Total Environment Assessment Model for Early Child Development

Total Environment Assessment Model
for Early Child Development
embedded. This includes (but is not limited
to) aspects of society such as culture, values,
and the law.
team-ecd further refines the micro,
meso, and ecosystems into spheres of influence
that fall into each of these three contexts.
Further, while Bronfenbrenner’s model
addressed the role of family, team-ecd
identifies additional environments that are
socially, rather than geographically bounded.
In addition, team-ecd challenges the hierarchical
perspective on environments of the
Bronfenbrenner model, instead showing the
interactions and interdependence between
the various contexts that are significant for
children.
In the field of social epidemiology and
public health more generally, several models
have been developed to address the role of
social determinants of health, though not
those concerned with ecd explicitly. The
models offered by Diderichsen and Hallqvist 2
and by Diderichsen, Evans and Whitehead[5]
provide some additional detail regarding the
broad environment, namely by explicating
the role of the policy domain as a social
context. However, this model is still quite
general in its effort to explain the effects of
social stratification on health, and is geared
to the understanding of adult health. teamecd
further elaborates on the policy and
social context environments, and provides a
model that explicitly focuses on early child
development.
Dahlgren and Whitehead[6, 7] offer a
model which, like team-ecd provides considerably
more specificity of the environment,
and one in which the interactional aspects
of environments are captured. However,
team-ecd further develops this previous
work in several ways. First, Dahlgren and
Whitehead’s model is aimed primarily
at explaining adult health status, at least
implicitly so. This is suggested strongly by the
model’s incorporation of “individual lifestyle
factors” (referring to health behavioral
factors) as a source of influence for health.
team-ecd, by contrast, is primarily
concerned with the three primary domains
(physical, language/cognitive, and socio-
2 Diderichsen’s and Hallqvist’s 1998 model was adapted by
Diderichsen, Evans and Whitehead , 2001
emotional) of children’s development, which
by and large don’t have the same direct
correlation to behaviors that health status
does to health behaviors. In the context of
ecd, children’s behaviors are considered to
be components of ecd (i.e. outcomes) to be
understood and improved (or supported),
rather than independent risk factors in and of
themselves.
Second, Dahlgren and Whitehead’s model
provides a rather hierarchical notion of
environments, while (to reiterate) environments
in team-ecd model are not strictly
hierarchically conceptualized. Finally,
Dahlgren and Whitehead do not explicitly
address the temporal aspect of social determinants,
nor of health. team-ecd incorporates
notions of time, both in terms of changes in
environments over historical periods, and the
development of children over the course of
their lives.
Mackenbach et al.’s Model of Selection
and Causation[8] introduces a temporal
aspect with explicit acknowledgement of
childhood circumstances and child health.
However, the primary intent of this model
is to introduce these factors as determinants
of adult health, rather than to understand
determinants of child well-being. Further,
this model is less specific regarding environments,
terming these collectively as
‘structural/environmental factors.’ Brunner,
Marmot, and Wilkinson[9] also provide a
model which incorporates early childhood
only as a determinant of adult health, rather
than guiding explanations of early childhood
health (let alone broad notions ecd) itself.
Like the Mackenbach model, Brunner et. al.
use a broader and less refined classification
of environmental factors when compared to
team-ecd.
In conjunction with the csdh, the who
has recently developed an elaborate framework
entitled the ‘who Equity Team Social
Determinants Framework [10].’ This framework
provides a nuanced and differentiated
understanding of environments that affect
health and health equity. However, in parallel
with models described above, the objective
of this framework (at least implicitly so) is
primarily to explain adult health. This model
uses ecd as a determinant of health, but does
not address how ecd itself is determined.
Introduction
and Overview
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