American equivalent of AEDC finds that health inequities in children begin from five

In a nationwide study, comparable to the Australian Early Development Census (AEDC) researchers from the University of California, Los Angeles (UCLA) have found that health inequities can be measured in children as young as five years of age. 

The research, published in Health Affairs, contributes to a growing body of literature finding that children of colour who are also poor face greater health inequities than their white counterparts.

To reach their findings, the researchers worked with kindergarten teachers in 98 American school districts to administer the Early Development Instrument (EDI), a measure of children’s physical, social, emotional and language development.

The assessment was administered to more than 185,000 kindergarteners between 2010 and 2017. After analysing and correlating the results according to where the children lived, the investigators found that 30 per cent of children in the lowest-income neighborhoods were vulnerable in one or more domains of health development, compared to 17 per cent of children in higher-income settings.

The researchers also found that income-related differences in developmental vulnerability varied substantially among children from different ethnic and racial groups. Black children, for example, were at highest risk, followed by Latina/o children. Asian children were at lowest risk. The differences in developmental vulnerability between black children and white children were most pronounced at the higher socioeconomic levels and tended to narrow for black and white children from lower-income neighborhoods. 

Such early disparities, researchers said, can have a profound influence on children’s long-term development, leading to higher rates of chronic conditions such as diabetes, heart disease, drug use, mental health disorders and dementia as adults.

While many other studies have highlighted patterns of income and racial inequality in health and educational outcomes, lead author Dr Neal Halfon said, what this study shows is that these patterns of inequality are clearly evident and measurable before children start school.

As well as demonstrating the patterns of inequality, fellow author Lisa Stanley said the findings underscore the value of understanding child-developmental inequities at the most micro levels. 

“Because the EDI is reported at and linked to Census-tract-level indices of neighbourhood risk, this measurement tool helps cities and local grassroots efforts develop targeted supports and services to address racialised disparities,” she added.

The EDI tool was developed by Dr. Dan Offord and Dr. Magdalena Janus at the Offord Centre for Child Studies at McMaster University in Ontario, Canada, and has been internationally validated, and used widely in Canada, Australia and other countries.

To read the findings in full, please see here.