Kerry McKenzie works with NHS Health Scotland and leads a programme of work to tackle child poverty. She talks here about the impact of poverty on children’s health and wellbeing and the positive action that is being taken in Scotland.

We all agree that Scotland must, and should, be a place where every child can live, grow and flourish to reach their full potential. But sadly, many children are prevented from doing just that as they are living under the grip of poverty. It’s just not acceptable in a rich country like Scotland that our children who live in poverty have poorer outcomes, not least their health and wellbeing. What’s more, there is a whole host of compelling evidence that shows a direct causal link between money and health, social, behavioural and cognitive outcomes for children. In short, money matters to health and income inequalities drive health inequalities. This plays out in two main ways. The stress and anxiety experienced by families living with not enough money coupled with the limits placed on home life and the opportunities that parents can give their children to fully support their development. All of this puts pressure on family life and restricts the lives of children living in poverty.

Recent work shining a spotlight on the cost barriers of school gives a clear picture of children who are not able to fully participate in what schools offer due to their family income. Children and young people talk of their sense of exclusion when they cannot afford to take part in school events or trips, be able to wear the same uniform or eat the same lunch as their friends, take advantage of the after school clubs or even complete homework tasks because they might require internet /IT access. Poverty impacts on friendships too: for example, you might not be able to accept an invitation to a birthday party because that means having the right outfit and a gift or have friends over when there may be little food to offer and feeling embarrassed about the house.

But the good news is that poverty can be solved. We know what can make a real difference to the incomes of families with children – it is actions that address the rising costs of living, low-paid and insecure work, housing costs and tackle the benefits freeze that can prevent families being locked into poverty. There have been periods in the last 20 years where poverty rates have fallen and this has been as a result of effective anti-poverty policies.

In Scotland, we now have the bold Child Poverty (Scotland) 2017 Act which places a range of duties on the Scottish Government and mandates it to do whatever it can with the powers it holds to take action to reduce poverty by 2030. Local authorities and health boards must also jointly produce a local child poverty action report on actions that can be taken at a local level. This recognises that collective effort is required across agencies and at different levels of government to stop rising levels of child poverty.  For example, the new social security payments, Best Start Grant, Best Start Foods and the Scottish Child Payment, are all examples of policies that aim to tackle poverty in Scotland. At a local level, increasingly health staff are asking the people they care for during appointments, “Tell me about any money worries you have?”, and directly referring to money/welfare advice services, many of which are based in hospitals or GP clinics. As a result, people are more likely to get all of the benefits they are entitled to as well as debt advice where necessary. Schools across the country too are poverty proofing the school day to ensure that their policies and practices are neither excluding nor further stigmatising children living in low income households.   Improving the affordability and accessibility of transport, housing and childcare are all important and can have a massive impact on family household incomes. Much is being done in Scotland to tackle poverty, at national and local levels.

But none of this progress means that we can be complacent when child poverty rates are predicted to rise dramatically in the coming years.  There is no doubt that poverty is a public health problem, a human rights issue and a political choice. Taking action to ensure everyone has the income they need to live longer, healthier lives is crucial.

Kerry McKenzie is the Organisational Lead on Child Poverty at NHS Health Scotland