Intersections between education and health

The Ohio Department of Education (ODE) oversees the state’s public education system, which includes public school districts, joint vocational school districts and charter schools. The Department also monitors educational service centers, other regional education providers, early learning and child care programs, and private schools. The Department’s tasks include administering the school funding system, collecting school fiscal and performance data, developing academic standards and model curricula, administering the state achievement tests, issuing district and school report cards, administering Ohio’s voucher programs, providing professional development, and licensing teachers, administrators, treasurers, superintendents and other education personnel. The Department is governed by the State Board of Education with administration of the Department the responsibility of the superintendent of public instruction. (Copied directly from the ODE website)

This webpage offers an extensive array of links to education data and resources, which visitors can browse by topic.

This is an independent, private foundation focused on post-secondary education opportunities and attainment. They are committed to increasing the proportion of Americans with degrees, certificates and other high-quality credentials to 60 percent by 2025. Their report, A Stronger Nation, tracks progress toward this goal for the U.S. overall, as well as for each individual state.

This webpage provides background information on ESSA, an explanation of how Ohio gathered stakeholder input to develop its ESSA-required state plan and a variety of webinars and other resources on the law. Links to Ohio’s state plan and the appendices are also on this page.

ODE submitted this consolidated state plan to the U.S. Department of Education in September 2017. It was approved in January 2018.

Community schools, often called charter schools in other states, are public nonprofit, nonsectarian schools that operate independently of any school district but under a contract with an authorized sponsoring entity that is established by statute or approved by the State Board of Education. Community schools are public schools of choice and are state and federally funded. More details can be found at ODE’s community schools webpage.

Report cards for all schools and districts can be accessed at this link, in addition to a variety of resources to help readers interpret the report cards.

For more than 20 years, Education Week has been grading states on their educational performance. A state’s overall grade is determined by averaging its scores on three indicators tracked by the report: chance for success, school finance and K-12 achievement. In 2018, Ohio ranked 22nd among all 50 states and the District of Columbia, with an overall grade of C and score of 74.8 out of 100 points. The overall U.S. also received a grade of C.

This report by the Thomas B. Fordham Institute presents an analysis of Ohio’s 2015-2016 school report cards. In addition to a statewide analysis, the report offers a more in-depth look at Ohio’s eight biggest cities. It also explains recent changes in Ohio’s assessments and accountability system.

The Kindergarten Readiness Assessment (KRA) is intended to gauge how prepared students are to engage in kindergarten-level instruction. The KRA addresses growth and development in four main areas: language and literacy, social foundations, mathematics, and physical well-being and motor development. Based on this assessment, in 2016-2017, 40.6 percent of Ohio’s kindergarten students were “Demonstrating Readiness”, meaning they entered kindergarten with sufficient skills, knowledge and abilities to engage with kindergarten-level instruction. An additional 36.3 percent were “Approaching Readiness” and needed some supports to be able to engage with kindergarten-level instruction. Finally, 23.1 percent were “Emerging in Readiness”, meaning they needed significant support to be able to engage with kindergarten-level instruction. The report also analyzes the data and shows differences by race, gender, disability status, income and English language proficiency.

This report from the Governor’s Office of Workforce Transformation and the Governor’s Executive Workforce Board presents Ohio’s most prominent workforce challenges and outlines recommended solutions for these challenges.

Each Child, Our Future is Ohio’s strategic plan for education. The vison of the plan is that each student is challenged, prepared and empowered for his or her future by way of an excellent preK-12 education. The plan acknowledges the importance of addressing the physical, social, emotional and intellectual aspects of a child’s wellbeing. Therefore, the “whole child” is at the center of the plan.

HPIO conducted the 2016 state health assessment (SHA) under a contract with the Ohio Department of Health and leadership of the Governor’s Office of Health Transformation. The SHA is a comprehensive and actionable picture of health and wellbeing in Ohio, including over 140 metrics organized into data profiles, as well as information gathered through five regional forums, a review of local health department and hospital assessments and plans and key informant interviews.

Released by the Governor’s Office of Health Transformation and the Ohio Department of Health in February 2017, the SHIP is a strategic menu of priorities, outcome objectives and evidence-based strategies designed to address three of Ohio’s greatest health challenges: mental health and addiction, chronic disease, and maternal and infant health. The SHIP was developed based upon findings from the 2016 state health assessment.

This video explains why education is so critical. From a health standpoint, it explains the considerable differences in life expectancy and disease prevalence among people with different levels of educational attainment and discusses some of the reasons for these disparities. The video also talks about the importance of an educated workforce for our nation’s economy and ability to compete globally. As the demand for lower-skilled jobs continues to decrease, educating the population becomes even more important. Similarly, the complementary text not only describes how investing in education will save lives, but also how it will save money due to the resulting decreases in health care costs and the ensuing economic returns from a more globally-competitive and productive workforce.

