Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)

BACKGROUND

Past research describes robust associations between education and health, yet findings have generally been limited to the examination of education as the number of years of education or educational attainment. Little is known about the specific features or processes underpinning education that are health protective. The objective of the current study was to address this gap by examining specific aspects of early education pertaining to student characteristics and experiences, as well as features of the classroom environment, in predicting cardiometabolic health in adulthood.

METHODS

Subjects were 1364 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD, 1991-2009) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE, 2018-2022). Models examined individual education indicators (student social skills, student-teacher relationship quality, and classroom emotional and instructional quality in the period of elementary school and student academic performance between ages 54 months and 15 years) in relation to a composite of cardiometabolic risk in adulthood (ages 26-31), reflecting central adiposity, blood pressure, insulin resistance, inflammation, and dyslipidemia. Models were adjusted for key explanatory factors including socio-demographics, infant characteristics, parental socioeconomic status (SES), and child health status. Follow-up analyses were performed to test potential mediators of early education effects on adult health, including adult SES (educational attainment, household income) and health behaviors (diet quality, activity level, sleep duration, smoking).

RESULTS

In adjusted models, results showed greater student social skills, indexed by a mean of annual teacher ratings between kindergarten and 6th grade, predicted lower cardiometabolic risk in adulthood (β=-0.009, p <.05). In follow-up analyses, results showed the protective effect of student social skills on cardiometabolic risk may be mediated by adult income (β=-0.0014, p <.05) and diet quality (β=-0.0031, p <.05). Effects of the other early education indicators were non-significant (ps > 0.05).

CONCLUSIONS

Findings point to the potential significance of early student social competence as a link to long-term health, possibly via the acquisition of resources needed for the maintenance of health, as well as through engagement in health behaviors supporting healthy eating. However, more research is needed to replicate these findings and to elaborate on the role of early student social competence and the pathways explaining its effects on cardiometabolic health in adulthood.

The Quality of Early Caregiving and Teacher-Student Relationships in Grade School Independently Predict Adolescent Academic Achievement

Prior research has demonstrated that teacher-student relationships characterized by high levels of closeness and low levels of conflict are associated with higher levels of academic achievement among children. At the same time: (a) some research suggests that the quality of teacher-student relationships in part reflects the quality of early caregiving; and (b) the observed quality of early care by primary caregivers robustly predicts subsequent academic achievement. Given the potential for associations between the quality of teacher-student relationship quality and academic achievement to thus be confounded by the quality of early parenting experiences, the present study examined to what extent children's experiences in early life with primary caregivers (i.e., ages 3 to 42 months) and relationships with teachers during grade school (i.e., Kindergarten to Grade 6) were uniquely associated with an objective assessment of academic achievement at age 16 years in a sample born into poverty (N = 169; 45% female; 70% White/non-Hispanic; 38% of mothers did not complete high school). Early maternal sensitivity, though a strong predictor of later academic achievement, was not reliably associated with either teacher-reports or interview-based assessments of teacher-student relationship quality in grade school. Nonetheless, early maternal sensitivity and teacher-student relationship quality were each uniquely associated with later academic achievement, above and beyond key demographic variables. Taken together, the present results highlight that the quality of children's relationships with adults at home and at school independently, but not interactively, predicted later academic achievement in a high-risk sample.

Early maternal sensitivity and markers of physical health: Enduring or transient associations from childhood to adulthood?

Individual differences in the quality of early experiences with primary caregivers have been reliably implicated in the development of socioemotional adjustment and, more recently, physical health. However, few studies have examined the development of such associations with physical health into the adult years. To that end, the current study used prospective, longitudinal data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1,306, 52% male, 77% White/non-Hispanic) to investigate whether associations between direct observations of maternal sensitivity in the first 3 years of life and repeated assessments of two commonly used, objective indicators of physical health (i.e., body mass and mean arterial blood pressure) remained stable or diminished in magnitude over time. Associations between early maternal sensitivity and lower body mass remained relatively stable from age 54 months to 26 years and were robust to the modeling of autoregressive and second-order stability processes as well as the inclusion of potential demographic confounders. In contrast, although associations between early caregiving and lower mean arterial pressure remained relatively stable from Grade 4 to age 15 years (the oldest age for which mean arterial pressure was assessed thus far), these associations were not robust to the inclusion of covariates and the modeling of second-order stability processes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The predictive significance of fluctuations in early maternal sensitivity for secure base script knowledge and relationship effectiveness in adulthood

Attachment theory suggests that both the quality and consistency of early sensitive care should shape an individual's attachment working models and relationship outcomes across the lifespan. To date, most research has focused on the quality of early sensitive caregiving, finding that receiving higher quality care predicts more secure working models and better long-term relationship outcomes than receiving lower quality care. However, it remains unclear whether or how the consistency of early sensitive care impacts attachment working models and adult relationship functioning. In this research, we utilized data from the Minnesota Longitudinal Study of Risk and Adaptation to examine to what extent the quality (i.e., mean levels) and consistency (i.e., within-person fluctuations) in behaviorally coded maternal sensitive care assessed 7 times from 3 months to 13 years prospectively predicts secure base script knowledge and relationship effectiveness (i.e., interpersonal competence in close relationships) in adulthood. We found that larger fluctuations and lower mean levels of early maternal sensitivity jointly predict lower relationship effectiveness in adulthood via lower secure base script knowledge. These findings reveal that nonlinear models of early caregiving experiences more completely account for relationship outcomes across the lifespan, beyond what traditional linear models have documented. Implications for attachment theory and longitudinal methods are discussed.

