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Health strategies to improve kindergarten readiness

Health strategies can support young children’s physical and cognitive growth and empower parents to better support their child’s development.

Children who enter kindergarten ready to learn are more likely to experience good outcomes through elementary and middle school, graduate from high school, and complete post-secondary education.

How does kindergarten readiness affect economic mobility?

Children who enter kindergarten ready to learn are more likely to experience subsequent academic success. 1 2 3

Children that enter kindergarten ready to learn have an 82 percent chance of mastering basic academic and social skills by age 11, compared to a 45 percent chance for children who enter kindergarten unprepared.

Children that enter kindergarten ready to learn are less likely to repeat a grade, be placed in special education, or be arrested and more likely to graduate from high school, receive a post-secondary degree, see better employment outcomes, and experience better health outcomes.

Readiness for kindergarten is particularly important for low-income children’s chances of upward economic mobility. 4

Low-income children who enter kindergarten unprepared are 25 percent more likely to drop out of high school, 40 percent more likely to become parents as teenagers, and 60 percent less likely to attend college than children who enter kindergarten prepared.

Investments in kindergarten readiness produce significant social returns. 5

Investments in preschool for low-income children are estimated to yield benefit-cost ratios between 2:1 and 4:1. Other estimates demonstrate a 7-10 percent return on investment due to better education, health, social, and economic outcomes; increased workforce productivity, and reduced reliance on public programs.

Categories of successful interventions

  • Home visiting programs: Health services, social supports, parent training programs, and connections to community resources delivered to new parents in their homes
  • Nutrition programs: Programs that provide healthy breakfast and lunch options to students for free or reduced prices
  • School-based health programs: Physical or mental health programs provided at schools. Some programs offer services to family and community members

Evidence-based interventions

Intervention Type Category Evidence Level
AVANCE Parent-Child Education Program (PCEP) Program
  • Parent training and support
Proven (highest tier)
Breastfeeding promotion programs Strategy
  • Parent training and support
Proven (highest tier)
Centering Pregnancy Program
  • Parent training and support
Proven (highest tier)
Child-Parent Centers Program
  • Parent training and support
  • Preschool
Strong (second-highest tier)
Clinic-based programs for pregnant and parenting teens Strategy
  • Parent training and support
Proven (highest tier)
Criando con Amor: Promoviendo Armonía y Superación (CAPAS) Program
  • Parent training and support
Proven (highest tier)
Early Head Start Program
  • Parent training and support
  • Preschool
Strong (second-highest tier)
Family Foundations Program
  • Parent training and support
Proven (highest tier)
Head Start Program
  • Parent training and support
  • Preschool
Strong (second-highest tier)
Home Instruction for Parents of Preschool Youngsters Program
  • Home visiting programs
  • Parent training and support
Proven (highest tier)
Nurse-Family Partnership Program
  • Home visiting programs
Proven (highest tier)
ParentCorps Program
  • Evidence-based childhood curricula
  • Parent training and support
  • Teacher training and professional development
Strong (second-highest tier)
Patient navigators Strategy
  • Health systems navigation assistance
Proven (highest tier)
Preschool With Family Support Services Strategy
  • Parent training and support
  • Preschool
Proven (highest tier)
SafeCare Program
  • Home visiting programs
  • Parent training and support
Strong (second-highest tier)
School breakfast programs Strategy
  • Nutrition programs
Proven (highest tier)
School dental programs Strategy
  • School-based health programs
Proven (highest tier)
School-based health centers Strategy
  • School-based health programs
Proven (highest tier)
Smart Start North Carolina Program
  • High-quality childcare
  • Parent training and support
Strong (second-highest tier)
Triple P: Positive Parenting Program Program
  • Parent training and support
Proven (highest tier)
Footnotes
  1. Pritzker, Bradach, and Kaufmann, "The Early Childhood Challenge for Philanthropists," Bridgespan 2015
    https://www.bridgespan.org/insights/library/children-youth-and-families/the-early-childhood-challenge-for-philanthropists
  2. Bettencourt, Gross, Ho, and Perrin, "The Costly Consequences of not Being Socially and Behaviorally Ready to Learn by Kindergarten in Baltimore City," Journal of Urban Health 2018
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862700/
  3. Isaacs, "Starting School at a Disadvantage: The School Readiness of Poor Children," Brookings Institution 2012
    https://www.brookings.edu/wp-content/uploads/2016/06/0319_school_disadvantage_isaacs.pdf
  4. Pritzker, Bradach, and Kaufmann, "The Early Childhood Challenge for Philanthropists," Bridgespan 2015
    https://www.bridgespan.org/insights/library/children-youth-and-families/the-early-childhood-challenge-for-philanthropists
  5. Karoly, "The Economic Returns to Early Childhood Education," RAND 2016
    https://files.eric.ed.gov/fulltext/EJ1118537.pdf