Poverty, parenting and poor health: comparing early years’ experiences in Scotland, England and three city regions

Experiences in early years and childhood have profound and long-lasting consequences for the health and wellbeing of individuals. This has prompted considerable interest from policy-makers, not least because investment in the early years can potentially avoid much more costly public expenditure to alleviate problems later in life. At a UK-level, the Field Review (2010) argued that “children’s life chances are most heavily predicated on their development in the first five years of life”. In Scotland, the importance of early years has been recognised at a national level by successive devolved administrations, a process that is likely to be further strengthened with the recent publication of the National Parenting Strategy. Deacon (2011) summarised the human, social and economic benefits of a focus on early years and the support for this approach, highlighting documents such as The Early Years Framework8, Getting it Right for Every Child and the Scottish Parliament Report on preventative spending. Deacon also argued that Scotland can and should improve its support for the early years by ensuring that the importance of maternal health and warm, secure parent-child relationships is widely understood, investing in a network of child and family centres across Scotland, and by empowering families, children, communities and frontline professionals. In West Central Scotland, the Glasgow Health Commission (2009) was explicit about the need to prioritise support for parents and children in the early years, for example through parenting programmes and advice

Negative early years’ and childhood experiences have also been proposed as a possible influence on the ‘excess’ levels of poor health seen in Scotland, especially in Glasgow and the West Central Scotland conurbation. This ‘excess’ relates to the higher levels of mortality seen in Scottish areas, even after controlling for age, sex and deprivation. It has been shown to exist for Scotland compared with England and more recently for Glasgow compared with Liverpool and Manchester, where despite these cities sharing identical deprivation profiles, premature mortality is 30% higher in Glasgow city14. Following publication of these studies, a number of hypotheses have been proposed, ranging from ‘upstream’ (e.g. social and economic inequality, deindustrialisation) to ‘downstream’ explanations (e.g. differences in health behaviours or individual values). Early years and childhood factors, especially family breakdown, acrimony between partners or dysfunctional parenting, are included among these hypotheses as a ‘midstream’ explanation. Research in this area may therefore provide insights into the phenomenon of excess mortality. This report aims to do this by examining whether there are differences in early years’ and childhood experiences in Scotland and England, and the three city regions of Glasgow and the Clyde Valley (GCV), Merseyside and Greater Manchester.