In late February, the European Commission issued its Recommendations on Investing in Children: Breaking the Cycle of Disadvantage. In this article EPHA takes an in-depth look at the paper, highlights its main conclusions and evaluates the key findings.
26 June 2013 – Children are more at risk of poverty or social exclusion than the overall population in a large majority of EU countries. At present, out of around 120 million Europeans living at risk of poverty and/or social exclusion, 27% are under the age of 18. Children growing up in poverty or social exclusion are less likely than their better-off peers to do well in school, enjoy good health and realise their full potential later in life. For example, growing up in material deprivation is associated with greater risk of obesity and overweight, chronic respiratory diseases, emotional distress, being a victim of domestic violence or taking up such unhealthy lifestyle habits like smoking or alcohol abuse.
Early intervention and prevention are essential for developing more effective and efficient policies, as public expenditure addressing the consequences of child poverty and social exclusion tends to be greater than needed for intervening at an early age. Tackling disadvantage in early years is an important means of stepping up efforts to address poverty and social exclusion in general. Prevention is most effectively achieved through integrated strategies that include access to services that are essential to children’s outcomes, such as health, housing, food, social services and quality (pre-school) education.
The policies focusing on child poverty should improve the well-being of all children, whilst giving careful consideration to children in particularly vulnerable situations.
The promotion of gender equality and equal opportunities, as well as the fight against discrimination faced by children and their families on all grounds (particularly those related to sex or sexual orientation, racial or ethnic origin, marital status or disability) should underpin efforts to address child poverty and social exclusion.
The current financial and economic crisis is having a serious impact on children and families, with a rise in the proportion of those living in poverty and social exclusion in a number of countries.
While policies addressing child poverty are primarily the competence of Member States, a common European framework can strengthen synergies across relevant policy areas, help Member States review their policies and learn from each other’s experiences in improving policy efficiency and effectiveness through innovative approaches, whilst taking into account the different situations and needs at local, regional and national level.
Various EU policies have addressed issues linked to child poverty and the inter-generational transmission of disadvantage, in particular in the fields of education, health (Solidarity in Health: reducing health inequalities in the EU, COM(2009) 567 final), children’s rights and gender equality. Many of EU level regulations and directives are also (in)directly linked to preventing child poverty or mitigating children’s status of vulnerable citizens and customers – the Audio Visual Services Media Directive (advertising and marketing), the Regulation on Food Intended for Infants and Special Medical Purposes, the Maternity Leave Directive, and many many more from environment (air quality, chemicals, pesticides) or social sectors (minimum income, social protection, equality between men and women).
In the context of the upcoming Multiannual Financial Framework, such guidance can also provide a basis for further cooperation and a focus for using relevant financial instruments, particularly the Structural Funds, to deliver on the proposed objective of ‘Promoting social inclusion and combating poverty’.
The European Commission encourages the use of the EU funds, such as the EU Health Programme and cohesion funds to reach the child poverty reduction objective and other objectives outlined in the Social Investment Package. As such, the Programme for Social Change and Innovation, the European Social Fund and Horizon2020 should be used to support the development of more evidence-based policies and social innovation. The Fund for European Aid to the Most Deprived, the EU School Fruit and the EU School Milk schemes should be fully exploited – however, we would advice them to be focused more on healthy and nutritious food provision as an alternative to the current produce provided. Use the Structural Funds and the European Regional Development Fund 2014-2020 to support children and their families. In addition, we would see an under-used potential for the European Rural Development Fund to strengthen relevant infrastructure and services necessary for better addressing of child and family poverty, social exclusion, regeneration of deprived and under-served areas and transition from institutional and centralised to community-based and led services, and various determinants of health at population level. These include in particular early childhood education and care, access to services of general interest (healthcare and social services), food, rural infrastructure or participation.
The Recommendations advise that Member States organise and implement policies to address child poverty and social exclusion, promoting children’s well-being, through multi-dimensional strategies guided by:
- going beyond ensuring children’s material security and promoting equal opportunities so that all children can realise their full potential;
- addressing child poverty and social exclusion from a children’s rights approach, making sure that these rights are respected, protected and fulfilled;
- maintaining an appropriate balance between universal policies, aimed at promoting the well-being of all children, and targeted approaches, aimed at supporting the most disadvantaged;
-* ensuring a focus on children who face an increased risk due to multiple disadvantage such as Roma children, some migrant or ethnic minority children, children with special needs or disabilities, children in alternative care and street children, children of imprisoned parents, as well as children within households at particular risk of poverty, such as single parent or large families;
- sustaining investment in children and families, allowing for policy continuity and long-term planning, and assessing how policy reforms affect the most disadvantaged and take steps to mitigate any adverse effects.
