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Mitigating the impact of health inequalities though early learning and childcare

In order to improve the outcomes for Scotland’s most vulnerable children it is essential that we aim to reduce the persistent inequalities that prevent health being improved for all.  Put simply unequal outcomes in health are unfair differences in the health of the population that occur across social classes or population groups. They are the result of social circumstances and they are not inevitable.

There is an increasing bank of evidence stressing the importance of prevention and early intervention during pregnancy and in the earliest years of a child’s life in improving long-term health and wellbeing outcomes. From the time a child is conceived they are affected by their life circumstances. Many different factors and events during pregnancy and early infancy, including parental security, health and the home environment, all shape the future development and learning outcomes for children and can have a lifelong impact. These factors can be things like a family’s ability to pay for goods and services, their exposure to harmful physical environments, like poor quality housing and dampness,  a lack of green spaces and the resources that parents have available to them to support them in their parenting role.

We know that these factors act together to increase the likelihood of better or poorer outcomes. However it is possible through our actions to intervene and support parents so that potentially poorer outcomes for the child improve. Opportunities to reduce these inequalities in outcomes are reduced as a child gets older which is why it is so important to intervene early.

Interventions should support the development of skills and resources for the child and their family to enable them to mitigate the potential impact of risk factors in their lives. Promoting responsive, consistent parental care contributes to providing a nurturing environment for children.  This supports the development of secure child attachment and resilience which is an important protective factor for emotional, social and cognitive development. Community Childminders provide such interventions in a non-judgemental, safe, nurturing environment.

Play is another area where early learning and childcare workers can support the development of parental skills.  Physical movement and active play have a positive impact on the development of social skills and bonding.  This begins in the earliest days by promoting skin to skin contact and baby massage, which also contribute to the development of secure attachment.  For babies and young children, learning and movement are interdependent, and encouraging parents and carers to play and interact with their baby can help build a sense of wellbeing that is important throughout childhood and adult life.  Establishing daily play routines early in childhood encourages children’s enjoyment of physical activity and is important in helping develop the attitudes, skills and behaviours for lifelong physical activity. 

Early learning, play and childcare workers working along with families can contribute by encouraging and supporting active and healthy lifestyles among parents or carers and their children.   Families who require additional support can be encouraged to play with their children using activities from resources such as play@home. The play@home programme is a set of books given to parents that can be shared with professionals to help strengthen the relationship between parents and children and develop parental self-esteem, giving them confidence to try new activities with their children.  Professionals can help parents use these resources by talking through the books while they work with families, creating opportunities for play and story times and sharing ideas as the parents confidence increases. 

Play@home has been evaluated to ensure it meets the needs of Scotland’s parents. A number of evaluations have reported that parents found the resources useful or very useful. In 2011 an impact evaluation of play@home found that exposure to the programme resulted in improved physical skills in toddlers and preschool children and an increase in time spent in more vigorous activity in preschool children. In addition parents scored their enjoyment of parenthood more highly when they had used play@home. Further evaluation in 2012 found that practitioners who had been using play@home for a number of years integrated it into their provision of additional support for vulnerable families, for example by  including play@home activities in their groups to encourage some back-to-basics play with parents. As Susan Deacon said in 2011, “Not everything that matters costs money”. play@home uses everyday articles to create toys and games, meaning everyone can take part.