Hertzman – social gradients in early child development

So the question then comes. What happens if children do not have equal access to nurturance at each of these different levels from the individual right through to the global environment?  And there’s a very simple answer to that.  And the answer is: That we get inequitable outcomes in terms of child development. What we call a social gradient in early child development. And this little graphic here shows the key domains of early development that matter early on and matter across the life course, so it represents physical health and well-being which matters early and across the life course. Communication skills, whether you understand and make yourself understood. Language and cognitive development – your thinking and reasoning skills and so forth. Emotional maturity – your ability to negotiate in difficult situations, your empathy, your helpfulness, etcetera, etcetera. Social competence – your ability to concentrate on tasks, work effectively in groups as opposed to being disruptive in one way or another. And all of these things are affected by the early years. And so what happens is, in most societies around the planet is, that the opportunities for developing across these domains differ greatly from one child to the next according to where they stand on that multi-layered set of social determinants and so by the time children reach school age what happens is we get inequities in their development and at the privileged end of society, the children of the best educated, wealthiest, and most privileged people in society, they tend, not always, but on average to get better opportunities to develop and at other ends of the spectrum among the poorest, the least educated and the least privileged families they tend to get the least opportunities to develop. And what we see when you go from the top end of the social scale in a society to the bottom end of the social scale that the fraction of children who are behind where we would like them to be on their development goes up in a step-wise, gradual fashion. So the most privileged, the fraction of vulnerable kids is slightly less than it is among the upper middle-class than it is among the middle of the middle class than it is among the poor than it is among the desperately poor. And we see this right across the world. And so to illustrate with that, with three examples. Here is the example of Canada – one of the world’s wealthiest countries. And if you look from most well-off quarter of the population, about 14% of children are behind where we would like them to be by the time they reach school age in their physical, in their social-emotional, or their language and communication skills. For the next middle-class group, about 23% are behind where we’d like them to be and then for the poor and the very poor it goes up over 30%, so you can see that as we go down the socioeconomic spectrum, the fraction of vulnerable children gradually goes up. Similarly, if we look at a middle-income country like Jamaica, it goes from a low of 19% among the most privileged, gradually up to reaching over 45% at the low end of the socioeconomic spectrum. And similarly in a poor, and war-torn area like Kosovo, the low of 30% among the most privileged people gradually going up into the 40-plus percent up to over 55% of the children are behind where we’d like them to be on their development by the time we reach school age. And what this shows is, an unequivocal objective for us which is that what we want to do is try to reduce these gradients in a positive direction because once these gradients, or this gradual increase in the fraction of vulnerability from the most to the least-privileged people in society, once that establishes itself it tends to track forward over time and influence children’s life chances and influence society’s ability to be able to produce healthy, competent adults to support the future.