The health effects of universal early childhood interventions: evidence from Sure Start

Early Childhood Interventions (ECI) offering disadvantaged children education, care and family services in the US show long-lasting health impacts. Can these benefits hold when these programs are offered in contexts with universal healthcare? We estimate the health impacts of Sure Start, a universal integrated ECI in England, from infancy to adolescence exploiting its rollout and administrative hospitalizations data. One additional Sure Start center per thousand age-eligible children increases hospitalizations by 10% at age 1, largely driven by infections. Admissions at ages 11-12 are reduced by 8-10%, and driven by injuries and mental health related admissions. Impacts are concentrated in disadvantaged areas.