Seeing and Hearing: The Impacts of New York City's Universal Prekindergarten Program on the Health of Low-Income Children

Overview

Kai Hong, Kacie Dragan, and Sherry Glied from the NYU Wagner Research Hub published a paper in the Journal of Health Economics exploring the health impacts of New York City’s 2014 roll-out of a Universal Pre-Kindergarten (UPK) program. The substantial size of the program, the emphasis on developmental screening, the age-cutoff rule for enrollment, and the timing of the roll-out made it an excellent case to evaluate potential short-term health and utilization impacts.

Findings

Using Medicaid data to determine health and utilization changes after the introduction of the program, the research team identified four key findings:

1. Eligibility for UPK increased the probability that a child was diagnosed with asthma or with vision problems, received treatment for hearing or vision problems, or received a screening during the pre-kindergarten year.
2. Eligibility for UPK accelerated the timing of diagnoses of vision problems.
3. Eligibility for UPK did not appear to lead to increases in injuries, infectious diseases, or overall health system utilization.
4. These observed effects were not offset by lower screening rates in the kindergarten year, suggesting that UPK might accelerate the rate at which children are identified with conditions that could potentially delay learning and cause behavioral problems.

Implications for Policy and Practice

One of the most robust findings in this study pertains to the increases in the diagnosis and treatment of vision and hearing problems. This suggests a new avenue by which pre-K might lead to long-term advantages. By diagnosing and treating chronic health problems earlier, children may be able to take greater advantage of educational opportunities, cope with challenges, feel less frustrated or overwhelmed in the classroom, and communicate with peers and educators more effectively. This research supports the idea that pre-kindergartens can be a valuable setting for early detection of and intervention for chronic health problems, particularly sensory deficits.

The researchers argue that future studies on UPK policies should continue to be conducted in fields outside of education. The team’s use of health utilization and outcome data in this study provided an opportunity to understand how detection and treatment of medical problems may play a role in the success of children eligible for pre-K programs. In turn, these findings may help bridge the gap in the current understanding of how pre-K imparts social and economic benefits many years later.