How to use misleading statistics in a bid for government funding - the LGA and public health at their finest

Terrible:

Council chiefs have warned of a ‘childhood obesity crisis’ as new figures reveal that the number of young people being treated for Type 2 diabetes has increased by nearly 50% in five years.

Not the statistic but the spectacularly misleading way in which this scary paragraph is framed. It is, I'm afraid, an absolute classic of the public health scare story genre - guaranteed to get media coverage but utterly deceptive.

So let's look at the numbers:

Figures from the Royal College of Paediatrics and Child Health show that 745 children and young people under the age of 25 received care for Type 2 diabetes in Paediatric Diabetes Units in England and Wales in 2017/18.

The first point here is that we're not talking about children here - unless we've begun categorising those aged 18-25 as children? Of the cohort in question (under 25 years old), a third -32% to be more precise - are adults i.e. aged over 18. Some of them may be obese and may have Type-2 diabetes but using these figures to claim an increase in child diabetes is simply wrong.

And that cohort? There are 17.4 million of them meaning that the 745 who have 'received care' for Type-2 diabetes represent a massive 0.004% of the population. There may have been an increase since 2015 of 50% but this is still not in any respect a crisis (except perhaps for the individuals most of whom will be over 18). Even with the more inflated Diabetes Association estimate of 7,000 under 25s who have received support for 'diabetes-related' conditions, the problem still only affects 0.04% of the cohort.

There has been a trend in public health using secondary factors to substantiate proposals for either new regulations, new taxes or more local government funding. Mostly this is because there's not really any evidence that child obesity is rising:





That's from King's College - here's the latest from the NHS itself:



Again no indication that child obesity is rising (indeed it has fallen for children arriving in primary school). So public health look for other statistics to peddle their hysterical fussbucketry, most commonly statistics like these on Type-2 diabetes that, while interesting, suffer from a whole load of flaws (changes in referral practice, greater awareness of symptoms, new centres and facilities to support diabetes) that mean the increase could be entirely unrelated to changes in the number of obese children and relate more closely to better diagnosis and more provision in the NHS system - both good things but no justification for advertising bans or bunging millions for local councils to splurge on useless obesity programmes.

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"Aren't all these kids supposed to be fat?" Why the Government's child obesity strategy is wrong

Every lunchtime Parkside school opens its gates and disgorges starving pupils onto the streets of our village. Long queues form outside the chip shop and the butcher - wise locals hunker down until these hungry young people are gone. A day or two ago, someone commented to me about these queues - "you know," she said, "aren't these kids all supposed to be fat?"

Indeed, to listen to the fussbuckets we put in charge of our health services and the media who, without even a glance at any actual evidence, publish those folks' nannying proposals, you'd think that near every child was a barely mobile lard-bucket unable to do anything but plonk before a screen. The truth - at least from watching those queues is that you've got to work pretty hard to find a fat child. I'm sure they're there, just as they were there when I was at school. I'm even prepared to believe that, like the population in general, there are more chubby kids than back in the 1970s (when, incidentally, we consumed more sugar than we do today). But it doesn't look like a crisis to me.

All this hasn't stop a host of fussbuckets, urged on by a couple of celebrity chefs with brands to promote and books to sell, from deciding that they know better - either by targeting so-called "junk" food or else by creating a moral panic about the food industry. At the heart of all this is the idea that parents - especially working-class parents - are unable to resist promotions:

"It is near impossible to shield children from exposure to unhealthy foods"

So says Jeremy Hunt, the Secretary of State for Health. Let's examine this little sentence and extract its meaning. Firstly is creates the idea of an 'unhealthy food' when this is an entirely evidence-free assertion - there are no unhealthy foods, only unhealthy diets. Secondly, the statement exploits our innate desire to protect children - "shield" suggests that the child will be damaged by the very act of seeing a chocolate bar, a fizzy drink or a burger. Yet all these things are both pleasurable and healthy, consumed without risk by children and adults most of whom are not obese.

I try to understand why it is that we've created this moralistic stampede about eating? Part of me suspects that it's influenced by upper middle class snobbery about food, typified by David Cameron's old advisors Camilla Cavendish and Claire Foges. But there has to be more - as consumers we look for excuses to explain away what we think are poor choices. The result is the overuse of words like 'addiction' to describe a lack of willpower rather than a pathological condition. Plus, of course, the belief that we wouldn't have bought all that chocolate, eaten all that pizza, stuffed our faces with cake if it hadn't have been for capitalism and its evil minion advertising.

When we see the countline bars lined up by the checkout, we know exactly what the retailer is doing. That shops wants to upsell us, add a little more value to the purchase we're making - essentially free margin. If we succumb, it is not because the retailer has made us buy but because we've made a choice to add that Snickers to our shopping basket. Thousands of other customers successfully ignore the line up of sweet goodies and negotiate their purchase without adding a bag of doughnuts.

This doesn't stop the fussbuckets - "...parents find offers for sugary sweets and snacks at checkouts annoying" says Jeremy Hunt. I beg to differ. If parents really were annoyed then there'd be enough consumer pressure on the retailers to change the practice - that they haven't tells me that parents are only 'annoyed' when some poll asks whether they are annoyed.

The same goes for advertising. It's an easy target. You've heard it said - "if advertising didn't work, they wouldn't spend so much money on it. It's common sense that advertising bans will work." Not only is this a complete misunderstanding of what "works" means for the advertiser but it also raises some profound questions about whether we should ever be justified in banning commercial speech for entirely healthy products. It bears repeating that advertising doesn't act to raise aggregate demand either across the economy as a whole or for individual categories of good (even "addictive" ones like tobacco, beer and sugar).

Advertising works by maintaining or increasing levels of market share - we don't buy bread because of an advert featuring Haworth Main Street to the strains of Dvorak, we might buy Hovis because of that advert. When you see the Rolex advert on the Wimbledon scoreboard, you are reminded of the brand and, when you next buy a wristwatch, might consider that brand. And when Tony the Tiger roars "they're grrreat" in a Frosties advert, he's increasing the chances of you buying Frosties rather than competing products promoted by cartoon monkeys or large yellow monsters. Banning advertising serves no purpose other than to say "look we've done something" and, the more of it we ban, the more we undermine the media that require the advertising to keep afloat.

If there's a child obesity crisis (and I'm completely unconvinced) then we should look at why this is happening rather than lollop about bashing things to make us look popular - sales promotions, advertising, calorie information, cartoon characters. Let's ask some sensible questions instead like:

Why, when average calorie intake in the UK has fallen, are we on average heavier?

What has changed in every day environments that may contribute to this increase in average weight (hint - it's not advertising, checkout promotions, two-for-one offers or cartoon characters as these were all around when we were skinnier)?

What aspects of consumer behaviour have changed over this time - more eating out, grazing not set meals, time-pressured working women?

