The best start in life? Vital for tackling health inequalities

Bump2Baby and Me is an innovative healthcare intervention, designed to coach mums at risk of gestational diabetes mellitus (GDM), through the upstreaming of service delivery, to help provide the best start for mum and baby. But how will it also help reduce health inequalities?

The best start in life is widely accepted as important for a child’s development. What happens in these early years, starting from conception and carrying on postpartum, has lifelong effects on many aspects of health and wellbeing. But it is also vital to ensure that EVERY child has the best start in life.

Differences in socio-economic status have a crucial role in determining how healthy we are. In England, the more deprived the area you live in, the more likely you are to die younger [1]. This is no different to the likelihood of having GDM during pregnancy, with links between weight gain and those most disadvantaged including socio-economic status [2].

When we look at obesity in Bump2Baby’s intervention trial countries (UK, Ireland, Spain and Australia) all, barring Spain, have higher adult obesity rates than the average for developed countries. And these rates are only expected to increase further [3]. When we look further at the link between obesity rates and those of the poorest communities, the evidence is clear, the poorer you are, the higher the rate of obesity, but more alarmingly the faster the increase [4].

So why does it matter and where does Bump2Baby and Me fit in?

Sir Michael Marmot in his worldwide recognised report ‘Fair Society Healthy Lives’ outlined the importance of pre and postnatal interventions in giving every child the best start in life [5]. This is particularly key around support for families to improve the health and wellbeing of mothers and thus their babies. Put simply, universal support to families will especially help those from the poorest communities and reduce health inequalities.

Since 2010, when Marmot produced his report, there has been a significant change in the way we use mobile apps in everyday life. More importantly, this increase has been seen across socioeconomic groups, with usage averaging to 96% of all adults, increasing to 99% in adults below the age of 44 [6].

In a world that has been forced into reflection by the ongoing COVID-19 crisis, the way in which we deliver healthcare services will be part of that reflection. The new virtual reality we currently find ourselves living in has never been more reliant on technology.

Policymakers have a unique opportunity to tackle these health inequalities by using technology. Bump2Baby and Me has the potential to level up the delivery of services during pregnancy. By using an app, focused on coaching women, our project will be able to reach individuals of all socioeconomic backgrounds by delivering a pre and postnatal intervention. It will support women to help them ensure the best start to their pregnancy journey, reduce their risk of GDM, and give every child the best start in life.

by Mitchell Salter