Centre for Community Child Health

CCCH art

Changing Children's Chances

  • CCC logo with strapline

    Reducing disadvantage in early childhood would have immediate and lasting benefits for children, families and communities. The Changing Children’s Chances project has already shown that we can almost halve problems with children's health and development if we address disadvantage. 

    What is CCC?

    The Changing Children’s Chances (CCC) project seeks to understand the best ways to address the inequity facing Australia’s children. Eliminating inequities provides substantial benefits for children and families. It is projected that redressing disadvantage in the early years could reduce socio-emotional problems by up to 59%, physical functioning problems by 49% and learning problems by 55% (see Figure 1). Now the CCC researchers are modelling how combining or ‘stacking’ interventions can reduce inequities in children’s health and development – particularly for those experiencing the greatest vulnerability or disadvantage.

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    View CCC Overview

    Figure 1: Projected benefits of addressing disadvantage early

    CCC-addessing-disadvantage_figure

    Source: Goldfeld et al. Addressing disadvantage to optimise children’s development in Australia. Research snapshot #2. (2018).

    A chance to thrive

    A child’s experiences and environments in their early years provide the foundation for lifelong health, development and wellbeing. When children are supported from conception onwards, they have the best opportunity to thrive. When children experience disadvantage, it limits their potential and creates a greater social and economic burden for all. Currently more than a third of Australian children experience some form of disadvantage. This is likely to increase as a result of the COVID-19 pandemic, which has disproportionately affected those already experiencing vulnerability and disadvantage. This inequity is unfair and avoidable.

    Project phases

    Phase one

    Phase one of the CCC project (2016-2020) described the complex circumstances in which children are born, live, learn and grow – known as social determinants (See Figure 2). These social determinants shape children’s health, development and wellbeing. 

    Figure 2: Framework for understanding the four key social determinants that contribute to inequities in children's health and development

    CCC vulnerability diagram 2024

    Source: Goldfeld et al., Understanding child disadvantage from a social determinants perspective (2018c).

    Phase two

    Phase two of the CCC project (2021-2024) extends on this foundation. This phase of the research aims to better understand policy opportunities for reducing inequities in children’s mental health, physical health and academic achievement.

    There are many existing policies and services across education, health and social care portfolios that can help children and families to thrive. However, no single intervention alone is sufficient for tackling inequities. CCC researchers are modelling how combining or ‘stacking’ interventions can reduce inequities – particularly for those experiencing the greatest vulnerability or disadvantage.

    Action can be taken at the family, community and policy level. The CCC project proposes that simultaneous action at all three levels can best optimise children’s health and development. Our findings can help to direct limited public funds towards opportunities that will have the greatest impact. This can inform more effective and precise policies to reduce inequities in children’s health, development and wellbeing.

    Publications and resources

    Academic papers

    Phase one

    • Goldfeld, S., O'Connor, M., Cloney, D., Gray, S., Redmond, G., Badland, H., Williams, K., Mensah, F., Woolfenden, S., Kvalsvig, A., & Kochanoff, A. (2018). Understanding child disadvantage from a social determinants perspective. Journal of Epidemiology & Community Health, 72(3), 223-229. http://dx.doi.org/10.1136/jech-2017-209036 
    • Goldfeld, S., O'Connor, M., O'Connor, E., Chong, S., Badland, H., Woolfenden, S., Redmond, G., Williams, K., Azpitarte, F., Cloney, D., & Mensah, F. (2018). More than a snapshot in time: Pathways of disadvantage over childhood. International Journal of Epidemiology, 47(4), 1307-1316.  https://doi.org/10.1093/ije/dyy086
    • Goldfeld, S., O'Connor, M., Chong, S., Gray, S., O'Connor, E., Woolfenden, S., Redmond, G., Williams, K., Mensah, F., Kvalsvig, A., & Badland, H. (2018). The impact of multidimensional disadvantage over childhood on developmental outcomes in Australia. International Journal of Epidemiology, 47(5), 1485-1496.  https://doi.org/10.1093/ije/dyy087
    • Goldfeld, S., Gray, S., Azpitarte, F., Cloney, D., Mensah, F., Redmond, G., Williams, K., Woolfenden, S., & O'Connor, M. (2019). Driving precision policy responses to child health and developmental inequities. Health Equity, 3(1), 489-494.  https://doi.org/10.1089/heq.2019.0045

