Pre-school childcare and inequalities in child development

Green, M. J. , Pearce, A. , Parkes, A. , Robertson, E. and Katikireddi, S. V. (2021) Pre-school childcare and inequalities in child development. SSM - Population Health, 14, 100776. (doi: 10.1016/j.ssmph.2021.100776) (PMID:33768138) (PMCID:PMC7980060)

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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.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal and Parkes, Dr Alison and Green, Dr Michael and Pearce, Dr Anna and Robertson, Ms Elaine
Creator Roles:
Green, M. J.Conceptualization, Methodology, Formal analysis, Data curation, Writing – original draft, Writing – review and editing, Visualization
Pearce, A.Conceptualization, Methodology, Writing – original draft, Writing – review and editing
Parkes, A.Methodology, Writing – review and editing
Robertson, E.Writing – review and editing
Katikireddi, S. V.Conceptualization, Methodology, Writing – review and editing
Authors: Green, M. J., Pearce, A., Parkes, A., Robertson, E., and Katikireddi, S. V.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:SSM - Population Health
ISSN (Online):2352-8273
Published Online:12 March 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in SSM - Population Health 14: 100776
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
3048230021Inequalities in healthAlastair LeylandMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
3048230031Relationships and healthKirstin MitchellMedical Research Council (MRC)MC_UU_00022/3HW - MRC/CSO Social and Public Health Sciences Unit
727631Social Relationships & Health ImprovementLisa McDaidOffice of the Chief Scientific Adviser (CSO)SPHSU11HW - MRC/CSO Social and Public Health Sciences Unit
727651Measuring and Analysing Socioeconomic Inequalities in HealthAlastair LeylandOffice of the Chief Scientific Adviser (CSO)SPHSU13HW - MRC/CSO Social and Public Health Sciences Unit
174091Improving life chances & reducing child health inequalities: harnessing the untapped potential of existing dataAnna PearceWellcome Trust (WELLCOTR)205412/Z/16/ZSHW - MRC/CSO Social & Public Health Sciences Unit
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiOffice of the Chief Scientific Adviser (CSO)SCAF/15/02SHW - Public Health