The Director of Public Health for NHS Highland says urgent action is needed to support the one in five Highland children living in poverty – a statistic that hasn’t changed for over 15 years. Jennifer Davies cites the experience of children and parents across the region in her call for agencies to work together to give every child in Highland and Argyll and Bute the best start in life.

In her first annual report since being appointed in April of 2025, Jennifer Davies sets out a series of recommendations for how different agencies can work together across five interconnected themes of prevention, addressing social and economic factors, making places and communities better for children and parents, enabling healthy living, and providing equitable health and care.

The report, A Strong Start: health and wellbeing in early years unusually draws on the contributions of more than 170 children and parents across Highland and Argyll and Bute.

Working with the Care and Learning Alliance and Let’s Grow Kids UK, the report used specialist play-based research methods to capture the perspectives of children as young as two, recognising that traditional engagement techniques are not suited to the very young.

Children identified what matters to their health not in terms of clinical services, but in terms of their everyday lives: outdoor spaces, parks and beaches, family routines, community connections, feeling safe, and having enough.

Some of those who took part spoke about financial constraints. One child who was under 5 years old said: "I want to go to a café. I’ve never been before".

Another, asked about swimming, said: "I can’t go because you have to have a car and money".

Ms Davies says it is morally and economically imperative for action to be taken early:

"What is clear from our research is that our children not only experience inequalities, they express them. These children’s voices should be central to how we plan and design the services and communities that shape their lives.

"The early years are the most important window of opportunity we have to shape health for a lifetime. We know that if left unchecked, health inequalities accumulate across the life course and that acting early is both the most effective and the most cost-efficient thing we can do.

"Our region is a beautiful place to grow up, and the vast majority of our children thrive here. However, the sheer geographic scale of our region means that for families living in remote and rural communities, simply reaching services can take considerable time, cost and effort. These are the daily realities of children's lives, and closing the current poverty gap that affects one in five of our children across Highland is a responsibility we share across the whole system: health, local government, communities and beyond."

The report cites evidence from economist James Heckmann suggesting that prioritising social investment in the first 1,000 days of life can return up to £10 for every £1 invested, through reduced social care and medical treatment costs, lower unemployment, and improved community outcomes.

Poverty and geography

The report provides data on early years health across the Highlands, Argyll and Bute.

Of the 12,834 children aged under 5 in NHS Highland’s area in 2024, more than one in five (21.9%) live in relative poverty, a figure that the report says has not improved since 2010.

One in three children live in a remote or rural area, with around half of all NHS Highland children living in the most ‘access-deprived’ 20% of areas in Scotland.

The data reveals stark health inequalities linked to deprivation.

NHS Highland says the rate of low birthweight babies in the most deprived areas (9.0%) is more than five times that of the least deprived (1.7%). Tooth decay in five-year-olds in the most deprived communities stands at 42.7%, compared with 15.4% in the least deprived. Childhood vaccination coverage has declined since 2020, with a widening social gradient that leaves the most vulnerable communities at greatest risk.

The report sets out five areas where collective action is needed across NHS Highland, local authorities, third sector organisations and communities, as follows:

• Invest early in prevention. System partners have committed to reducing child relative poverty to below 5% by 2030. We should focus our collective resources on preventative action, making decisions through the lens of equity to improve the economic, social and environmental conditions that help children and families thrive.
• Tackle the drivers of poverty. Most children in poverty in Scotland live in working households. We should promote fair work, strengthen family support, and maximise access to childcare, healthy food and income benefits.
• Create child-friendly places. Argyll and Bute declared the UK’s first Scottish housing emergency in 2023. We need to address the demand for housing, improve transport access, invest in play spaces, and apply a child health lens to planning.
• Strengthen universal services. We should improve Health Visitor pathway coverage and expand access to family support programmes, including the long established Family Nurse Partnership.
• Ensure equity and children’s rights. Around half of NHS Highland children live in Scotland’s 20% most access-deprived areas, making equitable service design essential. With the UN Convention on the Rights of the Child (UNCRC) now in Scottish Law, public bodies must embed children’s rights and voice in decisions on health, housing, transport and communities.

Jennifer Davies concludes:

"Investing in the early years is not just a moral imperative, it is the most effective economic and social investment we can make.

“By protecting the spark of potential in every Highland child today, we are securing the health and prosperity of our region for generations to come. I believe it is our joint responsibility to make that a reality."

 

Read more: The case for a Highland weighting; Politicians must take ‘bold’ action on child poverty; Childhood adversity health impacts felt at 50 revealed

Sign up to receive our bulletin for key health & social care updates straight to your inbox.