School marks, city lessons

Youth unemployment is up and GCSE grades are down.

Youth unemployment is up and GCSE grades are down. The odds are that it is the most disadvantaged young people and the most deprived parts of the county that are affected most by both.

As pupils go back to school, the debate over this year's GCSE results continues. It is the impact that GCSE grading can have on a young person’s future prospects that causes so much concern. GCSE results determine whether a young person can go on to study A-levels en route to university. They also matter to employers.

The map of GCSE attainment looks remarkably similar to the map of youth unemployment. We published research today that shows that the lower GCSE attainment is in a city, the higher youth unemployment is. GCSE results, especially Maths and English, matter to job prospects.

Official national figures with more detail on this year's results aren't due out till early next year. But if previous results and the experiences of individual schools are anything to go by, it is the most disadvantaged that are hardest hit in the apparent move to halt grade inflation. Pupils eligible for Free School Meals are far more likely to get scores around the C-D border.

Year-on-year, children from disadvantaged backgrounds are far less likely to get five good GCSEs. Social background remains the strongest predictor of educational attainment in this country; more so than many other developed countries.

Unsurprisingly, cities with higher proportions of pupils from disadvantaged backgrounds tend to have lower attainment rates overall. Over 59 per cent of pupils from all schools in the most economically successful cities achieve at least five GCSEs including Maths and English but excluding vocational  equivalents. The attainment rate drops to 47 per cent in weaker cities creating a gap of over 12 percentage points.

These pupils face multiple disadvantages. They are more likely to go to an underperforming school: 40 per cent of schools in weaker economies  are judged "inadequate" or "satisfactory"  compared to 26 per cent in economically successful cities. They are less likely to leave school with the qualifications education providers and employers require. And local employment options are likely to be more limited.

All of this serves to reinforce the socio-economic divides that have long existed across the country. 

What is also striking is that schools in many of our weaker cities are better at improving the performance of  pupils from disadvantaged backgrounds than economically strong cities. While there are fewer pupils from disadvantaged backgrounds in buoyant cities, they are less likely to achieve good GCSEs than disadvantaged pupils in struggling cities.

It is clear that policies to address educational inequalities cannot start and end with schools; there are many reasons why some pupils fall behind. But the experience of schools in some of the most deprived parts of London demonstrates that a child's background does not always pre-determine how well they do in their exams. Nearly 58 per cent of disadvantaged pupils in Tower Hamlets achieve five good GCSEs including Maths and English compared to a third nationally.

The fact that Tower Hamlets is located in one of the most economically buoyant cities in the country can't be ignored. It may affect pupil aspiration and schools may have access to a larger pool of teachers. Cities should, seek to understand what be learned from initiatives such as the London Challenge that led to marked improvements in attainment rates. One thing is clear. Without intervention to improve the education levels of our young people, the cycles of disadvantage will not be broken.

Naomi Clayton is a Senior Analyst for Centre for Cities.

Students getting their GCSE results. Photograph: Getty Images

Naomi Clayton is a senior analyst at Centre for Cities

Photo: Getty
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A clinically-approved birth control app is changing the way we think about contraception

The particle physicist Elina Berglund has created an app that is 99 per cent effective. 

Women around the world using the contraceptive pill have long complained to their friends about its perceived side effects – weight gain, acne, mood swings to name a few. Some more recent studies have verified that anecdotal evidence – a Danish study from 2013 confirmed that there was a 40 per cent increased risk of depression for women who were on the pill, compared to those who weren’t.

Frustration around the inadequacy or ill-suitability of certain methods of contraception is rife. One woman, Elina Berglund, decided to do something about it.

Formerly a particle physicist at CERN (and a member of the team responsible for the discovery of the Higgs Boson particle), Berglund co-founded Natural Cycles, a contraceptive app, with her husband Raoul Scherwitzl. Approved as a contraceptive app earlier this year, it is downloadable on a smartphone and relies on a relationship between body temperature and fertility to tell women when they're fertile.

But contraception campaigners have viewed the concept with caution. Widespread use of the pill, condoms, and diaphragms comes after decades of campaigns against reliance on "natural methods" – not to mention the opposition of religious organisations like the Catholic church. 

