The Health Survey for England in 2020, tracking children’s health for 30 years

Background Prior to their inclusion in the Health Survey for England (HSE), there was a dearth of information about children's health in England. Official data recorded use of health services and uptake of national programmes such as school vaccinations. Birth cohorts provided longitudinal data, including risk factors and non-clinical measures, but were spaced far apart due to cost. The annual HSE has been tracking child health since 1995 and the health of older adolescents (aged 16-19) since the surveys began in 1991. The survey uses a multi-stage design to deliver a nationally-representative random probability sample of the general population in private households in England. Over 110,000 children aged 0-15, and 16,000 16-19-year olds have been interviewed since 1995 and 1991 respectively. Questionnaire content has varied, but includes general health and longstanding conditions, smoking and drinking, fruit and vegetable consumption, physical activity, respiratory problems, childhood diabetes, and parental perception of strengths and difficulties. Regular measurements include infant length, height and weight, blood pressure and cotinine levels. Results As well as general monitoring overall and across socioeconomic groups, e.g. height, weight and obesity, HSE data have been used to infer the impact of government policies on child- and adolescent-health, e.g. changes to smoking legal age, advertising, and the smokefree law. This presentation describes in more detail the sample, measurement protocols, questionnaire, published results and research-policy case studies such as the smoking ban. Novel results using the full sample as a synthetic cohort, tracking BMI, smoking, drinking, and general health, are presented for the first time. Conclusions Child health monitoring, in terms of trends, inequalities and policy evaluation; is enhanced by regular surveys representative of the general population, which include both subjective and objective measures.