When we talk about inequality, a number of things come to mind: how much people earn, the schools they go to and the houses they live in. Countless debates take place around the world about how best to close the gap between the richest and the poorest in our societies.
Underlying all this, though, is something even more fundamental: a child’s early years.
With the help of thousands of studies and trials, we have never known more about just how important early development is to a child’s future. Their school achievement, future wages, likelihood of going to prison, chances of having major health problems – all these factors are directly linked to children’s physical and mental growth in their first five years, and especially in their first 1,000 days.
After 1,000 days, a child’s brain has reached 80% of its adult weight
In Jamaica, for example, a landmark study conducted in 1986-7 randomly selected a group of growth-stunted toddlers for two years of regular visits by community health professionals, who offered parents advice and encouraged positive mother-child interactions. Twenty years later, their wages were a staggering 25% higher than a control group of stunted toddlers who didn’t receive the extra help.
As that study illustrates, improvements in children’s development can have a significant impact on their future lives. A number of similar pieces of research have demonstrated promising results on a small scale, but the challenge ahead is huge: in developing countries, more than 200 million children under five fail to reach their developmental potential.
Why the first five years matter
Breakthroughs in early childhood development have been enabled by a deeper understanding of how babies develop. Between life in the womb to heading off to school, infants develop at an astonishing rate. After 1,000 days in the world, their brain has reached 80% of its adult weight.
A child’s brain architecture is built in a “bottom-up” sequence, meaning each important step is directly affected by the developments preceding it. The growing brain is ‘’experience-expectant’’, meaning that experiences both positive and negative – such as positive interactions with a parent, or trauma from a dangerous environment – shape its capacities and have a lasting impact.
At this stage in their lives, children’s physical and mental development are extremely impressionable. The right policies interacting with key areas of young children’s early years can therefore completely change their future, and help to ensure that every child has the best start.
Stunting: The biggest driver of inequality
The biggest issue in childhood development is ‘stunted’ growth, caused by several factors including undernutrition and disease, which affects nearly one in four children globally. The problem is particularly severe in sub-Saharan Africa and South Asia: in India a staggering 62 million children under five are stunted.
Stunting is linked to underachievement at school, lower economic productivity, and a higher likelihood of diabetes and cancer
Stunting hampers children’s physical and cognitive development, holding them back throughout their lives. It’s linked to underachievement at school, lower economic productivity, and a higher likelihood of future health problems such as diabetes and cancer. What’s more, the problem often becomes intergenerational, as malnourished children become malnourished mothers, whose lack of nutrition then begins affecting their baby in the womb.
The good news is this situation is improving. In 1990, stunting affected 39.6% of children under five, compared to 22.9% last year. Results in Peru have been particularly impressive, where their ‘National Strategy against Child Malnutrition’ reduced stunting from 22.9% in 2005 to 17.9% five years later. Involving government at all levels, along with sectors from health to housing, the strategy implemented several programs, such as a cash-transfer initiative which targeted the poorest municipalities to try to improve their health standards.
While stunting is the biggest issue, the impact of health and nutrition on developmental inequality in children is by no means limited to low-income countries. Maternal and paternal obesity, for example, is associated with delays in child development and significantly increases the probability of the child’s obesity in later life.
Learning early and living safely
An essential aspect of brain development is children’s access to quality education before school. We know that brain stimulation from a young age – from simple games to engaging with language – play a substantial part in building the brain’s architecture.
A number of studies have shown that even things like listening to music can have a substantial impact on brain development. Tests at the University of Washington have shown music to vastly improve infants’ ability to detect patterns in their environment, helping them make sense of their surroundings which allows them to keep calm and focus their attention on creative pursuits.
Most children around the world don’t have access to pre-school education, which is essential for developing children’s cognitive ability to help them make the most out of school. Inevitably, it is families with more resources who have the means to send their children to private pre-schools, which means that children in poorer families start their education a step behind.
In New York City, as part of the “Pre-K for All” program, the Department for Education is offering an evidence-based enhancement to pre-school education called “ParentCorps”. Consisting of 14-week programs for parents, children and teachers, the aim is to build the social, emotional and behavioural regulation skills which allow children to thrive at school. In a trial including black and Latino children in low-income communities, the impact on their kindergarten reading scores after the project suggested they had closed the achievement gap documented between black and white students.
Along with the right early education and stimulation, children’s environments in their early years have a significant impact on their development. Developing positive relationships with a caregiver as a young child can minimise the risks of problems in later life such as anger and difficulties forming friendships.
Toxic stress can cause damage to children’s brain development, which leaves a mark. In the same way that music and games help build brain architecture, stress caused by events such as domestic violence, conflict or displacement, has a lasting impact on young children.
The key to progress: parenting
If inequality is to be tackled head-on, positive early childhood interventions must get to those who need it. Perhaps unsurprisingly, parents, as the key caregivers for young children, usually have the most important role in this. From what is consumed during pregnancy to how mothers and fathers interact with their toddlers, parents have a significant influence over how their child develops.
In the United States, neonatal abstinence syndrome – a condition when babies are exposed to addictive drugs while in the womb – has quadrupled in 15 years. In 2012, almost 22,000 babies were born in withdrawal in the United States; around one every 24 minutes.
In response, a new program in Kentucky called PATHways is providing care to mothers who are addicted to opioids, using a number of interventions informed by the latest developments in science. While it is early days, studies of similar programs in the past have suggested that mothers who complete the program are more likely to beat their addictions and become better parents.
Due to poor child growth, Pakistan is estimated to lose 8.2% of its future GDP
Even very small changes in parenting can make a huge difference. Simply spending more time and playing engaging games with children can increase their cognitive development.
In Norway, for example, maternity leave was extended in July 1977, from just 12 weeks of unpaid leave to four months of paid leave and 12 months unpaid. A study showed that children born afterwards were 2% less likely to drop out of school, and at 30 years old earned 5% more than those children before the policy change.
Why early childhood must be a priority
Not only can the right early childhood policies tackle inequality head-on, but in the long-term, they can save governments money.
For example, Nurse-Family Partnerships in the United States, which provides extra support at home for first-time mothers, is expected to save $5.70 in future costs avoided for every $1 it spends. According to one projection, by 2031 the program could reduce estimated spending on Medicaid, TANF, and food stamps by $3 billion, dwarfing its rough cost of $1.6 billion.
Although it can take a while for results to be seen and money to be saved, there are countless similar examples of these positive solutions saving money in the long term.
As well as minimising the inequality between them, investing in early childhood boosts the productivity of future generations, making us all richer. It’s estimated that every dollar invested in quality preschool programs, for example, will yield a return of $6 to $17.
And countries cannot afford to not do so. Due to poor child growth, Pakistan is estimated to lose 8.2% of its future GDP, which represents three times the 2.8% of GDP that it currently spends on health care.
The Apolitical view
Now policymakers have the science and solutions at their fingertips, the next key step is transforming positive projects into policies at scale. As shown by the issues and case studies outlined above, the importance of early childhood development – and the potential impact associated with early childhood policies – makes it a huge priority for governments.
Millions of children around the world start their lives a step behind, their development impeded before they have even reached school. If policymakers are to face societal inequality head-on, surely few issues warrant more attention than early childhood development?
(Picture credit: Pexels/Pixabay, Flickr/Donnie Ray Jones)