New Publication: Full-day Kindergarten Boosts Health Equity for Low-Income, Minority Kids

A teacher turns the pages of a picture book for a group of childrenStrong scientific evidence shows that low-income and minority children who attend full-day kindergarten improve their reading and math skills, and that this is associated with better prospects for good health. The Community Preventive Services Task Force (Task Force) issued the following recommendation based on a systematic review of the literature that was conducted by scientists and subject matter experts from the Centers for Disease Control and Prevention (CDC). The review was carried out with Task Force oversight, in collaboration with a wide range of government, academic, policy, and practice-based partners.

  • The Community Preventive Services Task Force recommends full-day kindergarten programs to improve the health prospects of low-income and racial and ethnic minority children, based on strong evidence that full-day programs substantially improve reading and mathematics achievement determinants of long-term academic and health-related outcomes (e.g., reduced teen pregnancy and risk behaviors) when compared with half-day kindergarten or full-day kindergarten on alternating days.
  • The achievement gains apparent at the beginning of first grade do not, themselves, guarantee academic achievement in later years. Ongoing school environments that support learning and development are essential.
  • Because academic achievement is linked with long-term health, and because full-day kindergarten programs are commonly implemented in racial and ethnic minority or low-income communities, these programs are likely to improve health equity. Equity in health is the widespread, achievable, equality in health and in the major social determinants of health in all the principal social divisions of a population.

The economic evidence indicates that full-day kindergarten costs more than half-day kindergarten, but may offer significant benefits including lifetime gains in earnings if the achievement gains from full-day kindergarten could be sustained to the end of high school.

The recommendation and systematic review are published in the March 2014 American Journal of Preventive Medicine.

What is meant by “full-day kindergarten”?

  • Full-day kindergarten is a formal program offered for children aged 4 to 6 years in a school or school-like setting during the school year prior to entering first grade. Activities are organized, developed, and supervised by at least one adult. Full-day kindergarten programs run 5 days per week and last 5 to 6 hours per day. The goals of kindergarten are to prepare children academically, socially, and emotionally for effective participation in the educational system.

Why is the Task Force recommendation important?

  • Educational attainment is one of the most important determinants of health. (Feinstein et al. 2006; CSDH 2008)
  • Children from low-income and minority families are often behind higher-income and majority children in language, cognitive, and social development even before they enter school. Because educational achievement has been shown to improve long-term health, addressing these delays may foster greater health equity (Community Preventive Services Task Force, 2014).

What are the Task Force and Community Guide?

  • The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, uncompensated panel of public health and prevention experts. The Task Force works to improve the health of all Americans by providing evidence-based recommendations about community preventive programs, services, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community prevention services, public health, health promotion, and disease prevention.
  • The Guide to Community Preventive Services (The Community Guide) is a collection of all the evidence-based findings and recommendations of the Community Preventive Services Task Force.
  • The Centers for Disease Control and Prevention (CDC) is mandated by the U.S. Congress to provide ongoing administrative, research, and technical support for the operations of the Task Force. CDC is therefore committed to working with the Task Force to systematically review the scientific evidence on population-based strategies to reduce the burden of preventable disease, injury, and disability.

For More Information


Commission on Social Determinants of Health (CSDH). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: WHO, 2008. Available at URL:

Community Preventive Services Task Force. Recommendation for full-day kindergarten for children of low-income and racial/ethnic-minority families. [PDF – 162 kB] Am J Prev Med 2014;46(3):324 6.

Feinstein L, Sabates R, Anderson TM, Sorhaindo A, Hammond C. What are the effects of education on health? Measuring the effects of education on health and civic engagement. Proceedings of the Copenhagen Symposium, 2006.

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