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Annual Report of the Chief Medical Officer 2012. Our Children Deserve Better: Prevention Pays

Every year the CMO for England produces an Annual Report. This year Volume 2 focuses on children and young people. The report is based on the evidence of experts, who provided information about the life course stages. The report makes recommendations on how to improve the health of children and young people and why this is important to do.

As part of the report (annex 9) we have developed an Atlas of Variation in the Health of Children and Young People. This section illustrates the current state of child health in England by highlighting existing variation in healthcare and health outcomes for children and young people. It builds on the work of Right Care’s NHS Atlas of Variation in Healthcare for Children and Young People, published in March 2012 and expands on the analysis of healthcare indicators by using a broader range of measures of child health.

Section 1 : Determinants of child health
A: Poverty and homelessness
Map 1 - Child poverty: Percentage of children aged under 16 years living in families in receipt of out-of-work benefits or tax credits where their reported income is less than 60% of the median income, by local authority, 2010
Map 2 - Family homelessness: Rate of households accepted as unintentionally homeless and eligible for assistance per 1,000 households, by local authority, 2011/12
B: Vulnerable Children
Map 3 - Children in the child protection system: Rate of children aged 0–17 years who were the subject of a child protection plan, per 10,000 children aged 0–17 years, by local authority, at 31 March 2012
Map 4 - Healthcare (medical) for looked-after children: Percentage of looked-after children (in care for at least 12 months) who had their annual health assessment, by local authority, 2012
Map 5 - Healthcare (dental) for looked-after children: Percentage of looked-after children (in care for at least 12 months) who had their teeth checked by a dentist, by local authority, 2012
C: Education
Map 6 - School readiness: Percentage of children at the end of foundation stage (at age 5) who are assessed as having achieved a 'good level of development', by local authority, at January 2012
Map 7 - Special educational needs (SEN): Percentage of children in state-funded schools with a statement of SEN, by local authority, at January 2012
D: Crime & Youth Justice
Map 8 - Crime and youth justice: Rate of young people aged 10–17 years receiving their first reprimand, warning or conviction, per 100,000 population aged 10–17 years old, by local authority, 2011/12


Section 2 : Health promotion
A: Mortality
Map 9 - Perinatal mortality: Perinatal mortality rate per 1,000 births, by local authority, 2011–2013
Map 10 - Infant mortality: Infant mortality rate per 1,000 live births, by local authority, 2009–2011
Map 11 - Childhood mortality: Directly standardised mortality rate for children aged 1–17 years per 100,000 children aged 1–17 years, by local authority, 2009–2011
B: Injury
Map 12 - Hospital admissions due to injury: Rate of hospital admissions due to injury in children aged 0–17 years, per 10,000 children aged 0–17 years, by local authority, 2011/12
Map 13 - Injuries from road traffic accidents: Rate of children aged 0–15 years killed or seriously injured in road traffic accidents, per 100,000 children aged 0–15 years, by local authority, 2009–2011
Map 14 - Mortality from accidental injury: Directly standardised rate of death in children and young people aged 0–24 years due to all accidental injury, per 100,000 children and young people aged 0–24 years, by local authority, 2002-2011
Map 15 - Mortality from non-accidental injury: Directly standardised rate of death in children and young people aged 0–24 years due to all non-accidental injury, per 100,000 children and young people aged 0–24 years, by local authority, 2002–2011
C: Weight
Map 16 – Weight in 4–5-year-old children: Percentage of pupils in Reception class classified as overweight or obese, by local authority, 2011/12
Map 17 – Weight in 10–11-year-old children: Percentage of pupils in Year 6 classified as overweight or obese, by local authority, 2011/12
D: Alcohol, smoking and substance misuse
Map 18 - Alcohol-related hospital admissions: Hospital admission rate for people aged 0-17 years due to alcohol-specific conditions, per 100,000 people aged 0–17 years, by local authority, 2008/09 to 2010/11 (use 'Data' button, select Section 2, D)
E: Dental health
Map 19 - Dental health: Hospital admission rate for dental caries in children aged 1–4 years, per 100,000 children aged 1–4 years, by local authority, 2009/10 to 2011/12 (use 'Data' button, select Section 2, E)
F: Immunisations
Map 20 - Diphtheria, tetanus, polio, pertussis and Haemophilus influenzae type b (DTaP/IPV/Hib) vaccine coverage at 2 years: Percentage of immunisation completion for routine vaccinations against DTaP/IPV/Hib at 2 years, by local authority, 2011/12
Map 21 - Pneumococcal conjugate vaccine (PCV) coverage at 2 years: Percentage of immunisation completion for routine vaccinations against pneumococcal disease at 2 years, by local authority, 2011/12
Map 22 - Measles, mumps and rubella (MMR) vaccine coverage at 5 years: Percentage of immunisation coverage for routine vaccinations against MMR at 5 years, by local authority, 2011/12
Map 23 - Human papillomavirus (HPV) coverage at 13 years: Percentage of immunisation coverage for routine vaccinations against HPV for girls aged 12-13 years, by local authority, 2011/12
G: Sexually Transmitted Infection
Map 24 - Chlamydia: Rate of diagnoses of genital Chlamydia trachomatis in young people aged 15–24 years per 100,000 people aged 15–24 years, by local authority, 2012


