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Healthy Children, Better Learning

An education reform effort that seeks to confront systemic barriers to health and wellness — leveling the playing field for students

September 13, 2018
doctor checking a child's lymph nodes

Sometimes it seems as though education reformers, present company included, spend much of their time discussing the obvious: that good teaching matters, that learning to read by grade 3 is important, that early childhood learning is very valuable. But we also can be accused of ignoring or side-stepping the obvious, like the fact that a healthy child is a better learner, that poverty usually constitutes a serious impediment to learning, and that what children do during the 80 percent of waking hours they are not in school can mean the difference between thriving and failing.   

Let’s focus on just one area: health. Any teacher of disadvantaged children will have lots of stories about health care issues — from toothaches and anxiety to the need for eye glasses to the challenges of asthma — that get in the way of students being able to concentrate and learn at high levels. Some schools tackle these problems head-on by setting up a health care clinic or developing a partnership with a neighborhood health center, but others simply don’t have the resources and time to address these fundamental impediments to learning.

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We need more "connective tissue" between our schools and our family-serving organizations, so family support is not so fragmented, disarrayed, and difficult to access. Service silos don’t work.

In other words, we don’t have a system that guarantees children’s health and well-being. Our approach is hit or miss, unless you’re from a privileged family — and then you can count on getting wraparound health care, mental health services, and regular dental care. Is it any wonder, then, that children from these families routinely learn at higher levels, on average, than children who lack adequate access to health care?

Harvard’s Education Redesign Lab is focused on plugging that gap by working with communities to build systems of support and opportunity that put disadvantaged children on a level playing field with their more affluent peers. Our theory of action is this: Only by working toward equity of systemic services, supports, and opportunities can we break America’s iron-law correlation between socioeconomic status and educational achievement and life outcomes. We believe that a “schools only” approach to achieving equity is a proven failure — and that school reform, narrowly conceived, is destined to continue falling short.

"Connective Tissue" Between Schools and Families

Some communities are hard at work at the business of building more robust child development systems by, for example, linking health care supports with education to address the health issues that impede students from coming to school ready to learn. Through the Ed Redesign Lab's Partnership for Resilience, practitioners from medicine and education are working together in impressive ways to provide quality health care supports for students in the Southland communities near Chicago, and their work is making a difference. 

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After a nonprofit partnership created school-based access to vision and dental care for students, one Illinois district saw behavior referrals decrease by 72 percent, and students experienced English and math gains across all grades.

In one participating Illinois district, the Partnership created school-based access to vision and dental care for students. Among students participating in vision screenings, 60 percent needed and received eye glasses, and among students identified as needing restorative dental care, 85 percent completed the necessary treatment. That district has seen behavior referrals decrease by 72 percent, detentions by 87 percent, suspensions by 79 percent and expulsions by 100 percent. Students also experienced English and math gains across all grades (K–8) during this time.

In California’s Alameda County, the Oakland Unified School District began to implement a community school approach in 2012, which includes health and wellness, expanded learning opportunities, and family engagement. A Stanford report found that students in Oakland’s community schools are more likely to participate in out-of-school programs, which in turn has a positive impact on school attendance. The Alameda County Center for Healthy Schools and Communities, which has invested in more than 23 school-based health centers, has found that the clinics improved students’ access to health care and was associated with improved behavioral health and perceived positive effects on students’ academic outcomes.

We need to take a holistic approach to eliminating the barriers preventing children from coming to school and being attentive when they get there; food security, health, mental health, social support, housing stability, and a sense of safety all contribute to or limit a child’s ability to thrive.

A New Social Compact

But schools can’t solve these problems by themselves. Communities must step forward to create systems of opportunity and support in which teachers, upon identifying a non-school problem in the life of a child, can pick up a telephone and connect with someone in the community who can actually do something about the issue. We need more “connective tissue” between our schools and our family-serving organizations, so family support is not so fragmented, disarrayed, and difficult to access. Service silos don’t work.

What we really need is a new social compact between our communities and our families, one that guarantees all children — and all means all — can expect to receive the supports and opportunities they need to go to school each and every day fully ready to learn. More than half of U.S. students are now economically disadvantaged, many of them living in deep poverty. At the same time, students of color are now a majority of the children in U.S. public schools. These students are disproportionately afflicted by challenges outside of school, and, to date, we haven’t been very successful in educating high proportions of these students to proficiency. It is vital to bear in mind that their success will determine our success as a country, an economy, and a democracy.

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About the Author

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Paul Reville
Paul Reville is the Francis Keppel Professor of Practice of Educational Policy and Administration at the Harvard Graduate School of Education and the former Secretary of Education for the Commonwealth of Massachusetts. He is the founding director of HGSE’s Education Redesign Lab, which is implementing programs of research, fieldwork, and advocacy to identify and promote the creation of education and child development systems that seek to mitigate the effects of poverty and level the opportunity playing field for all students.  
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K-12 Parenting and Community School Leadership