When we look at the reduction in smoking - in health terms a far more serious issue than a modest increase in obesity - the two factors that seem to be most important are good quality health information (today everybody knows smoking is bad for your health) and price. It seems to me that making food more expensive wouldn't be popular - VAT on food anyone - which is why we have this idea of 'good' and 'bad' foods. The problem is that taxing foods high in fat, sugar and salt either runs the risk of clobbering everything but leaf vegetables and chicken or else leads to substitution (if you can't get your calories from Mr Kipling's cakes, you get them from Mr Warburton's bread).

This leaves us with public information - telling people what a healthy, balanced lifestyle means and allowing them to make choices armed with this knowledge. This worked for smoking, has largely worked for alcohol and could have the same impact on diet. The problem is that a great deal of the anti-obesity campaigns are driven by low carb cranks rather than by seeking a consensus view from dietitians. I suspect, however, that this advice should boil down to: eat regular meals, avoid snacking, have a balanced diet including meat, veg and stodge, don't eat too many sweets. Essentially what our mums told us back in the 1970s.

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"What's the point of a Secret Club if it doesn't have a Secret Fort?" Building child-friendly cities.

Or at least the rose-tinted suburbs of my youth. As a seven-year-old, I walked with my sister to the bus stop at the end of The Glade, got the 54 bus across town and walked up Foxgrove Road to school. On our own. When I wasn't at school, we'd tramp cross country (if you call the allotments, Monk's Orchard Primary playing fields and Elmers End Cricket Club 'country') exploring all the exciting things that a boy could find in that little chunk of South London suburbia.

In the other direction were Long Lane woods and what we called the golf course (it used to be one but was just open land between Bywood Lane and Addiscombe). Across the Main Road were the old sewage works - we weren't supposed to go in there but we did - that are now South Norwood Country Park.

They were happy days. The world - at least this child's world - was a happy one.

So yes, let's start building cities for children not childless, boring grown-ups:

Everyday freedoms refer to children’s ability to travel safely on foot or bike and without an adult in their neighborhood—to school, to a rec center, to a park. The “popsicle test,” in which a child can walk from their home to a store, buy a popsicle, and return home before it melts, is one way to measure this ability. Children’s infrastructure means the network of spaces and streets that can make a city child-friendly and encourage these everyday freedoms.

And let's remember this isn't just about parks and playgrounds but about the marginalia of suburbia, the little bits of scrub land, the borders between schools and playing fields, the paths of streams - places to explore, discover and adventure. Remembering that child wants you only when they want you - this was the best line is a very bad film I watched recently - "What's the point of a Secret Club if it doesn't have a Secret Fort?"

Right now we're cramming ever more 'housing units' into ever smaller spaces, recreating the hard, grazed-knees world of back-to-back terraces facing straight onto cobbled streets. We're forgetting the importance of the child's world, forgetting that it starts close to home and spreads as far as that child is brave enough to venture:

The most effective interventions are implemented at the hyperlocal level. Think front yards and neighborhoods. “On average,” the authors write, “[spaces in front of homes] make up at least 25 percent of a city’s space and have the greatest potential to encourage everyday freedoms and social interaction.” Focusing on the very local also means that more children can access the interventions.

Definitely. Make cities child friendly. Or maybe, I dunno, build suburbs again?

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Clean, green, child-friendly and joyful - why we need more suburbia

I wrote recently about our confused, often negative relationship with suburbs and the idea of suburbia:

So why is it that we have such a problematic relationship with suburbia? How did a suburban boy like Simon Schama come to use 'suburban' as an insult, as a way to dismiss someone he disagreed with and felt, in some way, beneath his attention? And when did we start the fetish of the city - the dirty, crowded, unsafe, unfriendly, child-free city? A fetish that, frankly, is something we (perhaps secretly) despise - what we hanker for is suburbia.

I feel that this attitude is damaging society by supporting the idea that somehow suburbs are places without soul or even worse, places that are environmentally damaging, socially divisive, mere creatures of our car-crazed culture. Suburbs are a sin:

In all, that suburban form of homogeneity, orderliness and spacing was an outward response to internal desires for security and control. But there was a cost to such an approach. Namely, the texture of life. Because sameness breeds sameness, which breeds stasis—hence, the “soulless” suburb moniker that has come to permeate the pauses in between suburban praise of “good schools,” “abundant parking” and “safety.”

Inside this desire is something else. Yes, it's to do with safety, comfort and good schools but it's also about space to live. And this is the reason why so much of the New Urbanist, city-focused planning and development approach is problematic. We might be building places suited to people in one stage of their lives but those folk don't stay in a sort of city living, Peter Pan world of endless youthful fun. Mostly because there comes a point in many people's lives when youthful fun isn't fun anymore.

Suburbs are essential if cities are to succeed rather than turn into rapacious parasites sucking the life from rural communities while the 24-hour party people become ever richer in their unhealthy, child-free towers:

For the first time in the history of the Western world, the one-person household has become the dominant mode of living. In Manhattan, New York City’s most densely populated borough, more than half of all homes have a single occupant.

Now I'm sure most of these single-person households are perfectly happy but there, niggling away in the back of my mind, is a question as to whether this really is ideal living. What we do know is dense urban environments in the developed world are increasingly child-free. Here's Aaron Renn, who lives in that child-free Manhattan:

The values and priorities of people without children are different from those with children. One example is the value people put on space. In our central cities populated with largely people who have no children, a big obsession is changing zoning regulations to allow smaller units, including so-called “micro-apartments.” These kinds of developments would enable more upscale young adult singles to live in cities. That’s good in itself. Yet it is not paired with equal concern about creating more housing for families.

When you look, for example, at the recently published (draft) London Plan - 2kg of turgid prose interspersed with nice maps - you see that, far from addressing the sort of concerns Renn raises, the Mayor simply sees housing as a numbers game with the solution being to build the little boxes on top of each other rather than next to each other. In places - Grove Park, Eltham, Southgate, Chiswick - that were once filled with family homes (with gardens), we can expect ever taller accommodation blocks suited to the frenetic, solo life lived by so many young Londoners. All this is intended to avoid taking anything out of the precious 'green belt', to not build new suburbs but crowd the ones we've got.

The attacks on suburbanisation - as typified by that London Plan - continue. Witness the responses to the damage done by Hurricane Harvey in Houston. We're told (by New Yorkers) it is the Texan laissez faire approach to development that made things worse:

For years, the local authorities turned a blind eye to runaway development. Thousands of homes have been built next to, and even inside, the boundaries of the two big reservoirs devised by the Army Corps of Engineers in the 1940s after devastating floods. Back then, Houston was 20 miles downstream, its population 400,000. Today, these reservoirs are smack in the middle of an urban agglomeration of six million.

Terrible! Suburban sprawl at its worst - we need denisification, zoning, strict enforcement. Or do we?

