• By Dartington SRU
  • Posted on Wednesday 04th April, 2012

Can better preschool education lead to better adult health?

It’s well known that good early education can help young children get ready for school. But it’s rare to be able to measure the long-term effects of preschool programs, and rarer still to see the long-term effects on health. A recent study looked at the benefits of the Carolina Abecedarian Project (ABC) and found positive impacts on health and health behaviors when the preschool participants had grown to adulthood. It could mean that better early education programs could cut lifetime health care costs and improve well-being – especially relevant for children from low-income families, who are most at risk for poor health as adults. The ABC success storyA team of public health researchers investigating the impacts of early education programs on adult health focused their attention on ABC, a randomized controlled trial of an early education program running from 1972 to 1977 at the Frank Porter Graham Child Development Institute in North Carolina. The project, which recruited 111 healthy infants at risk for poor educational outcomes, delivered a small but intensive program of learning aimed at improving cognition and language development. Interested by other positive results of the ABC program – which demonstrated improvements in IQ by age three, reading and math ability by age 15, lower rates of teenage pregnancy and depression, as well as an increased likelihood of college enrollment at age 21 – the researchers, led by Columbia University’s Peter Muennig, carried out further investigation into the health of the remaining 104 adult participants. The team hoped to identify whether the benefits of the program extended to better health and health behaviors for the 21-year-olds. They measured adult health as the number of reported health problems since age 15, the number of hospitalizations over the previous year, and scores for depression on the Brief Symptom Inventory (BSI). They also measured 11 health-related behaviors including smoking, alcohol and drug use, and car safety.The program resulted in significant improvements in both the reported health and health-related behaviors of participants. Examples of healthier behaviors included lower levels of marijuana use and a significantly older age of smoking take-up. Preschool education may lead to better adult health – but how? Interestingly, none of the reported benefits of the original study were found to be responsible for the improvements. Neither IQ, nor improved math and reading scores, nor higher education levels, nor health insurance seemed to lead from the preschool experience to better adult health. This finding stands in contrast to the only other long-term evaluation of a preschool RCT, the assessment of the Perry Preschool Program (PPP), where researchers found that better health outcomes were mediated by educational attainment and health insurance.The question of what factors are responsible for better health and health behaviors of the preschool participants remains an open question.Costs, benefits, and inequalityAnd another question remains: Why choose early education programs over more traditional medical and public health approaches to improving adult health? The authors suggest that the combined positive outcomes of early education may make early education programs a uniquely cost-effective method of improving public health. These other outcomes are as diverse as higher incomes, reduced criminal activity, and a more skilled workforce.Moreover, early education seeks to reduce inequality by shrinking the education and health gap that has grown so much between wealthy and poor families over the last four decades. Studies investigating the long-term health benefits of early education programs are rare, with results from the PPP and ABC research representing the strongest evidence to date. In order to strengthen the argument that early education programs improve health outcomes, studies must be conducted on a larger scale in order to identify significant results, must investigate how much early education is required to produce results, and must identify which specific elements cause changes in specific health and wellbeing outcomes. **********Reference: Muennig, P., Robertson, D., Johnson, G., Campbell, F., Pungello, E., & Neidell, M. (2011). The effect of an early education program on adult health: The Carolina Abecedarian Project randomized controlled trial. American Journal of Public Health, 101(3), 512-516.

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