What is your worst fear as a parent? Catastrophic illness, but thankfully it is uncommon. More subtle, but perhaps more important, is the tragedy of children being denied the opportunity to live up to their potential. It is happening in England today.
At age 5 only 59 pe cent of children are rated as having “good” child development. Or, to put it more miserably, 41 per cent of children don’t achieve a good level of development at age 5 – a really shocking finding. Predictably, poor early child development is intimately related to social circumstances: the greater the level of deprivation the more likely are children to have poor child development.
We published these figures today as a follow up to the Review on Health Inequalities in England, Fair Society Healthy Lives, that I published two years ago.
Early child development was at the centre of our life course approach to social inequalities because ancient wisdom and modern science come together – the child is father of the man. What happens in early childhood affects school careers, then whether the individual becomes a school leaver with no job and no aspirations, or goes on to get qualifications, a good job, a reasonable income, and hence the conditions that lead to good health in adulthood.
Health inequalities in adulthood have their origins in the early years of life.
How is it possible that in an advanced country like this one 41 per cent of children fail to achieve a “good” level of development? Is this not some artefact of measurement? Probably not. Out of 65 countries the UK is ranked 25th for reading, 28th for maths and 16th for science. Not good. Our elite universities are the best in Europe on various markers of performance. But societies and individuals need more than high functioning elites, they need high averages to be healthy and functioning well. We are failing our children on a grand scale.
How does such failure come about? The answers are in. The determinants of early child development start with effects from the children themselves, probably biological in nature, but are importantly influenced by quality of parenting.
Again, ancient wisdom and modern science come together: cuddling, playing, talking, reading, and generally loving children have huge influence on the quality of early child development. The evidence shows that social inequalities in early child development are related to inequalities in society. At the extreme end, policies that reduce child poverty, will reduce inequalities in early child development.
Professor Sir Michael Marmot is Director UCL Institute of Health Equity