J Public Health Manag Pract

Context: A previous 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 students. This follow-up economic review examines how the economic benefits of center-based ECE programs compare with their costs. Evidence Acquisition: Kay and Pennucci from the Washington 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. Evidence Synthesis: The median benefit-to-cost ratio from 11 estimates of earnings gains, the major benefit driver for three types of ECE programs (i.e., state and district, federal Head Start, and model programs), was 3.39:1 (interquartile interval [IQI]: 2.48 to 4.39). The overall median benefit-to-cost ratio from seven estimates of total benefits, based on additional components besides earnings gains, was 4.19:1 (IQI: 2.62 to 8.60) indicating that for every dollar invested in the program, there was a return of $4.19 in total benefits. Conclusions: 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.

28257407

PMC6172656

CDC Public Access