1

Montreal, Quebec

JASP – Annual Public Health Days

Communities and Equity in Early Child Development

By J. Fraser MustardThe Founders’ Network

Founding ChairmanCouncil for Early Child Development

March 12, 2010

The Rights of the ChildThe Rights of the ChildEquity in Human Development

2

World Health Organization

Michael MarmotMichael Marmot

Inequalities in Health and Development

Equity From the Start

WHO, August 2008

The Social Determinants of Human Development

10-015

Affects: - Health (physical and mental)- Learning

Behaviour- Behaviour

Nature and Nurture

3

Human Development

Nature Nurture

Genes Epigenetics Stimulation

10-008

p gand Nutrition

Gene Function

NeurobiologicalgPathways

Physical Mental LearningHealth Health

Canada – EDIChildren 5-6 yrs

07-026

% Vulnerable

30

20

Adapted from NLSCY/UEY 1999-2000; EDI 1999-2000

Q1 Q2 Q3 Q4SES - Income

10

0

4

Vulnerability on the EDI and Grade 6 outcomes

anda

rd

80N f EDI

10-011

10-011

eetin

g G

rade

6 s

ta

20

40

60

No. of EDI domains on which child is vulnerable -age 5

0

1

2+

Source: Toronto District School Board, 2007

% n

ot m

0Reading Writing MathReading Writing Math

2+

Provincial (EQAO) test

Lessons from Quebec’s Early Childhood and Family System Since 1997

Expanded parental leave and family income b fit

10-020

benefits.Early childhood centres often connected to community social & health centres.Child poverty has steadily declined by over 50%.Improved school achievement.Maternal workforce participation has increased fromMaternal workforce participation has increased from the lowest in Canada to the highest.The tax income from working mothers now pays for 40% of the child care program.EDI scores show reduced vulnerability in many low income Montreal neighbourhoods.

5

Direction de santé publique de l’Agence de la santé et des services

sociaux de Montréal

10-012

65% of kindergarten children are d h l

Montreal

ready to start school

35% are vulnerable

Early interventionHealth Social

servicesEducation Family

support

Chaos

Local school authoritiesPublic

healthMunici-palities

Community services

Parks & recreation

Preschools

Child care

Parenting centres

Children’s mental health centres

Kindergartens

6

Fonds pour le développement des jeunes enfants (financed by Govt

10-013

jeunes enfants (financed by Govt of Québec and Fondation Chagnon) focuses on partnering family resource centres, child care schools health socialcare, schools, health, social services, and municipalities

Day Care - Quebec

Regulated spaces increased from

10-009

Regulated spaces increased from 78,000 (1997) to 190,000

Quality27% good to excellent% g12% inadequate61% met criteria for minimum

quality

7

Staff Literacy and Children’s Language Development - California

60

Percent Inadequate Good to Excellent

09-011

Adequate

40

20

3 4

Literacy Level

0

20

Phillips and Whitebook, 2003

MontrealSocial Risk

0 – 2 low risk

3 – 6 medium risk

7 – 9 high risk

10-014

Social Risk and EDILow EDI vulnerability, high social risk

8

The Social Determinants of Human Development

10-015

Affects: - Health (physical and mental)- Learning

Behaviour- Behaviour

Nature and Nurture determine development

Human Development

Scandinavian Countries

and

Cuba

9

Scandinavian 0-6 Programs

Paid parental leave

Centre-based programs

Well trained (50% 4 yearsWell trained (50% - 4 years university) and financed staff

Publicly financed

Scandinavia and Canada10-016

0-6 Parental Leave Govt. Ministry %GDP income support

( th )(months)

Finland 1.7 12 Social Affairs

and Health

Norway 1.7 12 Education

Sweden 1.9 16 Education

Canada 0.4 12 Fragmented

10

Scandinavia and Canada10-017

Child Poverty Adult Literacy (16-25)

