Early Childhood Experiences and Health

Question 1

why do experiences in early childhood matter?

Answer 1

• the first 5 years are critical for long term health
• early experiences shape cognitive, emotional and behavioural development (brain is 95% developed by age 6)

positive conditions = better health and social outcomes
adverse conditions = higher risk of poor health and social disadvantage

Question 2

how do economic and social conditions shape children’s health?

Answer 2

• social factors like income, education, and neighborhood shape children’s health
• parental income and education strongly influence a child’s development
• systemic racism and poverty increase health risks
• chronic or “toxic” stress can lead to long-term health issues.

Question 3

what is the life course perspective?

Answer 3

• a perspective that recognizes that health at any stage of life is influenced by experiences during prior life stages
• emphasizes that adult health is powerfully shaped by childhood experiences

Question 4

How does Benzeval’s “Life Course Perspective” explain the shaping of health and well-being over a person’s lifetime?

Answer 4

• focuses on how social, economic, and environmental factors shape health and well-being throughout life
• emphasizes that health outcomes result from a complex interplay of factors, starting in early childhood and continuing throughout the lifespan, rather than being solely determined by individual behaviours

Question 5

what are the 6 key aspects of Benzeval’s “Life Course Perspective” ?

Answer 5

1) cumulative disadvantage
2) social context
3) critical periods
4) life events and transitions
5) timing and sequence
6) agency and control

Question 6

what does cumulative disadvantage mean in Benzeval’s “Life Course Perspective”?

Answer 6

inequalities in health and social position accumulate over time, with early life experiences having long-lasting effects, leading to widening health gaps as people age

Question 7

what does social context mean in Benzeval’s “Life Course Perspective”?

Answer 7

family, education, income, and employment conditions are key determinants of health outcomes, influencing an individual’s health throughout their life

Question 8

what does critical periods mean in Benzeval’s “Life Course Perspective”?

Answer 8

• certain life stages, like childhood or adolescence, can have a greater impact on health
• exposure to stress or trauma during these critical periods can lead to long-lasting health consequences.

Question 9

what does life events and transitions mean in Benzeval’s “Life Course Perspective”?

Answer 9

• key events in life, such as marriage, parenthood, or retirement, can influence health outcomes
• these events can serve as turning points, either protecting individuals or exposing them to health risks, depending on the nature of the transition

Question 10

what does timing and sequence mean in Benzeval’s “Life Course Perspective”?

Answer 10

suggests that the timing of events (e.g., experiencing a health problem or social change) and the sequence in which they occur can influence their long-term effects on health and well-being.

Question 11

what does agency and control mean in Benzeval’s “Life Course Perspective”?

Answer 11

• while structural factors play a significant role, individuals also have agency —the ability to make choices that influence their life course
• the decisions individuals make regarding health behaviours, education, and career choices can impact one’s trajectory

Question 12

what are the 3 types of effects described in the life course perspective?

Answer 12

these effects are used to describe the different ways in which early life experiences and exposures can influence health outcomes across a person’s life

1) cumulative
2) latent
3) pathway

Question 13

what does cumulative effects mean?

Answer 13

• cumulative effects refer to the idea that small, repeated exposures or disadvantages accumulate over time, gradually increasing their impact on health
• over time, individuals experience a series of social, economic, or environmental factors that may have minor effects individually, but when combined or accumulated, they create significant health disparities

Question 14

what does latent effects mean?

Answer 14

• latent effects refer to the long0term effects of early life exposures that become evident only later in life, even though the exposure itself occurred in childhood or adolescence
• early life experiences or exposures can “lie dormant” for years, and only later to they manifest as health problem
• these effects may not immediately be visible but show up as health issues when the individual reaches adulthood or old age

Question 15

what does pathway effect mean?

Answer 15

pathway effects refer to the idea that early life experiences influence the trajectories or pathways that individuals follow through life, which in turn impact their health outcomes
- early life experiences can shape the choices and opportunities a person has as they move through life (education, career, relationships)

Question 16

what are adverse childhood experiences?

