Health visitors need to adapt local practice as research by the National Children's Bureau finds that children's health is not always linked to economic status.
The analysis looked at important indicators of health and development in early childhood and found that there was disparities in the levels of obesity, tooth decay, injury and childhood development in under-fives across the country.
A child in a reception class in Barking and Dagenham, was over two and a half times more likely to be obese than a child of the same age in Richmond upon Thames, only 18 miles away. A five-year-old in Leicester is over five times more likely to have tooth decay than a child of the same age in West Sussex.
Poor Beginnings: health inequalities among young children across England has been published for public health services working with under-fives, including health visitors and family nurse partnerships. The report calls for the government to set out a renewed strategy to improve the health and development of children and families in the early years and further investigate health variations and how they can relate to local health initiatives.
Although the report generally found that the health and development of children was closely linked to the affluence of the area they grow up in with those living in deprived areas more likely to be in poor health, several areas of high deprivation bucked this trend.
Cheryll Adams, chief executive of the Institute of Health Visiting, said: 'Trends in inequalities in health can be complex as this report suggests, with poverty not always being associated with poor health outcomes. Local health professionals, such as health visitors, understand the social determinants of health in communities, and how these may most effectively be addressed upstream with the right local policies and interventions.'
The 30 most deprived areas were compared with the 30 most affluent and those in poor areas and had higher levels of obesity, tooth decay, accidental injury and lower education development. Only 18.4% of children living in well-off areas had tooth decay in comparison to 31.6% in the 30 most deprived areas.
However, less affluent areas such as Hartlepool, South Tyneside and Islington, had higher levels of good health than expected suggesting that more research should be done to understand how local strategies and programmes can make a difference.
Anna Feuchtwang, chief executive of the National Children's Bureau said: 'The link between poverty and poor health is not inevitable. Work is urgently needed to understand how local health services can lessen the impact of living in a deprived area.
'We need local and national government to make the same efforts to narrow the gap in health outcomes across the country for under-fives as has been made to narrow the gap in achievement between poor and rich pupils in school. Government must make it a national mission over the next five years to ensure that the heath and development of the first five years of a child's life is improved.'