% Level 4&5% Level 4&5

Finland 2.8

Norway 3.4 36%

Sweden 4 2Sweden 4.2

Canada 15.0 23%

Sweden ECD (Preschool) and Education Expenditure

C /Child E ll

08-044

Cost/Child Enrollment

Preschool* $16,500 US 2+ yrs >86%(age 1-6) (not compulsory)

CompulsoryCompulsoryEducation $10,500 US Compulsory(age 7-16)* Maternal and parental paid leave 1-1/2 years

Skolverket 2006

11

Cost of a Universal ECD-P Centre Program in Canada (conception to

Grade 1)

Conception to age 6

07-157

Conception to age 6

Universal (2,100,000 children)Not compulsory

Cost about $22 0 Billion per year (1 5%Cost about $22.0 Billion per year (1.5% of GDP)

(80 to 90% participation)

Present Expenditure 0.4% of GDP

Conception to adolescence

E i d b dExperienced-based neurobiological development affects health, learning, and behaviour throughout the lifebehaviour throughout the life course.

12

Human Development

Nature Nurture

Genes Epigenetics Stimulation

10-008

p gand Nutrition

Gene Function

NeurobiologicalgPathways

Physical Mental LearningHealth Health

Early human development has major effects on health and learning.

Why not integrate government departments (health, education, and social services) into a )ministry of human development – based on the recent neurobiological evidence.

13

Cuba

10-018

Developed a more integrated structure for health and early development – the polyclinics

In terms of the health and learning of children, Cuba is outstanding

Community PolyclinicsPregnancy to Age 6

Developmental Health (pre and post natal)Services provided by

Community Polyclinics Nutritional support

Child (Care) Stimulation

Weekly Home Visits

Child (Care) Stimulation (Puericultura)

14

Grade 3 Language Scores

Argentina _ _ _ _ _ _ _ _

05-066

Brazil _ _ _ _ _ _ _ _ _ _

Chile _ _ _ _ _ _ _ _ _

Cuba _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

UNESCO, 1998

100 250 300 350 400150 200

Mexico _ _ _ _ _ _ _

4thgrad

350

330

Language Scores – UNESCO First Regional Study (1998)

Health and Language Scores

70

90

Mor

talit

y R

ate

eLanguage (U

NE

SC

O, 1

310

290

270

250

Under One Mortality Rate (WHO, 1990)

50

30

Cub

a

998)

250

230

Chi

le

Arg

entin

a

Ven

ezue

la

Col

ombi

a

Par

agua

y

Méx

ico

Hon

dura

s

Bra

zil

Dom

inic

anR

ep.

Bol

ivia

Mustard, JF. @ Tinajero, A., 2009

10

15

Langua350

330

130

110

Language Scores – UNESCO First Regional Study (1998)

Health and Language ScoresM

orta

lity

Rat

eage S

cores –4th

gra

310

290

270

250

90

70

50

30

Under Five Mortality Rate (UNICEF, 1990)

Cub

a

ade

250

230

30

10

Chi

le

Arg

entin

a

Ven

ezue

la

Col

ombi

a

Par

agua

y

Méx

ico

Hon

dura

s

Bra

zil

Dom

inic

anR

ep.

Bol

ivia

Mustard, JF. @ Tinajero, A., 2009

Association Between Preschool Attendance and Learning

scho

olR

eading Sco

100%

80%

90%45

40

50% of preeschool enrolment - children ages 3-5 (UNESCO-LLECE, 2008)

rcen

t enr

olle

d in

pre

sores –

6th grade (UN

ES

CO

70%

60%

50%

40%

30%

25

20

15

35

30

40

% of children at Level IV – Reading Scores (high) - 6th grade (UNESCO 2008)

Cu

ba

Per

O, 2008)

Ch

ile

Uru

gu

ay

Co

sta

Ric

a

Arg

enti

na

Per

u

Co

lom

bia

Do

min

ica

n R

.

