Learning First Alliance

Strengthening public schools for every child

Healthier Students are Better Learners

obriena's picture

It has long been suggested that health disparities between low-income kids and their peers contribute to the academic achievement gap. If you are looking for evidence to support that theory, a recent research review by Charles E. Basch—Healthier Students are Better Learners: A Missing Link in School Reforms to Close the Achievement Gap—offers it.

Long story short (and it is a long report), Basch describes the evidence showing how groups of children differ in the incidence of (and access to care for) each of seven “educationally relevant health disparities”: vision, asthma, teen pregnancy, aggression and violence, physical activity, breakfast, and inattention and hyperactivity. He also reviews evidence on the “causal pathways affecting educational outcomes” (I think that means he shows that not only are there disparities, but that these disparities actually do affect achievement).

One brief, and extremely simplified, example: Children with asthma sleep less. Children who sleep less tend to have worse academic performance than those who sleep more, because sleep influences cognitive function. Low-income children, for a variety of reasons, have asthma at higher rates than middle- and upper-income children. So even assuming that low-income children come to school with all else equal and that they then attend schools that do an equally good job of educating them (both things we know not to be true), these health disparities put them at a disadvantage.

Say you buy Basch’s argument, and you believe that health disparities widen the achievement gap. The next question is, so what? Is it the job of the school to provide health care to students? Many argue no. But they also argue that schools must overcome the disparities that kids come to school with and make sure that all kids achieve at the same level.

Here’s a thought: Maybe schools themselves do not have to provide medical care to students. But maybe schools can partner with others in the community and provide a space where those whose job it is to provide medical care to children can do so. Such spaces are called school-based health centers, and there are about 2,000 in the United States.

The school-based health center is gaining political support. It fits into the Obama administration’s Promise Neighborhoods initiative. The new Patient Protection and Affordable Care Act creates federal grant programs to fund the expansion and support of school-based health centers (learn more from the National Assembly on School-Based Health Care here).

And research supports it. Studies have shown that school-based health centers have reduced inappropriate emergency room use. They have reduced Medicaid expenditures. And they have decreased absences and discipline referrals (the National Assembly on School-Based Health Care summarizes the research and provides academic references here). While a direct link to academic performance is still unproven, it is not a hard leap to think that decreased absences and discipline problems can help us in our school reform efforts. This promising strategy deserves more attention.

Read some brief stories on places where school-based health clinics have been tried: Montrose County School District RE-1J (CO), Washington Elementary School (NJ) and Chula Vista (CA). Tomorrow look for an in-depth story on how Montrose County School District RE-1J planned and implemented its school-based health centers.  And stay tuned next week for a conversation with a Montrose nurse practitioner on the day-to-day work and outcomes of these clinics.