Pre-K programs are educational programs designed for 3- and 4-year-olds that focus on school readiness as well as early learning skills like literacy, numeracy, cognitive development, socio-emotional development, and/or motor skills. To say a jurisdiction has “universal” pre-k means it is open to any child, regardless of family income, a child’s abilities, or other factors. Such programs are run in several ways: localities or states can provide the funding and infrastructure for Pre-K; community agencies and private providers may offer Pre-K programming; and sometimes federally funded school readiness programs are offered, such as Head Start. Some focus on different age categories (3-year-olds vs. 4-year-olds or both) or on specific populations such as at risk/low income students. 


Access to high quality early childhood education programs have been found to provide numerous health and societal benefits for children, their families, and communities as whole. These benefits include increased school readiness, better cognitive development for children, and decreased crime rates.

Our understanding of what impacts health is constantly expanding; we know there are many different determinants of health, including biological, environmental, and social factors. Social determinants of health are defined as the conditions in which people are born, grow, live, work, and age. These circumstances and forces include socio-economic status, educational attainment, political systems, health care, and more.

These factors have immense impacts on the health of individuals, populations, and communities. In fact, one’s zip code is often a better predictor of health than one’s DNA. Cities are working to address a variety of these elements, including access to high quality early childhood education. In addition to their health benefits, these programs are fiscally responsible: early childhood education programs can provide returns of over $5 for every $1 spent.

One way to increase access to early childhood educational programs is through "Universal Pre-K” programs, which enroll 4-year-olds. In 2015, about 47 percent of 3- and 4-year-olds were enrolled in some kind of pre-school or pre-kindergarten (Pre-K) program.


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Research has demonstrated that there are numerous health, educational, and societal benefits associated with attending high quality Pre-K programs, both in the short term and the long term. Preschool aged children experience a great deal of biological brain development at a young age, achieving 90% of their adult brain volume by age 6. Experiences during early childhood can affect the structural development and neurobiological pathways in the brain, that in turn can dictate aspects of a child’s functional development. Further, Pre-K programs greatly improve school readiness, so that young children are prepared to enter the school system.

Long term benefits of Pre-K have been shown to include improved academic achievement, cognitive development, emotional development, and self-regulation. Pre-K attendance also contributes to a reduction in teen birth rates, crime rates, and maltreatment. Children in poverty may experience even greater benefits, since Pre-K can help to minimize gaps in school readiness that persist between children from low income and higher income families. Future health/societal benefits include reduced crime rates, use of social welfare systems, and improved labor market success.


There are several benchmarks that have been developed to assess and describe what a high quality Pre-K program looks like, and these indicators also help to keep programs continually accountable for the services they provide. The National Institute for Early Education Research (NIEER) provides one example of a set of 10 benchmarks by which they evaluate the quality of state’s Pre-K programs. These benchmarks include:

  • Appropriate education and training for both lead and assistant teachers;

  • Annual professional development requirements, including individual plans and coaching or classroom support

  • Manageable class size and appropriate staff-to-child ratios; and

  • Continued quality improvement systems in place.

The full list of benchmarks came be found on NIEER’s website.

In addition to industry-based benchmarks, states also have Quality Rating Improvement Systems (QRIS), which are voluntary systematic approaches to assess, improve, and communicate the quality of early and school age care and education programs. In some states, programs receive financial incentives for increasing their quality of care. Further, in addition to state powers, many localities possess regulatory power to license early childhood care facilities, which can enable them to issue requirements around providing active outside time and serving healthy food and drinks (e.g., water, low fat milk, and all natural juice) and limiting screen time. For example, New York City Food Standards and regulations prohibit schools from serving any food with artificial trans-fat or deep-frying, and require that water be available at all meals, with no more than 4 ounces of juice be served a day.


Cities and states are always looking for innovative ways to fund Pre-K. One strategy is social impact financing. Sometimes called Pay for Success, this method utilizes investments from the private sector that are eventually paid back by the government as savings accrue. Other funding mechanisms include municipal, nonprofit, and private activity tax-exempt bonds, excise or other taxes, and expanded tax credits and deductions to help families finance education.

Universal Pre-K has been shown to make good fiscal sense for local and state governments. The Win-Win Project, an initiative of the Fielding School of Public Health studied the benefits of universal pre-k and predicted that if implemented in Los Angeles and Philadelphia, it would not only lead to positive results in high school graduation, employment and teen birth rates but would also generate returns for the local and state governments in both cases.