Early childhood development and the social determinants of health inequities

Abstract

Children's health and development outcomes follow a social gradient: the further up the socioeconomic spectrum, the better the outcomes. Based upon a review of multiple forms of evidence, and with a specific focus upon Australia, this article investigates the causes of these socially produced inequities, their impact upon health and development during the early years and what works to reduce these inequities. Using VicHealth's Fair Foundations framework, we report upon child health inequity at three different levels: the socioeconomic, political and cultural level; daily living conditions; the individual health-related behaviours. Although intensive interventions may improve the absolute conditions of significantly disadvantaged children and families, interventions that have been shown to effectively reduce the gap between the best and worst off families are rare. Numerous interventions have been shown to improve some aspect of prenatal, postnatal, family, physical and social environments for young children; however, sustainable or direct effects are difficult to achieve. Inequitable access to services has the potential to maintain or increase inequities during the early years, because those families most in need of services are typically least able to access them. Reducing inequities during early childhood requires a multi-level, multi-faceted response that incorporates: approaches to governance and decision-making; policies that improve access to quality services and facilitate secure, stable, flexible workplaces for parents; service systems that reflect the characteristics of proportionate universalism, function collaboratively, and deliver evidence-based programs in inclusive environments; strong, supportive communities; and information and timely assistance for parents so they feel supported and confident.

Sex differences between parental pregnancy characteristics and nonalcoholic fatty liver disease in adolescents

“…Nevertheless, maternal prepregnancy obesity is associated with NAFLD in both sexes. Low SES is a determinant of higher risk of MetS later in life . We are unable to determine a precise cause of the sex‐selective association of low family SES at birth with NAFLD in male adolescent offspring or the association between maternal obesity and offspring hyperleptinemia and IR in female adolescent offspring.…”

How Indigenous mothers experience selecting and using early childhood development services to care for their infants

“…Many First Nations people experienced poverty, with 70% living in Hamilton's lowest income neighbourhoods, compared to 25% of the non-Indigenous population as a whole (Smylie et al, 2011). Children growing up in economically disadvantaged neighbourhoods have reduced access to parks or green space, and face greater exposure to environmental toxins, air pollution, and noise that negatively impacts brain development, psychological well-being and educational achievement later in life (Moore, McDonald, Carlon, & O'Rourke, 2015). Extreme poverty and inadequate housing represent modes of structural violence, resulting in harm and trauma for those affected, and also leads to food insecurity and other social inequities (Moore et al, 2015;Varcoe, Wathen, Ford-Gilboe, Smye, & Browne, 2016).…”

“…Children growing up in economically disadvantaged neighbourhoods have reduced access to parks or green space, and face greater exposure to environmental toxins, air pollution, and noise that negatively impacts brain development, psychological well-being and educational achievement later in life (Moore, McDonald, Carlon, & O'Rourke, 2015). Extreme poverty and inadequate housing represent modes of structural violence, resulting in harm and trauma for those affected, and also leads to food insecurity and other social inequities (Moore et al, 2015;Varcoe, Wathen, Ford-Gilboe, Smye, & Browne, 2016). Indeed, First Nations people living in Hamilton reported high rates of overcrowding (73.7% compared to 3% of Canadians) and difficulties obtaining adequate amounts of food (63% report not buying food in order to meet shelter-related needs; 22% reported sometimes or often not having enough food to eat) (Smylie et al, 2011).…”

“…Access to high-quality ECD services is extremely important to mitigate the effects of social inequity and trauma on the development and subsequent health outcomes of infants. Early childhood development programs support healthy bonding and attachment between parents and infants, provide nutritional and other health-related education, and promote positive parenting and healthy play-all leading to the healthy neurophysiological and psychological development of infants (Gerlach, Browne, & Greenwood, 2017;Halseth & Greenwood, 2019;Moore et al, 2015). Research has demonstrated that by supporting early learning, ECD services are an excellent strategy to promote equity for families facing disadvantage, and promote improved school readiness (Gerlach, Browne, & Suto, 2016;Halseth & Greenwood, 2019;Moore et al, 2015).…”

Supporting positive parenting practices within a community‐based music therapy group program: Pilot study findings

“…The positive relationship between parental responsiveness and child health and development outcomes is widely acknowledged (Bernard, Meade, & Dozier, 2013;Jones, 2012;McFadden & Tamis-Lemonda, 2013). However, parents with low self-efficacy (Dunning & Giallo, 2012) as well as those who have various contextual risk factors may benefit from additional support to improve parental responsiveness (Moore et al, 2015;Perry, 2002;Shonkoff & Phillips, 2000). Although music-based group parenting programs have previously been shown to be a well-accepted intervention for this population (Teggelove, 2016), the aims of the Sing&Grows program have shifted since the initial studies were completed (Abad & Williams, 2006;Nicholson et al, 2008) and require ongoing evaluation.…”