High-quality early childhood development programs can help prevent onset of adult chronic disease

High-quality early childhood development programs with health care and nutritional components can help prevent or delay the onset of adult chronic disease, according to a new study by Nobel laureate economist James Heckman and researchers at the University of Chicago, University College London and the Frank Porter Graham Child Development Institute at the University of North Carolina.

Based on more than three decades of data from the landmark Abecedarian early childhood program in North Carolina, the study shows that children who participated in the intervention combining early education with early health screenings and nutrition had much lower levels of hypertension, metabolic syndrome and obesity in their mid-30s than a control group that did not participate in early learning program. The results are published in the March 28 issue of the journal Science.

"Prior to this research, we had indications that quality early childhood development programs helped produce better health later in life," said Heckman. "Abecedarian shows that investing in early learning programs that offer health components can boost education, health and economic outcomes. It also offers a different way to fight costly adult chronic diseases: Investing early in the development of children to build the knowledge and self-regulation necessary to prevent chronic disease and help them lead healthy, productive lives."

The Carolina Abecedarian Project, one of the oldest and most cited early childhood programs, was designed to test whether a stimulating early childhood environment could prevent developmental delays among disadvantaged children. The study involved 111 children from low-income families, born in or near Chapel Hill, N.C. between 1972 and 1977. It also included a health care and nutritional component. Children received two meals and an afternoon snack at an early learning center and were offered daily health screenings and periodic medical checkups. Participants who received this intervention, as well as those in the control group who did not, have been followed for more than 30 years to determine the effectiveness of the early intervention program.

This is the first time their health outcomes have been analyzed. Researchers found that men in the treatment group had lower systolic and diastolic blood pressure and were less likely to develop Stage I hypertension. They also had significantly higher levels of "good" HDL cholesterol and none manifested metabolic syndrome—co-occurring hypertension, central obesity and dyslipidemia, which dramatically increases risk of heart disease, stroke and diabetes. In contrast, the prevalence of metabolic syndrome in the control group was 25 percent. Women in the treatment group were less likely to be affected by abdominal obesity and less likely to develop pre-hypertension. Both men and women were at significantly lower risk than their non-participating peers for coronary heart disease.

Evidence also suggests that quality early childhood programs with health components can promote healthier lifestyle behaviors. For example, women in the treatment group were significantly less likely to start drinking before age 17, were more likely to engage in physical activity and more likely to eat fruit than control group peers. Men who had participated as children were likely to delay starting smoking cigarettes and using marijuana.

"Creating fully functioning and flourishing adults depends crucially on a variety of early life experiences: health, nutrition, good parenting and early stimulation and learning," Heckman said. "Together, they boost the capability for knowledge and self-regulation, giving children the capacity to shape their lives in many positive ways—educational achievement, higher earnings, better health and stronger families. We need to invest early if we want to raise a generation of healthy, socially and emotionally talented people equipped to lead successful lives. It's the most effective and cost-efficient investment we can make."