How inequalities develop through childhood: Life course evidence from the Young Lives cohort study

1. How Inequalities Develop Through Childhood
September 2015
Paul Dornan
paul.dornan@qeh.ox.ac.uk

2. Overview
1. Young Lives study design
2. Three stories
• Effective policies support multidimensional lives
• Early intervention is a priority, plus later remediation
• Identifying critical entry points is a priority to prevent
pathways diverging
3. Conclusions

3. Study design

4. Study design
1. Four country study with similar instruments used at same age
points across Ethiopia, India, Peru and Vietnam
2. Cohort design, with mixed method approach with both
qualitative and quantitative data collected.
3. Data collected from child, household members, community
and school
4. Acknowledgements:
• Study participants
• Funders – including DFID, DGIS, IrishAid, Children’s Investment
Fund foundation and others
• Study collaborators

5. AGES: 1 5 8 12 15
YOUNGERCOHORT
Following 2,000 children
OLDERCOHORT
Following 1,000 children
AGES: 8 12 15 19 22
Round 1 Round 2 Round 3 Round 4 Round 5
2002 2006 2009 2013 2016
Same age children at
different time points
Qualitative nested sample
1 2 3 4
Linked
school surveys

6. AGES: 1 5 8 12 15
YOUNGERCOHORT
Following 2,000 children
OLDERCOHORT
Following 1,000 children
AGES: 8 12 15 19 22
Round 1 Round 2 Round 3 Round 4 Round 5
2002 2006 2009 2013 2016
Same age children at
different time points
Qualitative nested sample
1 2 3 4
Linked
school surveys

7. Effective policies support
multidimensional lives

8. Context
1. Problem: children’s lives are multidimensional, but
siloed service delivery
2. Example: interrelationships between age points in
domains of children’s development
3. Evidence:
• fundamental contribution of earlier healthy growth to
wider development.
• important interrelationships between learning and
psychosocial development

9. Interdependent domains
Height at 15
years
Cognitive
skills at 15
years
Psychosocial development
at 15 years
Height at 12 Predicts later
height in four
countries
Predicts later
learning in
three countries
Does not predict later
psychosocial development
Cognitive skills
at 12
Predict later
height in one
country only
Predict
learning in
four countries
Predict later psychosocial
development in two
countries
Psychosocial
development at
12
Does not predict
later height
Predicts
learning in two
countries
Predicts later psychosocial
development in one county
only
Source: Sanchez, A. (2013) The structural relationship between nutrition, cognition and non-cognitive
skills: evidence from four developing countries, Young Lives Working Paper 111
Example: interdependencies between domains of development

10. Height at 15
years
Cognitive
skills at 15
years
Psychosocial development
at 15 years
Height at 12 Predicts later
height in four
countries
Predicts later
learning in
three countries
Does not predict later
psychosocial development
Cognitive skills
at 12
Predict later
height in one
country only
Predict
learning in
four countries
Predict later psychosocial
development in two
countries
Psychosocial
development at
12
Does not predict
later height
Predicts
learning in two
countries
Predicts later psychosocial
development in one county
only
Source: Sanchez, A. (2013) The structural relationship between nutrition, cognition and non-cognitive
skills: evidence from four developing countries, Young Lives Working Paper 111
Example: interdependencies between domains of development
Interdependent domains

11. Height at 15
years
Cognitive
skills at 15
years
Psychosocial development
at 15 years
Height at 12 Predicts later
height in four
countries
Predicts later
learning in
three countries
Does not predict later
psychosocial development
Cognitive skills
at 12
Predict later
height in one
country only
Predict
learning in
four countries
Predict later psychosocial
development in two
countries
Psychosocial
development at
12
Does not predict
later height
Predicts
learning in two
countries
Predicts later psychosocial
development in one county
only
Source: Sanchez, A. (2013) The structural relationship between nutrition, cognition and non-cognitive
skills: evidence from four developing countries, Young Lives Working Paper 111
Example: interdependencies between domains of development
Interdependent domains

12. Physical development - early is
best but never too late?

13. Context
1. Problem: high levels of stunting, concentrated among the
poorest households. Long term consequence for health and
development
2. Example: comparing children’s stunting status between 1
and 5 years
3. Evidence:
• Height trajectories not totally ‘fixed’ infancy, both
recovery and stunting happen
• Positive change has been associated with learning gains

14. Example: change in height for age status between 1 year and 5 years, Vietnam
Lundeen et al (2013) ‘Growth faltering and recovery in children aged 1-8 years in four low – and
middle income countries: Young Lives’, Public Health Nutrition
Change in height status post infancy
0
10
20
30
40
50
60
70
80
90
100
Stunted at 1 Not stunted at 1
Not stunted at 5
Stunted at 5
Recovered
Faltered
Why?
Factors which seem
important –
• Mothers height
• Household socio-
economic status
• Policy – school feeding
programmes
• Infrastructure

15. Identifying critical entry points as
a priority to prevent pathways
diverging

16. Context
1. Problem: considerable concern about gender
inequities, key question is how these come about
2. Example: how education enrolment rate changes with
age for boys and girls
3. Evidence:
• Small gaps in early childhood, gaps grow through
adolescence
• Not always pro-boy.

17. Why?
Decision making – by
households and
children - over who
stays in school shaped
by:
-> economic pressures
-> institutional
structural
-> socio-cultural
context
Gender gaps in enrolment by age
HOW, WHEN AND WHY GENDER INEQUITIES FORM
-20
-15
-10
-5
0
5
10
Ethiopia Andhra
Pradesh
Peru Vietnam
At age 8
At age 12
At age 15
At age 19
Pro girl
Pro boy
Percentage point

18. Conclusions
• Cross sectional data necessary but not sufficient to
evaluate what matters
• Key contributions of longitudinal data
1. Link earlier circumstances and later outcomes to
understand how child development is shaped
2. To identify change in children’s lives, to inform the
timing of interventions
• Survey data publically archived, lots of working papers on
website

19. Thank you!
Study website: www.younglives.org.uk
Dornan, P and Woodhead, M, 2015, ‘How inequalities
develop through childhood: Life course evidence from the
Young Lives cohort study’, Florence: UNICEF Office of
Research
Young Lives, 2015, ‘What can longitudinal research tell us
about children’s life-chances?’ Technical note