The PBS Newshour recently ran an article by John Komlos that summarizes some of the work by Nobel-Prize winning economist James Heckman and others on inequality and early childhood development.
The bottom line is that the human fetus, and then the infant in its early years, faces serious developmental challenges. The absence of nutrition or health care at certain critical junctures results in permanent underdevelopment of adult capacities.
The cost to society in terms of lost human capital is staggering, and as you would suspect, the cost of prevention would be much cheaper. Yet prevention (e.g., through universal health care) has not been a top agenda item in the American political economy landscape.
America is all about the ideology of the individual achiever, overcoming obstacles on his own, with no help from society.
Yet the fetus and the infant cannot be individual achievers! They are completely dependent on parents or other care givers. And the culture of low income parents can often lead to behaviors that exacerbate human capital formation in their own offspring.
Heckman thus concludes that, ““the accident of birth is the greatest source of inequality in America today.”