Category Archives: Education Level
“For too long, we’ve thought of health as something that happens to you in a doctor’s office,” explained Howard Koh, U.S. Department of Health and Human Services Assistant Secretary for Health on Monday at the American Public Health Association (APHA) 2013 meeting. “We have about 20 leading health indicators that we look at closely, one of them is high school graduation.”
Koh went on to describe social efforts such as boosting graduation rates as among the most important things we can do to improve health for the future. He also discussed the important role that learning plays in being healthy—and that being healthy can also free kids up to focus and get a better education. The assistant secretary’s sentiments kicked off a panel on the indelible connection between the nation’s drop-out crisis and public health, and the ways in which we can achieve success in both.
Robert Balfanz of the Johns Hopkins School of Education began by describing the drop out epidemic: the overall graduation rate in the United States is as low as 78 percent and is far lower in some communities with the greatest inequities. In fact, one third of all schools produce 85 percent of the country’s drop outs. Chronic absenteeism, often related to student health, is the leading cause of the issue. For example, 25 percent of students in one city missed a year or more of schooling over a five-year period.
Health factors have a significant impact on academic success and graduation rates. According to Charles Basch of Teachers College at Columbia University, health issues such as poor vision, asthma and teen pregnancy inhibit student success, disproportionately so in children of urban, minority communities. Left unaddressed, these issues can form causal pathways to the increased likelihood of dropping out.
In 2011, Sonoma County in California established the division of Health Policy, Planning and Evaluation (HPPE) in an effort to move the county up in the County Health Rankings, toward a goal of becoming the healthiest in the state by 2020. As the director of the division, Peter Rumble, MPA, has played a critical role in the development of numerous programs and policy efforts to help create opportunities for everyone in Sonoma County to be healthy. Rumble has worked on programs and policies that go beyond traditional public health activities and aim to address the root causes of poor health, including the local food system, education and poverty.
Following his presentation at the International Making Cities Livable Conference, NewPublicHealth was able to speak with Rumble about the ways in which his work with HPPE is pushing to achieve health equity in Sonoma County. Rumble will soon move into a position as Deputy County Administrator of Community and Government Affairs for the County of Sonoma, where he plans to continue his commitment to a vision of health and quality of life for the county.
NewPublicHealth: Sonoma is making a concerted effort to help address the root causes of poor health, like poverty and lack of education. Tell us about some of those efforts.
Peter Rumble: Health Action is our real heartbeat of addressing social determinants of health, and it’s a roadmap for our vision of being the healthiest county in California by 2020. Health Action is a community council that advises the Board of Supervisors. There are 45 seats on the council, including elected officials, individual community leaders, nonprofit leaders, and representative from the business, financial, labor, media, transportation and environmental sectors. If you pick a name out of the hat for all of the sectors in the community, we’ve got somebody who either directly or tangentially represents that sector. That group began talking about needing to do something around health in 2007.
If we’re going to be the healthiest county in California by 2020, what do we need to do to achieve our ten goals based on the best evidence available? We certainly have goals associated with the health system, but predominantly, we’re focused on influencing the determinants of health. Our first goal is related to education. We want all of our children to graduate from high school on time and ready to either enter a thriving workforce or go into college or a technical career academy.
We started with some grassroots initiatives. Being a real strong agricultural community, iGROW was a good place to start. It was a movement to develop community gardens—for people to tear up their front lawns and plant a garden there, and increasing access to healthy food. That was a huge hit. We set a goal of a few hundred community gardens, and we’re up to a thousand now—it’s just caught fire.
That was all great, but a community garden is not going to make us the healthiest county in California, right? You can see the beautiful posters out on shop windows, you can see your neighbor tore up their front lawn and is growing this beautiful zucchini and has an edible lawn now and all that’s wonderful, but we only have a graduation rate of 70 percent. We’ve got nearly one in four kids living in poverty by the federal poverty standards and if you look at what actually it takes to raise a family in Sonoma County, about half of all families can’t make ends meet.
NPH: Does that surprise people to hear about Sonoma?
Sesuagno Mola of Ethiopia, married at five, never went to school and had her first child at 14. More children would have followed in quick succession, but Sesuagno got involved with a program in her town run by Girl Up developed by the UN Foundation that empowers young girls to create a life for themselves and their families well beyond poverty and illiteracy.
In Sesuagno’s case, she joined a program developed to help teach literacy, and provide information about family planning, gardening and life skills to help reduce food contamination.
