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Childhood program improves health 30 years later

Preschool intervention led to reduced blood pressure, obesity, especially among men

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2:05pm, March 27, 2014
Magazine issue: Vol. 185 No. 8, May 3, 2014
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High-quality early childhood programs may reduce adults’ obesity and blood pressure, a new study finds.

Kids from poor families who were randomly assigned to a program of educational activities, basic medical care and healthy meals for the first five years of life displayed better health in their mid-30s than peers who didn’t get the intervention, say psychologist Frances Campbell of the University of North Carolina at Chapel Hill and her colleagues.

It’s not clear precisely how the childhood program boosted adult cardiovascular and metabolic health, the researchers report in the March 28 Science. But since a program with an average annual cost of about $18,000 per child in today’s dollars yielded sustained health benefits, the researchers conclude, early childhood interventions may represent a way to bring down health care costs.

Campbell’s team analyzed data from the Carolina Abecedarian (ABC) Project. Its designers wanted to see if an intensive early childhood program could prevent low IQs among kids born into poverty in North Carolina between 1972 and 1977. Researchers have found that IQ gains among children in the ABC Project and other early childhood interventions, including Head Start, tended to fade by young adulthood.

However, evidence indicates that participation in these programs leads to greater self-control and motivation, higher standardized test scores and better-paying jobs.

In the new study, a doctor performed physical exams on 68 individuals in their mid-30s. Of that group, 37 had participated in the ABC program from about age 2 months to 5 years. The rest had received social services only as needed.

The ABC intervention consisted of day care in small groups with teachers who led educational games; regular medical exams; and breakfast, lunch and a snack.

Health benefits among grown-up ABC participants, especially men, included relatively low rates of hypertension, obesity and vitamin D deficiency. For instance, mean systolic blood pressure among these men was 126 millimeters of mercury, compared with 143 millimeters of mercury among men in the comparison group.

No men from the ABC program, versus one of every four men from the comparison group, exhibited the combination of elevated weight, cholesterol and blood pressure that signals high risk of heart disease, stroke and diabetes.

For women, those from the ABC program had a lower rate of obesity than comparison women: 56 percent versus 76 percent.

Men, but not women, assigned to the early childhood program were also more likely to have health insurance at age 30 and to get medical care when sick.

Reduced obesity rates during the first two years of life, as a result of better nutrition and medical care, may somehow have primed kids in the ABC program for relatively good health decades down the line, the researchers speculate. But the study contains too few participants to determine whether any one aspect of the intervention worked better than the others.

“Early childhood intervention is a viable strategy for health promotion over the life course,” remarks child development professor Arthur Reynolds of the University of Minnesota, Twin Cities. The new report and several other long-term studies of preschool interventions suggest that kids who acquire self-control and other skills underlying school success also achieve better physical and mental health as adults, Reynolds says.

Reynolds directs the Chicago Longitudinal Study, which has followed 989 low-income children who participated in a preschool program and 550 peers who did not, up to age 28. Key adult advantages for preschool participants — and again, especially for males — have included better-paying jobs, lower crime rates and less depression and substance abuse. Physical health measures examined in the ABC Project weren’t tracked in the Chicago study. 

Editor's Note: This article was updated on April 8, 2014, to correct the number of people who participated in the new study.

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