Growing up in poverty: Rats, cockroaches and mould

A report shared with the BBC reveals how wealth inequality in north-west England is having a devastating impact on children's health.

"Lauren" is from Merseyside and has children with respiratory problems, which doctors fear are being made worse by where they live.

"I wake up in the night and hear rats squeaking in the cavity walls and then find their droppings on the toys."

The government says it's "determined" to address health inequality.

"Lauren" - who does not want to be identified - and her children often cram into their sitting room to sleep, because one of the two bedrooms has mould.

"If you stand in the garden, rats will just run past. They're quite big and roam about like they're wild cats."

She's spent years trying to be relocated by her registered social landlord, but so far has been unsuccessful, and she says she can't work because of her children's health problems. At the same time, rising living costs mean she now struggles to afford "basic stuff like fruit".

"I just feel like I'm letting the kids down. It's heart-breaking. I'm screaming for help and it just feels like a dead end."

'Children should not be growing up in poverty'

Sir Michael Marmot's All Together Fairer review, exclusively shared with BBC Two's Newsnight, has exposed the widening regional health inequalities across Merseyside and Cheshire, saying it has areas of "substantial wealth and substantial deprivation".

While disparities have always existed and successive governments have tried to address them, the report says they have increased following a decade of austerity policies, the Covid pandemic and now the current cost of living crisis.

Lead author and Director of The University College London Institute of Health Equity (IHE), Sir Michael, says: "There have been three major threats to health inequalities in recent history. The Chancellor's announcement is a step forward to dealing with the cost of living, but it doesn't deal with the other two problems.

"It's not about throwing money at it. It's saying children should not be growing up in poverty,"

Figures estimate the borough of Knowsley on Merseyside has the highest levels of poverty in England, with one in four households income-deprived, and while Cheshire East is relatively affluent, 36% of people who live there are estimated to be living in poverty.

"We've got a good grasp of how poverty damages health," says Sir Michael "Business can make a difference to workers' health. Pay every worker a living wage and improve the conditions of work, reduce stress and long working hours.

"We want access to better food. At the moment to eat healthily there is a huge cost disadvantage. Cheap food tends to be 'calorie-dense' and less nutritious, which promotes obesity."

The review will inform local health officials as well as bodies like NHS England.

"We are determined to address the long-standing health disparities that exist in many areas of England, including Cheshire and Merseyside," said a government spokesperson.

Data commissioned exclusively for Newsnight by the IHE estimates nearly 1.5 million more people died earlier than they should have between 2011 and 2019, because of avoidable health inequalities.

The most deprived groups were believed to be five times more likely to die earlier, compared with the wealthiest ones. The high number of deaths during the pandemic have not been included in the analysis, to avoid skewing the data.

'Cockroaches will crawl over their baby'

Research shows that growing up in poverty means your home, the food you eat and even the air you breathe are more likely to cause you harm, and may even shorten your life.

The Marmot review says improving health equity would ensure "every child is given the best start in life" and "one of the most significant ways that healthy and sustainable places and communities can be forged, is through good-quality housing".

A leading consultant respiratory paediatrician at Alder Hey Children's hospital in Liverpool, says the majority of patients he treats come from deprived backgrounds, and often live in inadequate housing.

"There is a clear link between poor lung health and poverty, and it begins in childhood," says Dr Ian Sinha.

"When children breathe dirty air, particularly in confined housing where they spend a lot of their time, it causes problems within the airways, so the lungs don't develop as they otherwise would.

"You have a window of opportunity for lungs and airways to grow so children enter adulthood with good respiratory health, but once you miss that window, it's gone. What happens to children by nursery is going to programme what they're like for the rest of their life."

The Liverpool District is estimated to be the second most deprived local authority in England.

Liz Parsons manages the Picton and Kensington Children's Centre. After concerns about rising cases of bronchiolitis - a chest infection which mainly affects babies - mothers who previously used the children's centre have been trained to educate new parents about the warning signs - this is the type of community work the Marmot review recommends, to help narrow the health inequalities gap.

Ms Parsons, who is also a Labour Councillor for Norris Green, says: "We have lots of old Victorian terraced houses, so they can be cold and damp at the best of times. We have lots of families who are living with overcrowding and they don't have access to green spaces, so clean air isn't readily available. It's the perfect storm for creating issues.

"We have families that can't put children on the floor because cockroaches will crawl over their baby. We have families who have got rats in their house and can't put their children down safely to sleep. That's not an extreme. It's the normal situation for a lot of our families."