Exploring Opportunities for Collaboration Between Health and Education to Improve Population Health Workshop Summary (2015) / Chapter Skim
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6 State and Local Collaboration Between the Health and Education Sectors
6 State and Local Collaboration Between the Health and Education Sectors
Pages 69-86
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From page 69... ...
MODELS OF STATE AND LOCAL COLLABORATION BETWEEN HEALTH AND EDUCATION Kaiser Permanente is the nation's largest nonprofit private health care organization that both delivers care and offers a health plan, olomon told S the workshop participants. Kaiser Permanente has both the incentives in place and the mission to provide high-quality, affordable care and to improve the health of the members in the communities that it serves, he said.
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From page 70... ...
Kaiser Permanente's school strategy primarily stresses health goals, but it also takes into account the fact that those are not the goals that are most important to its education partners. As a result, the Thriving Schools program aims to produce, in addition to health benefits, the benefits in academic performance, school achievement, and workforce productivity that are of most importance to school leaders.
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From page 71... ...
Kaiser Permanente's collaboration with the School-Based Health Alliance is looking at ways in which school-based health centers could become a more effective driver of school wellness. To date, out of the 14,000 schools located in its service areas, Kaiser Permanente has engaged some 1,000 schools in physical activity programs and about 250 schools in a joint program with the Alliance for a Healthier Generation.
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"Not too surprisingly, the lowest high school graduation rates are in the same geography." These are also the same areas where the least amount of money is spent on public school education, where life expectancy is lowest, where childhood obesity is most prevalent, and where teen pregnancy rates are the highest, he noted.
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FIGURE 6-3 Rates of persistent poverty. SOURCE: McGuire presentation, June 5, 2014, citing Holt, 2007.
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FIGURE 6-5 Obesity rates for high school students. SOURCE: McGuire presentation, June 5, 2014, Eaton et al., 2012.
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SOURCE: McGuire presentation, adapted from Hamilton et al., 2012.
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FIGURE 6-9 State and local funding of public schools. NOTE: State and local spending per student for K–12 education, 2011.
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More needs to be done to incorporate health and wellness into school metrics and accountability policies and to better integrate school and health care data systems so that student academic records are merged with health data, McGuire said. He also noted that most of the attention paid to data systems in public schools is focused on the alignment of administrative records for preparing school report cards.
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From page 78... ...
Wright briefly reviewed the reasons that had already been given for why high school graduation matters: Dropouts experience shorter life expectancy and are more likely to suffer from chronic illnesses such as cardiovascular diseases, cancer, infections, lung disease, and diabetes; dropouts earn 41 percent less than someone with a high school diploma and are 28 percent less likely than college graduates to have insurance coverage; and dropouts are less likely to be enmeshed in social conditions that promote health as an adult. Wright also reiterated the oft-stated
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From page 79... ...
"Because they have a track record of dealing with the social circumstances associated with educational success." They also have a track record of dealing with some of the social experiences associated with dropping out, such as school violence and bullying. In addition, school-based health centers explicitly focus on risky behaviors and the dangerous health outcomes associated with adolescents, and they do so as a confidential, nonudgmental, trusted j source of expertise in the school building upon which both students and school personnel have come to rely.
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From page 80... ...
school health programs, which put people in state health and education departments with the explicit mandate of collaborating together to address issues at the local level that can affect the health and success of children at school. At the local level, Wright continued, there are partnerships between local school districts and health agencies in which the school districts pay for school nurses, who are school employees, while the health providers in school-based health centers are sometimes funded by large hospitals or health systems.
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African American males in particular are three times more likely to stay in school if they have access to a school-based health center. There is even preliminary evidence that school-based health centers have a positive impact on school suspensions.
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In this assessment, Wright and her colleagues also asked about homelessness and whether the students had electricity or running water in their homes. "This is when you start unpacking what we mean when we talk about poverty and what it means in the lives of these young people: not being able to take a shower or wash their clothes and having to go to school perhaps not smelling good and being teased and then deciding they are not going back to school the next day because they are tired of being teased." She said that this is why one principal asked a school-based health center to put a washer, dryer, and shower facilities in the health center.
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I know that that social issue absolutely impacts what I see in an exam room, but I don't know what to do about it." One way to address this dilemma would be to integrate public health and primary care in a very deliberate and demonstrative way. This, Wright said, would give primary care providers some comfort in asking those questions because they will have other experts available to provide responses to those social factors.
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From page 84... ...
Transforming behavior -- as opposed to merely throwing money at a problem -- increases the odds that a successful program will find the support it needs to spread. For example, programs to address asthma in students that merely pass out inhalers are not transforming behavior, while those that include home teaching and that bring in a public health team to help address environmental and social factors that can make it difficult for a student to use their inhaler consistently are more likely to transform behavior.
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From page 85... ...
STATE AND LOCAL COLLABORATION 85 Sanne Magnan of the Institute for Clinical Systems Improvement brought up the need to find the right balance between accountability and flexibility -- a need that health and education share. As an example, Magnan told the story of a fifth grader who did not receive a grade on spelling because her teacher did not want to give her a failing grade but instead wanted to address this student's learning disability.
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