It takes a whole village?

Supporting parents and addressing inequalities for Black, Asian minority ethnic families Positive experiences with parenting early in life are closely associated better performance at school, social emotional development, improved work outcomes lifelong health, including longer expectancy.1 Conversely, less positive life, particularly of adversity, relate to many poorer outcomes: poverty, unemployment, homelessness, unhealthy behaviours poor mental physical health.2,3,4 Giving every child the best start is therefore crucial reducing health across course. Yet not all family backgrounds equal children's follow a gradient where improve progressively further up socioeconomic spectrum, worsen down,5 evidence that experience racial inequality means these often comparatively groups.6 Parenting has been focus policymakers number years this article we review key policy agendas understand how support groups featured what action required address inequity outcomes. The presence demonstrates need targeted services delivered from within universal provision all. Policies proportionate critical experienced by children, yet recent policies have struggled develop implement effective based on principle. original Sure Start programme, set Labour government late 1990s, aimed enhance chances young children aged under 5 years, those growing disadvantaged neighbourhoods. was providing most areas, rather than directly targeting individuals avoid any impact stigmatising families. first evaluation when were around 5-years disappointing showing little effect (also hampered difficulties study design),7 but subsequent research age 11-years found – helping home learning environment harsh disciplines.8 More recently, an 2019 areas 18 per cent likely hospital visit, association strongest among poorest children.9 centres had seemed be making good progress effects which build persist over time landscape changed before fully realised, turning into 2005 new provide additional childcare aid (mainly mothers) employment.10 “Cameron keen ‘normalise’ support, repeatedly presenting it as similar people ‘learn drive’” Throughout changing landscape, there attempts shortcoming support: reaching impacting Yet, multiple reviews shown programmes offer rarely reached if they did, did participate them or dropped out.14,15 Government initiatives missed examples practice happening beyond state. It context New Labour's reach Race Equality Foundation developed inclusive evidence-based programme called ‘Strengthening Families, Strengthening Communities’ (SFSC). This designed promote protective factors children. offers value engaging think about their cultural values beliefs examine influence behaviour choices. stood test time, despite various changes, used extensively reach, retain backgrounds, marginalised communities, teenage parents. A range group-based like SFSC UK shows can terms both parental outcomes, such wellbeing, relationships reduced use punishments.16,17 Meanwhile large national trial way specifically living poverty18 well adapting other population groups, men prison.19 During period also seen contexts facing There now more poverty since 2010, four million affected.20 Minority disproportionately affected, nearly half compared 20 white British On average, lower incomes, higher unemployment live overcrowded accommodation groups.21 labour market always route out poverty. majority rise ‘in-work’ disproportionate families, who enter roles wages precarious insecure employment contracts.22 Covid-19 pandemic exposed exacerbated rooted differences society.23 “Tests applications sent employers show continues systematic discrimination ethnicities” “it unfortunately reflects longstanding tradition recasting issues disadvantage problems individual moralising norms” “policy provided half-hearted, ineffective sometimes support” Anita Mehay improvement fellow Health holds honorary post UCL senior associate. worked projects focused parenting, midwifery care, prison particular interest relating inequality. She currently involved Communities leading project adapt fathers prison. chartered psychologist. Cara Leavey officer Foundation. Cara's focusses policy, drive issue. Jabeer Butt chief executive researched written care health. provides leadership parent education initiative Marmot Advisory Group supporting Sir Michael production his report determinants inequalities. He co-investigator £1.3 NIHR funded extension VirusWatch focusing BAME communities led Professor Robert Aldridge University College London.