Abstract
The relationship between child development and adolescent health, and how this may be modified by socio-economic conditions, is poorly understood. This limits cross-sector interventions to address adolescent health inequality. This review summarises evidence on the associations between child development at school starting age and subsequent health in adolescence and identifies factors affecting associations. We undertook a participatory systematic review, searching electronic databases (MEDLINE, PsycINFO, ASSIA and ERIC) for articles published between November 1990 and November 2020. Observational, intervention and review studies reporting a measure of child development and subsequent health outcomes, specifically weight and mental health, were included. Studies were individually and collectively assessed for quality using a comparative rating system of stronger, weaker, inconsistent or limited evidence. Associations between child development and adolescent health outcomes were assessed and reported by four domains of child development (socio-emotional, cognitive, language and communication, and physical development). A conceptual diagram, produced with stakeholders at the outset of the study, acted as a framework for narrative synthesis of factors that modify or mediate associations. Thirty-four studies were included. Analysis indicated stronger evidence of associations between measures of socio-emotional development and subsequent mental health and weight outcomes; in particular, positive associations between early externalising behaviours and later internalising and externalising, and negative associations between emotional wellbeing and later internalising and unhealthy weight. For all other domains of child development, although associations with subsequent health were positive, the evidence was either weaker, inconsistent or limited. There was limited evidence on factors that altered associations. Positive socio-emotional development at school starting age appears particularly important for subsequent mental health and weight in adolescence. More collaborative research across health and education is needed on other domains of development and on the mechanisms that link development and later health, and on how any relationship is modified by socio-economic context.
Highlights
Inequalities in many child health outcomes are increasing in the UK and the health of those living in its most disadvantaged areas are amongst the worst in the developed world [1]
There is evidence that aspects of child development at school starting age are associated with later academic success, but less is known about whether and how particular dimensions of child development influence health outcomes in adolescence. This gap in understanding limits cross-sector interventions to improve adolescent health and reduce health inequality. This review addresses this gap by undertaking a participatory systematic review to: (1) synthesise evidence on the relationship between child development at school starting age (3–7 years) and subsequent health in adolescence (8–15 years) and (2) identify factors that shape the relationship
The review clearly shows that positive development on starting school is good for later health outcomes, but that the evidence is stronger for relationships between some domains of child development than others, with gaps in the evidence base across domains
Summary
Inequalities in many child health outcomes are increasing in the UK and the health of those living in its most disadvantaged areas are amongst the worst in the developed world [1].
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