Publication Details

Melhuish, E. (2014). The impact of early childhood education and care on improved wellbeing. "If you could do one thing..." Nine local actions to reduce health inequalities (pp. 33-43). London, United Kingdom: British Academy.


My one suggested intervention for the new health and wellbeing boards is to focus resources on improving life chances in early childhood through the universal provision of early education centres that integrate education, child care, parenting support and health services. There are great differences in the health and development of individuals, linked to their social origins. Despite decades of social and educational reform, there has been little progress in equalising opportunities. The impact of social origins on child outcomes and wellbeing have persisted, and even increased. In this proposal I argue that: • Learning capabilities are primarily formed during the first years of childhood and this is the most effective time to improve the lives of disadvantaged children; • The imperative to act is not only educational and social, but economic too; • Providing any child care or pre-school education is not enough. The quality of preschool is critical for longer-term beneficial effects - ideal systems combine quality, affordability and accessibility; • The home learning environment can have an even greater impact on child development, but it is harder to influence. The best outcomes are when the home learning environment and early childhood education and care are all supportive of the child's development; • England has transformed its early childhood services. Sure Start centres have been a key component in bringing together local health, education and social welfare services for families with young children - initially in disadvantaged areas, and then universally as children's centres; and • Early evaluation showed that, when focused only on deprived areas, the centres helped poor children, but not the very poorest. However, a later study showed real improvements, including in health, parenting and behaviour. Inter-agency collaboration, quality and large scale provision were important factors for lasting success. School readiness assessments also revealed improvements at whole population level, with the poorest children benefitting most. In conclusion, much evidence supports the case for the provision of universal and high quality early childhood education and care. This is because of its impact upon the wellbeing of the population as a whole, and its even greater benefits for children from disadvantaged backgrounds.