Healthy Kids, High Grades: Using Data to Evaluate Health and Education Policy
It’s back-to-school time! As kids from across the country get back into classrooms this fall, many of them, at least in Colorado and Minnesota, will be attending a school that will offer free meals to all students through new state programs that voters approved last year. That’s good news for individual students and their classrooms. This post will look at why.
Using innovative data linkages and analysis, research finds that these policies, in combination with other school- and broad-based health policies, effectively enhance not just children’s health and wellbeing but also their reading, math, and classroom behavior. Moreover, the health policy effects on educational outcomes are comparable to a $1,000 increase in per-pupil spending.
Examining the Education Effects of Health Policies
A recent study systematically reviewed and synthesized results from 56 studies to evaluate the causal impact of various health policies targeting school-aged children and their parents on children’s education in the U.S. (Disclosure: this was my study, in conjunction with a graduate student.) We found that several health policies and programs aimed at improving the physical health of children and parents, particularly from low-income households, have positive effects on educational attainment.
For example, nutritional policies in schools, similar to the “Health School Meals for All” program started in Colorado this year, builds on empirical evidence from similar initiatives rolled out by the US Department of Agriculture (USDA) in select districts across the country through a program called the Community Eligibility Provision (CEP). Careful empirical analysis found that the CEP, which was designed to universalize the access to healthy school meals in high poverty school districts, improved children’s math scores (albeit primarily in schools serving the most vulnerable kids from low-income households). Similarly, researchers also found that this policy reduced adverse school disciplinary outcomes—such as suspensions and expulsions across several parts of the country, particularly for children from low-income households.
Reducing Hunger Improves Performance in School
Food insecurity affected nearly 10 million children in 2019 according to estimates from the USDA. This situation increased during the height of the pandemic despite stop-gap arrangements such as the pandemic-EBT. Research has shown the deleterious effects of food insecurity on a whole host of learning and socioemotional outcomes for children. Some children end up eating their only meal in school. This makes school-based nutritional policies an important complement to other broad-based, nutritional policies—such as the Supplemental Nutritional Assistance Program (SNAP). Studies find that at the end of the SNAP benefit cycle, students experience negative effects on their learning and behavior.
Children Lacking Health Insurance Struggle in School
With child poverty rising dramatically in recent weeks, it is hard not to stress the importance of access to subsidized, quality healthcare for our most vulnerable children. While past research clarified the beneficial effects of health insurance access—such as Medicaid and the Children’s Health Insurance Program (CHIP)—on children’s health and wellbeing; more recently, researchers are uncovering the positive, educational effects from these policies as well. When parents gained access to Medicaid through the Affordable Care Act, the benefits transferred over to their children, too. Studies show these children improved their reading scores and reduced the stubborn white-Black math achievement gap, achievement differences in math standardized test scores between white and Black students.
How do these improvements compare to other educational policy reforms? Indeed, we find that these nutritional interventions, while modest in absolute terms, are roughly comparable to a $1,000 increase in per-pupil spending (annually over four years) in schools. Both sets of federal policies/programs (Medicaid/CHIP as well as per-pupil school funding increases) improve student test scores by about 0.04 standard deviations. Although such comparisons across models/policies is not often straightforward, nevertheless, these research findings provide suggestive evidence that targeted, health policy interventions can be quite effective in improving school-aged children’s educational outcomes.
Integrated Data Linkages Can Power Effective Health-Focused Learning Policies
One significant barrier to examining such cross-policy research and policymaking is the lack of high-quality, integrated data. While some states are beginning to develop robust databases that cover health and education outcomes, we have a long way to go. But, by creating data linkages, we can more quickly find and replicate solutions that support student outcomes.
There are a few such projects underway. For example, California’s “cradle-to-career” is an example of an excellent statewide, longitudinal data system, which plans to connect data on early education, K-12 schools, colleges, social/health services, and employment. Similarly, states like Minnesota, and Wisconsin have also invested in such administrative data linkages between birth records, child welfare, and education data systems.
Indeed, the Institute of Education Science’s (IES) statewide longitudinal database system program has expanded across the country and education sectors (e.g., P-20/workforce expansions) since 2019. However, modernization and expansions that prioritizes linkages with other key social innovation issues—such as health—through innovative data linkages between education and health and human services, vital statistics (birth records), Centers for Medicare & Medicaid Services (CMMS), and child welfare systems represents a huge opportunity.
We hope that such linked datasets will be opened to researchers and policymakers across the country, not least because such datasets have been integral for the development of this nascent literature. For example, one study that used such linked data from Florida to examine the negative effects of environmental pollution on children’s academic achievement. Similarly, another study used linked birth-records and education data to examine the effect of Medicaid access among low-income parents on their children’s reading outcomes in Iowa.
We always knew that healthy children do better in school—they pay better attention in class, disrupt less frequently, and learn better when they are healthy and happy. We now have rigorous empirical research to show the precise effects of such health policies on the most vulnerable children’s education. More parents, policymakers, and researchers will gain more knowledge at the health-education nexus when data is shared.
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