Northern Ireland warned it could be raising ‘one of the unhealthiest generations in decades’

Northern Ireland now has the highest infant mortality rate in the UK as paediatricians warn that worsening mental health, falling vaccination uptake and high levels of childhood obesity are creating an increasingly concerning picture of children’s health.

The Royal College of Paediatrics and Child Health (RCPCH) has described the findings as a “wake-up call”, warning that without urgent action Northern Ireland risks raising one of the unhealthiest generations of children in decades.

Its latest analysis shows infant mortality increased from 4.2 deaths per 1,000 live births in 2018 to 4.5 per 1,000 in 2024. Rates are highest among babies living in the most deprived areas, while Northern Ireland now has the highest infant mortality rate of the four UK nations.

However, infant mortality is only one of several areas causing concern.

Childhood vaccination rates have also fallen. Uptake of the MMR vaccine has declined steadily since 2020, with just 86% of children having received both doses by the age of five. Northern Ireland also has the lowest uptake of the 6-in-1 childhood vaccine anywhere in the UK.

Paediatricians are equally concerned about children’s physical health. More than a third of 11 and 12-year-olds, 34.7%, were classified as overweight or obese in 2023/24.

The picture surrounding young people’s mental health is particularly troubling. An estimated 45.2% of 16-year-olds have a probable mental illness, while reported wellbeing among 11-year-olds has fallen to its lowest recorded level since 2010.

The findings form part of the RCPCH’s State of Child Health 2026 work, which assesses children’s health using 12 indicators including infant mortality, mental health, immunisation, obesity and asthma.

Dr Thomas Bourke, RCPCH Officer for Ireland, said the findings demonstrated that too many children were being let down across a range of important measures.

He said paediatricians were witnessing the consequences in clinics, hospitals and communities, arguing that years of political instability, underinvestment and a failure to sufficiently prioritise children’s health and wellbeing had contributed to the decline.

Northern Ireland spent several years without a functioning Executive following the RCPCH’s first State of Child Health report in 2017. Over the same period, demand on paediatric services has increased, waiting lists have lengthened and inequalities have widened.

The College is particularly concerned about the relationship between deprivation and children’s health.

The higher infant mortality rate among babies living in the most deprived communities reflects a wider pattern seen across child health, where socioeconomic circumstances can influence both the likelihood of developing health problems and the ability to access support early.

That makes prevention and early intervention central to the RCPCH’s recommendations.

Paediatricians argue that identifying and supporting children earlier can prevent some health problems from developing into long-term conditions, while delayed intervention can affect not only health but education, development and opportunities later in life.

The College is calling for improvements in the quality, collection and sharing of children’s health data so services can identify problems and gaps earlier. It also wants measurable targets against which progress can be monitored and decision-makers held accountable.

Sustained investment in children’s health services and the paediatric workforce forms another major part of its recommendations, including the development of a Child Health Workforce Plan.

The warning comes ahead of Northern Ireland’s 2027 elections, with the RCPCH calling for children’s health to become a priority for the next Executive. Its manifesto focuses on investment in the workforce, better health data, stronger child health services and greater emphasis on prevention.

The individual statistics are concerning in their own right. A rising infant mortality rate means more babies are dying before reaching their first birthday. Falling vaccination rates leave more children vulnerable to preventable infectious diseases. Increasing obesity can establish health problems that continue into adulthood, while worsening mental health can affect education, relationships and almost every aspect of a young person’s development.

Taken together, however, they suggest something bigger than a problem within any single part of the health service.

Children’s health is shaped long before somebody arrives at a hospital. Poverty, prevention, vaccination, early-years support, access to community services and the availability of healthcare professionals all influence the chances a child has of growing up healthy.

The RCPCH’s latest findings suggest too many of those indicators are now moving in the wrong direction at the same time.

Northern Ireland’s highest-in-the-UK infant mortality rate may be the statistic that attracts immediate attention, but paediatricians are warning against seeing it in isolation.

From a baby’s chances of surviving their first year to the mental wellbeing of a 16-year-old approaching adulthood, the latest data points towards a much broader challenge.

The warning from children’s doctors is that waiting until those problems reach hospitals will be too late. Improving the health of the next generation will require investment in treating children who are already unwell, but also a much greater effort to prevent them becoming unwell in the first place.

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