Examining the Contribution of the Neighborhood Built Environment to the Relationship Between Neighborhood Disadvantage and Early Childhood Development in 205,000 Australian Children

Abstract

Objective: We examined associations between neighborhood built environment features and early childhood development (ECD), and tested the contribution of the built environment to associations between neighborhood disadvantage and ECD.

Methods: Spatial neighborhood built environment measures were linked to participant addresses in the 2015 Australian Early Development Census (AEDC) for children ∼5 years old living in Australia's 21 most populous cities. The 2015 AEDC contains teacher-reported national data on five key child development domains for children in their first year of formal full-time schooling (approximately 5 years old). AEDC scores were classified as 'developmentally vulnerable' (≤10th centile). Using multilevel modeling, 44 built environment measures were tested with developmental vulnerability on at least one domain of the AEDC, adjusting for socioeconomic factors and neighborhood disadvantage.

Results: The dataset consisted of 205,030 children; 89.2% living in major cities. In major cities, children with more early childhood education and care services (OR 0.997) and preschool services (OR 0.991) exceeding Australian standards, and access to healthier food outlets within 3200 m of their home (OR 0.999) had decreased odds of developmental vulnerability, controlling for socioeconomic factors and neighborhood disadvantage. Neighborhood disadvantage remained significantly associated with developmental vulnerability after adjustment for child/family variables and neighborhood built environment characteristics.

Conclusions: The neighborhood built environment had small effects on the neighborhood disadvantage-ECD relationship at the national level. Few built environment measures were associated with ECD. Small effects at the population level may have wide-ranging impacts; modifying the built environment at scale are promising levers for supporting good child outcomes.

Keywords: built environment; child health and wellbeing; data linkage; neighbourhood; social determinants of health.