Effects of a school-based, early childhood intervention on adult health and well-being: A 19-year follow-up of low-income families

Objective: To determine the effects of an established preventive intervention on the health and well-being of an urban cohort in young adulthood. Design: Follow-up of a nonrandomized alternative-intervention matched-group cohort at age 24 years. Setting: Chicago, Illinois. Participants: A total of 1539 low-income participants who enrolled in the Child-Parent Center program in 20 sites or in an alternative kindergarten intervention. Interventions: The Child-Parent Center program provides school-based educational enrichment and comprehensive family services from preschool to third grade. Main Outcome Measures: Educational attainment, adult arrest and incarceration, health status and behavior, and economic well-being. Results: Relative to the comparison group and adjusted for many covariates, Child-Parent Center preschool participants had higher rates of school completion (63.7% vs 71.4%, respectively; P=.01) and attendance in 4-year colleges as well as more years of education. They were more likely to have health insurance coverage (61.5% vs 70.2%, respectively; P=.005). Preschool graduates relative to the comparison group also had lower rates of felony arrests (16.5% vs 21.1%, respectively; P=.02), convictions, incarceration (20.6% vs 25.6%, respectively; P=.03), depressive symptoms (12.8% vs 17.4%, respectively; P=.06), and out-of-home placement. Participation in both preschool and school-age intervention relative to the comparison group was associated with higher rates of full-time employment (42.7% vs 36.4%, respectively; P=.04), higher levels of educational attainment, lower rates of arrests for violent offenses, and lower rates of disability. Conclusions: Participation in a school-based intervention beginning in preschool was associated with a wide range of positive outcomes. Findings provide evidence that established early education programs can have enduring effects on general well-being into adulthood.