Answer 16

• refers to the stressful or traumatic life events that occur before the age of 18
• can have long-term effects on a person’s health and wellbeing

Question 17

what are the 11 examples of adverse childhood experiences?

Answer 17

1) Physical abuse
2) Emotional abuse
3) Sexual abuse
4) Physical neglect
5) Emotional neglect
6) Household substance abuse (e.g., parent or caregiver with alcohol or drug
problems)
7) Household mental illness (e.g., parent or caregiver with depression, anxiety etc)
8) Parental separation or divorce
9) Domestic violence (e.g., witnessing violence between caregivers or family
members)
10) Incarcerated household member (having a family member who is
incarcerated)
11) Bullying (a more recent addition to the list)

Question 18

long term impacts of adverse childhood experiences on an individuals health and behaviour

Answer 18

adults who had been exposed to 4 or more ACEs as a child were:
- more likely to have injected drugs
- more likely to have had or caused an unintended teenage pregnancy
- more likely to contract STDs
- more likely to have committed violence against another person
- more likely to be incarcerated during their lifetime
- more likely to suffer from depression
- more likely to have attempted suicide

Question 19

what is concept of ACE through the life course described by the pyramid model?

Answer 19

bottom of the pyramid to top of pyramid:
1) Adverse Childhood Experiences (ACEs) = events like abuse, neglect, household dysfunction, and exposure to violence.
2) Social, Emotional, and Cognitive Impairment = struggle with learning, forming relationships, or regulating emotions
3) Adoption of Health-Risk Behaviours = begin harmful behaviors to cope, such as substance abuse, unsafe sexual practices, poor diet
4) Disease, Disability, and Social Problems = accumulation lead to serious health issues, including chronic diseases, mental health disorders and social problems
5) Early Death = culmination can contribute to premature death from chronic disease, suicide, or violence

Question 20

What did the study on Adverse Childhood Experiences (ACEs) among Canadian federal offenders find?

Answer 20

• there is a profound link between early trauma and criminal behaviour later in life
• found that exposure to multiple ACEs is strongly associated with negative outcomes in the lives of offenders, both prior to and during their incarceration.
• offenders were exposed to ACEs at a much higher rate than the general population.
• these experiences are associated with a number of negative institutional and community outcomes

Question 21

what were the four ACE categories described in the Canadian Federal Offenders study?

Answer 21

(1) abuse and neglect
(2) witness partner violence or mother treated violently
(3) substance misuse in household
(4) incarcerated household member

Question 22

what is the relationship between childhood experiences and health?

Answer 22

• early childhood experiences directly and indirectly impact health and wellbeing throughout life
  –> favourable conditions early in life can set a child up for optimal health and wellbeing
  –> adverse experiences can set off a vicious cycle leading to social and health disadvantages in adulthood

Question 23

in what ways is health shaped by a children’s early development?

Answer 23

early cognitive, emotional, and behavioural difficulties can:
- lead to health-related outcomes like CVD, hypertension, diabetes, obesity and drug use
- impact physiological systems (brain architecture) due to toxic stress leading to challenges with attention and focus
- hinder educational success and long-term development
- increase the risk of unhealthy, risky behaviours
- poor impulse control and decision-making
- affect self-regulation and emotional well-being
- poorer social skills and relationships

Question 24

what does childhood refer to?

Answer 24

the first 5 years of a child’s life

Question 25

what socioeconomic factors influences a child's health?

Answer 25

1) nutrition / food security 2) housing quality 3) safety at home and in the community *all these factors are tied to a families economic resources and education*

Question 26

how does a child's nutrition impact health?

Answer 26

- budget constraints and exposure to convenience stores/fast food can hinder a parents effort to provide nutritious foods - many children in food insecure homes are obese, which is a strong predictor of obesity in adulthood

Question 27

how does a child's housing quality impact health?

Answer 27

- low-income children are more likely to be exposed to lead-based paint in low quality housing - lead exposure leads to neurological complications

Question 28

what factors of home safety impact a child's health?

