Rory Hearne: Children’s well-being is deeply affected by economic inequality. This is linked to, and results from, inadequate public expenditure on public services like health and education and wider economic inequalities in Irish society, such as income and wealth. In this blog, the second of two blogs dealing with Children and Economic Inequality in Ireland, I look at inequalities relating to health and housing and also some causes and potential solutions relating to reducing child inequality.
The first part of this blog can be read here: The Profound Impact of Inequality on Children in Ireland
There are strong links between economic inequality and children’s health outcomes. For example, the proportion of infants in the bottom decile born with a low birthweight (7.5%) is double the proportion of the highest decile (3.82%) while children in lower income deciles suffer more from chronic illnesses than higher income deciles (see Chart below).
At age just three years of old children in the bottom decile have a 10% higher rate of being overweight than the top decile. Obesity rates for the bottom decile are double those at the top.
Ireland’s two-tier health system exacerbates economic inequalities for children; those reliant on the public health and hospital system face long waiting lists for certain treatments and high costs (e.g. dental, various pharmacy medicines) while those who can afford to pay privately (or for private health insurance) can access timely and more extensive treatment and health care. This is shown by the figures where at aged three, 8% of children in the lowest income decile did not get medical treatment because they were still on a waiting list compared to 3% in the highest income decile. Furthermore, households with children in the highest income decile spend almost eight times as much on medical expenses (including private insurance) as those in the lowest income decile.
Housing inequalities also have a number of significant impacts on children. At the most extreme end of housing inequality, being homeless can have a deeply profound impact on the life of a child. Homelessness can cause immediate risks in terms of safety and physical health but also raised levels of anxiety, socio-emotional problems, family relationship stress, and impacts on educational development.
Insecurity of tenure (facing threat of eviction and being in mortgage or rent arrears) can have similar impacts, as can the impact of financial stress on a family as a result of high housing costs. Substandard housing conditions (dampness, mould, unsafe environment) can also have detrimental health impacts on children. They can also affect a child’s self-esteem, self-worth and ability to form friendships.
Public spending, services and child inequality in Ireland
Public investment in early years care (childcare and early education) amounts to less than 0.2% of GDP in Ireland. The average for OECD countries is 0.8% and the UNICEF international benchmark is 1% of GDP. Ireland ranks relatively high among OECD countries in the percentage of GDP spent on cash and tax breaks on family benefits, accounting for about three-quarters of total expenditure in this area (which benefits more higher income earners who can avail of tax breaks).
In contrast, Ireland ranks thirteenth out of thirty-three OECD countries in terms of the proportion of GDP spent on public services for families. The Nordic countries spend a significantly greater proportion (half) on services and they achieve much lower rates of child poverty.
There has been an increase in investment in early years services in recent years however, major challenges of affordability of quality childcare remain.
An important area to begin addressing child inequalities is investment in early years care and education, prevention and early intervention. The multiplier of investment in such ‘early year’s human capital’ runs between seven and 16 times. For example, thirteen area based prevention and early intervention (ABC) programmes in disadvantaged areas in Ireland to combat child poverty have resulted in significant improvements in child educational and wellbeing outcomes (although there is no funding allocated for this programme after the middle of next year).
The evidence suggests that Ireland needs to further develop high-quality universal public services for children and families that can guarantee greater equality for all children in the areas of health care, childcare, social housing, education (ensuring all levels are free and equally accessible), social work, family support services, and these area-based childhood anti-poverty programmes. A greater focus is also required on targeted interventions for children and families who suffer extreme forms of inequality e.g. children in poverty, in lone parent households, children with special needs and disabilities, Traveller and Roma children.
To address child inequalities also requires that children’s socio-economic human rights are fulfilled and placed at the centre of policy development ensuring adequate economic protection, equality and the participation in decisions that affect them and that children are empowered to have a voice in their own home lives and wider community and society.
Ultimately, to reduce child inequality and poverty requires tackling the root causes of economic inequality including market income and wealth inequality (which are more marked in neoliberal, marketised, economies like Ireland), deprivation, and inequalities relating to employment, education, health, housing, socio-cultural capital, and socio-emotional wellbeing, amongst others.
Improvements in overall levels of child wellbeing, therefore, require dramatic reductions in economic inequality. More equal developed countries have mitigated inequalities through their ‘societal commitment to greater equality’.
Reducing our current grossly unequal levels of income and wealth to ensure more balanced incomes and wealth across society is fundamental to this. This means ensuring a living wage and quality jobs and greater support for low income parents such as lone parents.
Ireland’s social, economic and state institutions and systems reinforce and reproduce economic inequalities that have extremely detrimental impacts on children, particularly (but not exclusively as inequality affects all groups in society) those from lower-income backgrounds.
Our current level of child inequality is unfair, unethical, morally unacceptable and reduces the human potential, wellbeing and ability to flourish for a substantial proportion of children in Ireland. As a consequence, it reduces the long-term potential and ability to flourish of our entire nation.
Reducing child inequality in Ireland is achievable but it requires a significant shift in policy to
make it a central political, economic and social priority.
You can access the full report here:Cherishing All Equally 2016
Dr Rory Hearne is a senior policy analyst with TASC and co-author (with Cian McMahon) of Cherishing All Equally 2016, Economic Inequality in Ireland.