Houston’s dispersed, multipolar form, notes MIT’s Alan Berger, may have helped it respond more effectively to Harvey; the city has no central point, like Manhattan in New York City, whose closure damages the entire region. If we accept that more Harvey-like events are possible, even probable, then the most important issue is not zoning but flood control, which requires resilient systems.

So sprawl ain't so bad after all. Indeed, it might just be a good thing. Let's start with a look at South London. This is part of Beckenham, the suburb where I was brought up (my old primary school is featured as is the house where Mary Finnegan - and David Bowie - lived):



The striking thing about this image is the presence of so many mature trees and so much undeveloped space (OK planners, I know you call a garden development). Across the vast acres of London's suburbs this is the norm - even in Croydon. Suburbia is a lot greener - and more environmentally sustainable - than most urbanists and planners credit:

“We’ve all grown up thinking that urban density and verticality is a good thing but there has never been a study that has really looked at this in any detail; they’ve all been generic studies, based on large sets of generalised data. So we thought we should undertake a more focused study to prove it. And the results have been quite the opposite to those we thought we would find.”

And what did they find?

The high-rise residents energy consumption was 27 per cent more per person than the suburbanites, and even per average square metre of space, consumption was 4.6 per cent higher. Remarkably, the suburban homes involved not only had a typically larger floor area and greater surface-to-volume area (e.g. higher ceilings, roof cavities, etc.), they were also wooden-framed and significantly older – nearly 100 years old on average.

Some of the greater energy use in the high-rises was due to the lifts and the lighting and heating of common spaces and amenities. But on the “embodied energy” (in construction and materials) measure, the high-rise buildings required 49 per cent more embodied energy per square metre, and 72 per cent more per resident.

Piling people up in tall towers feels like better land use but it turns out to be the wrong idea if we want a more sustainable urban environment as well as some children (and let's not get started on safety). And, if you're concerns are about social sorting, - planners are always on about mixed tenure and social mobility after all - densification is again a bad idea:

One important point that needs to be taken into account when studying this phenomenon, is just how steeply “exclusionary” a city is “by location”. It has often been noted (e.g. by the authors of the “Costs of Sprawl 2000” study) that the higher house prices are (e.g. expressed by a median multiple) in the entire urban area, the stronger the “drive to qualify” effect. Chicago is actually significantly cheaper in all housing options than Australia’s main cities. Explicit anti-sprawl growth boundary policies exacerbate this “spatial sorting by income” effect, inevitably forcing up the price of all urban land and housing of all types in all locations.

It seems that, far from suburban sprawl being a bad thing, it is instead pretty much essential if we want sustainable cities. Urban containment policies everywhere have failed (check out Auckland's homelessness, London's beds in sheds and Seattle's inward migration crisis) but despite this planners are still churning out strategies for cities based on 'green belts' and urban densification. The reason for this isn't because we want to protect environments but rather because we've convinced ourselves that suburbs - sprawl, to use the pejorative term - are unpleasant places filled with dull people.

We need to change our thinking and rediscover the joy of suburbia not just because suburbs are great but because not building them is making our cities less sustainable, more crowded, unfriendly to children and shockingly expensive. So let's start with a correction on the environment - here's one of the editors of Infinite Suburbs:

One of the consistent themes in the book, and what gets me most excited as a landscape scholar, is the virtue of low density and the ecological potential of the suburban landscape. Environmentally, suburbs will save cities from themselves. Sarah Jack Hinners’s research in the book really surprised me. It suggests that suburban ecosystems, in general, are more heterogeneous and dynamic over space and time than natural ecosystems. Suburbs, she says, are the loci of novelty and innovation from an ecological and evolutionary perspective because they are a relatively new type of landscape and their ecology is not fixed or static.

Yet - and these editors observe this - the planning and development profession still "overwhelmingly vilify suburbia and seem disinterested in significantly improving it. Robert Bruegmann’s essay in the book reminds us that those who consider themselves the intellectual elite have a long history of anti-suburban crusades, and they have always been proven wrong."

Much of the NIMBY argument - albeit from people already in suburbs - is made easier by the willingness of planners to argue that dense urban development will work. We've got to a stage where words like "brownfield" and "regeneration" dominate the case made by the likes of CPRE rather than the reality of that case as 'we don't want any more houses round here' and little else. This urban redevelopment argument (and it is one of the five purposes for the UK's 'green belts') acts as cover for a policy that is responsible for much of London's housing crisis.

I can understand how someone who has enjoyed a field view for years might be put out by it being replaced by an estate of family housing (and I know how developers like to push the country aspect - one development in Cottingley had hoardings with a picture of horses proclaiming "meet the new neighbours") but I also feel that we shouldn't let such sensitivities dominate the system to the point where:

Around 9,000 illegal “beds in sheds” housing tens of thousands of people have sprung up across London over the last five years, a report says today.

Do we seriously think that protecting someone's open view across a not particularly special field should prevent us building the homes we need to prevent people ending up in cramped flats or on a bed in a drafty wooden structure down the end of an inner city garden? Especially when building tower blocks is expensive, environmentally-damaging and unsafe?

It is time to get less precious about those fields, to end planning micro-management of housing delivery and to get back to the sort of build rates we saw from the private sector in the 1930s (when lots of those lovely London suburbs were built) - touching 300,000 in 1937/8. Suburbs are great - you can call them what you like, even 'garden cities' - and we need more of them. The best way to do this is to put the planners back in their box and let people get on building the homes they (and we) need.

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Quote of the day: On hanging out

Fast food shops provide a place for kids to hang out:

Having saved the children from the perils of walking to school and active play we are surprised that they are fat. In fact I suspect that half the appeal of fast food joints to schoolchildren is not the food per se; rather it is the chance to hang out with their friends and make minor decisions about what they want to do next without adults looming over them.

At my school we weren't allowed (below sixth form) to leave the grounds at lunchtime. Each day a precious few passes were granted to fifth formers - we could, if we secured one of these passes, go as far as Crown Point (about 400 yards from the school gates) where there was a convenient cafe.

The other part of the quote is just as pertinent - children have few opportunities to be children, everything has to be managed, organised, supervised and monitored. The idea of just going out to play has gone. Worse still, we tend now to treat children just hanging out as pretty much anti-social behaviour.

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Children in cities

I've observed before that cities aren't designed for children. And that this is something of a problem if we are to become a more urban society. Indeed there are some people out there trying really hard to rediscover play in our hard-edged and adult city spaces like Emma Bearman's Playbox in Leeds. There's still a problem, especially in the biggest and grandest cities, and this from Aaron Renn sets it out:

These global cities are where the culture is made, where the media are, etc. To the extent that they represent a very atypical demographic profile that largely excludes families with school-aged children, this only perpetuates the “bubble” in which America’s leadership class often lives. The values and priorities of people without children are different from those with children. One example is the value people put on space. In our central cities populated with largely people who have no children, a big obsession is changing zoning regulations to allow smaller units, including so-called “micro-apartments.” These kinds of developments would enable more upscale young adult singles to live in cities. That’s good in itself. Yet it is not paired with equal concern about creating more housing for families.

