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23 June 2022

Individuals as active co-creators of their environments: implications for prevention of inequalities

The chapter by Cattan et al. (2022) in the IFS Deaton Review of Inequalities documents stark inequalities in early human development in the UK, and their long-reaching shadow. The authors’ careful scrutiny of longitudinal cohort data is particularly pertinent at a time when reports of inequality feature regularly in
the press2 and when the COVID-19 pandemic has further highlighted the troubling differences in risks and opportunities between different parts of the population.3

Cattan et al. (2022) present convincing and systematic data, which indicate that tackling inequalities in the child’s environment may be as, or even more, important than tackling specific skills aimed at reducing later inequalities. Particular attention is paid to parenting practices and behaviours that are critical during the early years and beyond – including relationship quality and attachment, cognitive
stimulation, and family rituals. The chapter highlights that some children are disadvantaged on multiple fronts and that this requires that several factors must be addressed simultaneously for such children/families. The authors also point out that although there is a strong imperative for intervening early, it is also clear that the effects of some early interventions attenuate over time. The focus on early
intervention should therefore not detract from the importance of investments throughout childhood and adolescence.

Although the extant longitudinal data point to seemingly obvious targets for preventative and intervention efforts, there remain challenges that we want to consider in this commentary. Even in contexts where there is universal access to health care, education and income support (e.g. Nordic countries), considerable differences between people in mental and physical health outcomes, as well as
educational achievement, still remain and cannot be accounted for solely by lack of access to healthcare, education and income support (Paananen et al., 2013; Hegelund et al., 2018). Here we outline three important issues that warrant further consideration and investigation in the context of prevention and intervention of inequalities.

Cite this as:

Viding, E. and McCrory, E. (2022), ‘Individuals as active co-creators of their environments: implications for prevention of inequalities’, IFS Deaton
Review of Inequalities,