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United States Value:
Percentage of children ages 3-4 who are enrolled in nursery school, preschool or kindergarten
Percentage of children ages 3-4 who are enrolled in nursery school, preschool or kindergarten
77.3% - 53.8%
53.7% - 48.7%
48.6% - 45.0%
44.9% - 40.7%
40.6% - 35.9%
US Value: 49.3%
Top State(s): Vermont: 71.1%
Bottom State(s): North Dakota: 35.9%
Definition: Percentage of children ages 3-4 who are enrolled in nursery school, preschool or kindergarten
Data Source and Years(s): U.S. Census Bureau, American Community Survey, 1-Year Dataset, 2024
Suggested Citation: America's Health Rankings analysis of U.S. Census Bureau, American Community Survey, 1-Year Dataset, United Health Foundation, AmericasHealthRankings.org, accessed 2026.
For many, the path to higher educational attainment starts with early childhood education. Evidence indicates that early childhood education contributes to better health and promotes health equity.
The 2024-2025 school year set a new record high in state-funded preschool funding, although enrollment is lower when compared with the 2023-2024 school year. A significant proportion of these educational programs are failing to meet minimum quality standards, and some states are meeting less than half of their educational standards and requirements.
Investing in early childhood education yields an estimated $4.19 for every dollar spent.
The percentage of children ages 3-4 enrolled in early childhood education is higher among:
Strategies to increase enrollment in early childhood education include:
The Community Preventive Services Task Force recommends implementing high-quality, center-based early childhood education programs. These programs promote health equity and are associated with narrower educational achievement gaps, especially for children in low-income or racial/ethnic minority communities. For example, Head Start programs are federally funded services that promote school readiness in children from low-income families. Children participating in Head Start programs are more likely to pursue and complete higher education.
A 2026 report from the National Council of State Legislatures provides a summary of early childhood education legislation that has been enacted at the state level by bill category, driven by the child care crisis in the United States.
Healthy People 2030 is developing an objective to increase the proportion of children who participate in high-quality early childhood education programs.
Barnett, W. Steven, and Jason T. Hustedt. Improving Public Financing for Early Learning Programs. Preschool Policy Brief Issue 23. New Brunswick, NJ: National Institute for Early Education Research, April 2011. https://nieer.org/sites/default/files/2023-08/24-1.pdf.
Community Preventive Services Task Force. “Recommendation for Center-Based Early Childhood Education to Promote Health Equity.” Journal of Public Health Management and Practice 22, no. 5 (September 2016): E9–10. https://doi.org/10.1097/PHH.0000000000000354.
Friedman-Krauss, Allison H., W. Steven Barnett, Katherine S. Hodges, Karin A. Garver, G. G. Weisenfeld, Jennifer K. Duer, and Jessica A. Siegel. The State of Preschool 2025: State Preschool Yearbook. New Brunswick, NJ: National Institute for Early Education Research, 2026. https://nieer.org/sites/default/files/2026-04/2025%20NIEER%20Yearbook-ExecutiveSummary.pdf.
Hahn, Robert A., and W. Steven Barnett. “Early Childhood Education: Health, Equity, and Economics.” Annual Review of Public Health 44, no. Volume 44, 2023 (April 3, 2023): 75–92. https://doi.org/10.1146/annurev-publhealth-071321-032337.
National Center for Education Statistics. “School Enrollment Rates of Young Children.” In The Condition of Education 2024. U.S. Department of Education, Institute of Education Sciences, 2024. https://nces.ed.gov/programs/coe/pdf/2024/cfa_508c.pdf.
Ramon, Ismaila, Sajal K. Chattopadhyay, W. Steven Barnett, and Robert A. Hahn. “Early Childhood Education to Promote Health Equity: A Community Guide Economic Review.” Journal of Public Health Management and Practice 24, no. 1 (2018): e8–15. https://doi.org/10.1097/PHH.0000000000000557.
Schoch, Annie D., Cassie S. Gerson, Tamara Halle, and Meg Bredeson. Children’s Learning and Development Benefits from High-Quality Early Care and Education: A Summary of the Evidence. Child Care and Early Education Policy and Research Analysis, August 2023. https://acf.gov/sites/default/files/documents/opre/%232023-226%20Benefits%20from%20ECE%20Highlight%20508.pdf.
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