Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Public Administration and Sociology, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Int J Equity Health. 2022 Jun 7;21(1):79. doi: 10.1186/s12939-022-01675-8.
Addressing socioeconomic inequalities in early child development (ECD) is key to reducing the intergenerational transmission of health inequalities. Yet, little is known about how socioeconomic inequalities in ECD develop over the course of childhood. Our study aimed to describe how inequalities in ECD by maternal education develop from infancy to middle childhood.
We used data from Generation R, a prospective population-based cohort study in The Netherlands. Language skills were measured at ages 1, 1.5, 2, 3, and 4 years, using the Minnesota Child Development Inventory. Socioemotional (i.e. internalizing and externalizing) problems were measured at ages 1.5, 3, 5 and 9 years using the Child Behavior Checklist. We estimated inequalities in language skills and socioemotional problems across the above-mentioned ages, using linear mixed models with standardized scores at each wave. We used maternal education as indicator of socioeconomic position.
Children of less educated mothers had more reported internalizing (B = 0.72, 95%CI = 0.51;0.95) and externalizing (B = 0.25, 95%CI = 0.10;0.40) problems at age 1.5 years, but better (caregiver reported) language skills at 1 year (B = 0.50, 95%CI = 0.36;0.64) than children of high educated mothers. Inequalities in internalizing and externalizing problems decreased over time. Inequalities in language scores reversed at age 2, and by the time children were 4 years old, children of less educated mothers had substantially lower language skills than children of high educated mothers (B = -0.38, 95%CI = -0.61;-0.15).
Trajectories of socioeconomic inequality in ECD differ by developmental domain: whereas inequalities in socioemotional development decreased over time, inequalities increased for language development. Children of less educated mothers are at a language disadvantage even before entering primary education, providing further evidence that early interventions are needed.
解决儿童早期发展（ECD）中的社会经济不平等问题对于减少健康不平等的代际传递至关重要。然而，我们对于儿童时期 ECD 中的社会经济不平等是如何发展的知之甚少。我们的研究旨在描述母亲教育程度对 ECD 的不平等如何从婴儿期发展到儿童中期。
我们使用了荷兰的一项前瞻性基于人群的队列研究 Generation R 的数据。使用明尼苏达儿童发展量表（Minnesota Child Development Inventory）在 1、1.5、2、3 和 4 岁时测量语言技能。使用儿童行为检查表（Child Behavior Checklist）在 1.5、3、5 和 9 岁时测量社会情绪（即内化和外化）问题。我们使用线性混合模型，以每个波次的标准化分数，来估计上述年龄段的语言技能和社会情绪问题的不平等情况。我们使用母亲教育程度作为社会经济地位的指标。
受教育程度较低的母亲的孩子在 1.5 岁时表现出更多的内化（B=0.72，95%CI=0.51；0.95）和外化（B=0.25，95%CI=0.10；0.40）问题，但在 1 岁时具有更好的（照顾者报告的）语言技能（B=0.50，95%CI=0.36；0.64）。内化和外化问题的不平等随着时间的推移而减少。语言分数的不平等在 2 岁时逆转，到孩子 4 岁时，受教育程度较低的母亲的孩子的语言技能明显低于受教育程度较高的母亲的孩子（B=-0.38，95%CI=-0.61；-0.15）。
ECD 中社会经济不平等的轨迹因发展领域而异：社会情绪发展的不平等随着时间的推移而减少，而语言发展的不平等则增加。受教育程度较低的母亲的孩子甚至在进入小学教育之前就处于语言劣势，这进一步证明需要早期干预。
