A Quasi-Experimental Study of the Effects of Pre-Kindergarten Education on Pediatric Asthma

Rie Masuda, Paul Lanier, Ellen Peisner-Feinberg and Hideki Hashimoto
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Rie Masuda: Faculty of Political Science and Economics, Waseda University, Shinjuku, Tokyo 169-8050, Japan
Paul Lanier: School of Social Work, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Ellen Peisner-Feinberg: School of Education, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Hideki Hashimoto: Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo, Tokyo 113-0033, Japan

IJERPH, 2021, vol. 18, issue 19, 1-18

Abstract: Ensuring access to pre-kindergarten (Pre-K) education remains a pressing policy issue in the United States. Prior research has shown the positive effects that Pre-K has on children’s cognitive development. However, studies on its effects on children’s health outcomes are scarce. This study aimed to investigate the effects of the Pre-K program on pediatric asthma. Children’s individual data from existing research conducted in North Carolina were linked with state Medicaid claims data from 2011–2017. There were 51,408 observations (person-month unit) of 279 children enrolled in Pre-K and 333 unenrolled children. Asthma was identified using the ICD 9/10 codes. A difference-in-differences model was adopted using a panel analysis with three time periods: before, during, and after Pre-K. The explanatory variables were interaction terms between Pre-K enrollment and (a) before vs. during period and (b) during vs. after period. The results indicated that children enrolled in Pre-K had a greater risk of asthma diagnosis during Pre-K ( b = 0.0145, p = 0.058). Conversely, in the post-intervention period, the enrolled children had a lower of receiving an asthma diagnosis ( b = ?0.0216, p = 0.002). These findings indicate that Pre-K may increase the use of asthma-related health services in the short term and decrease the service use after participants leave the program.

Keywords: Pre-K; child asthma; Medicaid; difference-in-differences; propensity score weighting (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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