The Impacts of Universal Prekindergarten on Children’s Health

Prior research suggests that universal pre-kindergarten (UPK) programs can generate lifetime benefits, but the mechanisms generating these effects are not well understood. In 2014, New York City made all 4-year-old children eligible for UPK programs that emphasized developmental screening. We examine the effect of this program on the health of children enrolled in Medicaid using a difference-in-regression discontinuity design that exploits both the introduction of UPK and the fixed age cut-off for enrollment. We posit that one mechanism through which UPK might generate benefits is by accelerating the rate at which children are identified with conditions that could delay learning and cause behavioral problems.

In a secondary study, we examine the epidemiological pattern of influenza following the UPK rollout. Increasing the number of children in congregate settings could increase the speed or pattern of infectious outbreaks. Exploiting the age-cutoff for enrollment using a regression discontinuity framework, we apply both a survival analysis and harmonic regression to assess timing and infection rate. 

Evidence

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Overview

Kai Hong, Kacie Dragan, and Sherry Glied from the NYU Wagner Research Hub released a working paper exploring the health impacts of New York City’s 2014 roll-out of a Universal Pre-Kindergarten (UPK) program. The substantial size of the program, the emphasis on developmental screening, the age-cutoff rule for enrollment, and the timing of the roll-out made it an excellent case to evaluate potential short-term health and utilization impacts.