Children from Blackburn with Darwen are the most likely to be short, a study has revealed, as researchers said there was a direct link between shortness and poverty in England.

       Blackburn with Darwen, in the North West, had the highest rate of short stature – also known as stunting – among four to five-year-olds, four times higher than the lowest prevalence recorded, in Richmond upon Thames, London.

       Researchers at Queen Mary University of London analysed the heights of more than seven million children in England, using data from the National Child Measurement Programme.

       The average height among the sample was 109.6cm, while those classified as stunted were 10.2cm shorter. The researchers warned that those averages would fluctuate depending on the age and gender of the child.

       Between 2006 and 2019, around two per cent of four to five-year-olds in England were stunted, but researchers found there was a marked difference when viewing the figures regionally and by areas of deprivation.

       Joanna Orr, a post-doctoral research assistant at Queen Mary University and first author of the study, said: "Whilst the average prevalence of short stature across England was in line with what we'd expect, the regional differences we see are striking and there's a clear North-South Divide.

       "Our findings show that where a child is born and the environment in which they grow up have an impact on their height at a young age and suggest further investigation is needed into why children from poorer areas of England are shorter."

       The study, published in PLOS Medicine, revealed "clusters" of higher prevalence of stunting in the North and Midlands, while it was lower in the South.

       In Blackburn with Darwen, stunting prevalence was 3.92 per cent, while in Richmond upon Thames it was 0.97 per cent.

       Among children living in Yorkshire and the Humber, 2.18 per cent were short, and in the North West the prevalence was 2.14 per cent. It was 2.12 per cent in the North East, while in London it was just 1.57 per cent.

       Researchers said stunting was directly linked to deprivation and equated to a difference in absolute terms of 1,180 children with short stature per 100,000 reception class pupils between the most and the least deprived communities.

       "Collectively, our findings suggest that large numbers of children – particularly those in the most deprived areas of the country – could be failing to reach their full growth potential. Many of these children may in fact be particularly disadvantaged, unhealthy, and failing to thrive," the authors said.

       They said the findings should prompt "immediate action by local and national government to address the upstream factors that underlie short stature, especially in the areas where we have identified clusters".

       Andrew Prendergast, professor of paediatric infection and immunology at Queen Mary University, said most public health programmes focus on body mass index as the main indicator of health, but children with stunting are "not currently systematically being highlighted to their families or GPs for action".

       "Height could be a marker for other vulnerabilities such as underlying health conditions or poor nutrition, so nationwide screening programmes could provide an opportunity to identify children who are short for their age and intervene early," he added.