I've a feeling - it's just that as I've not dug around for evidence - that densification, the process Renn describes above, makes having a family less likely and more difficult. The successful, well-educated London couple living in a great little rented apartment in Shoreditch or Stockwell will have a pretty decent life - good money, plenty of social life and a plethora of little consumer pleasures. They know, however, that having a family means leaving the heart of the city. Here's Renn again - speaking as a new father in New York's Upper West Side:

...it’s hard not to notice that while there are lots of very young children here, there are far fewer school aged ones. I don’t have any desire or plans to leave, but I have to recognize that children have a way of changing your priorities. Realistically, most people with school-aged children still seem to move to the suburbs. Those I see raising older kids in the city are generally well-off enough to afford large apartments or even single family homes (in cities like Chicago). They can also either pay the premium to live in a high quality neighborhood school zone or pay the freight for private schooling.

In some of these great cities we make matters even worse because of the deliberate limitation of housing development through such things as zoning and green belt. Not only is raising a family in the city open only to the very rich (who have the cash) and the poor (who often have no choice) but increasingly the same goes for suburbia. This semi-detatched round the corner from where I was brought up now sells at about £450,000:



Maybe that's affordable to our hypothetical successful and well-educated London couple but I suspect the truth is that most of such people see this perfectly ordinary semi in an average South London suburb as beyond their means (not least because they'll probably need £45,000 cash deposit). So they stay right where they are putting off have children for another year, hoping for another promotion or a great new job that will make the family possible. And because there are fewer and fewer children, there are fewer and fewer facilities for those children. Why set up a ball park or soft play zone when there are no children to use it. Worse still those adults in the city without children resent the noisy intrusion and attention grabbing of children - even to calling for them to be banned from pubs and restaurants.

I don't want to change cities particularly. Central London was never all that child-friendly and I guess the same goes for Manhattan and San Francisco. But we create a problem if we see the great city as the model for everywhere - dense, crowded living, unsafe public spaces, congestion all leavened with 'culture'. Near every local planning document will talk about increasing housing density which means smaller gardens, more flats, less open space, narrower pavements and smaller rooms. All things that make bringing up children more difficult. The cities don't care - they're just importing the next generation of workers from other places and other countries - but, for all their finery and beauty cities like this are mistletoe, parasites on the productive, healthy apple tree of society. Good to kiss under but not not much else.

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Is this the new suburbia? And should we worry?

From City Lab comes an article about Urby who build high density apartments in New York suburbs (Staten Island, Jersey City, Stamford):

Barry says that at least 80 percent of Urby tenants are under 39, don't have children, and expect to stay for perhaps three years or so; he calls them “starter apartments.”

I get everything that Urby are doing - it's straight out of the New Urbanist playbook with densely packed accommodation near transport hubs meaning less parking. Assumptions about modern living argue for less storage or common storage (bike rooms and so forth) and, because there are a lot of single people, planned for entertainment:

...Urby employs a cultural director with a nightclub and hospitality background and deputies to organize activities for residents. There might be stump-the-chef or other paid event in the kitchen, standup comedy in the cafe, and flower arranging in a workshop room. “It’s a boost,” Barry says, “to help people in this demographic connect to each other—and make them feel more emotionally connected to the brand."

What we see here is an interesting shift in how we (or some of us) live. People leave home and live in shared student accommodation while at college. There next move is to the new style shared living (or, as we're already seeing in London, Manchester and Leeds as well as in many US cities to a world where student apartments become 'student and young worker' apartments) and then to something slightly more private like this suburban Urby development. Note that people are still single or at least haven't committed to a family and are 'under 39' - these are career-focused thirtysomethings we're talking about.

The question here is what happens next. Urby don't tell us where their former tenants move onto - is it family units of some sorts or are they simply earning more so can afford a slightly more swank address? More to the point is this where we're heading for suburbia in big cities? A sort of slightly more funky version of the crammed urban towers of downtown living. Millennials living in what sounds like a younger version of elderly retirement living.

I've said before that housing design in inner urban places is persistently anti-child built without thought to the young and where space for kids to roam simply doesn't exist. Yes we can build playgrounds, tidy little places tucked into corner spaces where the very young can be watched at play but the old suburb with gardens, greens and recreation grounds is lost, cities simply aren't great places for ten-year-olds. Yet every planner talks now about ways to cram more and more into less and less space. People's worlds are becoming directed and organised even down to what happens in free time.

It does seem at times that this dense city living is a dead end despite its appeal and the manifest wealth of these places. But if the cramped world of modern apartment living is now spreading to suburbia, should we be bothered? Isn't the whole point of the suburb that it gave space, openness and the chance for a family to grow while still being reachable from the centre of the city. If suburbs become indistinguishable from the city then the world those ten-year-olds once enjoyed becomes only available to the wealthiest in the big city and those who opt for a less fancy, less well-paid life somewhere else. On balance we should be bothered - it shouldn't be a choice between a good rewrding job and the chance to raise a family. Right now it seems that it is.

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Let's ban stuff (or how not to get people's vote)

Today appears to be public health day in the election diary which means that we've proposals from the Labour Party to ban stuff:

"We are going to apply the rules currently applied to children’s TV and apply that to TV more generally, so when you’re sat down with your children, as I do, watching X Factor or Britain’s Got Talent, you’re not going to be seeing adverts for junk food,”

Apparently there is "research that children see the adverts for McDonald’s and hassle their parents to go there". And, of course, parents are incapable of resisting. Like zombies they rise from the sofa at nine in the evening (after Britain's Got Talent with all the wicked advertising has finished) and, as if in some drug-induced trance, take the pestering children to McDonald's, KFC or whatever else was advertised during the latest piece of cash generation for the Cowell empire.

We are, unlike the sort of wise person who becomes a Labour front bench spokesperson on public health, completely captured by advertising, snared by the subtle webs of influence that cunning marketers weave around their products. There is no escape. We are doomed to a life entirely driven by the content of prime time advertising. Like puppets we bounce along to the tunes of neoliberal hegemony as presented by crafty copywriters who force - yes, force - us to consume, consume and consume again.

Research has shown this. That sociologist friend of the Labour Party front bench spokesperson says so and who are we to argue with the author of masterworks whose titles drip with stuff about 'neoliberalism'. Parents everywhere will flock to the party's banner knowing that they will be rescued from their children throwing a tantrum because they've said 'no' to a sugar, fat and salt stuffed snack.

