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Does Place Matter? An International Comparison of Early Childhood Development Outcomes between the Metropolitan Areas of Melbourne, Australia and Montreal, Canada

1
Department of Social & Preventive Medicine, École de santé publique, Université de Montréal, Montréal, QC H3N 1X9, Canada
2
Direction Régionale de Santé Publique, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC H2L 1M3, Canada
3
Health Innovation and Evaluation Hub, Centre de recherche du CHUM, Montréal, QC H2X 0A9, Canada
4
Centre for Community Child Health, Murdoch Children’s Research Institute, & Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne VIC 3052, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(16), 2915; https://doi.org/10.3390/ijerph16162915
Received: 5 May 2019 / Revised: 24 July 2019 / Accepted: 28 July 2019 / Published: 14 August 2019
(This article belongs to the Special Issue Health Inequalities in Children)
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Abstract

There is strong consensus about the importance of early childhood development (ECD) for improving population health and closing the health inequity gap. Environmental features and public policies across sectors and jurisdictions are known to influence ECD. International comparisons provide valuable opportunities to better understand the impact of these ecological determinants on ECD. This study compared ECD outcomes between metropolitan Melbourne (Australia) and Montreal (Canada), and contrasted disparities across demographic and socioeconomic characteristics. Methods: Population wide surveys using the Early Development Instrument (EDI) were conducted among 4–6 years-old children in both Montreal and Melbourne in 2012, measuring five domains of ECD: 1-Physical Health/Well-Being (PHYS); 2-Social Competence (SOC); 3-Emotional Maturity (EMOT); 4-Language/Cognitive Development (COGN); and 5-Communication Skills/General Knowledge (COMM). Descriptive analyses of summary EDI indicators and domain indicators (including median scores and interquartile ranges) were compared between metropolitan areas, using their respective 95% confident intervals (CIs). Analyses were performed using Stata software (v14). Results: The proportion of children developmentally vulnerable in at least one domain of ECD was 26.8% (95% CIs: 26.2, 27.3) in Montreal vs. 19.2% (95% CIs: 18.8, 19.5) in Melbourne. The Melbourne advantage was greatest for EMOT and COGN (11.5% vs. 6.9%; 13.0% vs. 5.8%). In both Montreal and Melbourne, boys, immigrants, children not speaking the language of the majority at home, and those living in the most deprived areas were at greater risk of being developmentally vulnerable. Relative risks as a function of home language and area-level deprivation subgroups were smaller in Montreal than in Melbourne. Conclusion: This study shows that Melbourne’s children globally experience better ECD outcomes than Montreal’s children, but that inequity gaps are greater in Melbourne for language and area-level deprivation subgroups. Further research is warranted to identify the environmental factors, policies, and programs that account for these observed differences. View Full-Text
Keywords: early childhood development; child health inequities; early development instrument; children’s health and well-being; international comparison; Melbourne (Australia); Montreal (Canada) early childhood development; child health inequities; early development instrument; children’s health and well-being; international comparison; Melbourne (Australia); Montreal (Canada)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Dea, C.; Gauvin, L.; Fournier, M.; Goldfeld, S. Does Place Matter? An International Comparison of Early Childhood Development Outcomes between the Metropolitan Areas of Melbourne, Australia and Montreal, Canada. Int. J. Environ. Res. Public Health 2019, 16, 2915.

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