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In the March issue of the American Journal of Preventive Medicine, the Community Preventive Services Task Force reviews the literature on full-day kindergarten. After considering the evidence, the Task Force ultimately recommends all-day classes as an effective tool for promoting the health of low-income and minority students. Although many studies of full-day kindergarten look at non-academic outcomes over the long-term, measuring data on criminal activity, savings rates, and more, it’s rare to see an analysis focus so directly on health effects. This approach is important not just because our discussions of early childhood education too often focus on the short term, but also because there are good reasons for being much more cognizant of the health effects of our policy choices.

One serendipitous effect of a more health-focused approach to understanding the effects of full-day kindergarten is the proclivity of public health scholars to provide exhaustive accounts of the pathways through which policies achieve their effect. Here, the researchers’ theoretical model for how full-day kindergarten affects health outcomes for kids as they grow up is one of their most important contributions to the research base:

AJPM Framework Education Policy Is Health Policy: Full Day Kindergarten Edition

Such models are always a little overwhelming, but life is complex. And without a thorough account of the ways an intervention might affect students, it is easy to be confused or misled about some research findings on the subject.

Such a model is critical in full-day kindergarten, where the concept of the “fade-out effect” has wreaked considerable damage on our understanding of full-day kindergarten. Studies certainly have shown that students who haven’t had full-day classes often catch up to their peers who have by later grades, but if you don’t consider why this might be the case, it’s easy to draw the wrong conclusions. Models like these force us to ask why things work the way they do by requiring us to explain the mechanisms at work

This process helps to clarify quite a bit about the effects of full-day kindergarten. As the Task Force helpfully points out, a 2008 survey of elementary teachers revealed that teachers devote a great deal of attention to their struggling students. Full-day students’ early academic advantages mean that those students may appear to be struggling less than their peers coming from half-day classes. So when teachers get a class partially filled with kids who have had the advantage of full-day kindergarten, we would expect them to spend most of their time catching up the ones who haven’t. As a result, the more advanced students end up academically stagnating. Rather than being a defect in the design of full-day kindergarten, what we’re really seeing in the so-called “fade-out” effect are the consequences of filling our kindergarten classes with so many children who haven’t received full-day kindergarten. The time a teacher spends helping students who start out at a disadvantage is time he or she doesn’t spend advancing the rest of the group. Full-day kindergarten isn’t the problem, it’s the solution.

Beyond, the contribution of the model, however, the approach itself is a step in the right direction for thinking about the impacts of education. Though much of our health discourse in this country is dominated by policies related to insurance and health care access, these factors contribute to population health in relatively small ways. As many are noticing, social factors, from nutrition and sanitation to education and earnings are much more important. Though failing to account for such effects is an important problem across many fields, it is especially the case for education generally and full-day kindergarten specifically.  Given both the compelling evidence for educational attainment as central factor in health outcomes and the paucity of studies devoted to the long-term effects of full-day kindergarten, it is encouraging to see an approach to assessing full-day kindergarten from a health perspective.

However, though its conclusions jibe with much of what we already know about full-day kindergarten and have argued in our own issue brief on the subject, the study itself leaves a lot to be desired. First, the meta-analysis on which the study largely relies leaves the researchers unable to report subgroup effects for low-income and minority students. Second, the data’s limitations also prevent the authors from drawing direct conclusions about the long-term effects of full-day kindergarten. As a result, the conclusions rely heavily on inferences made from the literature on pre-k. This seems largely the result of a limited literature on full-day kindergarten and, to their credit, the authors provide a strong developmental psychology case for the relevance of pre-k findings for their conclusions about full-day kindergarten. Still, the limitations of the research base underscore the need for continued investigation and improved research designs that could help inform policy makers thinking about full-day kindergarten investments