Childcare providers' views of challenging child behaviors, suspension, and expulsion: A qualitative analysis

Previous research has underscored a need to understand the experiences and decision-making processes that contribute to suspension and expulsion in early care and education settings, particularly among young children of color. The present study conducted qualitative interviews with 20 center- and family-based childcare providers from the Minnesota Early Care and Education (MECE) study. Participants were asked about challenging child behaviors that they have encountered, their perceptions of these behaviors and how they manage them, and their thought processes around suspension and expulsion. Overall, the most frequently reported categories of challenging behaviors were physical aggression and noncompliance/defiance/arguing. The most commonly reported perceived causes of challenging behaviors were typical child development and parenting problems. The primary reported strategy for addressing challenging behaviors was connecting with the child, with relatively few providers reporting using other evidence-based strategies. Finally, the most commonly reported reasons for considering suspension or expulsion were the providers feeling they had exhausted options and could not meet the child's needs, and the child's behavior being perceived as dangerous to self or others. Implications for future research and practice (including increased support services for childcare providers) are discussed.

Early Child Care Experiences and Attachment Representations at Age 18 Years: Evidence from the NICHD Study of Early Child Care and Youth Development

The role of early child care experiences on the development of the mother-child attachment relationship has been studied extensively. However, no prospective studies of early child care have addressed how these experiences might be reflected in the content of attachment representations during adolescence and beyond. The goal of this study was to estimate relatively precise associations between child care quality, child care quantity, and type of care in the first 54 months of life and the content of adolescents' attachment representations around age 18 years (N = 857; 51% female; 78% White, non-Hispanic; M income-to-needs ratio = 4.13), leveraging data from the longitudinal NICHD Study of Early Child Care and Youth Development (SECCYD). We identified a small positive association between the observed quality of early child care (but not quantity or type of care) and secure attachment states of mind as measured by the Adult Attachment Interview (but not the Attachment Script Assessment) at age 18 years that was robust to demographic covariates and observations of maternal and paternal sensitivity during childhood. We observed no significant interactions among child care variables. Associations between early child care experiences and indicators of adolescent attachment were likewise not moderated by maternal sensitivity from infancy to mid-adolescence or by maternal reports of child temperament in early childhood.

Early Maternal Sensitivity and Teacher-Student Relationship Quality Across Grade School: Enduring or Transient Associations?

Although teacher-student relationships are assumed to in part reflect early caregiving quality, their social provisions also undergo notable normative change over the course of primary school, shifting from a secure base for social exploration to an instrumental relationship centered on achieving academic goals. This report leveraged prospective, longitudinal data from the Study of Early Child Care and Youth Development (N = 1,306, 52% male, 77% White/non-Hispanic) to investigate whether the association between early caregiving and subsequent teacher-student relationship quality remains stable or diminishes in magnitude over time. Associations between early maternal sensitivity and teacher-student closeness faded from Kindergarten to Grade 6. In contrast, associations between early caregiving and teacher-student conflict endured and were partially accounted for by child externalizing problems.

Are parent involvement and school quality associated with adult smoking behaviors? Findings from an urban early childhood cohort

Although smoking prevention is a high priority, few studies have examined alterable family and school context factors in childhood that influence later smoking behaviors. The present study examined associations of parent involvement in and expectations for children's education, elementary school quality, and school mobility with lifetime smoking history in adulthood for a low-income, minority cohort. Participants from the Chicago Longitudinal Study (N = 1142) were interviewed at age 22-24 as part of a 20-year follow-up of a prospective early childhood cohort of economically disadvantaged families. The sample is 74% of the original cohort (N = 1539). Family surveys and school records measured parent involvement and expectations as well as school quality and mobility from 4th to 8th grades. At age 22-24 follow-up, 47% reported a smoking history, and 37% were current smokers. After controlling for family background and participant characteristics, parent involvement in school was associated with reduced odds of a smoking history (OR = 0.88; 95% CI = 0.78, 0.99). Magnet school attendance (a school quality indicator) was associated with lower odds of current (OR = 0.47; 95% CI = 0.28, 0.79) and daily smoking (OR = 0.40, 95% CI = 0.21, 0.74). More frequent school moves were consistently associated with increased odds of smoking (e.g., OR [currently] = 1.17; 95% CI = 1.07, 1.36). Results indicate that protective factors within the family and school context were consistently associated with smoking measures. Programs and practices that strengthen parent involvement and school support may contribute to prevention efforts.

Self-esteem development in middle childhood: Support for sociometer theory

Though it is well-established that self-esteem develops from childhood well into old age, little is known about the processes that influence this change, especially among young populations. This international, cross-sequential study examined the development of self-esteem in 1599 second-graders (Age MT1 = 7.99, SDT1 = 0.52 years; 52% male) in the Netherlands and Germany over three years. Multilevel models revealed that mean-level trends in self-esteem were stable across time among all demographic groups, but that males and students in the Netherlands consistently had higher self-esteem than females and students in Germany. Further analyses examining the role of social support in self-esteem development demonstrated that individuals with better peer and family social support tended to have higher levels of self-esteem and that within-person changes in social support were directly related to changes in self-esteem level, providing support for sociometer theory. These findings suggest that demographic factors as well as social support are important predictors of self-esteem as early as middle childhood.