title: Early Childhood Education to Promote Health Equity: A Community Guide Economic Review.
abstract: A recent Community Guide systematic review found that early childhood education (ECE) programs improve educational, social, and health-related outcomes and advance health equity because many are designed to increase enrollment for high-risk children. This follow-up economic review examines how the economic benefits of center-based ECE programs compare with their costs.
  
  
  
  Kay and Pennucci from the Washington State Institute for Public Policy, whose meta-analysis formed the basis of the Community Guide effectiveness review, conducted a benefit-cost analysis of ECE programs for low-income children in Washington State. We performed an electronic database search using both effectiveness and economic key words to identify additional cost-benefit studies published through May 2015. Kay and Pennucci also provided us with national-level benefit-cost estimates for state and district and federal Head Start programs.
  
  
  
  The median benefit-to-cost ratio from 11 estimates of earnings gains, the major benefit driver for 3 types of ECE programs (ie, state and district, federal Head Start, and model programs), was 3.39:1 (interquartile interval [IQI] = 2.48-4.39). The overall median benefit-to-cost ratio from 7 estimates of total benefits, based on all benefit components including earnings gains, was 4.19:1 (IQI = 2.62-8.60), indicating that for every dollar invested in the program, there was a return of $4.19 in total benefits.
  
  
  
  ECE programs promote both equity and economic efficiency. Evidence indicates there is positive social return on investment in ECE irrespective of the type of ECE program. The adoption of a societal perspective is crucial to understand all costs and benefits of ECE programs regardless of who pays for the costs or receives the benefits.
authors.affiliation: Community Guide Branch, Division of Public Health Information Dissemination, Center for Surveillance, Epidemiology and Laboratory Services, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Ramon, Chattopadhyay, and Hahn); and National Institute for Early Education Research, Rutgers University, New Brunswick, New Jersey (Dr Barnett). The names and affiliations of the Task Force members are listed at www.thecommunityguide.org/about/task-force-members.html.
authors.forename: Ismaila
authors.initials: I
authors.lastname: Ramon
authors.forename: Sajal K
authors.initials: SK
authors.lastname: Chattopadhyay
authors.forename: W Steven
authors.initials: WS
authors.lastname: Barnett
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hahn
mesh_terms: D003479:Curriculum; D004467:Economics; D004493:Education / Q000379:methods*; D000069576:Health Equity / Q000592:standards / Q000639:trends*; D006801:Humans; D000070777:School Teachers; D014861:Washington