Give every child a good start in life - Child of our...
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Give every child a good start in life Yvonne Kelly International Centre for Lifecourse Studies in Society and Health (ICLS) www.ucl.ac.uk/icls @icls_info @childofourtime
Transcript of Give every child a good start in life - Child of our...
Give every child a good start in life
Yvonne Kelly International Centre for Lifecourse Studies in Society and Health (ICLS) www.ucl.ac.uk/icls @icls_info @childofourtime
CSDH conceptual framework for action on the social determinants of health
Solar O, Irwin A (2010): A Conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva: World Health Organization.
Socioeconomic position
Social class Gender Ethnicity
Education
Occupation
Income
Child health and
development
Behavioural – including home environment and parenting activities (reading and telling stories), family routines (sleeping and meal times, screen based media use), physical activity Material - including, housing quality, overcrowding, air pollution Psychosocial – including parent mental health, parent-child interactions, discipline strategies, parental warmth and hostility
Soc
ial a
nd p
ublic
pol
icy
incl
udin
g he
alth
, edu
catio
n,
wel
fare
, hou
sing
Structural determinants Intermediary determinants
Social determinants for child health and development
-20
-15
-10
-5
0
5
10
0 1 2 3 4 5 6 7+
Num
bero
fmon
ths
advanced
ord
elayed
Numberofriskfactors
Verbal months ahead or behind at age 7 by number of risk factors
Kelly et al, forthcoming
0
5
10
15
20
25
30
0 1 2 3 4 5 6 7+
% c
linic
ally
rele
vant
pr
oble
ms
Number of risk factors
Mother Teacher
Clinically relevant behavioural problems at age 7, by number of risk factors
Kelly et al, forthcoming
Regression coefficients for behavioural difficulties scores (mother report) by non-regular bedtimes throughout early childhood, cumulative effects
0.0
1.0
2.0
3.0
4.0
5.0
any 1 age Any 2 ages All 3 agesUnadjusted Adjusted
Kelly, Kelly, Sacker Pediatrics 2013;132:e1184-93
-2.0
-1.5
-1.0
-0.5
0.0
0.5
1.0
Non-regulartoregular Regulartonon-regular
Diffe
renceinbeh
avioural
difficul7essc
ore
Changebetweenages3and7 Changebetweenages5and7
The effects of changes in the regularity of bedtimes on behavioural difficulties scores
Kelly, Kelly, Sacker Pediatrics 2013;132:e1184-93
Longitudinal Verbal Profiles
30
35
40
45
50
55
60
65
70
3 5 7 9 11
Mea
n B
AS
scor
es
Age
Average (74.9%) High (19.5%) Low (5.6%)
Zilanawala et al, Eur J Pub Health 2016
BMI trajectories in childhood
14
16
18
20
22
24
26
28
30
32
14
16
18
20
22
24
26
28
30
32
3 5 7 9 11
BM
I
Age Overweight range Obese range T1 Stable T2 Decreasing T3 Moderate Increasing T4 High Increasing
Kelly et al Pediatrics 2016
Being read to at age 3
*** differences compared to those read stories to every day p<0.001 Kelly et al, forthcoming
80 85 90 95
100 105 110
Every day 1-6 days/week ***
Less than weekly ***
Test
sco
re
School readiness
30
35
40
45
50
55
Every day 1-6 days/week ***
Less than weekly ***
Test
sco
re
Verbal ability
0 5
10 15 20 25 30
Every day 1-6 days/week ***
Less than weekly ***
Perc
ent
Socioemotional difficulties
-1.4
-1.2
-1.0
-0.8
-0.6
-0.4
-0.2
0.0
0.2
Diffe
renceinbeh
avioural
difficul7essc
ore
Changetoreadingdaily Changetoreadingweekly
Change in frequency of being read to, ages 3 to age 5
Kelly et al, forthcoming
Longitudinal Verbal Profiles
30
35
40
45
50
55
60
65
70
3 5 7 9 11
Mea
n B
AS
scor
es
Age
Average (74.9%) High (19.5%) Low (5.6%)
Zilanawala et al, Eur J Pub Health 2016
58.7 47.1
41.6
0 10 20 30 40 50 60 70
Every day 1-6 days/week ***
Less than weekly ***
Perc
ent
Read to at age 3
54.1
37.2
0
10
20
30
40
50
60
Girls Boys
Perc
ent
Reading for pleasure most days at age 11
Kelly et al, forthcoming
42.1 30.4 26.3
0 10 20 30 40 50 60 70
Every day 1-6 days/week ***
Less than weekly ***
Perc
ent
Read to at age 3
0.6
0.8
1.0
1.2
1.4
1.6
1.8
2.0
Self esteem Happiniess Socioemotional difficulties
Odd
s R
atio
Kelly et al, forthcoming
Well being at age 11 by reading for pleasure
Income gap in the risk of socioemotional difficulties at 5 years of age
0 1 2 3 4 5 6 7 8 9
10
Richest (2.0%)
Band 2 (4.0%)
Band 3 (6.4%)
Band 4 (11.2%)
Poorest (15.9%)
Ris
k
Income
Kelly, Sacker, Del Bono, Francesconi, Marmot. Arch Dis Child 2011;96:832-7
Summary • Early child health and development matters – now
and for the future
• Stark socioeconomic inequalities are evident and these start early
• Structural factors shape ‘intermediary’ environments: behavioural, material, psychosocial
• To give every child a good start in life - action is needed on intermediate and structural influences
Bridging social and biological sciences
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ICLS LIFECOURSE STUDIES IN SOCIETY AND HEALTH
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