Pre-school childcare and inequalities in child development.

Michael J Green,Elaine Robertson,Anna Pearce,Alison Parkes,S Vittal Katikireddi,S Vittal Katikireddi

doi:10.1016/j.ssmph.2021.100776

Abstract

Centre-based childcare may benefit pre-school children and alleviate inequalities in early childhood development, but evidence on socio-emotional and physical health outcomes is limited. Data were from the UK Millennium Cohort Study (n = 14,376). Inverse-probability weighting was used to estimate confounder-adjusted population-average effects of centre and non-centre-based childcare (compared to parental care only) between ages 26–31 months on (age 3): internalising and externalising symptoms, pro-social behaviour, independence, emotional dysregulation, vocabulary, school readiness, and body mass index. To assess impacts on inequalities, controlled direct effects of low parental education and lone parenthood on all outcomes were estimated under two hypothetical scenarios: 1) universal take-up of centre-based childcare; and 2) parental care only. On average, non-centre based childcare improved vocabulary and centre-based care improved school readiness, with little evidence of other benefits. However, socio-economic inequalities were observed for all outcomes and were attenuated in scenario 1 (universal take-up). For example, inequalities in externalising symptoms (according to low parental education) were reduced from a confounder-adjusted standard deviation difference of 7.8 (95% confidence intervals: 6.7–8.8), to 1.7 (0.6–2.7). Inequalities by parental education in scenario 2 (parental care only) were wider than in scenario 1 for externalising symptoms (at 3.4; 2.4–4.4), and for emotional dysregulation and school readiness. Inequalities by lone parenthood, which were smaller, fell in scenario 1, and fell further in scenario 2. Universal access to centre-based pre-school care may alleviate inequalities, while restricted access (e.g. during lockdown for a pandemic such as Covid-19) may widen some inequalities in socioemotional and cognitive development.

Highlights

Children from less socio-economically advantaged families tend to experience worse health and poorer socio-emotional and cognitive development than their more advantaged peers (Bradley & Corwyn, 2002; Pillas et al, 2014)
Data were from the UK Millennium Cohort Study (MCS), a nationally representative survey of children born in the UK, September 2000–January 2002 (Centre for Longitudinal Studies, 2014)
To address Question 1, we examined the association between childcare and the children’s outcomes adjusting for all the confounders listed above as well as for education and family structure

Summary

Introduction

Children from less socio-economically advantaged families tend to experience worse health and poorer socio-emotional and cognitive development than their more advantaged peers (Bradley & Corwyn, 2002; Pillas et al, 2014). Childhood education and care (ECEC) may benefit children’s cognitive and social develop ment (Bradley & Vandell, 2007; D’Onise et al, 2010; Melhuish et al, 2015), though a recent meta-analysis of natural experiment studies found mixed evidence, with the most consistent positive effects for cognitive and academic outcomes, higher-quality programmes, and publicly-funded provision (van Huizen & Plantenga, 2018). Mechanisms of benefit may include provision of cognitive or academic training and social experiences with other chil dren and adults, boosting confidence and easing transitions into school-based settings (Melhuish et al, 2015)

Methods

Results

Discussion

Conclusion