A new social contract - empowering parents, strengthening community support, and backed by bold state action - is how we stand a chance of building the “healthiest generation of children ever”.

🙏 to co-author @sebrees1.bsky.social and @impurbanhealth.bsky.social for their generous support.

/ENDS

So if govt is serious about its shifts prevention & community care, it has to break the silence on family life.

See our infographic below - there is so much untapped potential, aligned to families own preferences, in this top right quadrant 👇

Of course, some forces dwarf what families can do alone.

Parents say tech companies and the food industry have more influence on children’s health than the NHS.

Digital harms, food environments, squeezed incomes and working conditions all powerfully shape family life.

That political squeamishness leaves parents unsupported.

1 in 3 felt unprepared to care for their child’s health when they became a parent.

A third didn’t attend any antenatal education (despite 2/3s of those who attended wanting more and 8 in 10 wanting classes postnatally).

Policy often tiptoes around the family.

Politicians often fear being seen to blame parents or interfere in family life.

But this conflicts with what parents themselves told us: they feel immensely responsible for their children’s health and want more support to tend to it.

Our survey of 1500+ parents and focus groups across England shows parents are the hidden frontline of the child health system.

And this is more true now than ever - with the NHS under pressure, more are turning to ‘Dr Google’, costly private options or ‘DIY’ support.

The biggest health successes for young people (eg teenage pregnancy, smoking) happened when govt helped to shift everyday habits and social norms.

And as the providers of the vast majority of the daily care children receive, families are a huge part of the solution.

But this report shows it’s also a failure of approach.

Policy reaches for the most visible, easy-to-pull levers - more services, more treatment - instead of grappling with the huge social, economic and cultural shifts reshaping modern childhood.

In our last report - Fixing the Foundations - we argued this was partly a failure of sustained attention.

⏱️ the benefits of investing in children arrive decades later
🗳️ children have no vote
❗️politics gravitates to the visible, urgent and adult

www.ippr.org/articles/fix...

Successive govts have pledged to improve children’s health for decades.

Yet despite billions in investment, outcomes are stagnating - or getting worse.

(Check the latest childhood obesity stats - published a fortnight ago - for a case in point)

Thank you Adam!

Comment below, DM me or email me or Anna (Director of Policy and Impact) at: amy.gandon@demos.co.uk or anna.garrod@demos.co.uk.

We'll then be in touch where there are ideas to take fwd together to refine + iterate if we *really* want to 'rewire the state'.

(Chris Wormald are you listening... 👀)

So, the next bit is over to you. Answers on a postcard please.

👉 What resonated?
👉 What didn't? What have we got wrong?
👉 What can we practically do to address these issues?
👉 What thinkers / practitioners can help us?

We offer some of the potential directions we could take to tackling them in the paper...

BUT MOST IMPORTANTLY: we're sharing them while they're still emerging - in the spirit of the reforms we argue for - in the hopes that you'll join us in a dialogue on where we go next.

These all might feel like immutable features of our system of governance, or the pace and sensationalism of our media cycle and political culture.

But there are mature approaches to coping with these kinds of environments from management science and other sectors, from healthcare to aviation.

5️⃣ Politics is impatient for quick, legible results.

40 hospitals, 20k policy officers, 50k nurses. Headlines are better generated by things which are countable, or quick to bear fruit.

The reforms we need - i.e creating better relationships between service and citizens - are not so visible.

4️⃣ There is a bias towards standardisation and simplicity.

Faced with complexity, humans also prefer 'neat and tidy' solutions: scaling local innovations to a standardised national programme vs. embracing adaptive, uneven or 'messy' growth.

But often the latter is what works best.

3️⃣ The sheer scale of Whitehall fosters tribalism.

Beyond a certain level of complexity, humans sort people into 'ingroups' and 'outgroups'.

The trouble is that our systems currently promote greater loyalty to dept colleagues than others w/ a shared mission (in other depts or on the frontline).