At first glance, Natural Cycles might not seem all that different from the Vatican-approved "rhythm method", which is based on observing the exact stages of a woman's fertility cycle and avoiding sex during ovulation. This can be, according to the NHS, up to 99 per cent effective – but in reality it is closer to 75 per cent, because "people can make mistakes". 

Users of Natural Cycles take their temperature daily and input it into the app (which costs £6.99 a month). The app then compares the figure to its own dataset and uses an algorithm based on Berglund's days from CERN. It also asks for other data, such as the dates of user's periods and whether they are planning for a pregnancy or not, to create a personalised calendar.

If it’s safe to have unprotected sex, then the in-app calendar will show up as green. If not, the in-app calendar will show up as red. On those red days, users should find methods of contraception if they aren’t seeking pregnancy.  

Menstrual tracking apps are all the rage (there are around 1,000 of them on the current Apple app store). But recent studies have shown that those apps are often inaccurate and lack any scientific basis. 

Natural Cycles, by contrast, carried out three clinical trials, each time expanding the dataset to reduce errors. The most recent, written up in Contraception, involved 22,785 women across 37 different countries in settings that mimicked real life. The co-authors pointed out that in instances of perfect use, one out of 100 women become pregnant accidentally. However, in instances of typical use, seven out of 100 women had the same result.

When Natural Cycles first gained publicity, Berglund pointed out to the press that “now they (women) have a new, clinically verified and regulatory approved option to choose from”. Berglund and Scherwitzl are looking into getting Natural Cycles prescribed on the NHS, like the pill.

So is Natural Cycles the future of family planning? The first thing to make clear is that the app cannot actually function as physical contraception – on “red” days, the app advises users to use a condom if they’re having sex and don’t want to get pregnant. It cannot prevent the transmission of sexually transmitted diseases either. 

Nor is the app really marketed to those who may benefit from the most information about their sexual health – 16 to 25-year-olds, who are also the age group most likely to engage in risky sexual behaviour. 

A spokesperson for Marie Stopes, the reproductive health NGO, said: "Apps to track fertility are a high-tech version of what women have been doing for years with a diary and a thermometer.

"For anyone trying to get pregnant, they might well help. However, if you want to avoid pregnancy, it’s much better to choose a reliable, long-acting modern method of contraception like an IUD or implant. Traditional methods, including tracking fertility, carry a much higher risk of unintended pregnancy."

The app relies on an algorithm, meaning it is only as effective as the data that it receives from users. It is also not free, which may exclude its usage by certain sections of society. A blog written for NHS Choices emphasised that the data collected in all the trials was collected from women who were already signed up for the product, making it likely that they had an incentive to continue with this specific additional contraceptive, as opposed to looking elsewhere. Even so, a third of users who had signed up still dropped out, potentially because of the maintenance required to get results from it. 

All the same, Natural Cycles has 380,000 users and counting. It has received clinical approval to be marketed as a medical device, and it seems to be meeting a need – 70 per cent of Natural Cycle's users come from hormonal contraception, according to Berglund. In her account of Natural Cycles in the Evening Standard, Kate Wills highlighted that the Apple Watch had all sorts of health inputs, but no way to track periods.  All kinds of apps exist to make modern life easier – why has it taken so long for one that addresses a concern for so many women to make its way into the mainstream?

The history of contraception is littered with examples of women being ignored. Early birth control studies vastly underplayed the potentially debilitating side effects of hormone fluctuations on women’s mental health and physical appearance, often treating users as though they were hysterical. Add into the equation the stigma around accessing contraceptives safely and non-judgementally, and it’s easy to see why a relatively painless and private form of contraception might be appealing. 

Natural Cycles may well work for some women – those who are in stable relationships, hoping to get pregnant and fastidious enough to note their temperature every morning. But it doesn’t prevent diseases, requires a steady commitment and – here's the clincher – can't take measurements when you’re hungover as alcohol can affect your temperature. There's also a big difference between the "perfect" use of the app, and the likelihood of pregnancy when used in a "typical" fashion. So long as that's the case, old-fashioned contraception seems unlikely to be swept away by a digital revolution.