Abstract
Ensuring access to pre-kindergarten (Pre-K) education remains a pressing policy issue in the United States. Prior research has shown the positive effects that Pre-K has on children’s cognitive development. However, studies on its effects on children’s health outcomes are scarce. This study aimed to investigate the effects of the Pre-K program on pediatric asthma. Children’s individual data from existing research conducted in North Carolina were linked with state Medicaid claims data from 2011–2017. There were 51,408 observations (person-month unit) of 279 children enrolled in Pre-K and 333 unenrolled children. Asthma was identified using the ICD 9/10 codes. A difference-in-differences model was adopted using a panel analysis with three time periods: before, during, and after Pre-K. The explanatory variables were interaction terms between Pre-K enrollment and (a) before vs. during period and (b) during vs. after period. The results indicated that children enrolled in Pre-K had a greater risk of asthma diagnosis during Pre-K (b = 0.0145, p = 0.058). Conversely, in the post-intervention period, the enrolled children had a lower of receiving an asthma diagnosis (b = −0.0216, p = 0.002). These findings indicate that Pre-K may increase the use of asthma-related health services in the short term and decrease the service use after participants leave the program.
Highlights
Child gender, family military affiliation, more children in the household, history of metabolic diseases, asthma-related conditions, higher frequency of child routine health examinations, and lower-population-density counties were associated with Pre-K enrollment
The findings of this study support the hypothesis that Pre-K can increase the use of health services related to asthma during the program and decrease the service use after the enrolled children leave the program
The magnitude of the decrease after the program period was greater than the increase during it among the Pre-K participants
Summary
Access to high-quality pre-primary education remains a longstanding and pressing policy issue in the United States and other countries [1]. In the United States, federal funding for expanding pre-kindergarten (Pre-K) education for all. 4-years-olds (i.e., universal Pre-K) has strong support in opinion polls [2] and is generally seen as a bipartisan political issue. Despite this broad support, enrollment rates and the quality of Pre-K programs differ across states and regions. The average nationwide enrollment rate of 4-year-olds in public-funded (i.e., state- or city-funded) Pre-K programs has more than doubled over the last two decades, in 2016 this rate was merely
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More From: International journal of environmental research and public health
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