The paper examines the long-term health impacts of the Carolina Abecedarian Project (ABC), a high-quality early childhood intervention. Using recently collected biomedical data, the authors find that disadvantaged children randomly assigned to the treatment group had significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s, particularly males. The mean systolic blood pressure among control males was 143, while it was 126 among the treated. One in four males in the control group was affected by metabolic syndrome, while none in the treatment group was. The study addresses statistical challenges such as small sample sizes and multiple hypothesis testing, using exact permutation tests and bootstrap confidence intervals. The findings suggest that early life interventions can prevent disease and promote health, with potential implications for reducing healthcare costs and improving adult health outcomes.The paper examines the long-term health impacts of the Carolina Abecedarian Project (ABC), a high-quality early childhood intervention. Using recently collected biomedical data, the authors find that disadvantaged children randomly assigned to the treatment group had significantly lower prevalence of risk factors for cardiovascular and metabolic diseases in their mid-30s, particularly males. The mean systolic blood pressure among control males was 143, while it was 126 among the treated. One in four males in the control group was affected by metabolic syndrome, while none in the treatment group was. The study addresses statistical challenges such as small sample sizes and multiple hypothesis testing, using exact permutation tests and bootstrap confidence intervals. The findings suggest that early life interventions can prevent disease and promote health, with potential implications for reducing healthcare costs and improving adult health outcomes.