Early Childhood Education: Health, Equity, and Economics.

Many low-income and minority children in the United States and globally are at risk of poor educational trajectories and, consequently, diminished life courses, because their households and neighborhoods lack resources to adequately support learning and development prior to formal schooling. This review summarizes evidence on center-based early childhood education (ECE) for three- and four-year-olds as a means of assuring school readiness in cognitive and socioemotional skills. While the details of ECE programs merit further research, it is clear that ECE can benefit children, especially those most disadvantaged, with additional societal benefits and positive long-run economic returns. Universal ECE is not a cure-all, and its success requires ongoing alignment with subsequent education and attention to child household and community conditions. Because resource deprivation is concentrated in low-income and minority communities, publicly funded universal ECE can also be a powerful instrument for the promotion of social equity.

Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science.

Over a decade ago, the Society for Prevention Research endorsed the first standards of evidence for research in preventive interventions. The growing recognition of the need to use limited resources to make sound investments in prevention led the Board of Directors to charge a new task force to set standards for research in analysis of the economic impact of preventive interventions. This article reports the findings of this group's deliberations, proposes standards for economic analyses, and identifies opportunities for future prevention science. Through examples, policymakers' need and use of economic analysis are described. Standards are proposed for framing economic analysis, estimating costs of prevention programs, estimating benefits of prevention programs, implementing summary metrics, handling uncertainty in estimates, and reporting findings. Topics for research in economic analysis are identified. The SPR Board of Directors endorses the "Standards of Evidence for Conducting and Reporting Economic Evaluations in Prevention Science."

Early Childhood Education to Promote Health Equity: A Community Guide Economic Review.

CONTEXT: A recent Community Guide systematic review found that early childhood education (ECE) programs improve educational, social, and health-related outcomes and advance health equity because many are designed to increase enrollment for high-risk children. This follow-up economic review examines how the economic benefits of center-based ECE programs compare with their costs. EVIDENCE ACQUISITION: Kay and Pennucci from the Washington State Institute for Public Policy, whose meta-analysis formed the basis of the Community Guide effectiveness review, conducted a benefit-cost analysis of ECE programs for low-income children in Washington State. We performed an electronic database search using both effectiveness and economic key words to identify additional cost-benefit studies published through May 2015. Kay and Pennucci also provided us with national-level benefit-cost estimates for state and district and federal Head Start programs. EVIDENCE SYNTHESIS: The median benefit-to-cost ratio from 11 estimates of earnings gains, the major benefit driver for 3 types of ECE programs (ie, state and district, federal Head Start, and model programs), was 3.39:1 (interquartile interval [IQI] = 2.48-4.39). The overall median benefit-to-cost ratio from 7 estimates of total benefits, based on all benefit components including earnings gains, was 4.19:1 (IQI = 2.62-8.60), indicating that for every dollar invested in the program, there was a return of $4.19 in total benefits. CONCLUSIONS: ECE programs promote both equity and economic efficiency. Evidence indicates there is positive social return on investment in ECE irrespective of the type of ECE program. The adoption of a societal perspective is crucial to understand all costs and benefits of ECE programs regardless of who pays for the costs or receives the benefits.

Early Childhood Education to Promote Health Equity: A Community Guide Systematic Review.

CONTEXT: Children in low-income and racial and ethnic minority families often experience delays in development by 3 years of age and may benefit from center-based early childhood education. DESIGN: A meta-analysis on the effects of early childhood education by Kay and Pennucci best met Community Guide criteria and forms the basis of this review. RESULTS: There were increases in intervention compared with control children in standardized test scores (median = 0.29 SD) and high school graduation (median = 0.20 SD) and decreases in grade retention (median = 0.23 SD) and special education assignment (median = 0.28 SD). There were decreases in crime (median = 0.23 SD) and teen births (median = 0.46 SD) and increases in emotional self-regulation (median = 0.21 SD) and emotional development (median = 0.04 SD). All effects were favorable, but not all were statistically significant. Effects were also long-lasting. CONCLUSIONS: Because many programs are designed to increase enrollment for high-risk students and communities, they are likely to advance health equity.

Early childhood development and social mobility.

Steven Barnett and Clive Belfield examine the effects of preschool education on social mobility in the United States. They note that under current policy three- and four-year-old children from economically and educationally disadvantaged families have higher preschool attendance rates than other children. But current programs fail to enroll even half of poor three- and four-year-olds. Hispanics and children of mothers who drop out of school also participate at relatively low rates. The programs also do little to improve learning and development. The most effective programs, they explain, are intensive interventions such as the model Abecedarian and Perry Preschool programs, which feature highly qualified teachers and small group sizes. State preschool programs with the highest standards rank next, followed by Head Start and the average state program, which produce effects ranging from one-tenth to one-quarter of those of the best programs. Typical child care and family support programs rank last. Barnett and Belfield point out that preschool programs raise academic skills on average, but do not appear to have notably different effects for different groups of children, and so do not strongly enhance social mobility. In such areas as crime, welfare, and teen parenting, however, preschool seems more able to break links between parental behaviors and child outcomes. Increased investment in preschool, conclude Barnett and Belfield, could raise social mobility. Program expansions targeted to disadvantaged children would help them move up the ladder, as would a more universal set of policies from which disadvantaged children gained disproportionately. Increasing the educational effectiveness of early childhood programs would provide for greater gains in social mobility than increasing participation rates alone. The authors observe that if future expansions of preschool programs end up serving all children, not just the poorest, society as a whole would gain. Benefits would exceed costs and there would be more economic growth, but relative gains for disadvantaged children would be smaller than absolute gains because there would be some (smaller) benefits to other children.