Answer 28

- socioeconomic characteristics of neighbourhood are linked to safe living conditions - air quality (high level of pollution) - crime rates and violence - pedestrian safety (lack sidewalks, traffic control)

Question 29

what racial groups are most likely to live in poverty? what are the effects?

Answer 29

- African American, Indigenous, and Latino children are more likely to live in impoverished households than Asian or White children. - children living in impoverished families often face multiple adverse conditions simultaneously, experiencing the cumulative effects over time. - the combined effects of these adverse experiences can take a particularly heavy toll on children's health = toxic stress

Question 30

what are the key risks associated with living in poverty?

Answer 30

- food insecurity = poor nutrition and obesity - exposure to environmental hazard lead to variety of health problems - unsafe neighbourhoods = higher stress and risk of injury

Question 31

what are the effects of toxic stress?

Answer 31

chronic stress leads to the constant release of cortisol which has numerous physiological consequences: - altered immune function - inflammation - depression and anxiety - diabetes - CVD and hypertension

Question 32

what is structural/systemic racism?

Answer 32

laws, policies, and entrenched practices and beliefs that systemically and repeatedly put people of colour at a disadvantage, intentionally or subconsciously

Question 33

how does racism impact a families social and economic conditions?

Answer 33

- children from African American, Indigenous, and Latino families, across all economic levels, often face disadvantages due to structural and systemic racism - discriminatory housing and banking practices have pushed minority communities into neighbourhoods with poorer housing quality, environmental quality, inferior education/school and opportunities to build wealth - discriminatory policing and sentencing increase the likelihood of incarceration, limiting the ability of these communities to contribute economically to their families

Question 34

what is the relationship between socioeconomic conditions and a child's development?

Answer 34

- studies have consistently linked an infants and toddler early development with economic advantage or disadvantage in the home - their experiences create physiological, emotional and behavioural foundations, either adverse or favourable, for their lifelong health

Question 35

what were the key findings of the study regarding high-income and low-income children entering kindergarten?

Answer 35

- a national study showed that children entering kindergarten from lower and middle socioeconomic families are at a disadvantage compared to their wealthier counterparts - children entering kindergarten from higher-income families had better academic and social skills compared to those from lower-income backgrounds. --> higher-income children = demonstrated the academic and social skills necessary for kindergarten --> lower-income children = were least likely to possess the needed academic and social skills. --> middle-income children = also performed less well academically and socially when compared to affluent children

Question 36

what factors explain the SES gaps in child development?

Answer 36

- maternal depression - parents educational attainment and economic resources - chronic stress

Question 37

how does maternal depression impact child development?

Answer 37

maternal depression is more prevalent among low-income mothers - can inhibit mother-infant bonding - reduce maternal ability to cognitively stimulate an infant or young child - this can lead to delays in emotional, behavioural, and cognitive development.

Question 38

how does parental educational attainment and economic resources impact child development?

Answer 38

- differences in parental education levels impact their awareness of children's early developmental needs - parents with higher income and educational attainment tend to provide more stimulation and are more responsive to their children, which directly contributes to better brain development. - children from higher-SES families are exposed to more words, more complex speech, and greater back-and-forth conversations compared to children from lower-SES families, which supports future academic success and future opportunties

Question 39

how does chronic stress impact child development?

Answer 39

- higher income generally means lower levels of chronic stress at home and greater resources to cope with stress - stress can impede even highly motivated parents from providing the supportive and stimulating home environment needed for optimal child development - the ongoing strain of limited economic resources can affect parents' ability to cope with parenting challenges, further impacting the child's development

Question 40

how does racism impact childhood development?

Answer 40

- racism can limit parental wealth and educational attainment by relegating them to live in neighbourhoods with little opportunity to escape poverty - due to bias, children of colour are more likely to be punished and expelled from preschool for behavioural issues - racially discriminatory criminal justice practices have produced mass incarceration of men of colour and deprived children of their father

Question 41

what interventions work best to address adverse early childhood experiences?

Answer 41

research shows that early childhood interventions can break the cycle of social and economic disadvantage, improving long-term health outcomes - knowledge-based programs and policies can enhance children's prospects for lifelong health and well-being. - a comprehensive approach to intervention across multiple domains is most effective. - isolated programs tend to have limited impact

Question 42

what is considered the most effective intervention for early childhood development?

