Data Insight: BMI and immunisation uptake by different levels of engagement with Flying Start in Swansea

This Data Insight explores the body mass index (BMI) and immunisation uptake across different levels of engagement with the health visiting component of Flying Start programme, in the City and County of Swansea.

Read publication

This analysis compared health outcomes by different levels of engagement with Swansea Flying Start health visiting programme, rather than comparing outcomes for recipients and non-recipients of the health visitor elements of the Swansea Flying Start. This is because it is difficult to find an appropriate comparator group for Flying Start, given the programme is primarily targeted at children living in deprived areas.

This study represents the first analytical investigation into the health visiting service component of the Swansea Flying Start programme and its impact on health outcomes, specifically focusing on BMI thresholds and immunisation uptake.

This Data Insight has been produced by the ADR Wales Early Years team and forms part of the ongoing ADR Wales programme of work.

What we found 

The analysis showed that there was no significant relationship between levels of engagement with the health visitor element of the Swansea Flying Start programme and BMI thresholds.

Similarly, mean BMI did not differ between normal (mean = 16.7, standard deviation = 2.13) and under engagement (mean = 16.6, standard deviation = 2.14) groups in the Swansea Flying Start cohort.

Overall, 95% of children who engaged with the health visitor programme and lived in Swansea Flying Start areas were fully immunised by their fourth birthday.

The highest uptake was for the Hib/Meningitis c vaccine (over 99%), followed by the MMR vaccine (96%) and the “4 in 1” vaccine (96%).

Notably, these estimates are higher than those reported in the Public Health Wales (PHW) 2022 Cover annual report, whereby 86.5% of children living in Swansea were up to date with immunisations by age four (83.6% in those living in deprived areas in Swansea health board). The methodological differences between this study and the PHW annual cover report could explain these different results, as the methods employed are not directly comparable. 

Results showed that there was no significant relationship between levels of engagement with the Flying Start programme when children were aged from birth to 3.5 years and immunisation status by four years of age.

Why it matters

This study represents the first analytical investigation into the health visiting service component of the Swansea Flying Start programme and its impact on health outcomes, specifically focusing on BMI thresholds and immunisation uptake. The evidence from this research addresses policy priorities in early years and can inform potential adjustments to the Flying Start health visiting programme.

While the research did not find a statistically significant association between levels of engagement with Flying Start and core immunisation rates at age four, it is important to note that the data demonstrates widespread immunisation uptake overall. Likewise, this study did not find a statistically significant association between levels of engagement with Flying Start and BMI. The percentages of children estimated to be overweight or obese are consistent with the general population.

Taken together these findings might suggest that some engagement with the health visiting component of the Flying Start programme in Swansea is as good as any to have BMI estimates in line with children from non-deprived areas and widespread immunisation uptakes. However, this is only preliminary evidence that should be taken cautiously in light of the limitations listed in the full publication.

Additionally, this study sheds light on data quality issues related to the Flying Start dataset within the SAIL Databank. These findings have sparked valuable discussions among early years analysts in the Welsh Government, leading to making the case for better data, resulting in planned improvements to the data collection and its robustness