Childhood interventions: impacts on health, schooling, and socioeconomic outcomes
The first years of life are crucial for health and well-being throughout life’s course. During our childhood years, we are more malleable and receptive to external influence and this implies that there is an opportunity to promote the development of cognitive, social, and emotional skills.
The first years of life are crucial for health and well-being throughout life’s course. During the first years, the brain is under development, and the skills we use on the various social and economic activities in which we participate are formed. During that period, we are also more malleable and receptive to external influence. This implies that there is an opportunity to intervene, to promote the development of cognitive, social, and emotional skills.
There are childhood intervention programs a little bit all over the world. The first were implemented in the US in the ’60s. As those programs multiplied, so did the literature on their impact.
Recently, I conducted a systematic literature review on the impacts of childhood interventions with a health component on health, schooling, and socioeconomic outcomes. I reviewed 20 studies on the impacts of those interventions on adult outcomes (i.e., after 21 years of age), and 22 studies on the impacts of childhood interventions on outcomes measured until participants are 21 years old. Together, these studies assess 18 different intervention programs: six preschool programs in the US, two school programs focused on promoting healthy habits, one in Portugal and one in the US, eight home visiting programs in the US, England, Germany, Ireland, and Denmark, and lastly, Medicaid and Medicaid for oral health.
The overall result of my analysis is that childhood interventions have favorable impacts in every domain considered, both in the short-/medium-term and in adulthood. In addition, I can highlight four main implications of the results found:
First, the evidence is aligned and indicates that childhood investments, especially when focused on the least well off, have great return potential for both individuals and society. Even though not all programs assessed have positive impacts in every domain, there is favorable evidence from different contexts, different countries and times, as well as different types of programs.
Second, given that different types of programs have been successful, there is room for policymakers to choose the models that best adapt to the needs of the populations, the desired results, and the available resources.
Third, childhood investments take several decades to produce the most significant outcomes. Therefore, decisions to invest must be independent of political and electoral cycles.
Fourth and last, we need more research on the mechanisms that mediate the impacts of childhood interventions, as well as on the very long-term impacts.
In conclusion, besides the net benefits that seem to arise from childhood interventions, there are other economic arguments for investing in this type of program. One of them is equity. At birth, there is a great variation in individual resources, which leads to variation in results along life’s course, even if those results are efficient (i.e., even if the few or many resources are used in the best way possible). If equity is one of the goals of the State, then governments may adopt one of three options: compensate for different results, compensate for different resources or both. The second strategy — leveling resources — may be superior, and evidence suggests that interventions, earlier in individuals’ lives, are more cost-effective. Leveling results require larger investments the later in life intervention occurs.
The complete report, in Portuguese, is available here.
Judite Gonçalves is a researcher and invited teaching assistant at Nova School of Business &Economics. She is an active member of the Nova SBE Nova Health Economics and Management Knowledge Center. Her research interests are mainly in Health Economics and Economics of aging. She teaches Econometrics and Statistics.