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Original Investigation
June 7, 2021

Childcare Attendance and Academic Achievement at Age 16 Years

Author Affiliations
  • 1School of Public Health, University of Montreal, Montreal, Quebec, Canada
  • 2Department of Economics, Université du Québec à Montréal, Montreal, Quebec, Canada
  • 3Department of Criminology, University of Montreal, Montreal, Quebec, Canada
  • 4Montreal Mental Health University Institute, Montreal, Quebec, Canada
  • 5Department of Psychology, King’s College London, London, United Kingdom
  • 6University of Bordeaux, INSERM U1219, Bordeaux, France
  • 7Sainte-Justine’s Hospital Research Center, Montreal, Quebec, Canada
JAMA Pediatr. Published online June 7, 2021. doi:10.1001/jamapediatrics.2021.1192
Key Points

Question  What is the benefit-cost ratio of investing in childcare services regarding productivity returns of academic achievement at the end of compulsory schooling?

Findings  In this cohort study including 8936 children, childcare attendance was associated with higher academic achievement at the end of compulsory schooling only for children of mothers with lower education. The benefit-cost ratio for each £1 (US $1.40) invested in full-time childcare attendance for children of mothers with low education was £1.71 (US $2.39) for those who achieved a Level 2 General Certificate of Secondary Education qualification.

Meaning  These results suggest that subsidizing childcare attendance for children of mothers with low education would yield economic benefits in the long run.


Importance  Low school preparedness is linked to high school dropout, poor employment, and negative outcomes. Childcare attendance may increase school readiness and foster academic achievement.

Objective  To explore whether childcare attendance was associated with academic achievement at the end of compulsory schooling (age 16 years in the UK), whether maternal education level was a moderator, and the benefit-cost ratio of childcare regarding productivity returns of academic achievement.

Design, Setting, and Participants  In this cohort study, data were included from the Avon Longitudinal Study of Parents and Children (ALSPAC) born from April 1991 to December 1992 and the UK National Pupil Database for examination results. Data on academic achievement at age 16 years were available for 11 843 participants. Data were collected from June 2006 to June 2008, and data were analyzed from September 2019 to May 2020.

Exposures  On average, 3.7%, 5.9%, and 90.4% attended childcare full time, part time, and less than 10 hours per week, respectively. Maternal education was assessed by questionnaire during pregnancy. Analyses included weights for population representativeness and propensity score weights to account for parental selection into childcare.

Main Outcomes and Measures  Academic achievement was defined as no certificate, Level 1 General Certificate of Secondary Education (GCSE; limited training), or Level 2 GCSE (qualification for academic post-16 education; high school diploma equivalent). Lifetime productivity return estimates were withdrawn from previous economic analysis based on pupil’s qualifications.

Results  Of 14 541 children in the ALSPAC study, 8936 children had complete data on childcare attendance, academic achievement, and maternal education levels. Of these, 4499 (50.3%) were male. Attending childcare was associated with higher probabilities of obtaining a Level 1 or 2 GCSE qualification (Level 1: relative risk, 1.41; 95% CI, 1.16-1.73; Level 2: relative risk, 1.62; 95% CI, 1.30-2.01); however, this association was moderated by the child’s maternal education level. When children of mothers with low education attended childcare, their probability of no GCSE qualification went from 28.9% (95% CI, 26.8-31.0) to 20.3% (95% CI, 18.0-22.8), whereas children of mothers with higher education had a probability of no qualification of less than 10% regardless of childcare attendance. The benefit-cost ratio for each £1 (US $1.40) invested in full-time childcare attendance for children of mothers with low education was £1.71 (95% CI, 1.03-2.45; US $2.39; 95% CI, 1.44-3.43) for those who reached a Level 2 GCSE qualification.

Conclusions and Relevance  Promoting universal childcare with facilitated access for children of lower socioeconomic backgrounds deserves to be considered as a way to reduce the intergenerational transmission of low academic achievement.

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    1 Comment for this article
    ROI for Social Capital Investments
    Paul Nelson, MS, MD | Family Health Care, PC retire
    The ROI for Social Capital investments in education is generally recognizable as 3:1 (viz 7:1 for early childhood education). For disaster mitigation, the ROI is generally 4-6:1. This study adds subsidized childcare for children of parents with limited educational achievement to our general understanding of early childhood education. Along with parental leave, we are slowly acknowledging the future requirements for reducing the "population health" prevalence of entrenched social isolation and social mobility.