It is widely understood that what happens in the early stages of life – from conception to the age of 5 – can have long-lasting effects. How might the experience of lockdown and the Covid-19 recession influence future outcomes for the very young?
The lockdown constitutes a major disruption to the usual way of life for families in the UK. Children in utero during this time, as well as children in their early years (0 to 5), could be particularly vulnerable, especially as what happens during this stage of their lives can have lifelong effects. How might lockdown and the economic slowdown affect these groups?
What does evidence from economic research tell us?
- We know that recessions have negative consequences for birth outcomes – such as increasing the likelihood of having a baby with low birthweight – as well as a negative impact on children’s development during the early years.
- In addition, during the period of lockdown, we see the interruption of usual antenatal and family services alongside disruption to the social networks that are crucial for supporting the health and wellbeing of mothers and children.
- But not everyone’s experience of this crisis is the same: disadvantaged families rely more on support from services and have fewer resources at home, which means that their children are at greater risk of poor outcomes.
- Evidence tells us that what happens during pregnancy and the early years are particularly important determinants of outcomes throughout life. We may therefore expect to see the widening of existing inequalities for the cohort of babies and infants affected by this crisis over the longer term.
How reliable is the evidence?
There is a substantial body of evidence demonstrating the negative effects of an economic downturn on children in utero. There are typically greater environmental stresses, such as financial hardship and unemployment, during a downturn. These can contribute to poorer maternal health, both physical and mental, which in turn affects birth outcomes (Currie et al, 2015; Almond et al, 2018).
For example, a study that examines just under 200 years of Dutch mortality data finds that being born during a recession significantly increases mortality rates later in life (van den Berg et al, 2006). And a study of the Icelandic recession of 2008 finds that the sudden economic downturn significantly increased the probability of mothers giving birth to a low birthweight baby (Olafsson, 2016). Moreover, this impact can endure into adulthood with low birthweight babies typically experiencing lower educational attainment and earnings later in life (Black et al, 2007).
Another way in which economic hardship affects babies and infants is via nutrition, particularly in pregnancy. Even modest declines in nutrition during this period have a negative long-run impact on children’s educational results. Meanwhile, programmes of nutritional supplements can increase babies’ birthweight and improve longer-run outcomes (Almond et al, 2018).
Data on food security in this crisis are not yet available, but food bank use statistics from the Trussell Trust indicate that of the 1.5 million food packages distributed from April 2018 to September 2019, over one third were requested for children.
The current disruption of services provided by food banks, together with changes to the provision of food in shops and supermarkets (such as the suspension of multi-buy discounts), suggests that food security could be on the rise during this period. If this is the case, we might expect low-income mothers and their young children to be disproportionately negatively affected.
Given the nature of the current crisis, this period is likely to produce additional stress on parents that could affect infant outcomes, including bereavement and conflict within households during lockdown. For example, one study finds that the death of a mother’s parent during pregnancy has a negative effect on birth outcomes, though no long-term effects beyond infancy are detected (Black et al, 2016).
In terms of relationships within households, research highlights the detrimental impact of parental conflict, domestic abuse and harsh parenting on the outcomes of young children (Doyle et al, 2018; Cunha, 2015). We may worry that these will rise as families spend more time together and are put under more stress.
Another crucial finding from this body of research is that those from poorer socio-economic backgrounds are disproportionately affected by economic downturns. Investigating the effects of the 2008 financial crisis, one US study finds an increase in health harming behaviours such as smoking and poorer mental health among less advantaged mothers, while the health of better off mothers even improves (Currie et al, 2015). Another study finds that the impact of area-level unemployment on babies’ health ranges from significantly negative in deprived areas to mildly beneficial in the most affluent areas (de Cao et al, 2019).
Indeed, for some highly educated, well-resourced parents who are able to spend time with their young children during lockdown, we may not expect negative effects. In contrast, less educated, lower-income families may struggle to provide an enriching home learning environment.
These inequalities could have long-run implications as the early years are a particularly formative period in a child’s life, during which they develop the skills and competencies that enable them to succeed in school and beyond (Cunha and Heckman, 2007). For example, one study shows that maternal time is an important input for children’s skill formation and that its influence declines with children’s age (del Bono et al, 2014).
Another unique feature of this crisis is the current lockdown and the associated disruption of services for families. For both universal services and targeted services, take-up can be low among disadvantaged families, and engagement is likely to fall further during this period.
We would expect this to hit disadvantaged families the hardest as they disproportionately benefit from such services. For example, Sure Start community health centres have been shown to have significant health benefits for children from disadvantaged neighbourhoods in terms of reduced child hospitalisations, while those in the richest 30% of neighbourhoods experience practically no impact (Cattan et al, 2019).