Integrated strategies should be developed based on three key pillars:
1. Access to adequate resources by supporting parents’ labour participation as a mean to ensure adequate children’s living conditions; However, moving families out of risk of poverty and social exclusion would mean putting more emphasis on child-centered policies and measures to create decent working opportunities, flexible working hours on decent pay, paid parental leave, adequate family benefits and income support. It would be advisable as well to re-phrase current rationale of “investing in children” so as to purely “ensure the next working generation kept productive”. Good quality childhood is a moral imperative and not purely a cold economics-driven rationale.
Similarly to other child poverty NGOs, we are concerned about the issue of (punitive) conditionality of benefits that would depend on educational outcomes or parents’ labour participation. Parents and families should qualify for benefits according to the needs of the children, and as such should not be additionally punished for discriminating labour market (gender or ethnic background) or educational system.
2. Access to affordable quality services by investing in early childhood education and care, improved education system, improved responsiveness of health systems in order to address the needs of disadvantaged children and reduce inequalities. The recommendations urge Member States to ensure that all children can make full use of their universal right to health care, including through disease prevention and health promotion as well as access to quality health services.
More specifically in the field of healthcare, the Commission recommends to:
- address the obstacles to accessing healthcare faced by children and families in vulnerable situations, including costs, cultural and linguistic barriers, lack of information; improve the training of health care providers in this respect;
- invest in prevention particularly during early childhood years, by putting in place comprehensive policies that combine nutrition, health, education and social measures;
- tackle the social gradient in unhealthy lifestyles and substance abuse by giving all children access to balanced diets and physical activity;
- devote special attention to children with disabilities or mental health problems, undocumented or non-registered children, pregnant teenagers and children from families with a history of substance abuse.
In addition to focusing on access to healthcare services, given the fact that healthy lifestyle choices of children and their parents are made in the contexts given to them, EPHA would suggest a greater focus on enabling health-promoting environments in which a healthy choice – whether for diets, physical activity, tobacco-and alcohol-free – is an easy choice. With this regard, also a specific remark has to be made as for advertising and marketing environments targeting vulnerable consumers such as children, parents of your children, single parents and families of lower socio-economic status. Preventive healthcare services and health promotion activities should be responsive towards improving socio-economic-commercial determinants of early childhood health outcomes. We value very much a recognition of children’s right to health in a form of universal access to primary healthcare services that are available, affordable and of quality. Also, we value an acknowledgment of a link between deprivation and ill-health (physical, mental and social). Health risks caused by and associated with deprivation via channels of malnutrition (under- and over-nutrition), energy and fuel poverty, poor housing and physical environmental conditions require urgent and coordinated actions.
Laying within a broad spectrum of social determinants of health, safe, adequate housing and living environments should be indeed given greater priority if any comprehensive and sustainable progress on child poverty reduction is to be made. Overcrowding, indoor and outdoor air quality, insecurity and crime, road injuries, environments deprived of opportunities to access cultural, sport and other enriching experiences – all negatively impact on children’s health and well-being outcomes.
To enable messages made in this specific part of the recommendations, EPHA advocate for development of an EU-wide Child Health and Well-being Strategy.
3. Children’s right to participate by supporting their participation in play, recreation, sport and cultural activities. These areas are also of great importance to promote children’s social inclusion and social development, empowerment in matters related to their civic and democratic participation. As such we firmly believe these refer to socio-economic determinants of people’s health.
EPHA seconds a recommendation to strenghten synergies across sectors and improve governance arrangements in order to ensure that policies effectively address child poverty and social exclusion through comprehensive design and enhance coordination between key actors. In fact, we strongly recommend to place children’s well-being at heart of all policies at national and EU level.
With regards to governance issues, we very much appreciate efforts made by these Recommendations to urge the Member States to evaluate the impact of temporary policies introduced in response to the economic crisis before deciding to make these policies part of any structural reforms. To this end, development and monitoring of the health-specific child poverty indicators through a beyond-GDP approach would be advised.
Last but not least, EPHA would like to work further on strengthening the proposed indicator-based monitoring framework for child-poverty reduction, in particular with regard to health-related items such as:
- child deprivation;
- self-declared unmet need for medical care;
- obesity and overweight;
- tobacco smoking (primary and second-hand);
- food and nutritional insecurity;
- advertising and marketing to children;
- children of Roma and migrant backgrounds and their access to the health, social and educational systems (non-documented);
- integrated primary health and social services that put a child and a childhood at heart of their regular preventive interventions and care.
EPHA related articles
Report on the EP seminar ‘From Rhetoric to Action – Tackling Child Poverty and Promoting Children’s Health and Well-being in the EU’