Here, Professor Sheena Asthana argues, with reference to housing, education, skills, social care and health data and recent research, that children and young people in England’s coastal towns and cities have poorer health and educational outcomes than their peers inland.
We are culturally conditioned to believe that a ‘coastal childhood’, growing up by the sea, is idyllic. Images of young children rock pooling and building sandcastles and teenagers surfing the waves come to mind. Increasingly, Government data points to a contradictory narrative.
Home truths
Many English coastal towns have poor quality housing stock. A grand Victorian villa could now be an ill-maintained house of multiple occupation (HMO) today, home to transient and vulnerable people including those subject to out of area social services displacements. Such displacement is a risk factor for chronic psychological stress and, in turn, health inequality. Displacement creates turbulence for families and children, separating them from employment, schools, friends and support networks. It is not much, and it is not home.
Coastal areas have higher rates of second homes, holiday homes and short-term holiday lettings. These properties are effectively removed from the local housing stock, putting pressure on property and rental prices. A limited supply of, and poor access to, social housing compounds these challenges. Torbay has one of the lowest proportions of social housing (8%) of any English local authority, under half the national average (18%). Waiting lists are long. The rate of family homelessness (11.5 per 1000 households) is also significantly higher than the national average, meaning more children requiring protection and care.
The lack of affordable housing to rent and buy also hits young professionals hard, particularly those working in the public sector such as healthcare workers and teachers. Providing accessible, affordable housing to these key workers, many of whom are responsible for providing support services to children and young people, is crucial. Without them, it becomes more difficult to provide vital services in education, training and healthcare.
Learning to live
Pupils outside London generally perform less well than those within the capital. Disadvantaged pupils outside London fare particularly badly. At Key Stage 2 (7-11 year olds), 58% of disadvantaged pupils met the expected standard compared with 74.8% of their non disadvantaged peers (an achievement gap of 16.8%). In coastal areas outside London the achievement gap between disadvantaged children and their peers was 32%.
At Key Stage 4 (14-16 year olds), London significantly outperforms the rest of the country, with an Average Attainment 8 score of 50.9 against the non-London national average of 45.4%. Outcomes in coastal localities were considerably lower: 42.8 % versus 46.1% in non-coastal areas outside London.
The causes of lower educational attainment in coastal areas are complex. Financial and familial instability, as well as the lack of educational capital in households play a role. Regional differences are pronounced with respect to educational capital. Children’s perceptions of the value of education will be shaped by their future aspirations and the role education can play in helping them achieve these.
Children in coastal and rural areas are often unable to see or experience opportunities beyond the low-paid hospitality and care sectors. Opportunities for graduates vary according to location. In coastal areas, such as Lincolnshire and Cumbria, 42% and 49% or graduates are in a job that requires a degree, compared to 65% in Inner London. By comparison, many graduates in coastal areas have to resort to working in hospitality, retail, call centres of temporary positions on the minimum wage.
In 2021, only 13.4% of adults in Inner, and 17.6% of adults in Outer London had no qualifications. By contrast, young people in coastal built up areas (BUAs) in the East Midlands (33%) and East of England (23.4%) had no qualifications compared to 20.1% and 17.9% in non-coastal BUAs in the same regions.
Inequalities in educational outcomes have important consequences for children’s future life trajectories. Education predicts employment, income and access to material resources as well as psychosocial wellbeing and health behaviours. The educational underachievement of coastal children should be of greater concern to those responsible for wellbeing today and for economic growth, social mobility and health inequalities tomorrow. It is arguably the single most important modifiable social determinant of health inequality.
The coastal skills gap
The existing coastal brain drain will worsen if the aspirations of qualified young people are raised without expanding their opportunities. The Longitudinal Education Outcomes (LEO) database shows that Inner London was the most significant importer of graduates from the rest of the country. Some large coastal cities such as Liverpool, Bristol and Southampton retain and attract graduates, but there is a significant drain of graduate skills away from other large and medium-sized coastal cities. This is not a feature of their non-coastal counterparts. The low proportion of residents aged 25-34 with L4 qualifications (higher education equivalent to first year of a university degree or above) in large coastal cities (39.6%) is in stark contrast to Inner (74.6%) and Outer (57.4%) London.
Whilst efforts are being made to diversify coastal economies and boost the quantity of high skills jobs in areas such as offshore renewable energy, skilled manufacturing and the creative industries, there are concerns that local youngsters might not have the skills, or access to training, to do such jobs.
