The Emergence of health GAps in early Life (EGAL): A dynamic analysis of three national birth cohorts – EGAL

In this project, we propose to conceptually and methodologically bring together the economics literature on the measurement and conceptualization of childhood deprivation on the one hand, with the epidemiological literature on health inequalities on the other hand. Applying a longitudinal framework, we propose to make use of interdisciplinary, nationally-representative data (including the new French birth cohort, the Etude Longitudinale Française depuis l’Enfance, Elfe) to, first, characterize children’s multi-domain deprivation in France and explore how it links to dynamics of early health. Second, we will compare Elfe to two national birth cohorts from the US and UK, the Early Childhood Longitudinal Study – Birth cohort (ECLS-B) and the Millennium Cohort Study (MCS), to examine whether different national settings produce different patterns of inequities across countries. These large data infrastructures have not yet been used in comparative, longitudinal perspective.

A particular innovation of this proposed project will be the use of a lifecourse, multi-domain framework to study childhood deprivation, and how it correlates to early health. First, using longitudinal data and methods, we will explore how dynamics of early childhood deprivation are associated with dynamics of early health. Second, the focus on multi-domains of deprivation will allow exploring which dimensions of deprivation matter most for early health; this will be a critical step to move from describing to understanding health inequalities.

The project is only just started. Early results suggest that deprivation in very early childhood does not always overlap with poverty; that different domains of deprivation tap into slightly different segments of the population; and that deprivation is overall correlated with early child health.

Comparative analyses, comparing the Elfe cohort with UK and US data, will be the next major step. Longitudinal analyses, which will analyze dynamics of health and deprivation, will also be implemented.

TBA

Evidence suggests that inequalities in health begin from the starting gate and that therefore early childhood is crucial to our understanding of the production of health inequalities in later life. Compared to other national settings, there is less data and empirical research about the dynamics of health inequalities in the early years for France, yet preliminary results suggest stark health inequities from birth, comparable to those documented in other developed countries. The lack of nuanced data and empirical research on early health inequities in France is at odds with a renewed policy focus on anti-poverty measures, with a strong focus on early living conditions and childhood education.

A body of research has put an emphasis on multi-domain deprivation as tools to better understand childhood disadvantage, rather than classic measures such as income poverty; these tools have been applied both in France and internationally to measure the proportion of children vulnerable to disadvantaged living conditions. However, the international health inequalities literature still uses relatively simple concepts of (parental) “socio-economic status” to describe health gaps in the early years. Furthermore, most studies in this field focus on single national contexts, or cross-sectional comparisons. National contexts and policy environments may have a strong effect in moderating the relationship between early experience of deprivation and child health, leading to different dynamics of inequalities in early health. Longitudinal and finer data on deprivation can allow describing when and how early health inequities begin.

In this project, we propose to conceptually and methodologically bring together the economics literature on the measurement and conceptualization of childhood deprivation on the one hand, with the epidemiological literature on health inequalities on the other hand. Applying a longitudinal framework, we propose to make use of interdisciplinary, nationally-representative data (including the new French birth cohort, the Etude Longitudinale Française depuis l’Enfance, Elfe) to, first, characterize children’s multi-domain deprivation in France and explore how it links to dynamics of early health. Second, we will compare Elfe to two national birth cohorts from the US and UK, the Early Childhood Longitudinal Study – Birth cohort (ECLS-B) and the Millennium Cohort Study (MCS), to examine whether different national settings produce different patterns of inequities across countries. These large data infrastructures have not yet been used in comparative, longitudinal perspective.

A particular innovation of this proposed project will be the use of a lifecourse, multi-domain framework to study childhood deprivation, and how it correlates to early health. First, using longitudinal data and methods, we will explore how dynamics of early childhood deprivation are associated with dynamics of early health. Second, the focus on multi-domains of deprivation will allow exploring which dimensions of deprivation matter most for early health; this will be a critical step to move from describing to understanding health inequalities.

Our overall key research questions therefore are:
• What are the patterns of multi-domain deprivation across early childhood in France?
• How do different domains of deprivation link to dynamics of early health? Do these associations vary according to child age? Does the cumulation of deprivation (across time, across dimensions of deprivation) matter for early health?
• To what extent do these patterns of early health inequities in France compare to those observed in other developed countries?