Introduction

The common needs of children have been recognised in the United Nations (UN) Convention on the Rights of the Child and accepted within the policies and legislations of almost all countries. The Convention and the UN Millennium Development Goals (UN, 2006) emphasise the importance of global commitments to ensure that all children will be able to enjoy:

• • freedom from poverty and inequality

• • shelter

• • adequate nutrition

• • health

• • education

• • family and social care

• • protection from war, violence, abuse and exploitation

• • cultural and religious rights.

Yet there are enormous inequalities between countries and regions and within countries in children's life chances (WHO, 2005; 2008; UNICEF, 2005; 2006; 2007a; 2007b).

Many children live in enviable conditions where income, environment, housing, health and education allow them to achieve their potential and enjoy a good quality of life and well-being into old age. Other children experience harsh and brutal conditions, where life is an endless – often losing – struggle for survival. This variable picture needs to be understood in all its complexity if policies and services are to be effective in laying the foundations for health in childhood. Throughout the chapter, health and well-being will be seen as inextricably linked, related to the optimum developmental needs of children. The contribution of social work to health and well-being in childhood depends on a multidisciplinary analysis, within a strategic, inter-agency context.

This chapter will consider major differences in life chances for children. It will argue for holistic approaches, seeing children's needs and rights in the context of their families, social and cultural groups and wider environment. The consequences of wide-ranging policies, for example economic, defence, trade, immigration, housing, health and education, need to be explored as well as narrower more individualised policies. Such policies can ameliorate or aggravate the consequences of inequalities.

The European Health Report (WHO, 2005, p ix) argues that ‘the inequalities in children's health are unacceptably large, and overwhelmingly affect the countries, societies, communities, families and children with the fewest resources to cope with them’. Even within affluent countries, poverty is the greatest threat to children's health, with lifelong consequences. Poverty may arise from underdevelopment, wars, natural disasters, and political and economic problems.