Interventions might alleviate poverty’s impact on child health

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health, working to help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network. Send questions or suggestions to joe@healthjournalism.org or @rojasburke.

children-beach

Image by Victor Bonomi via flickr.

We know that about 45 percent of American kids are growing up in families that are poor or near poor, and that this degree of social inequality helps explain why the health status of Americans is failing to keep up with progress in other wealthy nations.

But how to make things better is not so clear, I insisted in a recent post. I may have spoken too soon. There is now solid evidence from a long-running study in North Carolina that early childhood programs can produce health benefits that persist into adulthood.

In the Carolina Abecedarian Project, babies born in the 1970s were randomized into two groups. Both received nutritional supplements, basic social services and access to health care, but one group also received cognitive and social stimulation interspersed with caregiving and supervised play throughout an eight-hour day for the first five years. Four decades later, researchers found that the group given enhanced care was far healthier. Disadvantaged children randomly assigned to treatment had significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The study was published in Science on March 28.

“The study provides rare experimental evidence that such programs can give poor children a better shot at living longer, healthier lives,” Science News staff writer Emily Underwood pointed out. The Abecedarian intervention and other early childhood programs had already proven effective at promoting school success, raising earnings in adulthood, and reducing crime. The health benefits were unknown until now.

The intensive early childhood intervention wasn’t cheap. Costs totaled about $70,000 per child after five years. The researchers told reporters they are analyzing how that compares with the savings in medical care and other benefits.

Underwood noted that, by school age, the children in the intervention group performed about one grade level higher than the control group in reading and math. By age 21, the treated group was four times more likely to have graduated from college and roughly 30 percent more likely to be employed in a skilled job.

For further reading, see these relevant studies.

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