A paper in the Journal of Social Policy led by Dr. Helen van Eyk and colleagues on the impact of early childhood education policy on the social determinants of health and health equity has given Australian governments a good score.

Early childhood education and development has been identified as a social determinant of health by the WHO Commission on Social Determinants of Health.  Early childhood education is internationally recognised as important to child health and wellbeing and to enabling children to become healthy productive adults.  Other social determinants of health, such as poverty, parental education and employment, and housing/homelessness, affect children’s access to or capacity to benefit from early childhood education by affecting children directly or shaping the circumstances and health status of their families and communities.

The research analysed 45 Australian state and federal early childhood education policies current in 2019 to determine the extent to which they recognised and acted on the social determinants of health and health equity.  Our analysis included education department policies and whole-of-government policies that had a major focus on early childhood education and development.

There was a high degree of consistency in language, concepts and approaches in all the policies.  There were consistent recurring themes:

• The best start in life and lifelong benefits for the child
• Longer term social and economic benefits for society
• Intersectoral collaboration, service integration and partnerships with families and communities
• Workforce and service quality.

Early childhood education was widely recognised as a social determinant of health and the impacts of other social determinants of health and health equity were also acknowledged.

Although the policies recognised the benefits of early childhood education for children in the present, we found that the idea of education making a difference was mainly future-focused, for the prevention of future socioeconomic disadvantage.  Circumstances, such as intergenerational poverty, are a form of structural disadvantage, and so a policy focus on improving current daily living conditions is important.  There was less recognition that current socioeconomic inequalities and entrenched forms of intergenerational disadvantage require redress, and of the need to address structural inequities such as power and resources that cause this disadvantage.  There was also less evidence of horizontal policy coherence with other sectors’ policies that adversely affect parents and families, such as on income support, employment, housing, and incarceration.

Consistent messages across the policies have been maintained despite changes of government, suggesting bipartisan recognition of the importance of investment in early childhood education.  Early childhood education policy has become an undisputed policy priority in Australia, with all states pursuing increased intersectoral collaboration and most states establishing integrated children’s centre models to address early childhood education within the family and community context, suggesting some horizontal policy coherence.

The policy coherence within Australian early childhood education policy is pretty good, but the policies lacked strategies to address social determinants, or to engage with other sectors for this purpose.  Education is a powerful equalizer, but this power is lost if children return to families experiencing stress, poverty, and inadequate housing.  To harness the power of early childhood education policies and increase coherence, all sectors that impact on parents’ and families’ lives need to address the social determinants of health and health equity, for example through better paid parenting leave for fathers, secure housing for families, and income support to ensure children are not living in poverty.

The research was funded by a Flinders Foundation Health Seed Grant.