Children who are healthy early in life—from conception to age five—not only grow up to be healthier adults, they are also better educated, earn more, and contribute more to the economy. The United States lags behind other advanced countries in early childhood health, threatening both the health of future generations and the nation’s long-term economic viability.
Moreover, unhealthy childhoods are not evenly distributed. An accounting of early childhood health in the United States reveals stark inequalities along racial/ethnic and socioeconomic lines. Because of the strong connection between early health and adult outcomes, early childhood offers a critical window to improve disadvantaged children’s life chances through evidence-based interventions and thereby to reduce inequality. Restricting her review to studies that can plausibly show causation, Maya Rossin-Slater examines the evidence behind a variety of programs and policies that target any of three groups: women at risk of getting pregnant, pregnant women, or children through age five.
She finds that some programs and policies have failed to show consistent results. But the good news is that others are quite effective at improving early childhood health. The most successful include the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), universal immunization, and high-quality, center-based early childhood care and education. Economic analyses reveal that these programs’ benefits outweigh their costs, suggesting that public spending to support them is more than justified.