TACKLING INEQUALITIES IN THE EARLY YEARS: KEY MESSAGES FROM 10 YEARS OF THE GROWING UP IN SCOTLAND STUDY

PART TWO: CHANGES IN OUTCOMES AND INEQUALITY ACROSS THE TWO COHORTS

Comparisons between the two GUS cohorts, up to age three, have revealed some overall improvements for children born in 2010/11 compared with those born in 2004/05:

• An increase in the proportion of mothers who abstained from alcohol during pregnancy, from 74% of mothers in BC1 to 80% in BC2^[23].
• A decline in the proportion of mothers who smoked when their children were aged three from 28% in BC1 to 24% in BC2^[24].
• An increase in the proportion of parents who looked at books or read stories with their 10 month old child either every day or most days. This increased from 66% in BC1 to 69% in BC2^[25].
• A small but statistically significant increase in mean vocabulary scores at age three^[26].
• A small but statistically significant increase in mental wellbeing scores^[27] among main carers when their children were aged three^[28].

Comparisons have also revealed that some health outcomes appear to have deteriorated overall across the cohorts. It is possible, however, that this is due to earlier or more effective diagnosis of conditions:

• An increase in the proportion of age three children with a long-standing illness or disability, from 14% in BC1 to 17% in BC2^[29].
• A decrease in self-reported levels of excellent health amongst mothers, around the time of their child's third birthday, from 21% in BC1 to 17% in BC2^[30].

And that overall breastfeeding rates have remained static:

• There was no statistically significant change in the proportion of children who were breastfed for at least six weeks across BC1 and BC2.

With regard to the socio-economic gap, GUS has shown that some inequalities have narrowed over recent years.

Breastfeeding

In BC1 there was a 43 percentage-point difference in the proportion of mothers who breastfed (even if just for a few days) in the lowest and highest income quintile: 37% breastfed in the former and 80% in the latter group. In BC2 this gap had reduced to 36 percentage-points (45% in the lowest income and 81% in the highest income group)^[31]. This narrowing of the gap was driven by an increase in the prevalence of breastfeeding among mothers in the lowest income quintile^[32].

Analysis of the GUS data on breastfeeding duration has also revealed that among mothers who did breastfeed, those who gave birth in 2010/11 managed to breastfeed for longer than mothers who gave birth in 2004/05. Closer analysis of the data has shown that this change was driven by an increase in breastfeeding duration among mothers from more disadvantaged social circumstances. While there was very little change among mothers educated to degree level, in 2010/11 mothers with no educational qualifications were one and a half times more likely to breastfeed for between six and 10 months than similar mothers who gave birth in 2004/05^[33].

Cognitive development

In BC1, at age three, there was a 7.8 point gap in the average vocabulary scores of children in the lowest and highest income quintiles. In BC2 this gap had reduced slightly to a 6.3 point gap. The narrowing of the gap was due to a slightly greater improvement in vocabulary score at age three in the lowest income group than the highest.

Overall, there was no change in problem-solving ability at age three across the two cohorts. However, there was a narrowing of the gap in ability across the income groups. In BC1 there was a 6.7 point gap in the average scores of children in the lowest and highest income quintiles. In BC2 this gap had reduced to a 3.4 point gap. The narrowing of the gap was due to an improvement among those in the lowest income group as well as a decline among those in the two highest income groups^[34].

Mental wellbeing among main carers

Although the increase in mental wellbeing scores among main carers, when their child was aged three, was seen across all socio-economic groups, there was a slight (and statistically significant) narrowing of the gap between the lowest and highest household income quintiles^[35]. In BC1 there was a 5.5 point difference in mental wellbeing scores in the highest and lowest income quintiles. In BC2 this gap had reduced to 2.9 points. The narrowing of the gap was due to a greater improvement among those in the lowest income group compared with those in the highest^[36].

Although the socio-economic gap has widened for alcohol consumption in pregnancy, this is due to a larger increase in rates of abstinence among the most economically disadvantaged than the most advantaged.

Alcohol consumption in pregnancy

In BC1 there was an 18 percentage-point difference in the proportion of women in the highest and lowest income quintile who stated that they abstained from alcohol during pregnancy (63% and 81% respectively). In BC2 this gap had widened to 23 percentage points (66% and 89%)^[37]. This means that, although abstinence rates have increased at both ends of the income quintiles, in 2010, compared with six years earlier, those in the lowest income groups were even less likely to have consumed alcohol in pregnancy than those in the highest^[38].

GUS has revealed that there has been some progress in improving the life chances of children in Scotland and that there has been a narrowing of the gap in some important areas. Nevertheless, there is still a great deal of improvement to be made in the early years if we are to realise our ambition to become a fairer nation.