Clean, safe and secure environments to support early childhood development Why is the environment important for What is nurturing care? early childhood development? To reach their full potential, children need the five inter-related and indivisible components of nurturing Clean, safe and secure environments contribute to enabling care: good health, adequate environments for nurturing care. Clean air, safe and secure nutrition, safety and security, surroundings, and outlets for physical activity are essential responsive caregiving and conditions for children to survive and thrive. An infant or young opportunities for early learning. child who is exposed to environmental pollutants from sources This begins in pregnancy and such as unsafe drinking water, air pollution or chemicals, as well continues throughout the life course. as a child who lacks access to spaces for outdoor physical activity and exploration is at higher risk of both We have made great strides in noncommunicable diseases (NCDs) as well as infectious improving child survival, but we also diseases (such as pneumonia and diarrhoea) and developmental need to create the conditions to help delays that can reduce their lifelong cognitive, socio-emotional children thrive as they grow and and physical potential. develop. Nurturing care protects children from the worst effects of This brief summarizes some of the most important adversity and produces lifelong and environmental health risks faced by children today and it intergenerational benefits for health, explains why infants and young children are particularly productivity and social cohesion. vulnerable. It elaborates on the components of Nurturing Care, especially good health and security and safety. It aims to alert Nurturing care happens when we policymakers and practitioners, whether involved with childcare maximize every interaction with a or environmental issues, about the importance of considering child. Every moment, small or big, early childhood needs in policies and practices, to create structured or unstructured, is an environments in which young children can thrive. Examples of opportunity to ensure children are practical actions are provided for key settings that affect healthy, receive nutritious food, children’s early development - healthcare, home, and childcare are safe, and learning about settings; and the broader urban and community settings that themselves, others and their create both risks and opportunities for children’s development. world. What we do matters but how we do it matters more. Environmental health and early childhood – the linkages WHO estimates that about one Air pollution, for example. Infants Harmful exposures to environmental quarter of deaths of children under 5 and young children breathe more air pollutants start as early as in utero, could be prevented through healthier than adults. A typical adult takes as a pregnant mother exposes her environments that reduce key risks between 12 and 18 breaths a minute, developing foetus to the toxicants to including: air pollution, unsafe while a 3-year old child takes 20 to which she, herself is exposed, via the drinking water, sanitation, and 30 breaths a minute and a newborn air, water, foods or her own skin inadequate hygiene as well as baby takes 30 to 40 breaths. contact with harmful chemicals. exposures to certain toxic chemicals, such as lead and mercury. On busy streets, infants in strollers Clean and safe indoor and outdoor and young children are most directly environments optimize a child’s Infants and young children are exposed to vehicle tailpipes. Air early development opportunities, particularly vulnerable to pollution reduces lung function, by reducing the exposure to environmental pollution since their increases risk of common respiratory contaminants and by enabling bodies and respiratory airways are infections and asthma, and can social interaction and physical much smaller, and their organs and cause childhood cancers and even activity, whether it is in play and immune systems are still developing. obesity, due to adverse metabolic exploration, or simply accompanying And they have a higher proportion of changes. It is an important cause of a caregiver on foot to the local grocery. skin to volume ratio. Relative to their preventable child mortality and there Such activity is key to reducing obesity size, young children also ingest more is evidence that both prenatal and risks for infants as well as young food and drink more water. postnatal exposure to air pollution children, as well as developing motor, Behaviours typical of infants and can negatively influence neuro socio-emotional and cognitive skills.3 young children – such as putting development.1-2 Finally, air pollution hands and objects into their mouths contributes to climate change, which Advancing healthier environments to explore their environments – as is expected to increase food thus represent a major opportunity well as the need to explore and play insecurity, undernutrition, water- and for improving children’s health, outdoors – also put young children at vector-borne diseases, affecting development and wellbeing – and is particularly high risk of exposure to children in particular. essential for achieving Sustainable hazards in unsafe or poorly adapted Development Goal 3, Good Health community environments. and Wellbeing. It is also part of commitments made under other SDG goals and targets such as Clean Water and Sanitation (SDG 6), Sustainable Energy (SDG 7), Sustainable Cities and Communities (SDG 11), Responsible Consumption and Production [including sound chemicals and waste management] (SDG 12) and Climate Action (SDG 13). What are the nurturing care Good health Adequate nutrition components? Refers to the health and well-being of Refers to maternal and child nutrition. the children and their caregivers. Why Why both? We know that the nutritional both? We know that the physical and status of the mother during pregnancy mental health of caregivers can affect affects her health and well-being and their ability to care for the child. that of her unborn child. After birth, the mother’s nutritional status affects her ability to breastfeed and provide adequate care. Remember Key SDG indicators relevant to environmental health* • Mortality rate [0-5] attributable to household and ambient air pollution Clean, safe and secure environments (SDG 3.9.1) create the conditions for children to develop to their full potential. • Mortality rate [0-5]-attributed to unsafe water, unsafe sanitation and lack of hygiene (3.9.2) Air pollution is estimated to cause 543 000 child deaths annually due to • Mortality rate [0-5] attributable to unintentional poisoning acute lower respiratory infections (SDG 3.9.3); before the age of 5.1 This includes emissions from polluting household • % of [0-5] population exposed to annual mean levels of PM 2.5 stoves and fuels at home to above 10 µg/m3 (SDG 11.6.2) emissions from traffic, dust, waste • % of urban population living in slums, informal settlements or burning, power generation and other inadequate housing (SDG 11.1.1) outdoor (ambient) sources. Similarly, exposures to chemicals, heavy • % of population that has convenient access to public metals and other toxicants through transport [with special attention to women/children**]. air, water, food or skin contact are (SDG 11.2.1) particularly harmful for infants and young children and can lead to • Proportion of urban solid waste regularly collected lifelong disorders as well as reducing and with adequate final discharge out of total urban their potential to develop mentally solid waste generated [11.6.1] and physically. Individual • Average share of the built-up area of cities that contaminants often have multiple is open space for public use [accessible to impacts on health. women and children**] (SDG 11.7.1) Lead exposures, for example can reduce children’s IQ, as well as cause learning disability, antisocial * For SDG indicators with age behaviour and increased risk of stratification, [0-5] is noted for cardiovascular disease in adulthood. Persistent organic pollutants purposes of this brief as the One important source of exposure (POPs) are another cause of relevant age group. is through ingesting or inhaling neuro-developmental delays ** Target refers to particles of paint.4 Methylmercury and exposure occurs “women/children” exposures, often through dietary through direct contact with sources, adversely affect neonatal pesticides, or indirectly, brain and nervous system through air pollution or even development, including cognition, ingested through pathways memory, attention, language, fine such as mother’s breast motor and visual spatial skills, and milk contaminated with can occur in-utero as well. pesticide residues.5-6 Safety and security Opportunities for early learning Responsive caregiving Refers to safe and secure environments Refers to any opportunity for the infant or Refers to the ability of the caregiver to for children and their families. Includes child to interact with a person, place, or notice, understand, and respond to their physical dangers, emotional stress, object in their environment. Recognizes child’s signals in a timely and appropriate environmental risks (e.g., pollution), and that every interaction (positive or manner. Considered the foundational access to food and water. negative, or absence of an interaction) is component because responsive contributing to the child’s brain caregivers are better able to support the development and laying