Task Force Recommends Education Programs to Promote Health Equity

Can education programs impact students’ health later in life? Yes, says the Community Preventive Services Task Force (Task Force), which released recommendations for high school completion programs and out-of-school-time academic programs to improve the health prospects of racial and ethnic minority students and students from low-income families. The Task Force based its findings, on systematic reviews of the scientific literature that are carried out with Task Force oversight, in collaboration with a wide range of government, academic, policy, and practice-based partners.

High School Completion Programs

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 economic 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.

Out-of-School-Time Academic Programs

The Task Force issued findings for four types of programs:

1. Reading-focused programs are recommended for academically at-risk students in grade levels K-3.
2. Math-focused programs are recommended for academically at-risk students, with potentially larger effects among older students (grade levels 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.

Because academic achievement is linked with long-term health, and because the above programs are commonly implemented in racial and ethnic minority or low-income communities, high school completion and out-of-school-time academic programs are likely to improve health equity. Health equity is widespread, achievable, equality in health and in the major social determinants of health among all the principal social divisions of a population.

What are high school completion and out-of-school-time academic programs?

High school completion programs aim to increase the likelihood that students receive either a high school diploma or a general educational development (GED) diploma. Programs take many forms and may be delivered in schools or other community settings. They may target at-risk students as individuals or as groups (e.g., students who are pregnant or have children), or they may include all students in schools with low high school completion rates.

Out-of-school-time academic programs are programs provided outside of regular school hours to students in grades K-12 who are either low-achieving or at risk of low achievement. They may be offered during the school year usually after school hours or during summer recess. Programs must include an academic component, and they may include sports and recreation, snacks, or counseling. Attendance is most often voluntary, though students may be required to participate under certain circumstances (e.g., to avoid retention in grade).

Why are these Task Force findings important?

In the United States, disparities in educational achievement between students from racial and ethnic minority and low-income families compared with those from white or more affluent families are well documented (U.S. DOE 2013a, U.S. DOE 2013b, Centers for Disease Control and Prevention 2011, Duncan & Murnane 2011). These disparities have long-term consequences, and education has been demonstrated to be one of the most important determinants of both longevity and health (Feinstein et al. 2006, Hanushek 2009, Montez et al. 2012).

What are the Task Force and The Community Guide?

• The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, uncompensated panel of public health and prevention experts. The Task Force works to improve the health of all Americans by providing evidence-based recommendations about community preventive programs, services, and policies to improve health. Its members represent a broad range of research, practice, and policy expertise in community prevention services, public health, health promotion, and disease prevention.
• The Guide to Community Preventive Services (The Community Guide) is a website that is a collection of all the evidence-based findings and recommendations of the Community Preventive Services Task Force.
• The Centers for Disease Control and Prevention (CDC) is mandated by the U.S. Congress to provide ongoing administrative, research, and technical support for the operations of the Task Force. CDC is therefore committed to working with the Task Force to systematically review the scientific evidence on population-based strategies to reduce the burden of preventable disease, injury, and disability.

For More Information

• The Community Guide Promoting Health Equity
• CDC Social Determinants of Health

References

CDC. CDC health disparities and inequities report – United States, 2011. MMWR 2011;60(Suppl):1-113.

Duncan GJ, Murnane RJ. Whither opportunity? Rising inequality, schools, and children’s life chances. New York, NY: Russell Sage Foundation, 2011.

Feinstein L, Sabates R, Anderson T, Sorhiando A, Hammond C. What are the effects of education on health? Measuring the effects of education on health and civic engagement. Paper presented at the Copenhagen Symposium; 2006.

Hanushek EA. The economic value of education and cognitive skills. In: Sykes G, Schneider B, Plank DN, editors. Handbook of education policy research. New York, NY: Routledge Publishers, for the American Educational Research Association; 2009. p. 39-56.

Montez JK, Hummer RA, Hayward MD. Educational attainment and adult mortality in the United States: A systematic analysis of functional form. Demography 2012;49(1):315-36.

U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. Percentage of high school dropouts among persons 16 through 24 years old (status dropout rate), by sex and race/ethnicity: Selected years, 1960 through 2012. Digest of Education Statistics, 2013a; http://nces.ed.gov/programs/digest/d13/tables/dt13_219.70.asp.

U.S. Department of Education, Institute of Education Sciences, National Center for Education Statistics. Percentage of high school dropouts among persons 16 through 24 years old (status dropout rate), by income level, and percentage distribution of status dropouts, by labor force status and years of schools completed: 1970 through 2012. Digest of Education Statistics, 2013b; http://nces.ed.gov/programs/digest/d13/tables/dt13_219.75.asp.