Early Childhood Education and the Social Determinants of Health

This blog is based on an article in the Journal of Social Policy by Helen Van Eyk, Fran Baum, Matt Fisher, Colin MacDougall and Angela Lawless. Click here to access the article.

Early childhood education and development is internationally recognised as important to child health and wellbeing and to enabling children to become healthy productive adults.  We undertook research to assess Australian state and federal early childhood education policy in 2019 to determine the extent to which it recognises and acts on the social determinants of health and health equity.  

The social determinants of health and health equity are vital in shaping early childhood experiences.  They are the political, economic, social and cultural factors that determine the distribution of health and illness for individuals and populations.  They determine the everyday circumstances in which people are born, live and age and include the wider forces and systems that shape the conditions of daily life.  As a social determinant, early childhood development has a determining influence on subsequent life and health, and on addressing societal inequities.  Other social determinants of health, such as poverty, parental education and employment, and housing/homelessness, affect children’s access to or capacity to benefit from early childhood education by affecting children directly or shaping the circumstances and health status of their families and communities.

We selected 45 policy documents for analysis from Australian federal and state governments, including education department policies and whole-of-government policies that had a major focus on early childhood education and development.  We found a high degree of consistency in language, concepts and approaches in all the policies.  The policies included consistently recurring themes, suggesting significant policy coherence and a common understanding of the benefits of early childhood education.  The themes we identified during our policy analysis were: 

  • Best start in life and lifelong benefits for the child
  • Longer term social and economic benefits for society
  • Intersectoral collaboration, service integration and partnerships with families and communities
  • Workforce and service quality.

Early childhood education was widely recognised as a social determinant of health in the policies and the impacts of other social determinants of health and health equity were acknowledged.  

Although the policies recognised the benefits of early childhood education for children in the present, we found that the idea of education making a difference was mainly future-focused.  Current circumstances, such as intergenerational poverty, are a form of structural disadvantage today, and so a policy focus on improving current daily living conditions is important.  Early childhood education was positioned as a response, assuming education prevents future socioeconomic disadvantage.  

There was less recognition that current socioeconomic inequalities and entrenched forms of intergenerational disadvantage require redress, and therefore less recognition of the need to address structural inequities such as power and resources.  There was also less evidence of horizontal policy coherence with other sectors’ policies that adversely affect parents and families, such as income support, employment, housing and incarceration.  While these issues are not education sector core business, early childhood education policy should point to them given their recognised impact on child wellbeing.

The policies we analysed lacked strategies to address social determinants, or to engage with other sectors for this purpose.  While some policies focused on breaking the cycle of disadvantage, they did not explore potential policy responses to pathways from intergenerational disadvantage to reduce poverty.  

The idea of early childhood education’s importance appears to have cut through Australia’s congested policy space, resulting in strong vertical policy coherence within the education sector.  The consistent messages across the policies have been maintained despite changes of government, suggesting bipartisan recognition of the importance of early childhood education investment.  This bipartisan support may be a result of balancing social and economic agendas to successfully appeal to both neoliberal and social democratic perspectives.  Early childhood education policy has become an undisputed policy priority, with all states pursuing increased intersectoral collaboration and most states establishing integrated children’s centre models to address early childhood education within the family and community context, suggesting some horizontal policy coherence.  

The policy coherence within Australian early childhood education policy is positive, as is the acknowledgement of education as a social determinant of health and of the impacts of other social determinants.  However, the policies we analysed lacked strategies to address social determinants, or to engage with other sectors for this purpose.  Education is a powerful equalizer, but this power is lost if children return to families experiencing stress, poverty, and inadequate housing.  To harness early childhood education policies’ power and increase coherence, all sectors that impact on parents’ and families’ lives need to address the social determinants of health and health equity, for example through better paid parenting leave for fathers, secure housing for families, and income support to ensure children are not living in poverty.  This highlights the importance of intersectoral policy advocacy and dialogue.

About the authors

Helen Van Eyk is a Senior Research Fellow at Flinders University.

Fran Baum is Professor of Public Health at Flinders University.

Matt Fisher is a Senior Research Fellow at Flinders University.

Colin MacDougall is Emeritus Professor of Public Health at Flinders University.

Angela Lawless is a Senior Lecturer at Flinders University.


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