Likewise, the provision of pre-school education has been significantly disrupted during lockdown. There is robust, cross-country evidence demonstrating the benefits of pre-school on children’s development, particularly for those from low-income households. Furthermore, the importance of formal pre-school education is reflected in the significant increases in public investment that the sector has attracted over recent years, with government spending on free childcare for 3 and 4 year olds more than doubling between 2004/05 and 2018/19 (Britton et al, 2019).
A review of the evidence documents long-lasting effects from attending a high-quality pre-school environment on outcomes, including increased school completion and reduced participation in crime and teenage pregnancy (Almond and Currie, 2011). The authors also note that non-cognitive skills may be particularly amenable to early intervention. Indeed, a recent study of UK pre-school provision demonstrates effects of attending additional months of pre-school on cognitive outcomes up to the age of 7 and on non-cognitive outcomes up to the age of 11, with the greatest effects for boys from a disadvantaged background (Cornelissen and Dustmann, 2019).
Similarly, evidence from the Study of Early Education and Development (SEED) finds positive effects of free pre-school provision for disadvantaged children. Children from more affluent backgrounds experienced negative effects on socio-emotional outcomes, suggesting that children of well-educated mothers already benefit from high-quality learning opportunities at home.
This evidence on the differential effects of pre-school education suggests that once again, learning losses will be greater for low-income children during the period of pre-school closures, resulting in widening developmental gaps between the richest and the poorest children.
What else do we need to know?
The effects of current changes in antenatal services are not well understood. Many appointments have been conducted virtually and for those happening in person, mothers are required to attend alone.
Similarly, targeted home visiting programmes, such as Family Nurse partnership, have moved to telephone consultation, and universal health visiting has been disrupted. Research on the impact of disruption to these services is limited, though evidence from a two-month nurse strike in Denmark (Kronborg et al, 2016) finds that the associated reduction in care increased the number of GP visits in the first month of life and reduced breastfeeding. Another study documents how poorer breastfeeding support services in hospitals at the weekend cause fewer babies born on weekends to be breastfed, which in turn affects cognitive development (Fitzsimons and Vera-Hernandez, 2013).
While these examples suggest a detrimental impact on child health, it will be important for future research to evaluate the effectiveness of current adaptations to services.
Though unemployment has risen during the Covid-19 crisis, many workers have also been put on furlough, earning at least 80% of their usual income (up to £2,500 a month) for not working. In this respect, this crisis differs in its early stages from previous recessions, which may make evidence that focuses on the impact of unemployment less applicable. Looking at the time use of furloughed parents and the effect on their wellbeing is key to understanding the impact on children.
In the longer run, economic hardship may be more of an issue, particularly as the furlough scheme comes to an end. Understanding the different characteristics of employed, unemployed and furloughed workers will also be important for understanding the extent to which current labour market conditions perpetuate existing inequalities.
The effects of formal childcare and pre-school have been well studied, yet there is less evidence on the role of informal childcare supplied by friends and relatives. The impact of disruption of these informal support networks is largely unknown but could also have a significant effect on child outcomes.
A distinct feature of this crisis is the social isolation of individuals and families. Even at a young age, children benefit from social interactions with significant adults and later with peers. The evidence on the long-run impact of removing these social interactions from children’s life is lacking.
Where can I find out more?
Supporting parents and children in the early years during (and after) the COVID-19 crisis: Gabriella Conti discusses potential effects of the Covid-19 pandemic on parents and children, as well as policies to mitigate these effects.
The hidden victims of the Global Crisis: Arna Olafsson provides a discussion of the effects of the Great Recession on birth outcomes using evidence from Iceland.
COVID-19 and educational losses: The case for sending the youngest back to school: Jo Blanden and Birgitta Rabe summarise evidence about the effect of schooling by age group and explore the case for sending the youngest children back to school.
What further research is going on?
Cattan S., The effects of COVID-19 on families’ time-use and child development Coverage: survey of parents in England Field: Child development.
Twamley K., Faircloth C., Iqbal H., Families and Community Transitions under Covid Coverage: UK-based survey data plus international case studies (including Argentina, Singapore and Sweden).
IFS work to analyse financial pressures on nurseries and what these could mean for capacity in the sector.
Who are economic experts on this question?
This brief has provided an overview of the economic evidence on the likely impact of the pandemic on babies and infants. Clearly other disciplines provide equally important insights from different perspectives, for example, on the psychological impact of the crisis. The experts listed below are the leading researchers on this topic from an economics perspective.