To date, little attention has been paid to those young people who grow up and remain in coastal communities. Some choose to stay to maintain ties to place, family and friends. Equally, some are ‘left behind’ in a place that offers them little and from which they feel unable to escape and improve their lot as they lack the skills, financial resources or personal contacts to move elsewhere. The Department of Health and Care’s Fingertips (Public health profile) data on the age-standardised rate per 100,000 of suicide aged 10-24 years shows that half of 15 local authorities with the highest suicide rates are peripheral ones with coastal borders.
Coastal variations in children’s social care
Between 2015 and 2020 more than 10,000 additional children became looked after than would have been expected had 2015 child poverty levels remained constant. The geography of children in need of support from children’s social services shows a strong North-South and a coastal distribution. Understanding more about such coastal inequalities is challenging as there is a lack of published data on social services expenditure below local authority level. However, if we were to define coastal local authorities as those with over 75% of their population residing in coastal LSOAs (between 400-1200 households and using the 5km from the coast definition) and mixed local authorities as having between 25% and 75% of their population in coastal LSOAs, it is clear that coastal local authorities are spending more on children’s services than their non-coastal (defined as having less than 25% of their population in coastal LSOAs) counterparts. In 2023/24 total spend per child aged 0-15 on children and young people’s services ranged from £1,656 in coastal local authorities to £1,153 in mixed local authorities.
A picture of health?
Children and young people in coastal areas are at significantly higher risk of mental distress as measured by key health indicators of health risk behaviours and the suicide statistics mentioned earlier. This reflects the shifting pattern of child poverty, poor educational outcomes and adverse socio-psychological factors associated with a limited range of employment opportunities,
An ONS MSOA-level analysis (that is between 2,000-6,000 households) of more recent NHS Hospital Episode Statistics (HES) from (2019/20 to 2023/24) confirms that children and young people in coastal areas are at significantly higher risk of hospitalisation for self-harm. Admission rates per 10,000 for 0-14-year-olds are 10.5 in coastal areas compared to 8.8 in non-coastal areas (excluding London) and 4.2 in London. At 15–24 years old, admission rates for self-harm in coastal MSOAs (58.9) are nearly three times higher than in London (20.4) and significantly higher than in non-coastal MSOAs (45.6). In this age group, the highest rates are found in coastal MSOAs in the North East (71.3), non-coastal MSOAs in the South West (71.1) and coastal MSOAs in the South West (65.0). Psychological distress is a risk factor for chronic inflammation and, in turn, the development of chronic and degenerative diseases.
Looking again at Fingertips data provides a range of indicators at MSOA level such as rates of smoking, prevalence of obesity and emergency hospital admissions. The number of smokers is a modelled estimate, using individual level data from the national What About YOUth 2014 survey. According to the measure, 6.5%, 5.6% and 3.5% of young people aged 15 are regular smokers in coastal, non-coastal (excluding London) areas and London respectively.
There is also regional variation in child health indicators. For example, coastal MSOAs in the East Midlands have the highest rate of overweight and obesity aged 10–11 years of all types of area (40.0%), coastal MSOAs in the South-West the lowest (31.8%). Across all three age groups, the coastal North-East has the highest rate of emergency hospital admissions for injuries, more than twice the rate in London for both under five-year-olds (170.7 per 10,000) and under fifteen-year-olds (130.7 per 10,000). In this region, the rate of emergency admissions for injuries among 15-24-year-olds is 167.7 per 10,000 compared with a national average of 127.9.
Analysis of the UK Household Longitudinal Study found that, among adolescents and young adults living in England from 2009 to 2020, those living in a coastal community reported worse self-rated health and more long-standing impairment, illness, or disability than adolescents living inland. This study also found a negative relationship between coastal residence and mental health summary scores, but only in the most deprived communities.
What next?
Childhood circumstances and the life trajectories of children and young people have an important bearing on adult health; there are worrying inequalities here relating to the health and wellbeing of children and young people in coastal communities. These trends in the health of children and young people along the coast point to a future public health crisis on the coastal periphery. Whilst English coastal communities can potentially offer children a wealth of opportunities for life enhancing and resilience building activities, many children who grow up in such communities today have limited access to the resources enjoyed by their peers elsewhere. Urgent policy attention is required to address issues of health inequality, education outcomes and social justice now. Policymakers need to prioritise those growing up on the periphery.
These issues will be explored further in our forthcoming book; The Coastal Divide – The Challenges Facing Britain’s Coastal Communities which will be published in June 2026.