Quality preschool programs have long been connected to positive education and health outcomes for students, and over the past two decades, some state legislatures have taken steps to improve both the availability and the quality of these programs.

But there’s still a very long way to go: The coronavirus pandemic wiped out years of progress, and the National Conference of State Legislatures reports that only six states have established early-childhood agencies that have directors in cabinet-level positions. They are Alabama, Connecticut, Georgia, Massachusetts, New Mexico and Washington — and Alabama just saw its governor, Republican Kay Ivey, force the resignation of the woman in charge of its successful preschool program because Ivey didn’t like passages in a well-regarded book about developmentally appropriate practice in early-childhood programs.

This piece is a new review of early-childhood programs and why they are vital to the education and overall health of children. It was written by Robert A. Hahn and W. Steven Barnett. Hahn is an adjunct faculty member in the Department of Anthropology at Emory University and Barnett is a professor and senior co-director of the National Institute for Early Education Research at Rutgers University’s Graduate School of Education.

By Robert A. Hahn and W. Steven Barnett

Our new review of scientific evidence finds that preschool education for 3- and 4-year-olds can improve health and longevity, and reduce persistent educational gaps. The evidence suggests greater gains for those in poverty, but because children in middle-income households also benefit, gains accrue to the population as a whole.

That’s a key reason we recommend public funding for preschool education for all 3- and 4-year-olds. Providing quality preschool education for all children will benefit not only children and their families, but also the economy, saving taxpayers money in the long run.

We found a remarkable number of U.S.-based studies revealing long-term health and longevity benefits for preschool education.

The well-known Perry Preschool study found health benefits for participants and their children over many decades. The federal Head Start program has been found to reduce depression and the use of alcohol and tobacco by middle school. And a very recent study found preschool attendance was linked to a 6 percent increase in high school graduation, an 18 percent increase in on-time college attendance and a 5.5 percent increase in attendance at a four-year college. These positive effects were found for children from middle- as well as low-income backgrounds. Similar findings for educational attainment come from a recent Head Start study — findings confirm older research linking Head Start participation to reduced mortality and educational gains.

Taken together, the studies we reviewed suggest that policymakers and the public should give more attention to the effects of preschool education on health, mortality and equity.

Past debates about public investments in preschool education have tended to focus on achievement test results and the extent to which they persist beyond a few years. Our review finds that preschool programs can produce long-term benefits on health and mortality even when their effects on achievement appear to “fade out.” One reason is that educational attainment can be improved even when achievement test gains seem to be temporary. And educational attainment is a key determinant of health, longevity and equity.

Life expectancy recently has fallen for all groups in the United States, and the decline has been much greater for Hispanic and Black populations. As the nation focuses on how to counter these trends, new investments in preschool education should be given strong consideration. These new investments should address two limitations that currently prevent preschool programs from producing the desired benefits.

First, about half of 3- and 4-year-olds don’t enroll in a preschool program, and enrollment is unequal by race, ethnicity and income. Second, preschool program quality often is too low to produce the desired benefits.

High-quality preschool programs provide much more than just the ABCs and counting. They support the development of the whole child — cognitive, social, emotional and physical. The programs we found to be effective had better-prepared, better-paid teachers and smaller classes than is typical.

The strongest evidence is for programs in public schools with the best-educated, best-paid teachers. While these features are not guarantees of success, it seems unwise to expect to succeed by offering children far less than what we know has worked. Unfortunately, that sort of false economy is all too common.

When it comes to the economics of early-childhood education, benefit-cost studies consistently show that public investments in quality preschool education yield substantial long-term payoffs. Even modest improvements in educational attainment and nonacademic outcomes can result in increased earnings, decreased crime, and greater empathy and civic participation.

The benefits far outweigh the costs of programs. Our review found program benefit-to-cost ratios ranging from 2.6 for Head Start to 4.2 for strong state and local programs — well above breaking even — despite the higher costs of these effective programs. Clearly, investing in quality preschool education is a smart move for society.

While advocating for preschool education, we do not mean to suggest that other policies should be neglected. Preschool is not a panacea. Preschool education cannot by itself alone be expected to raise educational attainment, health outcomes and life expectancy to the levels of such other countries as Australia, Canada and Ireland.

Larger impacts can be expected from a multifaceted approach, including increased resources for a wide range of safety net programs that support children — especially those in low-income families — starting from the earliest years, even prenatally. Policies that more directly boost economic growth, employment and earnings also could contribute to improving and equalizing health and longevity.

Nevertheless, in the current landscape of increasing inequality, the nation would do well to have as one top priority increased public investment in quality preschool education. This critical intervention has the potential to significantly improve equity in the most fundamental aspects of our lives.

It is no secret that quality is not cheap. However, the costs of declining health and increasing mortality are much higher. Investments in quality preschool education can help put the nation on a path to better and more equitable health outcomes, while saving taxpayers money in the long-term. Leaders at all levels of government should prioritize making substantial new public investments in ECE now.