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Promoting Health Equity Through Education

Note: Raegen Miller, the vice president for research partnerships at Teach For America, is guest posting this week.

Domestic media coverage of the 2014 Ebola outbreak really soared when a patient infected with the horrible virus was brought to a special unit at Emory University Hospital in Atlanta. The Centers for Disease Control and Prevention (CDC), a key player in combating communicable diseases worldwide, is also based in Atlanta. In fact, its headquarters sit on 15 acres purchased from Emory University in 1947 for the token sum of $10, but the CDC didn't set up shop in Atlanta because land was cheap. Atlanta, plunked in the middle of the South, was well located for combating domestically what remains a scourge to public health in large swaths of the world, namely malaria.

The CDC succeeded in quashing malaria in this country, and now its scope of effort extends well beyond suppressing communicable diseases. In particular, the CDC provides administrative, research, and technical support for the Community Preventive Services Task Force. Not nearly enough people concerned with education are aware of the Task Force, and this is a shame. Its recommendations are based on systematic reviews of scientific literature, including the social sciences. Some interventions in the education space hold great promise for improved health outcomes, and it's been my honor to serve as an individual along with others from the education research community in helping inform the Task Force's agenda.

The Task Force's latest recommendations focus on two types of interventions: High School Completion Programs and Out-of-School-Time Academic Programs. Because academic achievement is linked to long-term health, implementing the recommended programs with fidelity and vigor in racial and ethnic minority or low-income communities is likely to improve health equity. But not just any old program fitting these categories made the cut. Here's the rundown:

The Task Force recommends High School Completion Programs for students at high risk for non-completion. The following types of programs were shown to be effective for all at-risk students, in this approximate order:

  • Vocational training
  • Alternative schools
  • Social-emotional skills training
  • College-oriented programming
  • Mentoring and counseling
  • Supplemental academic services
  • School and class restructuring
  • Multiservice packages
  • Attendance monitoring and contingencies
  • Community service
  • Case management

Of these, only attendance monitoring and multiservice packages were evaluated with students at risk for non-completion because they were pregnant or had children, and both were found to be effective.

A review of the evidence shows that interventions to increase high school completion produce substantial economic benefits to government and society. And for most programs, benefits exceed costs for all students at risk for non-completion, including students who are pregnant or have children.

The Task Force issued findings for four types of Out-of-School-Time Academic Programs:

  1. Reading-focused programs are recommended for academically at-risk students in grades K-3.
  2. Math-focused programs are recommended for academically at-risk students, potentially with larger effects for older students (grades 7-12).
  3. General academic programs that focus on more than one subject are recommended for all academically at-risk students
  4. Programs with minimal academic content (e.g., those that provide time for homework) have insufficient evidence to determine their effectiveness.

--Raegen Miller

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