Early childhood investments substantially boost adult health.
Early childhood investments substantially boost adult health.
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DOI：
10.1126/science.1248429
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发表时间：
2014-03-28
期刊：
影响因子：
--
通讯作者：
Pan Y
中科院分区：
文献类型：
--
作者：
Campbell F;Conti G;Heckman JJ;Moon SH;Pinto R;Pungello E;Pan Y
高质量的儿童早期教育项目已被证明在减少犯罪、增加收入和促进教育方面有很大的好处。人们对它们对成人健康的益处知之甚少。我们报告了一种最古老和被引用最多的儿童早期干预措施的长期健康影响，并通过随机化的方法进行了长期跟踪评估：卡罗莱纳初学者项目(ABC)。使用最近收集的生物医学数据，我们发现随机分配到治疗的弱势儿童在35岁左右时心血管和代谢性疾病的风险因素患病率显著较低。这一证据对男性来说尤其有力。对照组男性的平均收缩压为143，而接受治疗的男性仅为126。对照组每四名男性中就有一人受到代谢综合征的影响，而治疗组没有。为了得出这些结论，我们解决了几个统计挑战。我们使用精确的置换检验来解释小样本量，并进行并行Bootstrap可信区间分析来证实置换分析。我们调整推论，以解释测试的多个假设和非随机磨损。我们的证据表明，早期生活干预在预防疾病和促进健康方面具有潜力。
High-quality early childhood programs have been shown to have substantial benefits in reducing crime, raising earnings, and promoting education. Much less is known about their benefits for adult health. We report the long-term health impacts of one of the oldest and most heavily cited early childhood interventions with long-term follow-up evaluated by the method of randomization: the Carolina Abecedarian Project (ABC). Using recently collected biomedical data, we find that disadvantaged children randomly assigned to treatment have significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s. The evidence is especially strong for males. The mean systolic blood pressure among the control males is 143, while only 126 among the treated. One in four males in the control group is affected by metabolic syndrome, while none in the treatment group is. To reach these conclusions, we address several statistical challenges. We use exact permutation tests to account for small sample sizes and conduct a parallel bootstrap confidence interval analysis to confirm the permutation analysis. We adjust inference to account for the multiple hypotheses tested and for nonrandom attrition. Our evidence shows the potential of early life interventions for preventing disease and promoting health.
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