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Friday, March 28, 2014

High-Quality Preschool Could Prevent Chronic Diseases In Adulthood, Study Finds

US President Barack Obama visits with preschoolers at Powell Elementary School in Washington, DC, March 4, 2014. The President has called for universal prekindergarten. (Saul Loeb/AFP/Getty Images)

President Barack Obama visits with preschoolers at Powell Elementary School in Washington, DC, on March 4, 2014. The President has called for universal prekindergarten. (Saul Loeb/AFP/Getty Images)

A new study in the journal Science finds that high-quality preschool may prevent chronic diseases in adulthood.

Researchers looked at children who were in a preschool program in North Carolina during the 1970s and 80s.

The researchers found that when those kids were adults in their 30s, they had significantly better health outcomes, including lower levels of obesity and heart disease.

Professor James Heckman, a University of Chicago economist and Nobel laureate, joins Here & Now’s Sacha Pfeiffer to discuss the findings of this study and implications for early childhood programs.

The program Heckman and his colleagues studied provided disadvantaged children with early health screenings and interactions with quality caregivers — including meals prepared in consultation with a certified nutritionist.

Heckman says this study and others he has done about the impact of preschool on future outcomes creates a different measure of success.

“The way that preschool is actually being evaluated in Washington today … all the witnesses on all sides are focusing on test scores,” Heckman said. “What I’m suggesting is that the measures used now in the public debate on early childhood are actually missing a whole spectrum of other outcomes that these programs produce.”

Heckman has done research showing that every one dollar invested in preschool now can lead to seven dollars in returns to society.

However, Heckman says the real value of preschool is to remedy disadvantages poor children face.

“I don’t think its a necessary condition to attend preschool to have a successful life, and especially for people from middle class families, and upper middle class families,” Heckman said. “These are supplements to family life, and so the real question is how the American family is functioning for different parts of the social and economic spectrum. And I think it’s functioning much less well for disadvantaged children.”

Guest

  • James Heckman, lead researcher and Nobel laureate and professor of economics at the University of Chicago.

Transcript

SACHA PFEIFFER, HOST:

It's HERE AND NOW. A new study in the journal Science finds that high-quality preschool may prevent chronic diseases in adulthood. Researchers looked at children who were in a preschool program in North Carolina during the 1970s and '80s, and they found that when those kids were adults in their 30s, they had significantly better health.

Professor James Heckman led this research. He's a Nobel laureate and a professor of economics at the University of Chicago. He's also done research showing that every $1 invested in preschool now can lead to $7 in returns to society later. And Professor Heckman, as part of this study, researchers looked at how preschool attendance affects academic performance in later grades. But you're now looking at the long-term health impacts of preschool.

And I'd like you to explain that to us, but would you first describe what made this preschool program different than many others?

JAMES HECKMAN: The preschool program was a very intensive affair. It was a program that started early in the life of children, just children who were a few months old. They are all disadvantaged children, by the way, and the disadvantage is measured by the family status, the parental income and education and so forth.

Children from these environments, and they were predominantly African-American, were randomly assigned in treatment and control. The treatment group received, over a period of five years, many different things, but in particular they got early health screenings. Secondly, they had interaction with quality caregivers playing games, learning how to read, encouraging them and doing what many parents in the middle-class and upper-middle-class families do on a routine basis and gave those children the opportunity to get that same kind of feedback, attachment relationship.

PFEIFFER: And the program also had a health and nutrition component?

HECKMAN: The treatment group children got health screenings. They didn't get free medical care; what they got instead was doctor visits, and the doctors could say oh, your child has this condition and that.

PFEIFFER: And the kids were also getting food while they were there. They got I think a meal and...

HECKMAN: Yes, they did. They were fed and by a nutritionist who was certified. So this is quality food. They had - you know, certainly during the lunch break and so forth they were given food, and breakfast, too.

PFEIFFER: What did your study find in terms of the health outcomes of these kids once they became adults?

HECKMAN: Oh, for example, there are some substantial differences in the for example blood pressure. So the control group in this particular study, these are now at age 35, had a systolic reading of about 143, as compared to the treatment group that had a systolic reading about 126. So that's a substantial difference.

PFEIFFER: So generally speaking, better blood pressure rates and so forth.

HECKMAN: Yeah, they're less overweight, and if you look, though, at things like what's called the metabolic syndrome, so it's multiple risk factors that have to do with hypertension, obesity, these are precursors that many view might be precursors to diabetes. Among the treatment group, you find none of these individuals have this indicator, whereas in the control group some 25 percent - this is the male control group. So there are some substantial differences.

And plus these people are living in a more healthy lifestyle, you know, eating less, they're exercising more, they're actually engaged in their health and taking healthy practices.

