Schools and communities must do more to support disadvantaged pupils in wealthier areas, according to a major report into health inequality in England published today.

Pupils eligible for free school meals who attend schools in affluent areas perform worse academically than they do in schools in deprived areas where most pupils are disadvantaged, according to the report, Health Equity in England: The Marmot Review 10 Years On.

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The report, published today by the Institute of Health Equity (IHE) and authored by Sir Michael Marmot 10 years after his landmark review of health inequalities in 2010, finds that stark inequalities in health and educational attainment have worsened over the last decade.

It notes that, since 2010, “evidence has shown that children in families with low incomes do better at schools in more deprived areas than they do in wealthier areas”.

“It seems clear that schools and communities in some more deprived areas are making a beneficial difference for the most deprived students and breaking the close association between deprivation and lower outcomes.

“A second possibility is that being a poorer child among more privileged children may lead to feelings of exclusion and lack of self-esteem.”

Dr Jessica Allen of the IHE said that in order to reduce educational inequalities, attainment needed to be raised through a “focus on children with free school meals, particularly in wealthier areas where outcomes are worse for FSM children than in more deprived areas”.

She drew attention to how some local authorities, such as those in Tower Hamlets in London and Oldham in Manchester had managed to raise attainment for deprived pupils by demonstrating the importance of improved education outcomes to pupils and their families,

She told Tes: “In Tower Hamlets, the schools say, ‘Poverty is not destiny.’ They have had a push for this.

“There are areas where they have managed to reduce these inequalities, and it’s been a concerted effort by schools, demonstrating the importance of attainment. In richer areas they do not need to do that as much, they can coast a bit more.”

She said that in Oldham, schools had raised attainment by working with the community, emphasising to parents how important it was for pupils to have a quiet space or desk where they can complete homework, for example.

The report also said there needed to be more investment in preventative services to reduce school exclusions and off-rolling - whereby pupils are removed from the school roll before their GCSEs. 

Dr Allen said there needed to be more investment in other services such as behaviour and attendance support services, as well as those specialising in additional needs such as autism, speech and language delay, dyslexia and further underlying needs. 

In the report, Sir Michael said the growth in health inequality had been “unprecedented”.

The report raised concerns over the rise in child poverty over the last decade, pointing out that the number of children living in poverty once housing costs are taken into account has now exceeded four million.

The Institute of Fiscal Studies has predicted that relative child poverty - the proportion of children living in a household with less than 60 per cent of the median income - will increase from 30 per cent to 36.6 per cent by 2021 in the UK. 

The report notes that inequality in educational attainment has lifelong consequences for disadvantaged pupils’ health and wellbeing.

It says: “Persisting socioeconomic inequalities in attainment during primary and secondary school have lifelong impacts on health and on a range of other outcomes throughout life.”

It adds that, while some areas in greater Manchester and inner London have managed to close attainment gaps, “funding cuts are undermining the potential to do more”.

The review linked child poverty with increasing levels of knife crime among young people. 

“Between 2010-11 and 2018-19, there was a 31 percent increase in the total number of offences in England involving a knife or sharp instrument,” it said.

“Knife crime particularly affects young males from deprived communities. Household poverty and area deprivation are closely associated with youth violence.”

The report also drew attention to the closure of hundreds of Sure Start centres over the last decade, which had been shown to improve outcomes for the most disadvantaged children and their families.

Dr Allen said all policy and funding decisions needed to “ensure that more deprived areas and pupils have greater funding attached - including regionally”.