Sure Start had positive health benefits for children in poorer neighbourhoods

A new evaluation conducted by the Institute for Fiscal Studies considers the overall impacts on children’s health of the Sure Start programme as a whole between its inception in 1999 and its peak in the late 2000s. Sure Start is an early intervention programme targeted at parents and children under the age of four living in the most disadvantaged areas. Sure Start projects deliver a wide variety of services, which are designed to support children’s learning skills, health and well-being, and social and emotional development. They include preschool education; medical, dental, and mental health care; nutrition services; and efforts to help parents encourage their child’s development.

The study, funded by the Nuffield Foundation, followed children who had access to Sure Start right through to the end of primary school, and found that Sure Start had major health benefits for children living in disadvantaged areas. The main findings of the study include:

  • Sure Start reduced hospitalisations among children by the time they finished primary school, and these effects built over time. By age 11, greater Sure Start coverage (one more centre per thousand children ages 0–4) prevented around 5,500 hospitalisations per year (18% of the pre-Sure Start baseline).
  • Sure Start benefited children living in disadvantaged areas most. While the probability of any hospitalisation fell by 11% at age 10 and 19% at age 11 for children in the poorest 30% of areas; those in more affluent areas saw smaller benefits, and those in the richest 30% of areas saw practically no impact at all.
  • At every age in primary school, Sure Start reduced hospital admissions for injuries. At younger ages, injury-related hospitalisations fell by around 17% of their pre-Sure Start (1998) baseline; at ages 10 and 11 they fell by 30%. 

The authors suggest that a reason greater benefits were seen in the poorest neighbourhoods could be because disadvantaged children were more able to benefit from Sure Start as the types of services the programme offered in poorer areas were more helpful, or because children in disadvantaged areas were more likely to attend a centre.

In 2012 the Department for Education published a report on the impact of Sure Start Local Programmes (SSLPs) on seven-year-olds and their families, which found no impact on children’s outcomes.

Source: The health effects of Sure Start (June 2019), The Institute for Fiscal Studies

Sure Start survey shows why disadvantaged families need support

New research published by the Department for Education presents findings from a baseline survey of families using Sure Start Children’s Centres (SSCCs), which aim to reduce inequalities in child development and school readiness. The data forms part of a six-year study examining SSCCs in the most disadvantaged areas of England, and was taken from interviews with a sample of 5,717 parents with a “selected child” aged 9-18 months old.

The survey explored take-up of services at the centres, as well as the socio-economic characteristics of the families using them.

Extensive findings are detailed in the report, and a research brief outlines key results. Negative findings were often associated with disadvantaged families, including:

    • Families with lower incomes and where mothers had lower levels of educational attainment had a less favourable home learning environment (HLE).
    • Families where parents did not work had lower HLE scores than those where at least one parent was in paid employment.
    • Households with lower incomes were slightly more likely to be characterised by less favourable parenting and family functioning.
    • Families with lower incomes, those where mothers had lower educational attainment, single parents, and those where parents did not work, tended to have slightly more chaotic and less organised homes than those in more advantaged circumstances.

Source: Evaluation of Children’s Centres in England (ECCE). Strand 2: Baseline Survey of Families Using Children’s Centres in the Most Disadvantaged Areas. Research Report (2013), Department for Education.

Study suggests Head Start advantages dwindle after preschool

Similar in some ways to the UK’s Sure Start programme, Head Start is a US programme that promotes the school readiness of low-income children from birth to five. Services include preschool education; medical, dental, and mental health care; nutrition services; and efforts to help parents encourage their child’s development. A follow-up study has now shown that there are few lasting impacts of the programme on children in Kindergarten (Year 1) to 3rd Grade (Year 4).

The study included nearly 5,000 newly entering, eligible 3- and 4-year-old children who were randomly assigned to either: a Head Start group that had access to Head Start programme services; or a control group that did not have access to Head Start, but could enroll in other early childhood programmes or non-Head Start services selected by their parents. Data collection began in autumn 2002 and continued through to 2008, following children until they were in Year 4.

Evidence from the study showed initial positive impacts from having access to Head Start, but by the end of Year 4, there were very few impacts found in any of four key programme domains: cognitive development, social-emotional development, health status and services, and parenting practices. The few impacts that were found did not show a clear pattern of favourable or unfavourable impacts for children.

Source: Third grade follow-up to the Head Start impact study: Final report (2012), OPRE

The impact of Sure Start Local Programmes

This research report from the Department for Education presents findings of a longitudinal study that measures the impact of Sure Start Local Programmes (SSLPs) on seven-year-olds and their families. The study looks at over 5,000 families in 150 SSLP areas and makes comparisons with children and families in similarly disadvantaged areas that do not have an SSLP.

The results show positive effects on family functioning and maternal well-being associated with living in an SSLP area. However, no impact was found on any of the child outcomes measured. The report demonstrates that SSLPs are extremely popular and have proved to be successful in engaging and supporting the poorest families. However, greater emphasis is needed on services that will directly improve child outcomes, particularly language development and children’s daily experiences.

Source: The impact of Sure Start Local Programmes on seven year olds and their families (2012), Department for Education