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Social Determinants of Health: Education

The national average for high school graduation has been steadily increasing over the years. However, 20 percent of the students who started with their freshman class are still missing their diplomas. Over their lifetime, this group will most likely earn substantially less than their graduating classmates – potentially reducing their access to healthier foods, safer homes, and better neighborhoods – and ultimately experience worse health outcomes.

Education is a significant social determinant that influences health over the course of a lifetime. Levels of educational attainment have been directly linked with important health outcomes such as self-rated health, infant mortality, and life expectancy. The data is striking: Across all racial and ethnic groups, adults with lower educational attainment are more likely to report worse health outcomes; babies of mothers who did not graduate high school are twice as likely to die before their first birthday; and college graduates are expected to live at least five years longer than individuals who have not completed high school. Moreover, a recent report estimates that decreasing dropout rates could save nearly $7.3 billion Medicaid dollars annually.

Looking at these statistics it is easy to see that graduating high school can be one of the most significant life events for an individual’s health. There are a number of reasons why students drop out, but poor performance due to health problems can be a major factor. Therefore, treating health issues that impact learning and performance is a critical intervention to ensure better health outcomes down the road.

School-Based Interventions Are an Essential Investment

Providing medical care at every stage of the educational years can help students perform well in school, reduce absenteeism, and promote high school graduation. To this end, a number of essential hospitals are stepping in and partnering with local schools to promote better school performance and health outcomes.

One example is Arrowhead Regional Medical Center’s Breathmobile. This program focuses on asthma management, which is often a leading cause of absenteeism. The Breathmobile, a mobile asthma clinic, visits 43 participating schools every six weeks to provide full exams and care plans for asthmatic children. Not only has this program seen improved health outcomes and decreased ED visits, but it has also shown an 83 percent decrease in missed school days due to asthma.

Additionally, the Health Care District of Palm Beach County runs the School Health Program, which employs a registered nurse at each of the 169 public schools in the county. These nurses provide medical care to keep students healthy and prepared to learn each day. Their duties include first aid, administering medications as directed by physicians, verifying that immunizations are up to date, administering vision and hearing tests, and providing case management for chronic conditions. For many students whose families may be struggling financially, these school nurses may be the only primary care providers their children see all year. Having this free and comprehensive medical service available helps ensure all students stay healthy and stay in school.

Similarly, many essential hospitals collaborate with local school-based health centers (SBHCs). For example, Contra Costa Health Services, Denver Health, and Henry Ford Health System all employ health care providers at one or multiple SBHCs in their local area.

Education = Health

Investing in education equates to investing in health, and vice versa. Treating health issues during the school years can lead to better academic performance and educational achievements, which lead to better adult health outcomes and cost savings. Modeling after the hospitals discussed above, essential providers should seek to invest in the health and education of local school children. It is never too late to help a student get back on track at school, and doing so can mean all the difference in providing a healthier future.

EssentialCommunities.org provides a resource for hospitals on the journey to community-integrated health care. Learn more about how our hospitals address social and economic factors that influence health, take a virtual tour of population health programs nationwide, and share a program of your own.

Visit EssentialCommunities.org »

About the Author

Janelle Schrag is a senior program analyst with America's Essential Hospitals.

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