Duke 2008 | ASHE | Equity and Efficiency in Health and Healthcare

The link between early childhood conditions and adult outcomes suggests that public investments in the health and human capital of poor youths may significantly improve individual and social welfare. Beginning with the War on Poverty in 1965, the Head Start program has been one of the largest federal investments in the development of disadvantaged children, providing educational, health, nutritional, and social services to over 24 million children. Participation in Head Start is generally associated with improvements in health and human capital; however, there has been little research on the impact of the differences in Head Start services on health outcomes. One important difference is that federal guidelines require that children in half-day classes receive at least 1/3 of the recommended daily allowance of nutrients through meals and snacks, while children in full-day classes are provided with twice that amount. This research examines the impact of variation in the intensity of Head Start services (full-day attendance compared to half-day attendance) on childhood obesity and nutrition. Using unique, restricted data from a Head Start program in Michigan from 2001 to 2006, we examine the information of approximately 1500 participants, their families, and Head Start centers. These data include height and weight measured at the beginning and end of the program year. We compare the change in obesity status of children enrolled in full-day services to those enrolled in half-day services to estimate the marginal impact of additional Head Start services as opposed to the average treatment effect of the Head Start program. A benefit of this approach is that is allows for selection on unobserved characteristics to influence the decision to participate in Head Start. We utilize the extensive information on pre-Head Start characteristics to control for nonrandom selection into full day services. Additionally, we use an unexpected elimination of a state-provided full-day expansion grant in 2002 that reduced the program options to half-day classes in subsequent years for the majority of participants to identify the impact of full-day services. Preliminary results suggest that full-day services reduce the rate of obesity at the end of the year by approximately an additional four percentage points more than half-day services.