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

Robert A. Hahn, Veda Rammohan, Benedict I. Truman, Bobby Milstein, Robert L. Johnson, Carles Muntañer, Camara P. Jones, Mindy T. Fullilove, Sajal K. Chattopadhyay, Pete C. Hunt, Ana F. Abraido-Lanza

Research output: Contribution to journalArticle


Context 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. Evidence acquisition 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. Evidence synthesis 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.

Original languageEnglish (US)
Pages (from-to)312-323
Number of pages12
JournalAmerican journal of preventive medicine
Issue number3
StatePublished - Mar 2014


ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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