    Phase two

    • Goldfeld, S., Moreno-Betancur, M., Guo, S., Mensah, F., O'Connor, E., Gray, S., Chong, S., Woolfenden, S., Williams, K., Kvalsvig, A., Badland, H., Azpitarte, F., & O'Connor, M. (2021). Inequities in children's reading skills: The role of home reading and preschool attendance. Academic Pediatrics, 21(6), 1046-1054.  https://doi.org/10.1016/j.acap.2021.04.019
    • Goldfeld, S., Gray, S., Pham, C., Badland, H., Woolfenden, S., Schor, E., & O'Connor, M. (2022). Leveraging research to drive more equitable reading outcomes: An update. Academic Pediatrics, 22(7), 1115-1117.  https://doi.org/10.1016/j.acap.2022.04.001
    • Goldfeld, S., Moreno-Betancur, M., Gray, S., Guo, S., Downes, M., O'Connor, E., Azpitarte, F., Badland, H., Redmond, G., Williams, K., Woolfenden, S., Mensah, F., & O'Connor, M. (2023). Addressing child mental health inequities through parental mental health and preschool attendance. Pediatrics, 151(5), e2022057101.  https://doi.org/https://doi.org/10.1542/peds.2022-057101
    • Priest, N., Guo, S., Gondek, D., O'Connor, M., Moreno-Betancur, M., Gray, S., Lacey, R., Burgner, D. P., Woolfenden, S., Badland, H., Redmond, G., Juonala, M., Lange, K., & Goldfeld, S. (2023). The potential of intervening on childhood adversity to reduce socioeconomic inequities in body mass index and inflammation among Australian and UK children: A causal mediation analysis. Journal of Epidemiology and Community Health, 77(10), 632-640.  https://doi.org/10.1136/jech-2022-219617
    • Goldfeld, S., Downes, M., Gray, S., Pham, C., Guo, S., O'Connor, E., Redmond, G., Azpitarte, F., Badland, H., Woolfenden, S., Williams, K., Priest, N., O'Connor, M., & Moreno-Betancur, M. (2024). Household income supplements in early childhood to reduce inequities in children’s development. Social Science & Medicine, 340, 116430.  https://doi.org/https://doi.org/10.1016/j.socscimed.2023.116430

    Conference presentations

    • Goldfeld S, et al. Measuring child disadvantage from a social determinants perspective. presented at: 15th World Congress on Public Health; 2017; Melbourne, Australia.
    • Goldfeld S, et al. Poster presentation: A social determinants perspective to measuring child disadvantage. presented at: Pediatric Academic Societies (PAS) 2017 Meeting; 2017, 6-9 May; San Francisco, USA.
    • Goldfeld S, et al. Measuring child disadvantage from a social determinants perspective. presented at: 6th Conference of the International Society for Child Indicators; 2017, 28-30 June; Montreal, Canada
    • O'Connor M, et al. More than a snapshot in time: Pathways of disadvantage over childhood. presented at: Australian Social Policy Conference; 2017, 25-27 September; Sydney, Australia.
    • Goldfeld S, et al. The impact of early disadvantage on child development outcomes in Australia. presented at: Pediatric Academic Societies (PAS) 2018 Meeting; 2018, 5-8 May; Toronto, Canada.
      • Goldfeld, S., et al. Can home reading and preschool attendance reduce inequalities in children’s literacy skills: Evidence from simulated interventions. Pediatric Academic Societies (PAS) Meeting; 2019, 24 April-1 May; Baltimore, USA.
      • Goldfeld, S., et al. Can population-level interventions promoting parent mental health and preschool attendance reduce inequities in children’s mental health problems? Pediatric Academic Societies (PAS) Meeting; 2021, 30 April-4 June; Virtual program.
      • Goldfeld, S., et al. Is it possible for a family income supplement in early childhood to reduce developmental inequities? Pediatric Academic Societies (PAS) Meeting; 2022, 21-25 April; Denver, USA.
      • Priest N, et al. Poster presentation: Could intervening on childhood adversity reduce inequities in body mass index and inflammation among Australian and UK children? presented at: International Society for Developmental Origins of Health and Disease World Congress; 2022, 27-31 August; Vancouver, Canada. 
      • Priest N, et al. Poster presentation: Could intervening on childhood adversity reduce inequities in body mass index and inflammation among Australian and UK children? presented at: Society for Longitudinal and Lifecourse Studies 2022 Conference; 2022, 23-25 October; Ohio, USA.

      Other presentations


      • Goldfeld S. Measuring developmental vulnerability and disadvantage in early childhood data collections: Phase Two. Presentation to the Australian Government Department of Education; 2023, 5 December; Virtual Meeting
      • Goldfeld S. Radical pragmatism: Can we achieve equity in child health and development in a generation? Presentation to the Australian Government Department of Health and Aged Care; 2022, 21 October; https://vimeo.com/792446924. https://doi.org/10.25374/MCRI.21588177 Access the presentation slides [PDF]
      • Goldfeld S. Radical pragmatism: Can we achieve equity in child health and development in a generation? Australian Government Department of Social Services Early Years Strategy Advisory Panel meeting; 2023, 22 June; Virtual Meeting.
      • Goldfeld S. The knowing and doing of addressing equity gaps in ECEC. Invited Expert to represent Australia: Multidisciplinary group of experts for the OECD's 2023-2024 ECEC project; 2023, 5 October; Virtual Meeting. 

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          Our team

          Changing Children’s Chances unites leading national and international child equity researchers and child health clinicians. 

          Investigator team

          The CCC team also works collaboratively with our Knowledge Translation Reference Group, made up of policy experts from Australian state and federal governments and non-government organisations.

          Funding and partners

          The Changing Children’s Chances project is funded by the Australian Research Council Linkage Program (LP190100921). The University of Melbourne and Murdoch Children’s Research Institute are partnering with:

          CCC team

          Data sources

          The Changing Children’s Chances project capitalises on powerful national datasets. This includes the Longitudinal Study of Australian Children (LSAC) and the Person Level Integrated Data Asset (PLIDA). Learn more about the CCC data sources.

          Contact us

          For further details about the CCC project, contact Professor Sharon Goldfeld, Lead Investigator or Dr Sarah Gray, Project Manager.

         

        Murdoch Childrens Research Institute

        The Centre for Community Child Health is a department of The Royal Children’s Hospital and a research group of Murdoch Childrens Research Institute.