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The Health Effects of Universal Early Childhood Interventions: Evidence from Sure Start

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  • Conti, Gabriella
  • Cattan, Sarah
  • Farquharson, Christine
  • Ginja, Rita
  • Pecher, Maud

Abstract

We evaluate the short- and medium-term health impacts of Sure Start, a large-scale and universal early childhood program in England. We exploit the rollout of the program and implement a difference-in-difference approach, combining data on the exact location and opening date of Sure Start centers with administrative data on the universe of admissions to public-sector hospitals. Exposure to an additional Sure Start center per thousand age-eligible children increases hospitalization by 10% at age 1 (around 6,700 hospitalizations per year), but reduces them by 8-9% across ages 11 to 15 (around 13,150 hospitalizations per year). These findings show that early childhood programs that are less intensive than small-scale ‘model programs’ can deliver significant health benefits, even in contexts with universal healthcare. Impacts are driven by hospitalizations for preventable conditions and are concentrated in disadvantaged areas, suggesting that enriching early childhood environments might be a successful strategy to reduce inequalities in health.

Suggested Citation

  • Conti, Gabriella & Cattan, Sarah & Farquharson, Christine & Ginja, Rita & Pecher, Maud, 2021. "The Health Effects of Universal Early Childhood Interventions: Evidence from Sure Start," CEPR Discussion Papers 16730, C.E.P.R. Discussion Papers.
    • Handle: RePEc:cpr:ceprdp:16730
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    2. Mara Barschkett, 2022. "Age-specific Effects of Early Daycare on Children's Health," Discussion Papers of DIW Berlin 2028, DIW Berlin, German Institute for Economic Research.
    3. Mara Barschkett & Laia Bosque-Mercader, 2023. "Building Health across Generations: Unraveling the Impact of Early Childcare on Maternal Health," Discussion Papers of DIW Berlin 2059, DIW Berlin, German Institute for Economic Research.
    4. Gabriella Conti & Sören Kliem & Malte Sandner, 2024. "Early Home Visiting Delivery Model and Maternal and Child Mental Health at Primary School Age," AEA Papers and Proceedings, American Economic Association, vol. 114, pages 401-406, May.
    5. Dan Anderberg & Christina Olympiou, 2023. "Children's social care and early intervention policy: Evidence from sure start," Economica, London School of Economics and Political Science, vol. 90(359), pages 953-977, July.
    6. von Hinke, Stephanie & Sørensen, Emil N., 2023. "The long-term effects of early-life pollution exposure: Evidence from the London smog," Journal of Health Economics, Elsevier, vol. 92(C).
    7. Claire Crawford & Laura Outhwaite, 2023. "Why should we invest in Early Childhood Education and Care?," CEPEO Briefing Note Series 24, UCL Centre for Education Policy and Equalising Opportunities, revised Mar 2023.
    8. Anna Aizer & Adriana Lleras‐Muney, 2025. "The safety net and child health and well‐being: evidence from the United States and the United Kingdom," Fiscal Studies, John Wiley & Sons, vol. 46(1), pages 37-63, March.
    9. Mara Barschkett, 2022. "Age-specific Effects of Early Daycare on Children’s Health," Berlin School of Economics Discussion Papers 0005, Berlin School of Economics.
    10. Barschkett, Mara, 2023. "Age-specific Effects of Early Daycare on Children's Health," VfS Annual Conference 2023 (Regensburg): Growth and the "sociale Frage" 277588, Verein für Socialpolitik / German Economic Association.

    More about this item

    Keywords

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    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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