Answer 42

- early care and education programs has been shown to have positive short- and long-term health outcomes - the positive impact are NOT confined to a particular social group -- they are apparent across various SES and income groups

Question 43

what is the goal of early care and education programs?

Answer 43

they were designed to provide young children with experiences that buffer or protect against the negative effects of the social and economic challenges they may face in their home and neighbourhoods

Question 44

what health benefits are associated with early care and education programs?

Answer 44

- lower rates of maternal and child mortality - reduced child emergency department visits - decreased childhood maltreatment - fewer adolescent mental health problems - improved eating habits - lower rates of substance use in adolescence - better use of preventative health services (vaccinations, screenings)

Question 45

how do early child care and education program influence social factors associated with health?

Answer 45

- reduced and delay teen pregnancy - increased school performance - enhanced IQ levels - less need for special education services - greater self-sufficiency and less reliance on public assistance - higher educational attainment - stable employment and income later in life - reduce involvement in criminal activity, arrests and incarcerations

Question 46

how do early childcare and education programs support disadvantaged families?

Answer 46

high quality childcare, education and family support programs help buffer against physical and psychosocial adversity by: (1) providing stability and stimulation for children (2) strengthening parents abilities to meet their children's developmental and health needs at home

Question 47

what are the challenges with early child care and education programs?

Answer 47

- access to high-quality interventions is often limited among socioeconomically disadvantaged families - low-income families tend to use childcare with unlicensed or untrained caregivers due to affordability and accessibility issues

Question 48

what are the challenges in studying the health effects of early childcare and education programs?

Answer 48

- the direct health effects of early childhood programs are difficult to measure since many health issues emerge later in life, typically during adulthood - few studies have the resources to follow participants over extended periods, making it hard to demonstrate direct links between early childhood interventions and long-term health outcomes - much of the existing evidence connects early childhood programs to health indirectly, often through correlating data rather than direct causality - randomized experimental trials are expensive and often impractical or unethical so many studies rely on non-randomized observational methods which may not be as robust

Question 49

how do child care and education programs support the parents?

Answer 49

- provide referrals to social services and centre-based activities to help with parenting skills - help parents continue their education, find work or job training - help parents with self-efficacy and life skills - provide take-home activities that facilitate positive parenting behaviours - referrals to social workers, mental health professionals and community resources --> this is sometime carried out by home visits from professionals and paraprofessionals --> others provide pediatric primary care sites that serve as entry points for parental services

Question 50

why is paid parental time off so important?

Answer 50

- paid time off and parental leave are linked to significant reductions in maternal stress and depression, low birth weight, and early childhood mortality - paid leave helps facilitate better parent-child interactions and increases the likelihood of breastfeeding, both crucial for early childhood development.

Question 51

is paid parental leave available in Canada and USA?

Answer 51

- in Canada, paid parental leave is accessed through Employment Insurance (EI) and allows eligible parents to take time off for their child - in USA, they do not guarantee paid parental leave *the US is the only affluent country that doesn't guarantee time off = low- and middle-wage workers are much less likely to have access to paid leave compared to higher earners*

Question 52

what is the business case for investing in early childhood programs?

Answer 52

- investing in early childhood can produce significant economic and human returns however, benefits may take years or decades to fully materialize - Early childhood programs lead to healthier, better-educated adults are more productive, more likely to meet future workforce demands, and less likely to engage in criminal behaviour. - center-based early care and education programs have an estimated return on investment ranging from $2.88 to $17.07 for every dollar spent - investments should focus on both early education and creating supportive, health-promoting environments, addressing poverty and systemic racism.

Question 53

what are examples of early childhood interventions?

Answer 53

- centre-based early care and education programs (with additional supports for parents) - professional home visiting programs that support parents connect them to resources - efforts to improve the quality and coordination of care and education across multiple sectors (healthcare, education, social services) - economic and social policies like tax credits, affordable housing, and efforts to support low-income families