Project Summary This study will investigate links between participation in a large-scale established ECP and life course outcomes across generations of the Chicago Longitudinal Study (CLS) cohort up to age 48 and the current Midwest Longitudinal Study (MLS) scale up of the program by age 19. The central purpose is to determine if CPC participation for different lengths of time affects well-being in three cohorts: CLS participants’ physical and economic well-being in midlife, the educational well-being of participant’s children, and impacts in the present context for a 2012-2013 preschool cohort (MLS). Federal earnings and health data will be analyzed in collaboration with federal agencies. The key outcomes are cardiovascular health, socioeconomic status and career success, and school achievement, attainments, and health for the younger cohorts. Mechanisms of change also are assessed. Among the major questions are (1) Is participation in the CPC program associated with better well-being by age 48, including physical health (e.g., disease onset, mortality), economic and career success, and health behavior?, (2) Does participation affect the educational and economic well-being of CLS offspring in the 20s?, (3) Are effects in the MLS through high school similar to the CLS, and (4) What mechanisms of change from individual to community contexts of inequality contribute to long-term impacts and by sex and early family risk? By expanding the CLS to age 48 and intergenerationally, the study will assess for the first time the full impact and cost-effectiveness across generations of this continuing large-scale program. Prospective longitudinal studies beginning early in life and continuing into midlife remain very rare, especially for low-income Black children in urban contexts. No studies of sustained ECPs have continued through midlife. In addition to having a large sample with high rates of retention (91% for 1,400 program and comparison individuals [93% Black]), CLS members also enrolled in K-3 services thus enabling an assessment of the added value. The importance of assessing long-run and intergenerational impacts is elevated by the increasing priority on ECPs in the context of the pandemic and systemic racism and structural inequality. Given the expansion of programs and evidence that the quality and continuity of most are not sufficient for sustained gains, evidence in the MLS (N = 1985 in Chicago) is needed more than ever. In the next five years, we will collect, obtain, and analyze a comprehensive set of data for the three across- generation cohorts, with the MLS children followed through high school. In collaboration with the Census Bureau and Centers for Medicare and Medicaid, we will assess for the first time the impact of CPC for a complete profile of SES and health outcomes, and changes over time. Mechanisms of change also are probed. A CLS offspring survey for over 700 young adults will assess impacts on education and health. Generalizability of the MLS to current practice is assessed. New knowledge will strengthen scale up of early childhood investments. CLS is the largest and longest- running ECP study. The project is not only unique in following existing cohorts but is resource efficient. Only by integrating long-term and intergenerational data will a complete understanding of ECP benefits be achieved.

A major goal of early childhood investments is to promote healthy development across the life course, especially for children growing up in poverty. By assessing the effects of the preschool-to-3rd grade Child-Parent Center (CPC) program on physical health, economic well-being, and education up to age 48 in two cohorts and for young adult offspring, a more complete understanding of the breadth and depth of benefits will be achieved. Findings will identify elements and structural contexts by which gains are sustained, maximize health benefits, and reduce disparities.