Par

agu

ay

Mustard, JF. @ Tinajero, A., 2009

20%

10% 5

10(UNESCO, 2008)

16

Ludwig and Sawhill –Early Child Development

06-076

Intervene:

Early,

Often andOften, and

Effectively

Brookings Institution, 2006

Early Child Development and Parenting Centres

Available from pregnancy to school entry

04-230

p g y y

Provide support for parents (centres and home visits)

Learning parenting by doing

Provide non parental careProvide non-parental care

Nutrition and stimulation

Stage 1 of human development (conception to age 6)

17

Qualified Competent Staff

Sweden - 50% in preschool program have 4 years university

education

Staff Literacy and Children’s Language Development - California

60

Percent Inadequate Good to Excellent

09-011

Adequate

40

20

3 4

Literacy Level

0

20

Phillips and Whitebook, 2003

18

Need integrated human development education for staff in the conception to 6 page group and in primary education.

25% of education should be in developmental neurobiology (experience and epigenetics).

Cost to Individuals and Canadian Society of

Poor Early Child Development (estimates)

07-158

Crime and Violence $120 Billion/year

Mental Health $100 Billion/yearBehaviour andAlcohol and Drug AddictionAlcohol and Drug Addiction

Cost of universal high quality ECD program – about $22 billion per year (1.5% of GDP)

19

Creating ECD Infrastructure

Centres as part of primary schools.

Training staff in developmental neurobiology and

10-019

Training staff in developmental neurobiology and developmental health and learning.

Establish leaders (principals for integrated ECD programs and primary schools).

Pay equity.

Paternal paid leave.

Publicly financed.

Integrated health and education data system,

e.g. Manitoba

20

Grade 3 Performance (Language) by SESPass/Fail Rates of Test-writers (Winnipeg)

07-042

93%

94%

%

Low Low-Middle Middle High

83%

91%

Manitoba CentrePass Fail

Grade 3 Performance (Language) by SESOutcomes for 8-Year Olds Who Wrote and Should

Have Written Test (Winnipeg)

07-041

78%

84%

%

Low Low-Middle Middle High

50%

70%

Manitoba CentrePass Absent, exempt, incomplete, lower gradeFail

21

Decrease in the % of vulnerable children as a result of improved ECD in Western Australia

Y

07-204

Year2003 2006

Floreat 47.22% 14.3%

Wembley 47.11% 11.8%

AEDI

With Our Best Future in Mind – Pascal report - Ontario

Recommendation 1:

09-079

The province should create a continuum of early learning, child care, and family supports for children from the prenatal period through to adolescence under thethrough to adolescence, under the leadership of the Minister of Education.

Pascal, 2009

22

Establish a Ministry of Human Development

Integrate Education, Public Health, and Social programs

Post secondary educational institutions and human development – 25% of education in developmental neurobiology

ReferencesMustard, J.F. Early child development and experience-based brain

development: the scientific underpinnings of the importance of early child development. Washington: The Brookings Institution. 2006. Available at: www.founders.net

Mustard J F Early human development Equity from the start LatinMustard, J.F. Early human development – Equity from the start – Latin America. Latin American Journal of Social Sciences, Childhood and Youth, vol. 7, #2, July-Dec 2009. Available at: www.founders.net

Mustard, J.F. Early brain development and human development. In: Tremblay RE, Barr RG, Peters RDeV, Boivin M, eds. Encyclopedia on Early Childhood Development (online). Montreal, Quebec: Centre of Excellence for Early Childhood Development; 2010:1-5. Availableof Excellence for Early Childhood Development; 2010:1 5. Available at http://www.child-encyclopedia.com/documents/MustardANGxp-Importance.pdf.

Mustard, J.F. The effects of nature and nurture on early human development and health, behaviour and learning. Presentation at the First International Symposium in Puebla, Mexico. January 27, 2010. Available at: www.founders.net

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01-039

www.founders.net

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