Section 3 : Child health in the perinatal period
A: Teenage pregnancy
Map 25 - Teenage conceptions: Conceptions in females aged <18 years, per 1,000 females aged 15–17 years, by local authority, 2011
Map 26 - Teenage births: Percentage of delivery episodes where the mother is aged <18 years, by local authority, 2011/12
B: Antenatal health
Map 27 - Low birth weight: Percentage of live and stillborn infants who have a birth weight <2,500g, by local authority, 2011
Map 28 - Smoking in pregnancy: Percentage of women who currently smoke at the time of delivery, by local authority, 2011/12
C: Breastfeeding
Map 29 - Breastfeeding initiation: Percentage of infants who are given breastmilk within 48 hours of delivery, by local authority, 2011/12
Map 30 - Breastfeeding at 6–8 weeks: Percentage of infants who are totally or partially breastfeeding at 6–8 weeks, by local authority, 2011/12
D: Postnatal Health
Map 31 - Postnatal health: Rate of emergency admissions to hospital of babies within 14 days of being born per 1,000 deliveries, by local authority, 2011/12
E: Preterm birth
Map 32 - Neonatal mortality: Percentage of infants born at <30 weeks' gestation and admitted to neonatal units, who died <=28 days, by neonatal network of booking, directly standardised by gestational age, 2012
Map 33 - Breastfeeding at discharge: Percentage of infants born at <30 weeks gestation and admitted to neonatal units who were receiving any mother's milk at discharge from neonatal care, by neonatal network of discharge, directly standardised by Index of Multiple Deprivation (IMD), 2012


Section 4 : Healthcare for children and young people
A: Accident & Emergency Attendances
Map 35 - Emergency attendance: Rate of attendance to Accident and Emergency departments in persons aged 4 years and under per 1,000 population aged 4 years and under, by local authority, 2010/11
B: Unplanned Hospital Admissions
Map 36 - Duration of non-elective hospital admissions: Mean length of stay (days) for non-elective admissions in children aged 0–17 years, by local authority, 2011/12
Map 37 - Zero-day admissions: Percentage of hospital admissions in children aged 0–17 years where the duration of stay was shorter than 24 hours, by local authority, 2011/12
Map 38 - Emergency readmissions: Percentage of emergency admissions in children aged 0–15 years occurring within 28 days of the last, previous discharge from hospital after admission, by local authority, 2010/11


Section 5 : Healthcare for acutely ill children
A: Bronchiolitis
Map 39 - Bronchiolitis – Hospital admission rate: Directly standardised rate of emergency admissions with bronchiolitis in children aged under 2 years, per 100,000 children aged under 2 years, by local authority, 2011/12
Map 40 - Bronchiolitis – Duration of hospital stay: Mean length of stay (days) for bronchiolitis in children aged under 2 years, by local authority, 2011/12
B: Lower Respiratory Tract Infections (LRTIs)
Map 41 - LRTIs – Hospital admission rate: Directly standardised rate of emergency admissions with LRTIs in children aged 4 years and under, per 100,000 children aged 4 years and under, by local authority, 2011/12
Map 42 - LRTIs – Duration of hospital stay: Mean length of stay (days) for LRTIs in children aged 4 years and under, by local authority, 2011/12
C: Ear, Nose and Throat Surgery
Map 43 - Tonsillectomy: Directly standardised rate of elective tonsillectomy in children aged 0–17 years per 100,000 children aged 0–17 years, by local authority, 2011/12
Map 44 - Aural ventilation tube insertion: Directly standardised rate of aural ventilation tube (grommet) insertion in children aged 0–17 years, per 100,000 children aged 0–17 years, by local authority, 2011/12


Section 6 : Children with long term conditions
A: Asthma
Map 45 - Asthma: Rate of emergency admissions for children with asthma, per 100,000 population aged 0–18 years, by local authority, 2011/12
B: Epilepsy
Map 46 - Epilepsy: Rate of emergency admissions for children with epilepsy, per 100,000 population aged 0–18 years, by local authority, 2011/12
Map 47 - Epilepsy – Duration of hospital stay: Mean length of emergency inpatient stay (days) for children with epilepsy aged 0–18 years, by local authority, 2011/12
C: Diabetes
Map 48 - Diabetes: Percentage of children and young people aged 0-24 years with diabetes cared for in a Paediatric Diabetes Unit (PDU) whose most recent HbA1c measurement was less than 58 mmol/mol (7.5%), by PDU, 2010/11

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