PFEIFFER: So overall, your study found that kids who had had this high-quality early childhood education were healthier adults. But is that outcome obvious in a way, I mean, that in your early years if you get a good education, and you eat well, you'll do better physically and mentally in the long run?

HECKMAN: Well, it should be, but as I say, the way that preschool is actually being evaluated in Washington today, if you look at some of the congressional hearings, all the witnesses on all sides actually are focusing on test scores. They're saying oh, the Oklahoma program isn't successful because the NAEP scores didn't go up. And, you know, NAEP is a measure on an achievement test.

What I'm suggesting is that the measures used now in the public debate on early childhood are actually missing a whole spectrum of other outcomes, which these programs produce.

PFEIFFER: There are certainly many older Americans who didn't attend preschool, and maybe their diets in their early childhood years weren't that great, and they turned out fine.

HECKMAN: Correct.

PFEIFFER: So how would you answer those critics?

HECKMAN: Well, I mean, that's fine. I mean, there's a lot of resilience among the human race. I don't think that it's a necessary condition to attend preschool to have a successful life. I think that's just not true and especially from people from middle-class families and upper-middle-class families, there's a lot of stimulation going on.

Don't forget what pre-K really is, and this is something that also gets ignored totally in the debate. These are supplements to family life. And so the real question is how the American family is functioning for different parts of the social and economic spectrum. And I think it's probably functioning much less well for disadvantaged children and I think maybe even increasingly so, if you look at the incidents of child poverty broadly defined in the sense of - you know, lack of access to parenting and...

But these programs is just kind of working with the family, helping the family, in some cases teaching the parents more. The parents come into the center. They learn how these learning games - so the parents get involved. It changes the nature of parenting, and that stays with a kid throughout the lifetime.

PFEIFFER: There was a federal study of the Head Start Program that got a lot of attention, and it showed that the program did have positive impacts, but by the time children were in third grade, those benefits had largely disappeared. Why do you think the preschool program you studied had longer-lasting effects?

HECKMAN: Well first of all, I'm not convinced that the Head Start study that's reported, and it's been debated so much and discussed as a way of, say, discrediting early childhood programs, is a competent study. And I'll say that for a very simple reason. The experiment that was conducted, and it was an experiment, is an experiment where children were randomly assigned to Head Start, and then the control group was put off to go where it wanted to go.

It turned out a lot of the control group went to other Head Start programs or to other programs, as well. That's one point. The second point is that many of these studies have to do with short-term follow-ups, a few years later. The same measures that these people use fade out, yet we find seven to 10 percent rate of return. So what's going on? It just means that our limit - we're just using a very limited set of measures and that much more than IQ matters.

PFEIFFER: You seem very passionate about this. How do you hope that your research affects policy?

HECKMAN: Well, I hope it broadens our understanding of what we should be looking at, how we should judge these programs, and I also hope that it informs the health care debate. In the whole debate about health care, I saw very little mention of saying, oh, a good health care strategy that would actually prevent disease would be an early childhood program.

I think we can see substantial benefits for these disadvantaged kids, and I think we can proceed and target that. It's just not on the table now.

PFEIFFER: Are you in favor of the president's push for universal pre-K?

HECKMAN: I'm all in favor of pre-K that's universal, but I would put it on what we would call the sliding scale. I don't know how many children in very advantaged neighborhoods, how many of those children would benefit to the same extent, given the quality of the family life that they currently experience. The real public policy case is focused on the disadvantaged, and my understanding is the universal plea is partly a political criteria not to stigmatize the disadvantaged.

So yes, make it universal, but make people pay on a sliding scale. That's been actually proposed by Secretary Duncan, universality with a sliding schedule.

PFEIFFER: That's University of Chicago economics professor James Heckman. Professor Heckman, thanks for talking with us.

HECKMAN: OK, thank you.

PFEIFFER: And a question for our listeners. If children who attend pre-K programs grow up to be healthier adults, should preschool be mandatory? Let us know your thoughts at hereandnow.org. You're listening to HERE AND NOW. Transcript provided by NPR, Copyright NPR.


Please follow our community rules when engaging in comment discussion on this site.
  • Barbara Smith Wilke

    I like the sliding scale concept… Personally, I love having my little ones home for the majority of their youngest years, and supplementing with activities for social interaction and enrichment. Providing quality opportunities for disadvantaged families, however, is so crucial to a healthy society and economy.

  • Lesley Carson Hamann

    Head Start was one of the best choices I made for my children. They learned that other adults care about them and enriched their lives. The learned how to seek out information not just from Google and loved school from then on. They also helped me diagnose my youngest with aspbergers, because of early support he is medication free and thriving. He is 12 now and all of his MEAP scores are 12th grade level or higher. I’m a very involved parent, but I also know that I don’t know everything, and would never be able to access the resources that this program could.

  • jonathanpulliam

    The teacher’s unions’ll surely find a way to debase and dismantle this…

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