Related Experiment Video
Updated: Mar 6, 2026
Breakfast Habits among Schoolchildren in the City of Uruguaiana, Brazil
Published on: July 29, 2020
Early Childhood Education to Promote Health Equity: A Community Guide Economic Review
Ismaila Ramon1, Sajal K Chattopadhyay, W Steven Barnett
1Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology and Laboratory Services, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Ramon, Chattopadhyay, and Hahn); and National Institute for Early Education Research, Rutgers University, New Brunswick, New Jersey (Dr Barnett). The names and affiliations of the Task Force members are listed at www.thecommunityguide.org/about/task-force-members.html.
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.
Related Concept Videos
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
01:29Environmental Influences on Intelligence
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:25Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
01:18Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results...
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...