This is easy politics - "for the children" screeches the Labour frontbench spokesperson and the media joyfully laps it up, wraps it in a comfort blanket of "we should do something", and then wheels out all its friends from the public health industry to support the proposals. Action on Sugar, Campaign Against Salt, Fuss About Fat - legions of publicly funded cheery souls pop up on TV and radio sternly explaining how if we banned advertising everyone will suddenly be thin as rakes and healthy as the butchers dog (except we're not allowed red meat any more because that will give us cancer).

Let's get some things clear here.

Advertising does not raise aggregate demand (however loudly kids shout)

People have agency (we don't have to buy stuff just because it's on telly)

Obesity isn't caused by eating sugar (or fat)

Salt is not bad for you (it's an essential nutrient - without it you die)

Obesity - or smoking or drinking - isn't the reason for the NHS funding crisis (quite the opposite)

Banning adverts means less money for TV companies to make programmes you like

Neoliberalism is a word made up by idiot sociologists

Voters are fed up with being bossed around (hadn't you noticed yet?)

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Voluntary bans - smoking and the power of tutting!

Oxford City Council has just rolled out its 'voluntary ban' on smoking in children's play areas across all of its 87 such places. This follows a three month trial in three parks. The coverage reports that stickers have been placed at the sites advising parents not to smoke - for the sake of the children, of course, because ASH have said that second-hand smoke is bad. Even on a windy September morning. And even when the playground is a few yards from a busy road filled will fume-spewing diesel motor vehicles.

This is a voluntary ban as the resident fussbucket (or, if you prefer, Council Board Member for Leisure, Parks and Sport) puts it:

"It's something we need to keep an eye on.

"I don't think a PSPO is necessary at the moment; it's just asking people to respect other users and respect the children playing."

A bit of a warning there, I suspect, as the councillor invokes the "do as you're told citizens or we'll have to take sterner action" approach that we love so much. Right now the signs have all the enforcement power of tutting and a bit of side-eye and, I guess, the Council wants to enlist the self-appointed school gate enforcement team.

Most parents will probably abide by the advice, mostly for the sake of a quiet life, but I think the response from one hints at a growing appreciation of the smoking issue:

Alex Thomas, a father-of-three from Botley, said: "I suspect it's a good idea in terms of encouraging children not to see smokers as a norm."

But the 34-year-old said he 'wouldn't mind' if he saw people smoking in play areas, adding: "I think it's entirely their right.

"There are enough places smokers aren't allowed to smoke and if a parent needs a cigarette to get through an hour in the playground on a cold November day, fair enough."

Well said Alex. Shame that public health bosses seem unable to summon anything like this degree of respect for other humans.

....

Ban everything, ban it now. For the children.

Back in early 1970s South London, I used to drag my self from bed, throw on clothes and some breakfast down my gullet, get on my bike and cycle to Elmers End News. Where, as generations of children before me had done, I picked up a bag of newspapers and shoved them through a load of doors. As it happens the round I did took me back over the railway bridge and past the cricket club (holding my nose at the stench from the paint factory and tannery) almost to home. I then got into my school uniform and cycled to school in SE19.

There was nothing unusual about all this, it was what loads of other children did. For sure there were some who had other jobs - milk rounds, serving in shops, washing cars at the garage, helping on a market stall. But children worked. In my case it was simple - once I was 13 and could get a paper round there was no more pocket money (as an aside my last pocket money amount was 12p).

Apparently all this wasn't a useful exercise in self-organising and an introduction to work but an offence to my rights:

Turning to newspaper delivery rounds, it said that “allowing children to work before school begins in the morning is, in principle, contrary” to the charter, because it puts at risk their “attendance, receptiveness and homework”.

This 'charter' is the European Social Charter (and before you all get anti-EU on me, this was signed by the UK in 1961 long before we joined that awful organisation) and it has apparently been captured by the 'wrap children in cotton wool' school of thinking along with the deranged idea that making children do anything is some sort of imposition rather than an education.

We live in a world where parents are told that just beyond their sight is a terrible dark place filled with stranger danger, with poisonous plants, with trees that might be climbed, with bicycles ridden dangerously without brakes down steep hills. The idea that an eight year old could safely walk half a mile to a bus stop, get on a bus across town and walk another few hundred yards to school - on his own (or with his nine-year-old sister) would horrify both our fussy authorities and most modern parents. Yet that is what I did every day of school - as did many other children.

And the idea that it infringes a teenager's rights to do an hour's work before school (so as to get a little money for the teenager to spend on sweets, comics, games, trips and records) is such manifest nonsense it makes one wonder what sort of weird old world the people who sit on the European Committee on Social Rights inhabit. I do know, however, that what we see is people who respond to everything they dislike with proposals for a ban, for restrictions, for controls. Instead of an exciting world for children to explore, these people see a world from which children must be protected. Until that day, after the hangover has passed from the 18th birthday party (although our social rights fascists almost certainly disapprove of drinking), when blinking and naive the fully fledged grown up is thrown into that big ole world to make his or her own way.

We damage children more by 'protecting' them, restricting their play, limiting their chances to learn about work and managing their social interactions to the extent that they become stultified, the very antithesis of fun. Everywhere we go there are signs designed to close off the world from children - don't climb trees, don't go on the grass, don't play ball games, don't run, don't sing, don't cross, don't do this, don't do the other. There are no signs that say please play here, have fun, take a risk or two, swim, run, laugh and dance.

Instead we see people who behave like the Childcatcher from Chitty Chitty Bang Bang - corralling children into a dull, purposeful programme of approved activities monitored by the agents of those authorities. Much of the effort here is dedicated to creating obedient little unchallenging conformists. And what we create are a bunch of snowflakes who demand safe spaces, who cry at criticism and who would rather ban free speech than accept that some people are unpleasant or rude. Disagreement is dealt with not through a handshake and "we'll talk about this again" but by one or other party running off to cuddle a teddy bear while listening to calming whale sounds.

"Ban everything, ban it now - for the children" is one of the most corrupting approaches to social policy ever. It creates weak-willed, dependent people who believe they've some sort of right never to be challenged, never to be upset and certainly never to be offended. And it is used - again and again - to control both the transition to being a grown up and to stop grown up people from doing things of which the controlling authorities disapprove. Don't drink - for the sake of the children. Don't smoke - the children, you know. Don't eat fat, salt or sugary foods - think what you're doing to the children.

None of this protects children. All it does is reinforce again the process of creating supine, subservient masses who, in the manner of Huxley's 'Brave New World', gladly accept authoritarianism - "for the good of the children".

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Nine out of ten teachers don't think energy drinks contribute to poor pupil performance

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I've never drunk a whole one of those energy drinks. I had a sip of a Red Bull once and can safely say 'never again' - it made Coca Cola (which I detest) seem appealing. But I understand that they're popular with a lot of people (popular enough for the leading brand to splash millions on racing cars), which has - as night follows day - led to calls for action. For the children of course:

Children are using energy drinks as “legal highs”, making them hyperactive in class, teachers have warned as they called for more restrictions on the drinks.

