Publications

Murphy T, Kaufman JS, Weinstock D, Yang S. Effect of preschool childcare on school-aged children’s adiposity in Quebec, Canada. Paediatric and Perinatal Epidemiology 2021 (in press). 

Measuring the effect of Quebec's subsidized daycare program

Quebec’s universal publicly funded childcare program was developed to advance early childhood development by improving overall accessibility to quality childcare services. In turn, this would have the anticipated effect of alleviating social disparities in children’s school preparedness. First introduced in 1997, this policy saw spaces gradually made available for prekindergarten children to attend subsidized childcare regulated by the province through educational childcare centres (Centres de la Petite Enfance or CPEs), day care centers, CPE home childcare and school daycares. This policy further saw implementation of quality standards including minimum children-to-daycare worker ratios, educational curricula, and mandated hiring of trained staff. Research has found that CPE-regulated childcare facilities have generally received higher quality rankings than those unaffiliated. 

Access to high-quality childcare may improve child health and development through increasing early exposure to infections, improving educational preparedness, and expanding social engagement. Subsidized affordable childcare may offer the most benefit to those from socioeconomically disadvantaged backgrounds, for whom high quality care might otherwise be inaccessible. As social inequalities in health and development emerge early in life, a high-quality universal childcare program has potential to lower these inequalities both in childhood and throughout the life-course. 

Pre-existing evaluations of Quebec’s universal childcare program have established that the policy increased maternal labour force attachment and child care use, although studies have also found mixed or negative results in health outcomes among children and parents. Our research will update this literature, which usually focuses on ecological or aggregate effects over the province, by evaluating differences in childcare source by quality. That is, we will compare outcomes in child health and development in children who primarily used a high quality program-affiliated (CPE) form of childcare compared to those who did not. A further contribution will be to evaluate whether the effects of program-affiliated childcare vary across socioeconomic groups, thus measuring the program impact on inequalities in child health and development. We will investigate both short and long-term health and developmental impacts to assess effects of the program from elementary school ages into adolescence.