Fitzpatrick C, Boers E, Pagani L. (2020). Kindergarten Readiness, Later Health, and Social Costs. Pediatrics, 146(6): e20200978.
OBJECTIVES : To estimate associations between kindergarten readiness and academic, psychological, and health risks by end of high school. METHODS: This study is based on 966 Canadian children. At age 5, trained examiners assessed child number knowledge and receptive vocabulary. Teachers reported kindergarten classroom engagement. At age 17, participants reported academic grades, school connectedness, anxiety sensitivity, substance abuse, physical activity involvement, and height and weight. High school dropout risk was also estimated for each participant on the basis of grades, school engagement, and grade retention. RESULTS: Kindergarten math skills contributed to better end-of high school grades (β = .17, P < .01) and lower dropout risk (β = −.20, P < .001), whereas receptive vocabulary predicted lower anxiety sensitivity (β = −.11, P < .01). Kindergarten classroom engagement predicted higher end of high school grades (β = .17, P < .001), lower dropout risk (β = −.20, P < .01), better school connectedness (β = .15, P < .01), lower risk of substance abuse (β = −.21, P < .001), and more physical activity involvement (β = .09, P < .05). Kindergarten classroom engagement was also associated with a 65% reduction (odds ratio = 0.35) in the odds of being overweight at age of 17. Analyses were adjusted for key child (sex, weight per gestational age, nonverbal IQ, and internalizing and externalizing behaviors) and family (parental involvement, maternal depression and immigrant status, family configuration, and socioeconomic status) characteristics. CONCLUSIONS: Early childhood readiness forecasts a protective edge by emerging adulthood. With these findings, we build links between education and health indicators, suggesting that children who start school prepared gain a lifestyle advantage. Promoting kindergarten readiness could reduce the health burden generated by high school dropout.