New IFS research finds that one of England’s biggest early years
programmes delivered long-lasting health benefits for children
through their teenage years. Taken together, the savings
from reduced hospitalisations up to age 15 offset around 31% of
spending on the programme.
Established in 1999, Sure Start Children’s Centres brought together
health, parenting support, childcare and parental employment
services into a one-stop shop for families with children under 5.
At its peak in 2010, Sure Start received £1.8 billion a year (a
third of overall early years spending), but spending has since
fallen by more than two-thirds as many centres have been closed,
scaled back or integrated into Family Hubs.
The research, funded by the Nuffield Foundation, builds on previous
IFS analysis and provides the first evidence of how this major
initiative affected children’s health up to age 15. Focusing on the
2000s (when the programme was expanding), the researchers find that
the impact of Sure Start changed as children aged:
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Greater access to Sure Start initially increased
hospitalisations at age 1. This likely reflects the
programme’s role in referring parents to appropriate healthcare
for children’s illnesses, and greater exposure to infectious
illnesses from group settings.
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However, these early increases are more than
outweighed by longer-term effects, which reduced
hospitalisations through childhood and adolescence.
Sure Start provision at the level of its peak (in 2010) reduced
hospitalisations at age 5 by 7%; this translates to around
2,900 fewer hospitalisations a year.
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These long-term benefits persisted as children
aged. For example, peak levels of Sure Start provision
during childhood prevented over 13,150 hospitalisations of 11-
to 15-year-olds each year (an 8% reduction on pre-Sure-Start
hospitalisation rates).
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This means that Sure Start had long-term benefits
for children’s health, lasting almost a decade after children
have ‘aged out’ of eligibility.
These results highlight the importance of
integrating a range of services during the early years to improve
child health in both the immediate and longer term.
These are important lessons for existing services (such as Family
Hubs) and should inform the government’s approach to the
recommendations in the recent Leadsom Report on the
first 1,001 days of life. While this autumn’s Spending Review
will be a tight one, these results highlight the importance of
considering the long-term benefits of early intervention
policies, not just their up-front cost.
The research also finds that:
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These benefits for child health likely come from several
different channels, including stronger immune
systems(which prevent infections in later childhood);
less risky environments (which reduce
poisonings and accidents); and improved mental health and
potentially better behaviour during adolescence. However, we
find no evidence that Sure Start affected mothers’
employment.
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Boys enjoy longer-lasting benefits from Sure Start than
girls, reflecting their greater sensitivity to disadvantage in
the early years. After the end of primary school, the impact of
Sure Start on girls’ hospitalisations fades out, but the
benefits for boys continue to grow. By age 15, an extra
Sure Start centre per thousand children during childhood
prevents over 3,200 hospitalisations a year among boys, but has
no effect for girls.
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The benefits of Sure Start were also longer-lasting in
more disadvantaged neighbourhoods. This suggests that
Sure Start provision helped to reduce health
inequalities. Going forward, an important lesson for
services such as Family Hubs is that a model combining
universal services with an area-based focus on disadvantaged
neighbourhoods can be a successful approach to early years
interventions.
Maud Pecher, a co-author of the report,
said: ‘By bringing together a wide range of early years
services for children under 5, Sure Start centres dramatically
improved children’s health even through their teenage years.
Children who had greater access to Sure Start in their early
years were far less likely to be hospitalised later on – at its
peak, Sure Start provision prevented over 13,000 hospitalisations
of 11- to 15-year-olds each year. These benefits were
particularly long-lasting for boys and children in disadvantaged
neighbourhoods.’
Sarah Cattan, IFS Associate Director and a co-author of
the report, said: ‘The savings from reduced
hospitalisations up to age 15 offset around a third of the cost
of the Sure Start programme – and that’s before considering any
potential benefits in education, social care or crime. Ahead of
this autumn’s tight Spending Review, these results are a reminder
that policymakers should consider a programme’s potential for
long-term savings, not just its up-front costs.’
ENDS
Notes to editors
1. ‘The health impacts of Sure Start’, authored by Sarah Cattan
(IFS), Gabriella Conti (University College London and IFS
Research Fellow), Christine Farquharson (IFS), Rita Ginja
(University of Bergen and IFS International Research Fellow) and
Maud Pecher (IFS), will be published on the IFS website at
00.01 on Monday 16 August 2021 via this URL:
https://ifs.org.uk/publications/15573
