1. Health inequalities in the early years
Catherine Bromley ScotCen

2. Research questions
What is the extent and character of health inequalities in the early years?
What factors, if any, correlate with the avoidance of negative early health outcomes, among families from disadvantaged backgrounds?

3. Defining health and inequality
“…not merely the absence of disease or infirmity” (WHO)
Measures spanned pregnancy to 46 months
Interested in outcomes (e.g. poor health)…
…and risk factors for negative outcomes (e.g. poor diet)
Inequality
“The unequal socio-economic patterning of outcomes which disadvantages less affluent children”
Analysis focuses on area deprivation and household income

4. What do we
already know?

5. Origins of Health Problems often Linked to Circumstances in Early Life
2nd Decade
3rd/4th Decade
5th/6th
Decade
Old Age
Obesity
Hypertension
Depression
Addictions
School Failure
Teen pregnancy
Criminality
CHD
Diabetes
Premature aging
Memory loss
Hertzman C. Early Child Development: A powerful equalizer.
Cited by: Sally Haw, MRC Scottish Collaboration for Public Health Research and Policy

6. What does
GUS add?

7. Inequalities in pregnancy
Household income quintile

8. Inequalities in early childhood
Household income quintile

9. Developmental outcomes (46 months)
Household income quintile

10. % with a long-term condition at least once since child’s birth
Household income quintile

11. What can
we do?

12. Total no. of negative outcomes

13. Total no. of negative outcomes

14. What might help disadvantaged children avoid negative outcomes?
Child factors
Being a girl
Maternal factors
Not experiencing a long-term condition in child’s early years
Older age at birth
Having a positive attitude towards seeking help early on
Household factors
A highly enriched home learning environment
At least one adult in full-time work
Neighbourhood factors
Not having low satisfaction with facilities in local area

15. Early risks and outcomes
Social gradients generally steeper for risk factors than for outcomes
Policy response clearly beyond reach of NHS alone
Needs of wider family critically important
Emotional, cognitive and linguistic development all show clear gradients
Often more so than for illness/poor general health measures
Powerful illustration of the potential – and need – for:
Early identification and intervention
Action to combat poverty and exclusion