This video and issue brief describe how education and health are connected. They explain how individuals with higher educational attainment generally have more opportunities to be healthy due to having more exposure to people, resources and information that positively impact health. Also explained is the importance of committed parents and a nurturing home environment for children’s future health and success. The brief describes these ideas in greater detail and touches on the fact that poor health can hinder a child’s educational success due to school absences and an inability to concentrate in class.

This brief asserts that investments in education are likely to lower health care spending. It explains that state health care dollars are disproportionally spent on caring for individuals with lower levels of education, as these people tend to have poorer health and are more likely to have chronic conditions. The brief also outlines the many other financial benefits to educational investment aside from health care savings, including greater productivity and less need for economic assistance and safety net programs.

This report describes how students who are physically and emotionally well, present, and engaged are better learners. It focuses on how various aspects of health impact grades, test scores, attendance and graduation. Some of the health-related topics discussed include behavioral health, nutrition, physical activity and education, dental issues, asthma, teen pregnancy, and substance use.

This study summarizes literature on the connection between health and academic achievement using the Whole School, Whole Community, Whole Child (WSCC) framework. The WSCC model offers school leaders a comprehensive approach for addressing the health-related barriers to learning. The study asserts that “schools can improve the health and learning of students by supporting opportunities to learn about and practice healthy behaviors, providing school health services, creating safe and positive school environments, and engaging families and communities.” More information about the WSCC model can be found in the “Promising models to integrate education and health” section of this resource page.

This resource from the Centers for Disease Control and Prevention (CDC) describes the evidence surrounding how healthy eating and physical activity positively impact academic achievement. It offers core messages for communicating this information to specific audiences, including states and school districts, and lists key actions that can be taken by each audience. Links to additional resources are included.

This webpage offers a large array of resources on topics such as school nutrition, physical activity, obesity prevention, and management of chronic health conditions in schools. It also contains links to the school health guidelines, information on local school wellness policies (see below) and many other useful resources.

All schools that participate in the National School Lunch program or other child nutrition programs are required to develop a local wellness policy which addresses nutrition, physical activity and other school-based activities to promote student wellness. This link on the CDC’s Healthy Schools website includes more information, including the federal requirements for these policies. There is also a link to Putting local school wellness policies into action, which describes how 11 schools developed their policies and identifies common themes and best practices for developing a school wellness policy.

The “Schools” section of the website offers many useful tools and resources on school wellness policies, nutrition, physical education and physical activity, health education and health promotion for staff. Additional resources are available for healthy eating, physical activity and youth engagement in out-of-school time.

Developed by the Joint Committee on National Health Education Standards, these national standards outline what students should know and be able to do by grades 2, 5, 8 and 12. The standards do not address specific health education content areas. Instead, they provide a framework for selecting or developing a curriculum, allowing for specific content and concepts to be included as appropriate for local needs. They reflect a research-informed focus on the skills children need to be healthy.

This policy brief from the Society for Public Health Education discusses the importance of health education and how it can be enhanced with ESSA. It also includes descriptions of several states with strong health education programs.

This report explains that chronic absence is highly concentrated, with half of chronically absent students being in just 4 percent of the nation’s school districts. It outlines common characteristics among schools with high rates of chronic absenteeism, emphasizes the importance of tracking chronic absenteeism at the state and district levels and suggests ways in which the data can be used to effectively and efficiently reduce chronic absenteeism.

This report from the Center on the Developing Child (Harvard University) describes how various aspects of development and early childhood can impact health. It describes three foundations of healthy development – stable and responsive relationships, a healthy physical environment and sound, appropriate nutrition – and presents a variety of policy options for enhancing each.

This report from the Center on the Developing Child (Harvard University) describes how various aspects of development and early childhood can impact health. It describes three foundations of healthy development – stable and responsive relationships, a healthy physical environment and sound, appropriate nutrition – and presents a variety of policy options for enhancing each.

This document lists six consensus statements on the effects of pre-kindergarten developed by a task force of national early childhood experts. The experts identified three factors that together tend to make a pre-kindergarten program strong and effective – a curriculum that is known to build foundational skills and knowledge, professional development and coaching for teachers and organized and engaging classrooms. They also acknowledge the critical importance of a child’s experiences prior to and after pre-kindergarten.

The Ohio Business Roundtable (BRT) recognizes the importance of early childhood education for preparing the future workforce. This report is a follow up to their 2010 report which set a goal that by 2020, 90 percent of Ohio children entering school will be ready to succeed in kindergarten. The BRT believes that the core driver to kindergarten readiness is access to quality, cost-effective early learning experiences. This report discusses progress made since 2010, extends the goal to 2025 and includes recommendations for achieving it.

