Article

Early Childhood Investments Substantially Boost Adult Health

Science (Impact Factor: 33.61). 03/2014; 343(6178):1478-85. DOI: 10.1126/science.1248429
Source: PubMed

ABSTRACT

High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143 millimeters of mercury (mm Hg), whereas it is only 126 mm Hg among the treated. One in four males in the control group is affected by metabolic syndrome, whereas none in the treatment group are affected. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health.

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Available from: Yi Pan, May 04, 2014
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    • "Anderson, 2008; Eckenrode et al., 2010; Heckman et al., 2010). Many find that such programs are more effective for girls than boys in the long term, particularly in the area of human capital; however, recent work has also found long term effects for men regarding health outcomes (Campbell et al., 2014). To explore the potential for differential treatment effects by gender we conducted a subgroup analysis using the same methodology as above (i.e. "
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    ABSTRACT: This article investigates the impact of an early intervention program, which experimentally modifies the parenting and home environment of disadvantaged families, on child physical health in the first 3 years of life. We recruited and randomized 233 (115 intervention, 118 control) pregnant women from a socioeconomically disadvantaged community in Dublin, Ireland into an intervention or control group. The treatment includes regular home visits commencing antenatally and an additional parenting course commencing at 2 years. Maternal reports of child health are assessed at 6, 12, 18, 24, and 36 months. Treatment effects are estimated using permutation testing to account for small sample size, inverse probability weighting to account for differential attrition, and both the stepdown procedure and an indices approach to account for multiple hypothesis testing. Following adjustment for multiple testing and attrition, we observe a positive and statistically significant main treatment effect for wheezing/asthma. The intervention group are 15.5 percentage points (pp) less likely to require medical attention for wheezing/asthma compared to the control group. Subgroup analysis reveals more statistically significant adjusted treatment effects for boys than girls regarding fewer health problems (d=0.63), accidents (23.9pp), and chest infections (22.8-37.9pp). Our results suggest that a community-based home visiting program may have favorable impacts on early health conditions.
    Full-text · Article · Sep 2015 · Economics and human biology
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    • "In a recently published follow up study using that cohort, ABC was found to produce large health benefits for children in the treatment group (Campbell et al., 2014). These included large reductions in participants' Framingham risk scoreda combined measure of multiple risk factors for premature death including high blood pressure, cholesterol, and blood sugar. "
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    ABSTRACT: Recent research has found that children who attended pre-kindergarten programs in childhood were more likely to be healthy as adults. One intuitive way of improving population health and longevity may therefore be to invest in pre-kindergarten programs. However, much of the research linking pre-kindergarten programs to health is very recent and has not been synthesized. In this paper, I review the mechanisms linking pre-kindergarten programs in childhood to adult longevity, and the experimental evidence backing up these linkages. I conclude with a critical exploration of whether investments in pre-kindergarten programs could also serve as investments in public health.
    Full-text · Article · Aug 2014 · Social Science & Medicine
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    • "teenage pregnancies , and less marijuana use . Now in their mid - 30s , they demonstrate improved educational outcomes , employment stability , and physical health . Children who began attending the programme during their school - aged years demonstrated no such improvements , suggesting that programme effectiveness is tied to early intervention ( Campbell et al . , 2012 , 2014 ; Campbell , Ramey , Pungello , Sparling , & Miller - Johnson , 2002 ) ."
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    ABSTRACT: The profound injuries caused by child maltreatment are well documented in the neurological, attachment, cognitive, and developmental literature. In this review paper, we explore the potential of early childhood education (ECE) as a community-based resilience intervention for mitigating the impacts of child abuse and neglect and supporting families in difficulty. There is clear empirical evidence that providing quality ECE to disadvantaged and vulnerable families in conjunction with other services (e.g. parenting education) is associated with positive outcomes. Challenges facing ECE centres, such as integrating children with behavioural, cognitive, and socio-emotional difficulties, are considered. Examples of successful programmes are presented.
    Full-text · Article · Jun 2014 · Early Child Development and Care
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Questions & Answers about this publication

  • Khalil El-Saghir added an answer in Early Childhood Education:
    What are the essential articles for teaching early childhood education?

    I am looking to expand an introductory graduate course on early childhood education and would like to examine articles and perspectives from across the globe. Thank you for any suggestions, advice, and/or links. 

    Khalil El-Saghir

    @Kevin. Christodoulou’s (2014) information-processing perspective of knowledge and understanding merely focuses on the what (content), not the how (process) nor in which context (environment) knowledge and understanding are constructed. She does not suggest any approach or a method of teaching “facts” to students.

    Instead, the author claims “Rousseau, Dewey, and Freire were wrong to see facts as the enemy of understanding,” and “they all make a further assumption: that teaching facts is therefore opposed to teaching meaning.” I am unsure as to where in all the writing of these progressive scholars did she find any notion that could be synthesized as such! Using just the quotes she cited, one could simply see that they were all critical of the de-contextualization of content and the inefficiency and ineffectiveness of an education system that treats child’s brain as a tabula rasa, an empty pot, or, in today’s terms, a hard drive ready to be filled with facts.

    She reasoned, “Rousseau was writing in the 18th century; Dewey at the turn of the 20th; Freire in the 1970s” and thus our educational methods that are based on such “misguided, outdated, and pseudoscientific stigma against the teaching of knowledge” are failing!

    The argument over what to know and how to know it started millennia ago with Plato and Aristotle and there is no sign that it will ever subside. However, I found the author’s argument, which is entirely premised on artificial intelligence research, lacks deep understanding of the psychological and social dimensions of learning. Human brain is not as simple as a learning machine, and the process of learning is much more complex than a mere ‘transmission’ of knowledge from one brain (teacher) to another (learner). Furthermore, I find it rather disingenuous the claim that the failure of education reforms is due to progressive schools of thought when we all know that traditional education has always been based on different versions of behaviorist and cognitive perspectives, similar to those in which the authors’ views are grounded.

    Finally, in direct response to the question, here is an important recent article (from Science) that is available on RG:

    • Source
      [Show abstract] [Hide abstract]
      ABSTRACT: High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report on the long-term health effects of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143 millimeters of mercury (mm Hg), whereas it is only 126 mm Hg among the treated. One in four males in the control group is affected by metabolic syndrome, whereas none in the treatment group are affected. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health.
      Full-text · Article · Mar 2014 · Science

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