Preschool and child health: Evidence from China's universal child care reform

Early childhood education programs have been found to effectively promote children's social and cognitive development. However, the health impact of these programs is less understood. Using a quasi-experiment of the first universal child care reform in China from 2010, this paper aims to identify whether the preschool reform produces any short-term effects on health-related outcomes of preschoolers (3-6 years old). Specifically, this reform expands access to affordable preschools that provide full-day center-based education, with school meals and essential health services on campus. I exploit the variation in the number of newly established preschools across provinces and implement difference-in-differences and triple-difference strategies. Results confirm the effectiveness of this reform by showing a strong and positive impact on preschool attendance. This paper then documents the benefits to alleviating underweight among preschoolers. Estimates show a larger effect in rural areas, suggesting that the reform narrows rural-urban disparities in education access and undernutrition prevention. I also explore the impact on caregivers’ health consciousness and find improved health-seeking behavior when children get sick.