TACKLING INEQUALITIES IN THE EARLY YEARS: KEY MESSAGES FROM 10 YEARS OF THE GROWING UP IN SCOTLAND STUDY

PART ONE: INEQUALITIES IN THE EARLY YEARS

GUS has highlighted that, even in the early years of a child's life, there are consistent inequalities, not only in outcomes, but particularly in risk behaviours that we believe have longer-term consequences for health and development.

Risk behaviours in pregnancy

In BC2, 8% of mothers in the highest income households smoked during pregnancy compared with 49% of those in the lowest income group^[3].

However, the social pattern in alcohol use in pregnancy is very different, with mothers living in the most advantaged circumstances being more likely to say they consumed alcohol during pregnancy^[4]. In BC2, 34% of those in the highest income quintile consumed alcohol while they were pregnant compared with 11% of mothers in the lowest income quintile^[5].

Low birth weight

In BC1, 5% of children in the highest income quintile were born with a low birth weight (defined as less than 2.5 kilos). This increased to 9% among those in the lowest income quintile^[6].

Breastfeeding

In BC2, while 81% of children in the highest income quintile were breastfed (even if just for a few days), this proportion dropped to only 45% among those in the lowest income quintile^[7].

Home learning activities

In BC2, 80% of parents in the highest income quintile looked at books or read stories to their child at age 10 months. This proportion dropped to 62% among parents in the lowest income quintile^[8].

Illness and long-term health problems

In BC2, by age three, 14% of children in the highest income quintile had a longstanding illness or disability, compared with 19% of those living in the lowest income quintile^[9].

In BC1, during the first four years of their lives, 12% of children in the highest income quintile were assessed by their main carer as having fair, bad or very bad health. The same was true of 26% of those in the lowest income quintile^[10].

Diet

Data collected from BC1 at age five shows that 13% of children in the highest income quintile were classified as having a relatively poor diet. This proportion increased to 39% in the lowest income group^[11]. Poor diet was defined as eating a small variety or no vegetables or fruit and frequent consumption of crisps, sweets and soft drinks.

Cognitive development

GUS has measured cognitive ability at ages three and five using an assessment of expressive vocabulary and non-verbal reasoning. The data has revealed that the cognitive ability gap is already apparent by both of these ages. With regard to vocabulary ability at age five, 20% of children in the highest income quintile had below average ability, compared to 54% in the lowest income quintile. For problem-solving ability, the equivalent proportions are 29% and 53%^[12].

The assessment data can also be used to express the gap in developmental age. At age five, compared with children in the lowest income quintile, those in the highest income quintile were around 13 months ahead in their knowledge of vocabulary and 10 months ahead in their problem-solving ability^[13].

Social, emotional and behavioural development

At entry to primary school, children in the lowest income group were around twice as likely (or more, depending on which measure was used) than those in the highest income group to exhibit borderline or abnormal social, emotional or behavioural health. For example, 19% of children in the highest income group had scores in the borderline or abnormal ranges for conduct problems compared with 43% of children in the lowest income group. With regard to emotional problems, the figures were 6% and 16% respectively and for hyperactivity they were 12% and 30% respectively^[14].

Social, emotional and behavioural development was measured again in GUS shortly before the child's eighth birthday. At this stage, the proportion of children classified as having high levels of social, emotional and behavioural difficulties was 3% among those living in households in the highest income quintile but 18% among those in lowest income quintiles^[15].

Life satisfaction

In BC1 at age eight, 25% of children in the whole sample were classed as having low life satisfaction, relative to the remaining 75%. However, a lower proportion of children in households in the highest income quintile (19%) reported low life satisfaction, compared to the lowest income quintile (29%)^[16].

GUS has also highlighted the considerable inequality that mothers face in the early years. Socio-economically disadvantaged households appear to face a double burden of inequality with the child and the main carer at greater risk of negative health outcomes.

Alcohol consumption

In BC2, when their children were aged 10 months, main carers in the highest income quintile were more likely to drink alcohol than those in the lowest income quintile. However, parents in the lowest income quintile were over twice as likely to drink five or more units on a typical drinking day compared with those in the highest income quintile (45% compared with 20% respectively)^[17].

Smoking

In BC2, when their child was aged three, smoking among main carers was 7% in the highest income quintile but 40% in the lowest quintile^[18].

In BC1, when their child was aged around eight, smoking among main carers was 7% in the highest income quintile and 44% in the lowest income quintile^[19].

Physical health

In BC1, 26% of mothers in the highest income quintile reported having a long-standing health problem or disability at some point during their child's first four years. This proportion increased to 47% among those in the lowest income quintile^[20].

Mental health

In BC1, 6% of mothers in the highest income group had poor mental health^[21] at two or more of the annual sweeps of data collection over the first four years of their child's life. This proportion increased to 24% among those in the lowest income quintile^[22].