New Study of Classic Early Childhood Program Shows Big Health Gains

When it comes to early childhood education, the Perry Preschool Project and the Carolina Abecedarian Project (ABC) are the two most classic, widely discussed programs in existence.

They’re also far from new. Perry Preschool was carried out in the 1960s, Abecedarian in the 1970s.

What is new, however, is a fresh analysis of longitudinal data from the aging Abecedarian participants that suggests the right type of program can have huge impacts on kids’ health much later in life.

In a study published in Science last week, a team of researchers led by Nobel Laureate James Heckman, a University of Chicago economist, found that the ABC kids who received the program’s “treatment” — mental stimulation, learning and supervised play along with daily meals and health care — were less likely to be at risk for chronic disease as adults.

“Children randomly assigned to the treatment group for ages 0 to 5 have a significantly lower prevalence or risk factors for cardiovascular and metabolic diseases in their mid-30s,” the study states. “Treated males have a healthier body mass in their childhood years. These early benefits persist into adulthood.”

Previous research has shown how childhood adversity is strongly linked to later-in-life health problems. But this new research suggests the opposite is true as well: A focus on learning, social interaction, health and nutrition in the first years of life can better the odds that kids grow into healthier adults.

“What we really hadn’t realized before was how substantial the health impacts would be,” Heckman said in a statement.

Those impacts were especially substantial among males. A quarter of males in the control group showed signs of metabolic syndrome, which increases the risk of heart disease, diabetes and stroke. But none of the men in the treatment group had it. Men in the treatment group also were significantly more likely to have higher levels of “good” HDL cholesterol. They were less likely to be obese, tended to have lower blood pressure and started smoking cigarettes and marijuana later than their control-group peers.

Women in the treatment group also had lower risk of heart disease, were more likely to eat healthier foods and were less likely to start drinking by age 17, and have obesity and pre-hypertension than their control-group peers.

One potential criticism of the research, acknowledged in the study itself, is the small sample size. The ABC Project, which took place in Chapel Hill, North Carolina, involved 111 kids, with about half randomly assigned to the treatment group and half to a control. There are also serious concerns about the attrition of study subjects: less than three-quarters showed up for the mid-30s medical assessment.

But Heckman’s team contends the differences in health outcomes are nonetheless real and statistically robust. “The estimated treatment effects survive corrections for several statistical challenges faced by small-sample randomized controlled trials,” the research summary insists.

While the new study suggests the ABC Project had a big impact on the kids’ health, it’s still unclear what part of the program is most responsible for the better health outcomes enjoyed by the treatment kids. Was it the regular, nutritious meals? The access to health care? The impulse control learned through supervised instruction and play?

Since the ABC program combined all these variables, it’s hard for scientists to tease out which element was the most powerful. Heckman’s team instead focuses on the results:

Whatever the channel, our evidence supports the importance of intervening in the first years of life and suggests that early childhood programs can make a substantial contribution to improving the health of adult Americans and reducing the burden of health care costs.

That may sound like a surprisingly bold extrapolation to make from one small but influential study. But Heckman has for years now been gathering evidence and advocating on behalf of early childhood programs. His basic argument: Invest early in quality programs or pay more later in the form of lower economic productivity, higher crime and higher health care costs.

If Heckman is right, early childhood programs such as ABC save society money in the long run. But if Congressional Republicans’ tepid response to President Obama’s $75 billion universal preschool initiative is any indication, mustering the political will needed to corral federal funding for broader-scale implementation of ABC-style programs will be a formidable challenge. (At the state level, Republicans have been actively expanding preschool programs in recent years.)

As Heckman’s study notes, the cost of the ABC Project over the first five years of a child’s life was $67,000 (in 2002 dollars). Those are college-tuition-level dollars.

In an editorial earlier this week, The New York Times editorial board notes the brow-raising cost, but concludes: “Even so, the results are worth the investment, especially if costly medical care is avoided as the participants age.”

Photo by Andrew Malone via Flickr.