The Child-Parent Center Education Program and Midlife Physical and Mental Health

• In Event: The Child-Parent Center Program and Age 40 Well-Being: Impacts and Returns, Processes, and Scale Up Evidence

Abstract

Decades of research reveal systemic health disparities in the United States by income and race/ethnicity - underscoring a need for preventive interventions. Since the 1960s, early childhood programs such as the Child-Parent Centers (CPC) have aimed to enhance academic outcomes among low-income populations (Reynolds, 2000). Many of these programs have held complementary goals of enhancing health and wellbeing. However, these outcomes have been under-studied. Thus, important questions remain about whether interventions can reduce not only educational disparities, but long-term health disparities.

This study draws from the Chicago Longitudinal Study, which follows 1,539 individuals who grew up in urban poverty in the 1980s. The sample includes 989 CPC preschool graduates and 550 demographically matched comparison group members. Participants were surveyed at age 35-37. Drawing on previous research and transactional-ecological models, we hypothesized that participation in CPC preschool and school-age services would be associated with significantly lower rates of depression, and higher psychological wellbeing and physical health in adulthood.
Methods

Table 1 displays baseline characteristics of the midlife sample. 1,104 participants completed the survey, representing a completion rate of 74.8% of living participants. Program and comparison groups were equivalent at baseline. 60% of the CPC group participated to 3rd grade (P-3).

Outcome data were from self-reports on the Age 35-37 survey. Depressive symptoms were from the Brief Symptom Inventory Scale (Derogatis, 1975) and also included a dichotomous variable reflecting at least one clinically significant symptom. Psychological wellbeing was based on the 18-item Ryff Scales (e.g., “life has been a continuous process of learning…”; Ryff & Keyes, 1995).

Physical health outcomes included Body Mass Index (BMI) and obesity (BMI ≥ 30), diabetes, and two composites of cardiovascular health, the Framingham Risk Score (FRS; higher = unhealthier) and American Heart Association score (AHA; higher = healthier).

Results and Discussion

Linear and logit regression analyses were conducted with baseline covariate being family demographic risks, sex, race, birthweight, early adversity, and neighborhood poverty. CPC preschool at ages 3 and/or 4 was associated with significantly higher psychological wellbeing (β = 0.12; p < .01) but not depressive symptoms (Table 2). CPC preschool was marginally associated with BMI ((β = -1.0; p = .055) but not obesity. CPC was associated with a healthier FRS and a marginally better AHA score (p = .056). CPC preschool also significantly reduced the odds of diabetes (odds ratio = 0.37; p < .05).

Although school-age services showed no linkages, CPC participation to 3rd grade (P-3) relative to lesser participation was associated with lower FHS and diabetes, and a healthier AHA score. Analyses of subgroups and paths of change will be further assessed, with educational attainment being a latter focus. Finding indicate that a large-scale early childhood program links to higher psychological wellbeing and physical health. Benefits tended to increase with longer duration. High quality, comprehensive prevention programs can affect health outcomes in the consequential midlife period. The program elements and processes that most contribute will enhance generalizability to other programs and contexts.

Authors

• Christina Mondi-Rago, Boston Children's Hospital
  Presenting Author

• Lauren Eales, University of Minnesota - Twin Cities
  Non-Presenting Author

• Arthur Reynolds, University of Minnesota - Twin Cities
  Non-Presenting Author

• Suh-Ruu Ou, University of Minnesota - Twin Cities
  Non-Presenting Author

• Alison Sara Giovanelli, University of California - San Francisco
  Non-Presenting Author