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A Quasi-Experimental Study of the Effects of Pre-Kindergarten Education on Pediatric Asthma

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  • Rie Masuda

    (Faculty of Political Science and Economics, Waseda University, Shinjuku, Tokyo 169-8050, Japan
    Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo, Tokyo 113-0033, Japan)

  • Paul Lanier

    (School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA)

  • Ellen Peisner-Feinberg

    (School of Education, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA)

  • Hideki Hashimoto

    (Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo, Tokyo 113-0033, Japan)

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.

Suggested Citation

  • Rie Masuda & Paul Lanier & Ellen Peisner-Feinberg & Hideki Hashimoto, 2021. "A Quasi-Experimental Study of the Effects of Pre-Kindergarten Education on Pediatric Asthma," IJERPH, MDPI, vol. 18(19), pages 1-18, October.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10461-:d:650110
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    References listed on IDEAS

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    1. Gabriella Conti & James J. Heckman & Rodrigo Pinto, 2016. "The Effects of Two Influential Early Childhood Interventions on Health and Healthy Behaviour," Economic Journal, Royal Economic Society, vol. 126(596), pages 28-65, October.
    2. Hong, Kai & Dragan, Kacie & Glied, Sherry, 2019. "Seeing and hearing: The impacts of New York City’s universal pre-kindergarten program on the health of low-income children," Journal of Health Economics, Elsevier, vol. 64(C), pages 93-107.
    3. James Heckman & Rodrigo Pinto & Peter Savelyev, 2013. "Understanding the Mechanisms through Which an Influential Early Childhood Program Boosted Adult Outcomes," American Economic Review, American Economic Association, vol. 103(6), pages 2052-2086, October.
    4. Pablo Orellano & Nancy Quaranta & Julieta Reynoso & Brenda Balbi & Julia Vasquez, 2017. "Effect of outdoor air pollution on asthma exacerbations in children and adults: Systematic review and multilevel meta-analysis," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-15, March.
    5. Gabriella Conti & James J. Heckman & Rodrigo Pinto, 2016. "The Effects of Two Influential Early Childhood Interventions on Health and Healthy Behaviour," Economic Journal, Royal Economic Society, vol. 126(596), pages 28-65, October.
    6. Fletcher, Jason M. & Green, Jeremy C. & Neidell, Matthew J., 2010. "Long term effects of childhood asthma on adult health," Journal of Health Economics, Elsevier, vol. 29(3), pages 377-387, May.
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