with their parents or carers.^[17] These weekly sessions run year-round and provide a welcoming space for families to play, learn and connect with others in their community.

In addition to in-person support, ECFS also delivers a variety of online information sessions for parents in Norfolk. These cover important topics such as baby brain development, behaviour management, oral health, toilet training and car safety.^[18]

In 2024/25 there were 456 schools recorded as open in Norfolk.^[19] These schools educated 123,885 pupils (including those who attend part-time).^[20] In 2023/24, among those Norfolk schools with an Ofsted rating, 10.0% were rated as Outstanding, 76.1% were rated as Good, 12.3% were rated as Requires Improvement and 1.5% were rated as Inadequate.^[21]

In 2022/23, the average attainment 8 score (which measures pupil achievement across 8 qualifications at Key Stage 4, i.e. GCSEs) in Norfolk was 44.6. This score is lower than that of 46.2 for England as a whole and places Norfolk in the bottom 40% of counties and unitary authorities nationally.^[22]

Sexual health services provide essential support and information on sexually transmitted infections (STIs), contraception, planning a pregnancy, unplanned pregnancy, and abortion. These services can help individuals make informed choices, protect their health, and access the care they need in a safe and confidential environment.^[23]

In 2024, 981 cases of chlamydia were detected per 100,000 individuals aged 15-24 in Norfolk. While higher than the East of England average, this is below the rate for England as a whole.^[24] However, Norfolk has a lower proportion of young women(aged 15-24) who receive Chlamydia screening than the English average (16.7% compared to 18.0%).^[25]

As a proportion of conceptions among those under 18, in Norfolk in 2021 50.6% resulted in an abortion. This figure is similar to the 53.4% recorded for England as a whole.^[26]

In 2024 the Norfolk Flourish Survey of school children found that just under 1-in-2 of those aged 10-18 reported drinking alcohol at least once and just over 1-in-4 reported drinking alcohol at least once a month. For 11-15 year olds, there is some evidence that those in the Norfolk sample may be more likely to report drinking alcohol at least once than the English average.^[27]

The survey also asked pupils about their drug use. Of those aged 12-18, around 9-in-10 reported never taking drugs. Among those who report taking drugs, cannabis is the most widely used substance. The 11-15 year olds in the Norfolk Flourish Survey appear less likely to report having taken drugs at least once than similarly aged children across England as a whole.^[28]

The 2024 Flourish Survey found that among those aged 10-18 in Norfolk more than 1-in-4 reported vaping at least once compared to 1-in-10 who reported smoking at least once. Just over half of those who reported vaping at least once reported never smoking. Since the previous Flourish Survey in 2017, the proportion of respondents smoking in each age group has remained stable, but the proportion vaping has increased noticeably.^[28]

The Government’s vision for children and young people with special educational needs and disabilities (SEND) is the same as for all children and young people – that they achieve well in their early years, at school and in college and make a good transition to adulthood, to lead contented and fulfilled lives. The 2014 Children and Families Act^[29] requires local authorities to set out a clear ‘local offer’ of services across education, health and social care and for these services to be jointly commissioned.^[30] The act also introduced Education, Health and Care (EHC) plans for children with disabilities, with the option of a Personal Budget for families and young people who want one.

In 2024/25, 14.5% of pupils in Norfolk schools had SEN support and 6.6% had an EHC plan. The figures for England as a whole are 14.2% and 5.3% respectively.^[31]

While a home is frequently thought of providing support to a child, it is important to remember that some children have to provide support to other household members. The 2024 Norfolk Flourish Survey found that 6.8% of sampled pupils aged 8 to 18 reported being young carers and a further 8.6% were not sure if they were carers or not.^[32] 2021 UK census data indicates that 1.4% of those aged 5-17 had unpaid caring responsibilities in England as a whole and 1.6% of those aged 5-17 in Norfolk had these responsibilities.^[33] One potential explanation for the figures from the local survey being noticeably higher than the census figures is that the survey was completed at school rather than in the home. The Flourish Survey questionnaire also provided a more extensive description of what might constitute providing care.

In the 2023/24 financial year there were 1,066 arrests of under 18s arrested in Norfolk. This is a decrease of 21% compared to the previous 12-month period. The most frequent first arrest offence types were violence against the person (30%), criminal damage and arson (17%) and theft offences (16%).^[34]

The Norfolk Youth Justice Service is multi-agency partnership that supervises and supports children who commit offences to help prevent offending, repair the damage of offending and to help children achieve their full potential in life.^[35]

Domestic abuse is an incident or pattern of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 years or over, who are or have been intimate partners or family members, regardless of gender or sexuality. This can encompass, but is not limited to, psychological, physical, sexual, financial or emotional abuse and also includes honour-based violence, forced marriage and female genital mutilation.

There were almost 11,400 domestic abuse related crimes recorded in Norfolk during 2023/24, a drop of 24.7% since 2021/22. Approximately 70% of victim-survivors of domestic abuse related crimes are female and 30% male.^[36]

Children and young people are vulnerable to being victims of crime – in 2023/24 in the East of England 6.1% of 10-15 year olds were the victims of crime, and the majority of this was crimes against the person i.e. theft and violence. This figure is lower than for England and Wales as a whole where 10.2% of 10-15 year olds were victims of crime in 2023/24.^[37]

Child sexual exploitation (CSE) is a type of sexual abuse. Children in exploitative relationships can receive gifts, money or affection as a result of performing sexual activities. They may be tricked into believing they are in a loving, consensual relationship, they may be groomed through parties, being given drugs and alcohol, or groomed online. The Norfolk Safeguarding Children Board has created a multi-agency CSE sub-group to develop the response in Norfolk.^[38]

A 2019 crime survey found that 8.9% of adults aged 18 to 74 in the East of England reported experiencing sexual abuse during childhood compared to 7.5% across England and Wales as a whole.^[39]

Norfolk is committed to promoting the welfare of all children, keeping them safe from harm and supporting them to thrive and fulfil their potential. Safeguarding is everyone’s responsibility and for services to be effective each professional and organisation must play their full part. Norfolk Safeguarding Children’s Board^[40] is a multi-agency group which ensures that arrangements for safeguarding children are co-ordinated and that these arrangements are monitored to evidence impact and effectiveness.

Norfolk has a similar rate of children who are looked after in care (i.e. fostered, living in children’s homes or placed for adoption) to England as a whole. In 2023/4 the rate was 68 per 10,000 children aged 0-17 in Norfolk compared to a rate for England as a whole of 70 per 10,000 children.^[41] In 2024 there were 1,152 children in care in Norfolk, with 64% in foster care (742 children) and 35% between the ages of 10-15 years old (408 children).^[42]