High-quality early intervention brings health benefits 30 years later

Children who received high-quality early care and education in UNC’s Frank Porter Graham Child Development Institute Abecedarian Project from birth until age 5 enjoy better physical health in their mid-30s than peers who did not attend the childcare-based program.

The findings, which appear in Science, have substantial implications for health care and prevention policy. The findings are the result of FPG’s collaboration with scientists from the University College London and the University of Chicago, where Nobel laureate James J. Heckman spearheaded an intricate statistical analysis of data from the Abecedarian Project.

Not only did FPG and Heckman’s team determine that people who had received high-quality early care and education in the 1970s through the project are healthier now, significant measures also indicate better health lies ahead for them.

Previous findings from the Abecedarian Project have been instrumental in demonstrating that high-quality early education and care for at-risk children can have positive, long-lasting effects on cognitive functioning and academic achievement that extend well into adulthood. However, the new study differs by examining physical measures of health.

“To our knowledge, this is the first time that actual biomarkers, as opposed to self-reports of illnesses, have been compared for adult individuals who took part in a randomized study of early childhood education,” said Frances Campbell, FPG senior scientist and principal investigator of the Abecedarian Project’s follow-up studies. “We analyzed actual blood samples, and a physician conducted examinations on all the participants, without knowing which people were in the control group.”

“This study breaks new ground in demonstrating the emergence of the relationship between education and health,” said Craig Ramey, the original principal investigator on the project, who now serves as a professor of pediatrics and a distinguished research scholar at the Virginia Tech Carilion Research Institute. “It broadens our understanding of the power of high-quality early experience to change lives for the better.”

The study determined that people who received early care with the Abecedarian program have lower rates of pre-hypertension in their mid-30s than those in the control group. They also have a significantly lower risk of experiencing total coronary heart disease (CHD), defined as both stable and unstable angina, myocardial infarction or CHD death, within the next 10 years.

Compared to the control group, males treated in the Abecedarian program have lower incidences of hypertension in their mid-30s. In addition, treated men less frequently exhibit combinations of both obesity and hypertension, and none exhibited the cluster of conditions known as “metabolic syndrome,” which is associated with greater risk of heart disease, stroke, and diabetes.

From the start, the Abecedarian Project represented a revolutionary approach to early childhood education by providing care from early infancy and exposing children to a high-quality center for five years, instead of the shorter durations typical of other programs. Children in the treated group benefited from stable early childhood environments, which included on-site health care and nutritious meals.

They also attended full days, five days a week, year round, and they learned under the “Abecedarian Approach,” an innovative curriculum that began in infancy.

“It is of particular significance that an early educational intervention produced long-term health effects,” said FPG senior scientist emeritus Joseph Sparling, who co-created the Abecedarian Approach. Sparling noted the importance of the curriculum’s educational content and five-year duration, which he and colleagues are now adapting and applying in Canada, Mexico, China and Australia.

Campbell, who has been with the project since it began in 1972, said many factors might have contributed to the sustained and substantial health benefits now seen for study participants: more intensive pediatric monitoring, improved nutrition, a predictable and less stressful early childcare experience and improved adult education. Even without pinpointing a single mechanism responsible for improved adult health, scientists involved in the Abecedarian effort agree that early childhood interventions are an encouraging avenue of health policy to explore.

“Good health is the bedrock upon which other lifetime accomplishments rest, and without it, other gains are compromised,” Campbell said. “Investing in early childhood programs has been shown to pay off in ways we did not anticipate forty years ago when the Abecedarian study was founded.”

Published March 27, 2014.