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Together public health and children's services are more than the sum of their parts

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The foundations for a long, healthy and wealthy life are often laid in the very earliest years. 

When we conducted the Marmot review, we saw evidence showing clear relationships between early years experience and later life outcomes.

There is a well-known association between health outcomes, life expectancy and socioeconomic status. We saw evidence of similar links between social class and such outcomes as children’s social and emotional health, educational outcomes and social interactions. 

These early years experiences add up to clear inequalities, which partly explain persistent health, wealth and education inequalities later on.

But there is much that can be done during the early years to reduce these inequalities, which is why our review prioritised the early years for action.

Local authorities are particularly well placed to improve early years experiences, especially for more disadvantaged groups.

For example, councils provide early years services, which do an excellent job improving children’s development.

They also run children’s centres – there is often even greater potential for these to do more to support parents and communities in giving children the best possible start in life. Our report, An equal start, sets out how centres might do this by focusing on the most important factors.

These include increasing the number of parents reading to their children every day and offering support to parents in relation to housing, work, debt and building social networks.

The most successful interventions tend to focus on behaviour – for example coaching parents during play sessions with children – instead of simply dispensing information to parents.

Programmes that involve health visitors and specialist nurses undertaking home visits have shown successful outcomes, including improved pre-natal health, reduced childhood injuries and an increase in maternal employment and children’s readiness for school.

But it is important that we maintain a holistic view.

We know that young children’s lives are profoundly affected by the quality of housing, green spaces, play areas and other environmental factors under councils’ influence.

We hope that those working in public health and early years will make common cause with others across these teams, so that together they can achieve marked improvements in services and help to reduce inequalities in health, education and wealth within local communities.

Jessica Allen, deputy director, Instittue for Health Equity, University College London and a project director of the Marmot review

Jessica Allen is deputy director of the Institute for Health Equity at University College London. She was project director of the Marmot review.

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