Pre-birth and early years (up to age five)

Introduction The findings and recommendations of the Marmot Review are structured on the framework of the ‘Life Course’. Fundamental to this is that the consequences of social, psychological, economic and environmental influences accumulate through life’s phases to have a combined impact. The evidence from the Review, however, is that it can be the impact of what happens in the Early Years that ‘casts the longest shadow’. The effects can either be:• Protective – increasing esteem; life skills; resilience and behaviours • Hazardous – destroying self-regard; undermining social skills and ability to learn; cre-ating the conditions for mental and physical ill health. (Marmot Review 2010: 40)One of the most striking findings of the whole Review relates to cognitive development. In summary ‘Children of educated or wealthy parents can score poorly in early tests but still catch up, whereas children of worse-off parents are unlikely to do so’ (Marmot Review 2010: 61-62). A range of empirical studies are pointed to which provide evidence that cognitive ability is a powerful determinant of earnings, propensity to get involved in crime(or not), and success (or otherwise) in many aspects of social and economic life as well as health, across the social gradient (Marmot Review 2010: 61-62).