Early-life access to primary healthcare and educational attainment: Evidence from community health centers in China

This paper uses the rollout of community health centers (CHCs) from the 1950s to the 1970s in China to study the long-term effects of early-life access to primary healthcare on educational attainment. By leveraging the variation across birth cohorts and communities in the establishment of CHCs, we find that exposure to CHCs in early life significantly increases children's completed years of education in later life. Event study estimates confirm that the beneficial effects of CHC exposure are concentrated in early life. Mechanism analysis reveals that early-life exposure to CHCs improves birth health and childhood health. The results remain robust after considering a series of robustness checks, such as ruling out confounding factors and placebo tests. Our findings underscore the significance of early-life primary healthcare in building human capital and indicate that the returns on accessing primary healthcare may be significantly underestimated.