The Lifelong Importance of Preparing for Kindergarten

May 2026

What is the most powerful thing we can do to help young children live longer and healthier lives?

As someone who has spent decades as a pediatric surgeon, my answer might surprise you: prepare them well for kindergarten.

A child’s kindergarten readiness sets them on a trajectory toward a longer, healthier life.

Researchers who have tracked generations of children find that children who enter the classroom physically well, socially and emotionally prepared, and equipped with foundational literacy are far more likely to be reading on target by the end of kindergarten. That strong start makes it more likely they will meet their reading targets in third grade — the critical juncture when children stop learning to read and start reading to learn.

Third-grade reading proficiency is one of the strongest predictors we have of who will graduate high school on time. High school graduation and every step further up the education ladder pays dividends across a lifetime in the form of higher income, less disability and chronic disease, and longer life.

Education Is Health

The link between education and longevity is one of the most robust findings in public health. An analysis of hundreds of studies from around the globe found that each additional year of education lowers a person's risk of premature death by 2%.

The cumulative effect is staggering. The most educated Americans live, on average, 11 years longer than the least educated. With more education comes lower lifetime risks of heart disease. Even simply graduating high school is associated with a 14% lower lifetime risk of heart disease for men and a 32% lower risk for women.

Put plainly, the more education a child completes, the longer and healthier their adulthood is likely to be. We also know that once children fall behind in school, it becomes harder and harder to catch up.

Today, nearly half of children across the country enter kindergarten without the skills and developmental progress they need to thrive.

Why the First Five Years Matter Most

That's why Nemours Children's has launched a kindergarten readiness initiative. It is an ambitious, multiyear effort to prepare entire communities of children for academic success that leads to better lifelong health. We are trying to prove that we, as a health system, can intervene at the population level to improve kindergarten readiness for every child, whether they are our patients or not.

This is classic Whole Child Health: To be ready for kindergarten, children need literacy skills as well as the social and emotional skills to thrive in a classroom of their peers. They can’t do their best in school if they are hungry or worried about housing, if they can't see or hear well, or if they have undiagnosed or poorly controlled health problems. Preparing a five-year-old to start school as a fully engaged learner means addressing all of these things.

Our work stretches from the exam room to early learning center to the halls of Congress — pairing excellent pediatric care with early literacy, nutrition, social-emotional development, and the policy changes that make those things possible at scale. We are building health, not just treating disease.

In the months ahead, I'll share more about what this looks like on the ground, and how community partners are working with us to make it possible. Because helping a child arrive at kindergarten ready to thrive may be the most important investment in lifelong health we can make.