Through the program, Sesuagno learned to build shelves to keep her family’s food off the floor, built a stove that sends the smoke out of the house instead of into her lungs—a cause of pneumonia and death for thousands of girls and women in the developing world—and jointly decided with her husband, because of her time in the program, that they would wait to have their next child.
“What we support are comprehensive services for adolescent services for girls to help improve access to health services, education and safe spaces,” says Andrea Austin, a spokesperson for the UN Foundation.
A new op-ed in the Minneapolis Star Tribune makes clear the connection between improving the economy and improving public health — especially when it comes to children. One can’t be accomplished without the other, according to authors Risa Lavizzo-Mourey, MD, MBA, the president and chief executive officer of the Robert Wood Johnson Foundation, and Arthur Rolnick, PhD, a senior fellow at the University of Minnesota and former senior vice president and director of research at the Federal Reserve Bank of Minneapolis.
By improving early education for kids — and even for parents before birth — we can dramatically improve the chances that kids will grow up to lead longer, healthier and more financially successful lives. This will benefit them individually and all of us collectively. The obstacle standing before public health officials and policymakers is to recognize this connection, the authors write.
“For many years, we have missed this connection because we tend to create policy in silos –with education under one roof, housing and economic development under another, and health under yet another roof. In reality, these policy areas are all interconnected and influence one another.”
>>Recommended reading: Read the full story.
>>Recommended viewing: Life Expectancy Disparities along I-94.
Also watch a video with Arthur Rolnick about the return on investment for investing in early childhood education.
As thousands of people who are striving to improve health and health care convene in San Francisco, Calif., for the American Public Health Association Annual Meeting, RWJF is hosting brief interviews with thought leaders from across sectors. Brian Gallagher, President and CEO of United Way Worldwide, provided his thoughts on partnerships.
NewPublicHealth also spoke with Stacey Stewart, who was recently named to the new position of president of United Way USA. She was previously the executive Vice President, Community Impact Leadership and Learning at United Way Worldwide. Stewart shared her goals for UnitedWay USA, as well as what she's learned about the integral connections between education, income and health.
United Way of North Central Florida is focused on the building blocks that lead to a good quality of life – education, income and health – recognizing that communities are stronger when children are successful in school, families are financially stable and people are healthy. One of their primary roles is as a convener, to bring hundreds of organizations together across diverse sectors to set priorities and create change.
As part of our series looking at the work of United Ways across the nation in creating healthier communities, we spoke with Debbie Mason, President and CEO of the United Way of North Central Florida, and Mona Gil de Gibaja, Vice President of Community Impact, about their community planning process, strategies for effective partnerships, and the role of critical partners such as businesses and the local health department.
NewPublicHealth: What is the planning process you’re engaging in to set priorities around education, income and health?
Debbie Mason: Our major focus is education, but this is so inextricably linked to income and health. No matter where you start, you still wrap into the other two.
As the National Prevention Strategy is rolled out, NewPublicHealth will be speaking with Cabinet Secretaries, Agency directors and their designees to the Prevention Council about their prevention initiatives. Follow the series here.
We recently spoke with Donald Yu, Senior Counselor to the General Counsel of the U.S.Department of Education and designee to the National Prevention Council, about the connection between health and education.
>>Listen to a related podcast with the Secretary of the Department of Education, Arne Duncan.
NewPublicHealth: What is the connection between education, high school completion, employment and health?
Don Yu: Secretary of Education Arne Duncan has always said that education is the civil rights issue of our generation, and that concept has really infused all of our work in all of our areas. In terms of the question about how health relates to education, high school completion and employment, I think it’s intuitive but also backed up by emerging research that there is a strong correlation between good student health and improved performance on academic assessments. Obviously, if students are hungry they cannot focus in class; much less perform on a test. Or if they can’t see well, can’t see the blackboard, they obviously can’t learn as well, and my point about the civil rights issue is that those kinds of health disparities impact low income and minority communities the most.
NPH: And what are some of the initiatives and innovations already underway at the Department of Education to support the National Prevention Strategy?
Much attention has been paid on NewPublicHealth and elsewhere to the connection between education, health, economic opportunity, and even life expectancy. Sadly, when we consider the health and life trajectories for our young men of color in this country, it’s clear that we have a lot of work to do. Boys and young men of color are more likely to grow up in poverty, live in unsafe neighborhoods and attend schools that lack the basic resources and supports that kids need in order to thrive. In addition, actions that might be treated as youthful indiscretions by other young men often are judged more severely and result in harsher punishments that have lasting consequences. Only about half of African American, Hispanic and Native American boys graduate from high school on time with their cohort. Down the road, pathways to stable, productive employment can be limited – they commonly lack access to career and positive mentorship connections. And disparities in their access to and quality of health care services persist.