This extensive report from Groundwork Ohio, titled From the Ground Up: Unearthing Fairness for Ohio Kids, presents a wealth of data related to Ohio children. The data is disaggregated by race, ethnicity and geography. Several examples of data covered in the report include infant mortality, early childhood poverty, access to early childhood education opportunities, incidence of trauma, academic performance and educational attainment, lead poisoning, asthma, special education and juvenile justice.

This slide deck was developed by Education First to inform efforts in the education sector to spread high-quality, integrated SEL to all schools in the U.S. It discusses the state of the SEL field and key insights to inform the field’s thinking and action on SEL and offers recommendations to build on SEL’s progress to date. SEL in federal and state policy is one of the five broad research areas that are covered.

This resource begins with a brief overview of social-emotional learning (SEL) then discusses six key implementation considerations – purpose, scale, instruction, measurement, adult SEL and sustainability. It ends with detailed case studies of three districts around the country that are implementing their SEL strategies, each describing key decisions they’ve faced along the way and challenges they’ve

These nine guidelines, developed by the Ohio Department of Education (ODE), describe how schools can create environments in which students feel welcomed, respected and motivated to learn. The document includes specific benchmarks for successfully implementing each guideline. ODE is currently in the process of updating the guidelines.

The National School Climate Council collaborated with leaders from across the U.S. to develop these five standards, which present a vision and framework for creating a positive and sustainable school climate. For each standard, there are more detailed indicators and sub-indicators for promoting effective teaching, learning and comprehensive school improvement.

Topics covered in this report from the Child Mind Institute include the prevalence of mental health conditions among children and adolescents, the gap between the number of children needing treatment and those receiving it, how child mental health disorders impact society and the effectiveness of treatment. (An email address must be submitted to download the full report)

This report from the Child Mind Institute discusses the negative effects of mental health conditions in school (e.g., suspensions, expulsions, dropout). It then presents specific, evidence-based examples of early intervention and prevention programs, school-wide behavior policies and programs, and targeted interventions. (An email address must be submitted to download the full report)

This policy brief provides recommendations to lessen the healthcare disparities that exist in rural communities by addressing ACEs.

This groundbreaking study brought light to the relationship between exposure to adverse childhood experiences and health in adulthood. It considered seven categories of adverse childhood experiences (psychological, physical or sexual abuse; violence against the mother; or living with household members who abused substances, were mentally ill or suicidal, or were ever imprisoned) and found a graded relationship between the number of categories of childhood exposure and many different adult health risk behaviors (e.g., smoking, alcoholism, drug use) and diseases (e.g., heart disease, cancer, diabetes).

The CDC provides ACEs fast facts, research, resources, prevention strategies and data on this page.

This page provides resources, learning materials and research related to child trauma and stress.

This page provides an aggregation of resources to advance the standard of care for ACEs and toxic stress.

This study, published in 1998, serves as a foundation for how ACEs are talked about and understood today.

The “CTA Library” on this website provides links to a variety of resources on trauma.

This legislation was introduced in December 2017 by Ohio Senators Peggy Lehner (R-Kettering) and Gayle Manning (R- North Ridgeville) to phase out out-of-school suspensions for Ohio students in pre-K through third grade for non-violent behavior, except in limited circumstances. It also includes some additional requirements related to Positive Behavioral Interventions and Supports (PBIS). It passed the Ohio General Assembly as a part of House Bill 318 and was signed by Governor Kasich in August 2018. This webpage includes the enrolled bill text.

The WSCC model combined and built upon two existing models – the Whole Child initiative developed by the ASCD (formerly known as the Association for Supervision and Curriculum Development) and the CDC’s coordinated school health (CSH) approach. The Whole Child initiative aimed to shift the conversation about education from being narrowly focused on academic achievement to one that promotes the long-term development and success of the whole child. Since 1987, the CSH approach had served as the model for integrating health-promoting practices into the school setting. In 2013, the CDC and ASCD, in collaboration with key leaders in the fields of education, health, public health and school health, developed the WSCC model.

In recognition of the connection between education and health, the WSCC model calls for greater collaboration across the community, school and health sector to improve both the health and academic success of students. With the child as the ultimate focus, the WSCC model combines the tenets of the Whole Child model – that the child is challenged, healthy, safe, engaged and supported – with elements of the CSH approach. The WSCC model includes ten school components, having added a few to the CSH list:

• Health education
• Physical education and physical activity
• Nutrition environment and services
• Health services
• Social and emotional climate
• Counseling, psychological and social services
• Physical environment
• Employee wellness
• Family engagement
• Community engagement

The WSCC model provides school leaders with a new comprehensive approach for addressing the health-related barriers to learning. It also provides the opportunity for health and education professionals to leverage their limited resources and work together to provide more effective and efficient programs and services to students.

