Childcare uptake and educational and health inequalities

This study is being led by Dr Charlotte Constable Fernandez and Prof Katie Harron (UCL) with Dr Becca Lacey (City St Georges University of London) and was funded by ESRC as part of the Equalise Centre for Lifecourse Health Equity. The study started in 2026 and aims to finish in 2028.

‍This project was reviewed and approved through ECHILD's data access process. Learn how ECHILD data is kept safe.‍

  • We want to know whether early childcare is related to inequalities in childhood education and health outcomes.

  • Early childhood is critical for developing solid foundations for learning and health, and formal childcare is an important part of this picture. However, little is known about whether childcare policies could help reduce socioeconomic inequalities in healthy development at school entry.

  • We will use linked records of attendance in early childcare settings in ECHILD to describe how update of early childcare varies across different sociodemographic groups and over time. We will explore whether early childcare uptake is related to childhood health outcomes such as hospital admissions, and educational outcomes (e.g. school readiness, attainment, Special Educational Needs and Disability provision, and absences).

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  • Why does this matter?

    Early childhood is critical for developing solid foundations for learning and health, and formal childcare is an important part of this picture. We also know that socioeconomic inequalities in healthy development are already evident at school entry. However, most policies on childcare focus on enabling parents to get back to work, whilst the importance of childcare and early education for children’s healthy development has been given less attention. 

    What do we want to find out?

    We want to understand how uptake of early childcare varies across England and over time, for different subgroups of the population (e.g. according to maternal age, ethnicity, neighbourhood deprivation). We also want to know whether early childcare uptake is related to childhood health outcomes such as hospital admissions, and educational outcomes (e.g. school readiness, attainment, Special Educational Needs and Disability provision, and absences).

    What we will do

    We will use records from the Early Years Census to understand which children are attending early childcare settings. We will use linkage to health records and the mother-baby link to understand whether uptake varies according to birth characteristics and early health conditions, or maternal characteristics (e.g. age). We will use linked school records to look at whether groups who are more likely to take up early childcare do any differently at school.

  • Background/aims: 

    This study aims explore how uptake of early childcare is related to inequalities in childhood education and health outcomes. We will

    -          Describe uptake of early childcare and how this varies across different sociodemographic groups (maternal age, maternal education, ethnicity, deprivation, geography) and over time.

    -          Evaluate how childcare uptake is related to childhood health outcomes (hospital admissions and emergency department attendances up to age 10) and educational outcomes (Early Years Foundation Stage Profile, Key Stage 1 attainment, Absences during primary school, recorded Special Educational Needs)

    -          Determine whether childcare uptake explains any of the relationships between socio-demographic characteristics and childhood outcomes

    Methods and analysis:

    The study population compromises children attending state-funded childcare in England between the 2008/09 and 2021/22 academic years and whose birth record was captured in HES.

    We will describe the study population overall and stratified according to whether children accessed funded early years education. We will describe uptake of funded childcare according to type of provider and the extent of uptake by number of hours. We will also consider uptake of funded childcare over time.

    We will also explore whether it is possible to use a Target Trial Emulation approach to evaluate how differences in early childcare uptake might influence outcomes.

    ECHILD data used:

    HES: Admitted Patient Care; mother-baby link; 2007-2021

    NPD: Early Years Census, Key Stage 1, Absences, Spring Census, 2008/09-2021/22

  • Related outputs from the Learning theme of the Equalise ESRC Centre for Lifecourse Health Equity.