The NASUWT teaching union is working with the drug charity Swanswell to examine the consumption of drinks such as Red Bull, Monster and Relentless. 

We have here an example of 'teachers say' as justification for a ban or other form of control. The NASUWT research is a poll of teacher opinion not an assessment of fact (nothing wrong with this of course but it does result in 'teachers say' being put on the same footing as 'a properly constructed scientific study has found'). And the worst thing about the reporting is that the researched opinion of teachers is different from what the NASUWT and their 'drugs charity' partner are saying - 87% of teachers do not hold the opinion that children are using energy drinks as "legal highs".

A survey by the NASUWT of around 3,500 teachers found that 13 per cent thought that the excess consumption of caffeine was contributing to poor pupil performance.

There are a whole bunch of reasons why children perform badly at school but most teachers don't see Red Bull as one of them. 

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No English child, not even the very poorest, lives in "Victorian condidtions"

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The airwaves have been filled with that traditional Easter refrain of teacher trade unions moaning about their lot. And amongst this has been a 'report' (I can't find it on their website so no link) from the NASUWT about child poverty. From the media reports this work is a collection of anecdotes from NASUWT members - pretty useful given that these are men and women at the 'front line' who undoubtedly are seeing examples of neglect and poverty in the children they are teaching.

But comments like this are quite simply misleading:

"Children in 2015 should not be hungry and coming to school with no socks on and no coats - some children are living in Victorian conditions - in the inner cities," said one unnamed teacher.

Now I know the term 'Victorian conditions' is simply a hyperbolic description but we really should recognise that, even for the very poorest in our society, life is vastly better than it was for the poor of England's 19th Century cities. Here's American writer Jack London (yes, the same bloke who wrote 'Call of the Wild') on East End slums:

The streets were filled with a new and different race of people, short of stature, and of wretched or beer-sodden appearance. We rolled along through miles of bricks and squalor, and from each cross street and alley flashed long vistas of bricks and misery. Here and there lurched a drunken man or woman, and the air was obscene with sounds of jangling and squabbling. At a market, tottery old men and women were searching in the garbage thrown in the mud for rotten potatoes, beans, and vegetables, while little children clustered like flies around a festering mass of fruit, thrusting their arms to the shoulders into the liquid corruption, and drawing forth morsels but partially decayed, which they devoured on the spot. [9-10]

London reports in detail on the slums including such practices as renting 'part of a room' and the letting of beds to three tenants for eight hours apiece. And the chances for children in these places - certainly compared to the circumstances of the children described by NASUWT members - were a different order of deprivation:

They die like flies, and those that survive, survive because they possess excessive vitality and a capacity of adaptation to the degradation with which they are surrounded. They have no home life. In the dens and lairs in which they live they are exposed to all that is obscene and indecent. And as their minds are made rotten, so are their bodies made rotten by bad sanitation, over-crowding, and underfeeding. When a father and mother live with three or four children in a room where the children take turn about in sitting up to drive the rats away from the sleepers, when those children never have enough to eat and are preyed upon and made miserable and weak by swarming vermin, the sort of men and women the survivors will make can readily be imagined. (from Arthur Morrison's 'A Child of the Jago')

Yet we persist in trying to suggest that child poverty in England today is in someway comparable to these conditions, to playing an exaggerated sensationalist game of poverty pornography.

Child poverty in parts of Lancashire is as bad now as it was in Victorian times, a councillor claimed today.

Coun Brian Rollo, who represents Preston’s most deprived ward Ribbleton, said “shocking” figures of up to 38 per cent of youngsters living below the poverty line show Britain has hardly moved on from the end of the 19th century.

The reality - and we should remind ourselves of this every time we discuss relative poverty - is that the 'poverty line' described by Cllr Rollo describes a level of material comfort that hardly anyone in Victorian England enjoyed. It's not just the free education, free healthcare and benefits system but the triumph of 100 years investing, innovating and creating. Radios, televisions, cars, running hot and cold water, central heating systems, an abundance of cheap food (so abundant that plenty of folk want to make it more expensive) and cheap clothing.

This isn't to deny poverty - the lack of what we see as essentials remains a problem and a challenge - but it is to say that the conditions in which the very poorest children live are vastly better than the circumstances of children in Victorian England.

Questions to which the answer is "no": "Are e-cigs a gateway drug"

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This should be seen as brilliant - only 4% of US teens now report having smoked. This is a dramatic switch and the reason for it is vaping, the e-cig. Yet the people reporting on the finding are now trying to suggest that somehow children vaping will, once their hooked on nicotine, switch to good old-fashioned cigarettes:

Twice as many teenagers are using e-cigarettes than conventional smoking with fears this could potentially lead to an addiction to nicotine.

The findings have raised concerns that e-cigarettes - widely viewed as harmless to health - might act as a 'gateway' to tobacco.

The study, based on surveys of 50,000 students in 400 secondary schools in the US, is the first sign among this age group the use of e-cigarettes has surpassed the use of traditional tobacco products, researchers claim. 

Let's be clear about one thing here - there is precisely zero evidence to support the suggestion from these 'researchers' that e-cigs "might act as a 'gateway' to tobacco", In fact the evidence tells us that the reverse is true - people who have used tobacco are switching to vaping.

Almost one-fifth of smokers who try ECs once go on to become regular users. ECs may develop into a genuine competitor to conventional cigarettes. Government agencies preparing to regulate ECs need to ensure that such moves do not create a market monopoly for conventional cigarettes.

There's no reason to believe that the situation with children will be markedly different from adults. But even if children are opting for vaping rather than smoking this has to be significant in terms of general health benefits. So why is it that researchers - and newspapers like the Daily Mail - persist in trying to suggest that e-cigarettes and vaping are somehow a gateway to smoking smoking? Even when Action of Smoking and Health (ASH) tell us this ain't so?

'Nicotine can be harmful to the growing brain so it's best if young people avoid it. But if they're going to experiment it's better to use e-cigarettes as vaping is far less dangerous than smoking and much less addictive.

'So far in the UK and the US, smoking rates are going down more than e-cigarette use is growing. This would not be the case if vaping really were a gateway into smoking.'

 ....

In which research shows (again) that I'm right and Bradford Council is wrong about hot food takeaways?

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Bradford Council recently - along with other councils - introduced some supplementary planning guidance on hot food takeaways. This guidance included a ban of such establishments within 400m of schools, youth clubs, parks and places where there might be 'young people'. This is, we're told, part of the City's 'obesity strategy'.

