title: Effects of full-day kindergarten on the long-term health prospects of children in low-income and racial/ethnic-minority populations: a community guide systematic review.
abstract: BACKGROUND
  Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity. This systematic review assesses the extent to which full-day kindergarten (FDK), compared with half-day kindergarten (HDK), prepares children, particularly those from low-income and minority families, to succeed in primary and secondary school and improve lifelong health.
  
  
  METHODS
  A meta-analysis (2010) on the effects of FDK versus HDK among U.S. children measured educational achievement at the end of kindergarten. The meta-analysis was concordant with Community Guide criteria. Findings on the longer-term effects of FDK suggested "fade-out" by third grade. The present review used evidence on the longer-term effects of pre-K education to explore the loss of FDK effects over time.
  
  
  RESULTS
  FDK improved academic achievement by an average of 0.35 SDs (Cohen's d; 95% CI=0.23, 0.46). The effect on verbal achievement was 0.46 (Cohen's d; 95% CI=0.32, 0.61) and that on math achievement was 0.24 (Cohen's d; 95% CI=0.06, 0.43). Evidence of "fade-out" from pre-K education found that better-designed studies indicated both residual benefits over multiple years and the utility of educational boosters to maintain benefits, suggesting analogous longer-term effects of FDK.
  
  
  CONCLUSIONS
  There is strong evidence that FDK improves academic achievement, a predictor of longer-term health benefits. To sustain early benefits, intensive elementary school education is needed. If targeted to low-income and minority communities, FDK can advance health equity.
authors: Community Guide Branch, CDC, Atlanta, Georgia. Electronic address: RHahn@cdc.gov.
authors: Robert A
authors: RA
authors: Hahn
authors: Community Guide Branch, CDC, Atlanta, Georgia.
authors: Veda
authors: V
authors: Rammohan
authors: Office of the Associate Director for Science of the National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention, CDC, Atlanta, Georgia.
authors: Benedict I
authors: BI
authors: Truman
authors: Hygeia Dynamics, Brookline, Massachusetts.
authors: Bobby
authors: B
authors: Milstein
authors: UMDNJ-New Jersey Medical School, Newark, New Jersey.
authors: Robert L
authors: RL
authors: Johnson
authors: University of Toronto, Toronto, Canada.
authors: Carles
authors: C
authors: Muntañer
authors: Epidemiology and Analysis Program Office, CDC, Atlanta, Georgia.
authors: Camara P
authors: CP
authors: Jones
authors: Columbia University, New York, New York.
authors: Mindy T
authors: MT
authors: Fullilove
authors: Community Guide Branch, CDC, Atlanta, Georgia.
authors: Sajal K
authors: SK
authors: Chattopadhyay
authors: Division of Adolescent & School Health, CDC, Atlanta, Georgia.
authors: Pete C
authors: PC
authors: Hunt
authors: Columbia University, New York, New York.
authors: Ana F
authors: AF
authors: Abraido-Lanza
mesh_terms: D002648:Child; D004493:Education / Q000592:standards*; D004522:Educational Status; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data; D011203:Poverty; D012574:Schools; D012959:Socioeconomic Factors; D013997:Time Factors