Early Child Development: A Powerful Equalizer

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Early Child Development A Powerful Equalizer

• Clyde Hertzman
• Lori G. Irwin
• Knowledge Hub for ECD
• Human Early Learning Partnership, UBC
• World Health Organizations
• Commission on Social Determinants of Health

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WHOs Commission on Social Determinants of Health

• The social determinants of health refer to both
  specific features of and pathways by which
  societal conditions affect health and that
  potentially can be altered by informed action.
  
• Krieger N. A glossary for social epidemiology J.
  Epidemiology Community Health 2001 55693-700

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Knowledge for Action

• The goal is not an academic exercise, but to
  marshal scientific evidence as a lever for policy
  change aiming toward practical uptake among
  policymakers and stakeholders in countries.

WHO Director-General LEE Jong-Wooks address to
the World Health Assembly, May 2004
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Core Values for CSDH

• Health equity
• "the absence of unfair and avoidable or
  remediable differences in health among groups
  defined socially, economically, demographically
  or geographically"
• Inequity ? inequality health inequities reflect
  social stratification
• Health equity concerns outcomes and also health
  opportunity

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CSDH Goal-driven structure
Country work
Leadership/Advocacy
Civil Society
Tackling social determinants
Action
Commissioners
Strengthening Health Equity
Evidence/Learning
Knowledge Networks
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CSDH Knowledge Networks
Women/ gender
Priority Public Health Conditions
Measurement / Evidence
Health Systems
Early Child Development
Health Equity
Urban Settings
Globalization
Social Exclusion
Employment Conditions
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Organizational Hub
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Knowledge Network for ECD

• Synthesize knowledge about the associations
  between social determinants and health equity
  policy and programs, and processes for addressing
  SDH
• Develop useful recommendations to inform
  policy, action and leadership globally

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Environments Matter

• ECD--physical, social/emotional,
  language/cognitive development
• Biological Embedding--environments get under the
  skin
• ECD is socially determined and, in turn, is a
  determinant of health across the life course
• ECD is primarily influenced by nurturant
  environments
• Intimate level (family) to the broadest level
  (global)

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Relational Community (Social ties,Tribe,
Religion, etc.)
ECD Services Programs
Civil Society
Family, Cultural, Economic, Social Environment
Institutional/historical time
Individual Brain and Biological Development,
Genetics, Age, Sex
Family Health Status and Dwelling Environment
Residential Community Health Status and
Cultural, Economic, Service Social Environments
Regional Health Status and Ecological, Economic,
Policy, Political Social Environments
National Health Status, Ecological, Economic,
Policy, Political Social Environments
Global Ecological, Corporate/Economic, Policy,
Political Social Environments
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• What we said

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Health problems start in early years

• Obesity/stunting
• Mental health (depression)
• Heart disease
• Literacy and numeracy skills
• Aging and Memory Loss
• Blood Pressure
• Non-insulin Dependent Diabetes

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Mismatch between Investment and Opportunity
Evidence
Optimal Investment Levels
Source Carneiro Heckman, Human Social Policy
(2003)
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Child Survival
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• The conditions in which children are dying are
  the same conditions in which children are
  surviving

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• Overarching Messages
• Transactional environment is the principal social
  determinant of healthy child development.
• Because of sensitive periods in brain
  development, early environments are the most
  powerful determinant of basic competencies.
• Early development goes on to influence health, in
  different ways, across the life course.
• Inequities in ECD have the capacity to threaten
  the level of competency needed for societal
  survival.

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Final Report Recommendations

• The World Health Organizations unique
  contribution to early child development globally
• Generating the necessary commitment at multiple
  levels of society
• Structural requirements for implementation
• Strategies for implementation
• Monitoring processes and outcomes related to ECD
• Creation of a Global Alliance for Early Child
  Development

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GA-ECDAligning Agendas

• MDG
• CSDH/WHO
• UNCRC-GC7
• GMR/UNESCO
• Lancet Series
• CG-ECCD

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Global Initiative GA-ECD
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I would like
To be vaccinated! To be read/told
stories To sing play with my parents! To be
protected from HIV/AIDS! To sleep under
an impregnated mosquito net!
To have my birth registered ! To be well fed
and to have drinking water! To be in
quality early learning programs with other
children when I am 3 and above!
Thank you for giving me a good start in life!