The Conservative Group opposed the policy (I would add that the Liberal Democrats, not to be outdone by Labour proposed an even more frightening set of controls, licenses and rules governing everything from the calorie content of the food down to the wages of the employees). This opposition was on the grounds that there really isn't any evidence supporting such a ban. The Local Government Association and one or two other bodies cite some research in Cambridge looking at adult commuters as justification - this is for a ban based on reducing obesity in children. To give Bradford's Director of Public Health her due, she agreed with me on the lack of evidence and suggested that perhaps this wasn't the best strategy.

So despite the lack of evidence, the Labour leadership of the Council still introduced the policy - more-or-less on the basis that the lack of evidence didn't matter because it was for the children.

Today I read - via Chris Snowdon - of some research conducted at Leeds Beckett University that comes to the following conclusion:

The research study, led by Leeds Beckett childhood obesity expert Dr Claire Griffiths, measured the exposure of over 13,000 children in Leeds to supermarkets, takeaways and retail outlets in three relevant environments – their home, their school and their commuting route. These environments were then used to estimate the association between the food environment and the child’s weight status.

Results from the study, published today in the International Journal of Behavioural Nutrition and Physical Activity, revealed that there was no evidence of an association between the number or type of food outlets and childhood obesity in any of these environments. Additionally, there was no evidence of an association between the proximity to the nearest food outlet from the home or school and childhood obesity.

So we have a planning policy that has no evidence to support it - none at all. Yet is will be used to stop people opening new businesses. Moreover - and importantly - the study wasn't just looking at takeaways but at all food outlets, at the so-called obesogenic environment. And they found no link between any environment and childhood obesity.

Perhaps Bradford needs to rethink its obesity strategy. Perhaps by focusing on the problem - people who are seriously overweight - rather than trying to deny pleasure to people who don't have a problem.

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Secret courts protect social workers not children...

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There may be a case for having secret courts - I can't right now think of what that case might be but someone made it and we have them. And if we are talking about being offended, then we should be offended by the government hiding behind children in order that we can't know what they are doing or saying.

A grandmother was hauled out of a comedy show and arrested on the orders of a family court judge – simply for hugging her granddaughter.

Kathleen Danby, 72, was sentenced in her absence to three months in jail by the secretive Court of Protection in April after a judge heard she embraced the vulnerable girl, 19, against the wishes of social services.

So, without any right to a defence or any warning an elderly woman has been sentenced to time in jail. I'm not concerned here with the merits or otherwise of the case but with the wrong that is imprisoning someone without their knowledge or them being able to defend themselves.

It seems to me that these cases - filled with people old and young who can't be named 'for legal reasons' - are an offence to justice. And the only beneficiaries from the secrecy are the social workers. The reason why secret courts exist is to allow social workers and other local authority staff to prosecute their actions free from scrutiny. As a local councillor - in theory a 'corporate parent' to these children social workers are 'protecting' through the secret court system - I am unable to challenge the work of those who, in theory, work for us 90 Bradford councillors.

The secrecy, protectiveness and evasiveness of social workers involved in these cases results in many people mistrusting - even fearing - social services. People make jokes that involve the social worker as some sort of bogeyman, a child snatcher who will drag little Johnny off kicking and screaming at the drop of a hat. And when you read reports such as the one above, it's easy to see how the prejudice of social workers and the courts destroys lives and wrecks families. It may all be for the best but we don't know and what little seeps out from the secret courts doesn't inspire confidence that they act in the interests of children rather than the interests of social workers and local councils.

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There is no evidence linking sports sponsorship with children drinking

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A few days ago "...a group of medical leaders, public health campaigners and health charities" wrote to The Guardian calling for the banning of sports sponsorship by drinks companies:

Our children deserve a better future and we must take the opportunity to give it to them. Self-regulation of alcohol advertising isn’t working when it allows drink brands to dominate sporting events that attract children as well as adults, creating automatic associations between alcohol brands and sport that are cumulative, unconscious and built up over years. Evidence shows that exposure to alcohol advertising leads young people to drink more, and to drink at an earlier age.

The lead signatory of the letter was Professor Sir Ian Gilmore perhaps the UK's leading temperance campaigner and a man who has never knowingly missed the opportunity to exaggerate, embellish and invent statistics to promote his mission to limit, perhaps to prohibit, drinking. And our natural instinct to protect children is a high value trump card to the likes of Sir Ian.


So - given that drinks brands have been advertising their brands on the shirts of football, rugby and cricket teams for a couple of decades, we'd expect there to be more teenage boozers drinking more alcohol. The problem is that this isn't true (pdf see page 122):

Thirty two per cent of young people reported having had an alcoholic drink. This represents a significant drop-off from LSYPE1, when 55 per cent of young people reported having tried alcohol. This fall appears to have taken place across almost all groups of young people.

This comes from a detailed longitudinal study by the Department for Education which makes it pretty reliable as evidence. So over the period when drinks brands have been sponsoring high level sport the consumption of alcohol by children and young people has fallen by around 40%. This suggests that Sir Ian and his pals have absolutely no evidence to support their argument. Not that this makes any difference to them using the argument.

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Giving your teenaged daughter a drink won't make her a drunkard

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A single glass of wine or beer at the age of 14 can push a young teenager along the path to binge drinking, say scientists. 

So begins the Daily Telegraph's report on some research into the psychological factors in adolescents that might predict whether they become "binge drinkers" at sixteen.  The thing is that this isn't what the researchers are saying. They aren't arguing that if you allow your fourteen-year-old daughter a half glass of champagne on New Year's Eve she will become, in short order, a raging alcoholic. Yet that is what is being implied here.

The research (or rather what is being reported) tells us that the researchers have a jolly model based on a series of 'personality' factors that has a 70% chance of predicting that a given young person will be 'binge drinking' at age sixteen. Now my gut instinct is that, like lots of psychological metrics, the model is deeply flawed. However, if we accept what it is saying, it is still a pretty blunt instrument that will both fail to identify young people 'at risk' and also identify young people who aren't 'at risk'.

Finally, we are having all population solutions - don't let your child drink - proposed for what is clearly not an all population problem. Indeed, although the size of the whole study cohort (2,000) is given we have no idea how many of the young people surveyed actually drink. We know that over 80% of adolescents don't drink at all and that most of those who do drink, don't so so dangerously. So even with the study's broad definition of 'binge drinking' (based on self-reported drunkenness) the numbers involved are likely to be very small. The certainty of the findings has to be questioned given these numbers (plus the likelihood of young people overstating consumption).

It is useful to study adolescent development and, clearly, risk-taking behaviour could be a predictor of many things (some good like being future innovators, creators and entrepreneurs) but to argue that giving a child a drink will "push" them into binge drinking is a complete misrepresentation of the research.

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Cinderella's vengeance...

When the bridal couple walked into the church, the older sister walked on their right side and the younger on their left side, and the pigeons pecked out one eye from each of them. Afterwards, as they came out of the church, the older one was on the left side, and the younger one on the right side, and then the pigeons pecked out the other eye from each of them. And thus, for their wickedness and falsehood, they were punished with blindness as long as they lived.

