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J Public Health Manag Pract. 2016 Sep-Oct;22(5):E1-8. doi: 10.1097/PHH.0000000000000378.

Early Childhood Education to Promote Health Equity: A Community Guide Systematic Review.

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Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology, and Laboratory Services (Drs Hahn and Knopf), Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; National Institute for Early Education Research, Rutgers University, New Brunswick, New Jersey (Dr Barnett); Office of the Associate Director for Science (Dr Truman) and Division of Adolescent & School Health (Dr Hunt), National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention, CDC, Atlanta, Georgia; UMDNJ-New Jersey Medical School, Newark (Dr Johnson); UCLA Fielding School of Public Health, Los Angeles, California (Dr Fielding); University of Toronto, Toronto, Ontario, Canada (Dr Muntaner); Morehouse School of Medicine, Atlanta, Georgia (Dr Jones); and Departments of Public Health and Psychiatry, Columbia University, New York (Dr Fullilove).



Children in low-income and racial and ethnic minority families often experience delays in development by 3 years of age and may benefit from center-based early childhood education.


A meta-analysis on the effects of early childhood education by Kay and Pennucci best met Community Guide criteria and forms the basis of this review.


There were increases in intervention compared with control children in standardized test scores (median = 0.29 SD) and high school graduation (median = 0.20 SD) and decreases in grade retention (median = 0.23 SD) and special education assignment (median = 0.28 SD). There were decreases in crime (median = 0.23 SD) and teen births (median = 0.46 SD) and increases in emotional self-regulation (median = 0.21 SD) and emotional development (median = 0.04 SD). All effects were favorable, but not all were statistically significant. Effects were also long-lasting.


Because many programs are designed to increase enrollment for high-risk students and communities, they are likely to advance health equity.

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