What kids really need

He wasn’t lazy. He was bright, funny and desperate to be out in the world. But his local park felt unsafe, the youth club had closed and the nearest sport sessions cost more than his family could spare.

By the time he came to my paediatric clinic, what looked like a 'health problem' – low mood, poor sleep, weight gain – was really a place problem.

Why local spaces are key

We often talk about children’s health as if it starts in the hospital or the GP surgery, but as I explored in my recent BBC Radio 4 series, Three Ages of Child, the real foundations of health are laid much earlier and elsewhere: in homes, schools, streets and parks – places where children feel they belong in their own areas.

Sport England’s latest place work and research puts into numbers what many of us see every day – like the fact that over half a million children, one in ten 12-17-year-olds, say they don’t feel they belong in their community.

This means that almost one in five don’t feel proud of where they live, often because there’s nowhere for young people to go to, and because of the worries about crime and antisocial behaviour.

Take a step back and look at how this paints a stark picture of children growing up in places that feel unsafe, unwelcoming and not really 'for them', so it’s no surprise that in those conditions activity levels are low and health problems multiply.

The same research also points to part of the answer.
 

When asked what gives them a sense of community – beyond friends and family – the top answer from young people was sports clubs and activity groups.

Anyone who has ever watched a child beam with pride after football training or a dance class knows why: a club is not just about exercise; it’s about belonging.

It offers a safe place to go with people who know your name and that offers the chance to be part of a team.

Dangers of the postcode lottery

But access to those opportunities is deeply unequal.

In England’s most deprived places, over a third of people are inactive, compared to around a fifth in the least deprived areas – a postcode lottery for physical activity that deepens health inequalities.

As a paediatrician, I see every day that a child’s postcode can be a stronger predictor of their health than their genetic code.

When local streets feel unsafe, there’s nowhere affordable to go and young people don’t feel they belong, it shows up in their bodies and in their minds.

If we care about the future of public health, we have to turn our thinking on its head, because health isn’t built in hospitals. It’s built in communities.

Exercise and sport are a kind of miracle cure – for health, wealth and happiness – but only if everyone can actually take part.

According to research by Sport England, every pound spent on community sport and activity brings multiple pounds back in benefits to health, wellbeing and the wider economy.

That’s why I welcome efforts to work in a genuinely place-based way – including Sport England’s commitment to invest in the areas facing the greatest challenges.

But beyond the work of any single organisation, the principle stays: you can’t fix place-based problems with purely top-down solutions.

Making children proud

For me, this is what it looks like to move from treating symptoms to changing systems.

You can’t lecture a child into feeling proud of their area or prescribe their way out of a broken play park.

But you can bring together the people who know that place best – including children and young people themselves – and invest in the spaces, clubs and connections that allow them to move, play and belong.

That means co-production, not just consultation: listening to what families say they need, backing trusted local organisations, designing activities that reflect different cultures, bodies and lives and being in it for the long haul.

Our children are telling us they want to feel proud of where they live and that they want to be part of something bigger.

Working locally, listening deeply and backing places over the long term is how we start to make that real – street by street, pitch by pitch, park by park.