There is growing evidence regarding the importance of the first 1001 days, from conception to age two, in long-term development. Stressors such as maltreatment, trauma and abuse may impede the course of brain development, which in turn may reduce a child’s emotional and mental abilities to respond effectively to challenging circumstances (2). Under-development in parts of the brain may prevent young children forming a healthy range of coping responses to adversity and stress, in contrast to children who experience the caring and nurturing environment required for healthy brain development.
The evidence suggests that such stressors may adversely affect approximately 40% of all children during the first 1001 days of life (3). These interruptions may have lasting impact culminating in lower educational attainment, increased risk of mental and physical illness, drug and alcohol misuse, higher unemployment, reduced capacity for forming relationships (including parental relationships), difficulties in social functioning, antisocial and disruptive behaviour and chronic illness. These may all be linked to lowered quality of life and life expectancy (4). Studies show that prevention of such stressors can more than halve the development of drug misuse, violent behaviours and reduce teenage pregnancy by a third in some groups (4).
The cost to the economy of some of these problematic outcomes can be significant; the WHO for example estimates child maltreatment to be responsible for almost a quarter of the burden of mental disorders with the associated economic and social costs on a par with those for all non-communicable diseases e.g. cancer and heart disease (5). Studies have demonstrated that when combined together perinatal depression, anxiety and psychosis carry a long-term cost to society of about £8.1 billion for each one-year cohort of births in the UK (6).
Interventions at a later stage, by which time such problematic outcomes may have developed, are often financially costly and less effective than those implemented early. Evidence does indicate that earlier interventions such as parenting classes are less costly and may be more effective (7). However, in the current economic climate, the number of suitable programmes available for children and families remains limited. For example, despite the evidence that maternal mental health issues can adversely affect neonatal and childhood health, at present only 3% of Clinical Commissioning Groups (CCGs) in England have a perinatal mental health strategy in operation (8).
Society needs to develop new, evidence-based and cost-effective approaches that ensure children receive the care they need in the first 1001 days of life. The establishment of such provisions of care will guarantee the best start in life that every child deserves.
“Children are most vulnerable in the first 3 years of life, and the greatest returns will be made by investment in early child development” (WHO (2014) Investing in Children: the European Child Maltreatment Prevention Action Plan 2015-2020, Written Evidence)2
Key Policy Drivers
The following have played key roles as drivers in developing the Zero2 Expo:
- The Public Health Outcomes Framework Healthy lives, healthy people: Improving outcomes and supporting transparency (2016)
- UK Government’s Early Years Policy Statement ‘Supporting Families in the Foundation Years’ (2011)
- World Health Organisation. Investing in Children: the European Child Maltreatment Prevention Action Plan 2015-2020 (2014)
- The 1001 Critical Days: the importance of the conception to age two period: A Cross Party Manifesto (2015)