Working Paper: CEPR ID: DP16730
Authors: Sarah Cattan; Gabriella Conti; Christine Farquharson; Rita Ginja; Maud Pecher
Abstract: We evaluate the short- and medium-term health impacts of Sure Start, a large-scale and universal early childhood program in England. We exploit the rollout of the program and implement a difference-in-difference approach, combining data on the exact location and opening date ofSure Start centers with administrative data on the universe of admissions to public-sector hospitals. Exposure to an additional Sure Start center per thousand age-eligible children increases hospitalization by 10% at age 1 (around 6,700 hospitalizations per year), but reduces them by8-9% across ages 11 to 15 (around 13,150 hospitalizations per year). These findings show that early childhood programs that are less intensive than small-scale ‘model programs’ can deliver significant health benefits, even in contexts with universal healthcare. Impacts are driven by hospitalizations for preventable conditions and are concentrated in disadvantaged areas, suggesting that enriching early childhood environments might be a successful strategy to reduce inequalities in health.
Keywords: early childhood intervention; health; difference-in-difference
JEL Codes: I10; I14; I18
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Exposure to an additional Sure Start center per thousand age-eligible children (C21) | Increases hospitalizations by 10% at age 1 (I12) |
| Sure Start program (I21) | Reduces hospitalizations by 89% across ages 11 to 15 (I14) |
| Increased access to Sure Start (I24) | Children's hospitalization rates (I19) |