Start Earlier, Stay Healthier? An Earlier Start to Public Preschool May Improve Detection of Health Problems

Public preschool can provide opportunities for earlier detection of child health problems and receipt of special needs services. This is especially important for children from low-income households who disproportionately face cost barriers to obtaining health screenings and services.

This study explores the possibility that entering public preschool at age 3 instead of age 4 could contribute to earlier detection of health problems and receipt of special needs services for low-income children.

We analyzed data on 757 low-income children in Tulsa, Oklahoma who attended Head Start or public pre-k. We compared rates of parent-reported health conditions and Individualized Education Plans (IEPs) at age 4 according to children’s pattern of preschool attendance across their 3- and 4-year-old years, using propensity score-weighted logistic regressions.

At the spring of their 4-year-old year, children who had entered preschool at age 3 were more likely than those who entered at age 4 to have eczema (OR = 3.25, p < .05) and vision problems (OR = 2.26, p < .05). Among children who entered preschool at age 3, those who stayed in Head Start at age 4 were marginally more likely than those who transitioned to school based pre-k at age 4 to have asthma (OR = 3.81, p = .055) and allergies (OR = 2.16, p = .088). There were no differences in rates of IEPs by children’s preschool experience.

If replicated, results underscore the potentially unrealized public health benefits of expanding public preschool access to 3-year-olds.