According to Unicef, the first 1,000 days of life – the time spanning roughly between conception and a child’s second birthday – is a unique period of opportunity. This is when the foundations of peak health, growth, and the brain’s development of pathways that influence performance or function such as intellectual functioning, reading ability, social skills, memory, attention or focus skills are established for life.

Surrey Heartlands Health and Care Partnership has chosen to make the first 1,000 days of life a focus of its work to remove health inequalities. In particular it plans to take greater account of what are known as the Wider Determinants of Health – a diverse range of social, economic and environmental factors which impact on people’s health

In addition, two national reviews – the Marmot review and the Dame Carol Black review – have highlighted the huge economic costs of failing to act on the wider determinants of health. As well as being influenced by individual and genetic factors, social, economic and environmental differences have a wider impact on life chances for parents, children and families.

It is well established that inequalities result in poor health, social, educational and economic outcomes and trap many of the most disadvantaged people in a cycle of deprivation. It is only by addressing inequalities and supporting children and their families, that the younger generation can break out of this cycle of deprivation and achieve their potential.

Dr Claire Fuller, Senior Responsible Officer at Surrey Heartlands, said: “The likelihood of developing poorer quality health, life expectancy and so on – even if we in health did everything perfectly with no delays – would only ever affect 20% of someone’s health profile.  The remaining 80% is down to what we term the ‘wider determinants of health’ such as housing, the environment, poverty and education;.

“To truly create a healthier population we need to tackle all these elements and we can only do that with health and social care working in partnership.

“Another really interesting statistic is that if a child enters school with what is known as a health inequality – obesity is a good example – this gap is likely never to close.  So if we are to create a long-lasting legacy for our population, we need to focus on the first 1000 days and so this has become one of our key priorities.”

Our Women and Children’s work stream have used the strong evidence base on what can make an impact during the first 1000 days, to offer a menu of options for organisations within the partnership to focus on – so areas such as reducing smoking, promoting smoke-free areas, making sure children are prepared when they go to school and supporting looked after children to have the best outcomes. These also reflect national and local priorities for continued improvement across health and social care.