World Bank Document

Figure 2, as an example, depicts the socioeconomic gradient in mor-
tality for men in the United Kingdom civil service. This is a middle-
class population not living in poverty.
The relationship between position in the socioeconomic structure
of society and health is a linear gradient. It is not simply a question of
poverty (low income), but rather of an individual’s position in the so-
cioeconomic hierarchy. In 1998, Donald Acheson chaired a commit-
tee that reported to the British government on the determinants of
inequalities in health in the United Kingdom (Acheson 1998) as seen
from the health gradient studies and other studies. The committee
concluded, based on the available evidence—

There is no doubt that early child development has a long reach that

affectsphysical and mental health and well-being in the later

stages of life.

Since early child development appears to be a factor contributing
to these gradients, and they are not disease-specific, further explo-
ration has led to recognition that the development of the brain and
biological pathways in early life is a key factor in causing these health
gradients seen in adult life.

Scientific Underpinnings of the Importance of ECD in a Global World 47

Cumulative mortality

0246810

Other

Clerical

Professional/

Executive

Administrative

16

12

8

4

0

Year of follow-up

Figure 2. Age-Adjusted Mortality Rates (Percent), All Causes, United Kingdom (Whitehall)

Civil Servants, Ages 40–64, by Employment Grade

Source:Adapted from Marmot 1994.