This webpage on the ASCD website contains information and resources on the WSCC model, including a short video.

School-based health centers (SBHCs) provide a variety of health care services to youth in a safe, convenient and accessible environment – normally inside their school or on school grounds. Services provided vary among SBHCs and are often tailored to meet the needs of the children in the community they serve. Some types of services that may be available in SBHCs include: primary care services, chronic disease management, mental health and/or substance abuse counseling, dental services and health education on topics such as nutrition or reproductive health. Centers are staffed by a licensed professional – normally a nurse practitioner or physician assistant.

• School-based health centers: Improving health, well-being and educational success: This issue brief from The American Public Health Association Center for School, Health and Education discusses the benefits of SBHCs and how they can impact barriers to education such as bullying and school violence; hunger, obesity and access to quality food; teen pregnancy and mental well-being, depression and suicide
• The School-Based Health Alliance’s website offers a lot of useful information on school-based health centers in the U.S. and resources including a literature database and national census of SBHCs. Below are some links that may be particularly helpful to those who are unfamiliar with SBHCs:
  • The About school-based health centers webpage provides a general explanation of school-based health centers.
  • The School-Based Health Alliance developed a set of seven core competencies that “represent the knowledge, expertise, policies, practices, and attributes that every SBHC is expected to demonstrate in its pursuit of student wellness.”
  • The health and learning link provides information on a number of health-related issues that SBHCs can help to address.

Using public schools as hubs, community schools bring together many partners to offer a range of supports and opportunities to children, youth, families and communities. Their integrated focus on academics, health and social services, youth and community development and community engagement leads to improved student learning, stronger families and healthier communities.

• The Coalition for Community Schools website provides useful information and resources about community schools, including descriptions of successful community school models around the U.S.
• Community schools: A whole-child framework for school improvement– This issue brief explains the opportunities created by community schools (powerful learning, integrated health and social supports, and authentic family and community engagement), the collaborative practices that foster these opportunities (inclusive leadership, shared ownership for results, strategic community partnerships, resource coordination and data-driven planning) and the capacity-building supports that enable successful implementation (all-stakeholder leadership development, professional development, coaching for continuous improvement).
• Ohio example of community schools: Cincinnati Public Schools Community Learning Centers

The National Collaborative on Education and Health “brings together advocates, policymakers, school stakeholders and funders to work toward more fully integrating education and health. This means building schools’ capacity to address the needs that exist today and the needs we can’t yet anticipate. It is also about building the health sector’s capacity to engage the community, including schools, in truly promoting health.”

The work of the National Collaborative grew out of the Health in Mind: Improving Education through Wellness report, which highlighted the need for this increased collaboration and offered federal-level policy recommendations which would help close the achievement gap and create a healthy future for all children.

The success of this report eventually led to the formation of the National Collaborative on Education and Health, which was launched in March 2014 by the Healthy Schools Campaign and Trust for America’s Health. After the Health in Mind report, the group pivoted its work beyond the role of the federal government and looked more broadly to public and private leaders in the health and education sectors to identify missed opportunities for health and education systems to work together to support student health, wellness and learning.

The work of the Collaborative primarily occurs through working groups that convene practitioners, experts and policymakers around a specific topic which is chosen by its national steering committee. The working groups identify best practices and develop recommendations on their respective topics. One current focus area is mental health.

Through this initiative, the U.S. Department of Education and U.S. Department of Health and Human Services acknowledged the need to better connect health and education services. In January 2016, they released a joint letter to chief state school officers and state health officials introducing Healthy Students, Promising Futures and the associated toolkit: State and local action steps and practices to improve school-based health. The toolkit offers high-impact opportunities to:

• Increase access to health insurance to promote better academic outcomes;
• Create school environments with the physical and mental health supports to help students succeed academically and lead healthy lives; and
• Strengthen coordination and collaboration between health and education systems at the local and state levels.

Work has continued on this initiative. The U.S. Department of Education, in partnership with the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services, is currently convening a learning collaborative as a part of Healthy Students, Promising Futures to address the need for expanded access to and resources for school health services. Ohio is one of the 15 states participating in the learning collaborative.

The primary goal of the Campaign for Grade-Level Reading is “to ensure that more children from low-income families succeed in school and graduate prepared for college, a career and active citizenship.” Grade-level reading at the end of third grade is the focus of the Campaign, as this is an important predictor of school success and high school graduation. The Campaign is supported by a broad range of public, private and nonprofit sector organizations around the nation.

• Campaign for Grade-Level Reading video: This video illustrates the gaps that often exist between children from low-income families and their more affluent peers. The video then explains how the Campaign for Grade-Level Reading attempts to eliminate these gaps.
• The Campaign’s “Growing Healthy Readers” initiative aims to ensure children from low-income families are in good health and developing on track.