RWJF Program Officer Maisha Simmons attests that the options for our young men of color have been too limited for too long. That’s why today the Robert Wood Johnson Foundation (RWJF), through its Vulnerable Populations portfolio, launched the Forward Promise initiative to strengthen education opportunities, pathways to employment and health outcomes for boys and young men of color. A new Call for Proposals released by the initiative today will focus on the following areas:
- alternative approaches to harsh school discipline that do not push students out of school;
- solutions that focus on dropout prevention and increasing school graduation rates;
- mental health interventions that tailor approaches to boys and young men who have experienced and/or been exposed to violence and trauma; and
- career training programs that blend workforce and education emphases to ensure that students are college- and career-ready.
NewPublicHealth caught up with Maisha about the challenges facing young men of color and the quest for collaborative solutions.
NewPublicHealth: Paint us a picture of the health and quality of life of young men of color. What are some of the causes of the disparities that persist?
Maisha Simmons: If you look at the statistics around men of color, specifically African American men, they usually die sicker and younger than any other population in this country. There are a lot of variables, but what we’ve begun to focus on is, what are some of the non-traditional, non-medical factors that go into that?
So for us, we began to really focus on education, workforce and mental health issues and how they coincide with opportunities for health. When you look at young men and boys of color, their school outcomes are often worse. There are large number of young men not finishing school and they often don’t finish high school with their cohorts. We know the linkages between school and employment often have a collective impact on health outcomes.
NPH: What are some other experiences that influence the health and quality of life of young men of color?
The National Prevention and Health Promotion Strategy offers a comprehensive plan to increase the number of Americans who are healthy at every stage of life. A cornerstone of the Strategy is that it recognizes that good health comes not just from quality medical care, but also from the conditions we face where we live, learn, work and play—such as healthy homes, clean water and air and safe worksites. The strategy was developed by the National Prevention Council, which is composed of 17 federal agencies including the Department of Education, the Department of Housing and Urban Development and others.
As the Strategy is rolled out, NewPublicHealth will be speaking with Cabinet Secretaries, Agency directors and their designees to the Prevention Council about their prevention initiatives. Follow the series here.
We spoke with Arne Duncan, Secretary of the U.S. Department of Education, about the connection between health and education. Listen to the short podcast, and read the full interview below.
NewPublicHealth.org: The Department of Education is a member of the National Prevention Council. Why is health a priority for the Department?
Secretary Duncan: Very simply, if children aren’t healthy they can’t fulfill their academic and social potential. I always talk about the foundation of building blocks for great education, which includes good physical and emotional health. If children can’t see the blackboard they can’t do well. If children are hungry they can’t do well. If children are obese they are not going to do as well as they should. So we have to collectively make sure that children are physically and emotionally healthy so they can think about AP Chemistry and Biology and Physics and the rest of their learning.
NPH: What are the Department of Education’s key target areas and specific initiatives in implementing the National Prevention Strategy?
In conjunction with the third release of the County Health Rankings, the Robert Wood Johnson Foundation and Virginia Commonwealth University’s Center on Human Needs have released an updated version of the County Health Calculator, an interactive, online app that illustrates the connection between social factors and health. The Calculator shows the impact that various social factors have on health and well-being, for U.S. states or counties. A key function of the Calculator is the ability to calculate how many premature deaths could be avoided in communities if more people had the better health that is so strongly linked with more education and higher income.
For example, if adults in Wyandotte, Kansas—where 39 percent have some college education—had the same education levels as the top county in the state— Johnson County at 78 percent—more than one out of three deaths (38 percent) could be averted per year.
This year, the County Health Calculator has been updated with additional features. NewPublicHealth spoke with Steven Woolf, MD, director of the Center for Human Needs and the lead designer of the County Health Calculator, about Version 2.0.
>>Read the full NewPublicHealth series on the launch of the 2012 County Health Rankings.
NewPublicHealth: What has been added to the new version of the calculator?
Steven Woolf: This is an upgraded version with new features. With the old calculator, users could pick any county or state of interest and see the effects of education and income on death rates in the area. The upgraded version will let people look not only at those factors but also on the effects on diabetes and on medical spending for diabetes.
NPH: How did you decide what changes to make to this calculator?