09 Jun 2020 Guest Blog: Protecting children’s health during Covid-19 – A DPH’s perspective
In our latest guest blog, we hear from Director of Public Health (DPH) at Liverpool City Council and Lead DPH at Food Active, Matthew Ashton, to explore how the Covid-19 pandemic has affected children’s physical and mental health.
Taking up my new role as Director of Public Health at Liverpool City Council on Wednesday 1st April 2020 couldn’t have come at a more challenging time – you would certainly need to be living in the far edges of earth if you didn’t know why.
The Covid-19 (CV19) pandemic is not solely a public health concern, but a concern for all – it has changed everyday life as we know it, and has far-reaching impacts that affect our social life, income and our local environment too. This also means that public health cannot solve all of the challenges that CV19 brings alone, but will require effort from across the whole system to find solutions, and protect our most vulnerable communities of whom may bear the brunt of CV19 hardest. A special mention has to be given to the amazing work that our NHS and social care colleagues are doing, putting their own lives at risk to save others.
In this blog, I explore some of the implications the pandemic is having on the physical and mental wellbeing of our future generations and arguably the most vulnerable in society, drawing on my experience as a DPH of one of the most deprived local authorities in the country, but also my own personal experiences at home. Whilst not all experiences are negative, it is important to remember that these impacts will be felt differently in households across the social gradient.
Reliance on emergency food aid
We know that the lockdown has had a significant impact on low income household’s ability to access healthy and nutritious food. Recent polling data published by the Food Foundation suggests that the number of households with children going hungry has doubled since lockdown began. The main cause of this has been disruption to household income – with larger households, single-parent households and those with disabled children the hardest hit. Almost one quarter of the workforce are furloughed, meaning their wages have been reduced by 20%. This may not seem like a huge amount, but to some families who are just about making ends meet, this will have disastrous consequences. There are also greater concerns for those who were just about to start a new job (furlough only covers those who have been employed before 19th March), and in ever sadder circumstances some have lost their jobs due to businesses going under.
Thankfully, we have a fantastic network of food banks which already provides emergency food aid to hundreds of thousands of families every year, pandemic or not. Thankfully may not be the most appropriate phrase to use, as the fact so many households have to rely on this to put food on the table is a sorry state of affairs in the 5th richest country in the world – but I am thankful that they exist, particularly in my own city of Liverpool, as this has been an invaluable in ensuring that emergency food has been provided to the families when they needed it, right from the get-go. As a comparison just over 5 days in May the food charity FareShare Merseyside distributed 40 tonnes of food across Merseyside. The same week last year the total food distribution totalled 14 tonnes
Because of shelf life most of these parcels are made up mainly of processed foods which do not have the best nutrition. Fresh fruit, vegetables, meat and dairy products require refrigeration, which makes it difficult to store without refrigeration (which most food bank hubs do not have) but also packing and delivery – fresh fruit, veg and eggs can spoil easily from being bruised or crushed. There are concerns that long-term, sustained use of these parcels may lead to nutritional problems[i] – and I agree. We now must look beyond the initial food response to the Covid-19 lockdown, and consider how we can best support healthy eating for our young people in the mid to long-term.
Lockdown life and impacts on children’s health and wellbeing
As a parent myself and working from home throughout the lockdown, I have seen first-hand the impact this had had on my own children. From managing home-schooling and homework, as well as my own, to figuring out how to burn off all their energy despite being cooped up indoors (particularly in March and April) – it has most certainly been a balancing act.
There are both positive and negative implications of lockdown life on children’s health. Positive impacts largely relate to having more time on our hands – spending more time together as a family (tantrums and teenage strops aside), exercising as a family and more time to prepare, cook and even get the kids involved in home cooked meals or baking, to name a few. Unfortunately, these implications will be felt differently by children of different backgrounds. For some children, spending more time with their family is simply not something they desire.
The negatives? Less energy expenditure for kids, particularly during the early stages of the lockdown, combined with increased snacking[ii] on unhealthy food due to boredom, comfort eating or parents succumbing to demands for treats in order to occupy the kids for at least five minutes – this has the potential to negatively impact on weight status, as we know that gradual, incremental increases in energy intake can result in obesity.
Another important negative impact that may have been felt by our children is mental health. The CV19 pandemic has been overwhelming for adults, let alone young children, who have yet to develop the skills to be able to deal with their emotions, stress and anxiety.
Missing friends, school life, playtime with anyone other than their family members, or just any type of normality will undoubtedly have an impact on children’s mental health, again some more than others depending on their circumstances. For some children, home is not a safe place as their peers may see it. Being at home 24/7, with no other social contact to break things up, may be a stressful situation for them. In addition, these are just some of the short-term impacts – it is likely that the impact of the lockdown and Covid-19 on mental health to be far-reaching, and may affect different children at different stages.
We know there is a two-way relationship between mental health, obesity and poor diets[iii]. Parents may also look to comfort their children who are struggling with more treats to try and help – with treats typically being associated with foods high in fat, sugar and/or salt.
This blog only touches on some of the potential impacts CV19 and lock down life has had on our future generations health and wellbeing. We will undoubtedly unearth more and more as time goes by.
Looking to the future
As we start to exit lockdown we are working hard to support our children and young people adapt to the new normal. We are ensuring that right mental health support is in place and that children have the opportunities to be active, access healthy food and have right environments to develop and thrive
Of course, we don’t do any of the above by ourselves, public health is all about really strong partnership working and first class systems leadership. And we must also always remember that communities are at the heart of everything we do, our mission is to make the world (starting with Liverpool) a better place, and I am proud to be able to do that in the best city in the world.
As we move into recovery from Covid19, we have an opportunity to put the health and wellbeing of children and young people at the heart of everything we do, from best start in life, through to healthy eating, positive mental wellbeing, and improved life chances. We should not let this opportunity pass us by.
You can follow Matthew on twitter at @DPH_MAshton
[iii] Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BWJH, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry 2010;67(3):220-9