The fussbuckets of the children's services world appear to have won their campaign to allow the government to lock up parents who are emotionally cruel to their children:

Parents who fail to show love and affection towards their children could be sent to prison for up to 10 years under a “Cinderella Law” to be announced in the Queen’s Speech in June, according to a report.

The move will make “emotional cruelty” a criminal offence for the first time.

The decision was hailed as a “monumental step” forwards by a children’s charity, which said children could grow up with “ lifelong mental health problems” or end up taking their own lives.

There is only one question to ask here - who is deciding when being strict and brusque tips over into 'emotional cruelty'? The MP promoting the bill chooses the stigmatise step-parents (most of which do an OK job helping to bring up someone else's children) and uses the most pathetic appeal to emotion available - the fairy tale:

“Not too many years after the Brothers Grimm popularised the story of Cinderella, the offence of child neglect was introduced,” he said, but added: “Our criminal law has never reflected the full range of emotional suffering experienced by children who are abused by their parents or carers.

“The sad truth is that, until now, the Wicked Stepmother would have got away scot-free."

Now, as I remember it, the Wicked Stepmother's sin was to treat Cinders as a skivvy and not let her go to the ball. There's nothing in the tale to suggest that Cinderella was emotionally scarred by this treatment however egregious it was and however much the Wicked Stepmother favoured her own (famously ugly) daughters. I fail to see in this how locking up the Wicked Stepmother would have achieved anything? Would it have made Cinders' life better somehow? Or, more likely, would it have provided a little cruel schadenfreude for her as she jollied off into the sunset with the Prince!

Just as we have done with 'offence' where the police are close to being able to arrest people randomly for just saying stuff, with this new idea we hand the power to public agencies to seize children and lock up their parents for almost anything. There is no boundary to emotional or social cruelty, it is simply a judgement made by one flawed individual about another flawed individual.

And it hands real power to people who say things like this:

Sir Tony Hawkhead, chief executive of Action for Children, said he had met children who had been “scapegoated in their families, constantly humiliated and made to feel unloved”.

Think of the teenage girl screaming at Mum (or worse step-mum); "you don't love me, you don't care". Or the grunting young lad refusing to make eye contact with Dad (god forbid, Step-dad) for days on end because he turned off the football and insisted he did his homework.

Child protection authorities already have the powers they need to respond to children who are being damaged by their home environment. What we have here are people who don't just want to protect the children, they want to punish the parents.

This proposal isn't about child protection, it's about vengeance.And we don't need it.

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Urbanisation, families and population decline

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Here's a quote taken from a report written by geographer Joel Kotkin ("What is a City for?"):

In developing countries, where the megacities of the future are being formed, as the price of space rises, the quality of life declines, and city services become less accessible and efficient. Average household size and fertility rates in cities have begun to decline. For example, while The World Bank data puts fertility for China and Japan at 1.6 and 1.4 respectively, Beijing and Shanghai are experiencing much lower rates than the national average. In Tokyo, fertility rate is about 1.2. In Shanghai, according to National University of Singapore demographer, Gavin Jones (2009), it has dropped to a remarkably low 0.7.

These phenomena can be seen in virtually every part of the world, from developing countries such as Iran, China, Mexico and across Northern Africa, birth rates have plunged towards those of higher income countries as they have urbanised. Birth rates among Muslims in Europe, as well, have dropped (Pearce, 2010, pp.114–116). Divorce over the past decade has grown by 135% in Iran, where women now constitute 60% of college graduates. Meanwhile, household size has declined to less than 3.5, according to the most recent national census. In Tehran, another city of largely apartment dwellers with forbidding cost of living, especially for housing, the latest average household size in 2011 was reported to be 3.1 (Erdbrink, 2012).

Not only is this not the picture we expect of developing countries (we are told repeatedly by those with a vested interest in telling us that fertility rates are high and population growth is rapid - this appears only to be true in rural societies) but is raises an interesting question about cities and the process of urbanisation.

On the one hand urban growth drives economic growth, innovation and development but at the same time the reality for individuals and families is that costs rise to the point where raising children is forfeited because the couple simply can't afford to have a family. And because there are no families, no children in our cities the development of the urban environment does not provide for children. Our economic development strategies focus on attracting the young, single and highly educated to creating what Terry Clark from the University of Chicago called the

"...new city, built around the needs of what he calls “the slimmer family” of childless couples and often single professionals, focuses primarily on recreation, arts, culture and restaurants; a system built around the newly liberated individual."

 In a world where few people have families and, where they do those families are small, we build up problems for our future. So far the gap left by the absence of children is made up by migration mostly from rural areas. The question we need to ask is what happens when the migrants run out?

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Malnutrition and public health - it's not austerity that's the problem

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Some "Doctors" have written a letter to the British Medical Journal expressing concerns about malnutrition:

In a letter to the British Medical Journal, David Taylor-Robinson from the University of Liverpool and six other academics warn: "This has all the signs of a public health emergency that could go unrecognised until it is too late to take preventive action."

They say they are particularly worried about the number of children with malnutrition because it can cause cardiovascular and other chronic diseases in adulthood.

And the newspapers and broadcasters lap it up without asking some simple questions - ones like "how many cases of child malnutrition are there?"

To help them, here are the figures from an answer to a Parliamentary question  - in 2008/9 there were 201 cases of children admitted to hospital where  the primary or secondary diagnosis was malnutrition. In 2012/13 this figure had soared to 205 admissions.

There is absolutely no evidence at all - other than anecdotes from teachers - to support the contention that child malnutrition is rising. The thing that should concern us is malnutrition among the elderly because this has risen significantly. The question is why?

Here's one stab at assessment that followed a report in The Independent earlier this month:

People with certain long-term health conditions can't always retain all the nutrients they need - particularly the elderly, who might also struggle to make the trip to the supermarket. With this in mind, the higher incidence of malnutrition might also reflect broader demographic trends, including the fact that the UK's population is ageing. The most recent Nutrition Screening Survey showed that those aged 65 plus were more likely to be malnourished than those who were younger. In addition, it may also be that hospitals are now more likely to screen a patient for symptoms of malnourishment. 

The reasons for increased malnourishment may be entirely unrelated to the current economic climate. Since the elderly are largely protected from the impact of welfare reform and make up the overwhelming majority of malnutrition cases, we should perhaps look elsewhere for the causes of the problem. There may be consequences from 'austerity' - reductions in social care visits, for example - that impact on the elderly eating properly but equally the rise may be a simple reflection of people living longer.

All this may not suit the political agenda of the people writing to the BMJ but we should perhaps pay more attention to the real challenges rather than write ill-researched and polemical letters that serve only to misdirect (and get a nice headline).

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