Child health inequalities and 'wilful blindness'

Heather Henry bridges the gaps between a broken community.

This is a story of a divided semi-rural market town and how children and young people were ignored. This is the story of how I helped children’s voices to be heard. It's a story of shame.

Ignored young person
Picture: iStock

It starts with statistics. I was invited, as part of the Exeter University’s ‘Connecting Communities’ programme, to undertake some asset-based community development by the clinical commissioning group and the district council’s public health team. They provided a needs assessment showing 32.8% of the children lived in poverty. Drugs, alcohol and domestic abuse completed the misery of the young.

Uncovering the truth

Undertaking a walkabout with local people, I wondered why on earth I was here. Two listed buildings, a charming town square and even an independent brewery. But the thigh-high weeds, closed shops and derelict housing told me more. This town was riven with prejudice: the tenants and residents, the young and old and even people on each side of the picturesque river were at war with each other.

I helped volunteer residents and service leaders to organise a public listening event and the townspeople flocked in. We asked: ‘What's good about the town?’ We only got a few replies to this. But then we asked:  ‘What's not so good?’ Ideas written on sticky notes flooded in and I sorted them into themes. Then everyone got up to place dots on the theme they thought was most important. All hell broke out.

The most popular issues were about housing, transport and the environment, but a rebel group of disadvantaged mothers had found spare dots and were voting en masse for activities for children. They were immediately demonised.

Action taken

The residents formed a partnership with local services to take forward the priorities that emerged from the listening event. I raised the issues of child poverty and domestic abuse, but I was ignored. It was a dark secret they didn't want to see.

Then I met the new youth council. They told me how some young people were afraid to go to the shops alone because their peers bullied them. There was a group of overseas students living in the town and they told me adults in the street racially abused them. I reported this to the police.

The youth council and I decided to hold children and young people's listening event. We had a stall at the Christmas fair and invited children to decorate cakes and biscuits with icing and place wishes for their future on a ‘wishing tree’. We all wore bright yellow T shirts with slogans such as ‘Stop Bitching: Start Talking’. We were as public about the prejudices of the town as we could be.

This community was ‘wilfully blind’ to the needs of the young; prioritising instead the issues of the adult majority. With the exception of the children’s centre and a few mothers who stood up and were ignored, these children had no voice and no importance. Disadvantage was being passed down the generations.

I wrote a report for the youth council, then helped them secure a spot on the town council’s agenda where they would present the report themselves. The spectacle of the town’s children speaking up for themselves was a sight to see. They wanted more sports, more fun and they didn't want to be bullied. They were hard to ignore.

Immediately the townspeople set about fixing up the playground: nailing things back in place, trimming and sweeping. Slowly I saw the ‘Tweenies Disco’ and ‘stay and play’ become permanent fixtures. Progress remains slow but steady.

Sometimes it takes someone like a nurse to help the young to hold up a mirror so adults can see themselves more clearly. The confidence that public health nurses can inject is better than any medicine.


Margaret Heffernan on ‘wilful blindness’

Royal College of Nursing (2016) Inequalities Experienced by Children Across the UK Accessing the Right Care, at the Right Time, in the Right Place

About the author

Heather Henry

Heather Henry is an independent public health nurse, Queen’s Nurse and co-chair of New NHS Alliance


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