Educational Outcomes Are an Underused Metric for Child and Life Course Health

• Published in: American journal of public health (1971) 2024-09, Vol.114 (9), p.864-869
• Main Authors: Sprague, Nadav L, Branas, Charles C, Rundle, Andrew G, Factor-Litvak, Pam
• Format: Article
• Language: English
• Subjects: Archives & records; Attendance; Child; Child Health; Children; Childrens health; Chronic illnesses; Cystic fibrosis; Detention; Education; Educational attainment; Educational psychology; Educational Status; Educational systems; Epilepsy; Health behavior; Health research; Humans; Illnesses; Information; Information systems; Medical records; Mental health; Prediction models; Public health; Public health education; Scarcity; Students; Upstream; Wealth
• ISSN: 0090-0036; 1541-0048; 1541-0048
• DOI: 10.2105/AJPH.2024.307761

We explore the reciprocal relationship between education and health. By combining the often siloed literature bases on how children's health affects their educational outcomes1 and how children's educational outcomes shape their life course health,2 we provide a comprehensive conceptual model for this reciprocal relationship. The potential for using educational data to enhance public health understanding is significant, particularly in high-income countries such as the United States, where the creation of databases of de-identifiable data for all students' educational outcomes is feasible.Such databases could encompass a wide range of anonymized information, including academic performance metrics (e.g., grades and standardized test scores), attendance, disciplinary incidents (e.g., detention, suspensions, and expulsions), and socioeconomic demographic data. These databases could also be connected to medical records by a third party (to preserve anonymity) and used to create predictive models for an array of health outcomes. Using this comprehensive information offers a more inclusive and insightful approach to public health analysis, encompassing data from every student in a country's educational system rather than relying solely on smaller cohorts that have more detailed biometric data but are often poorly representative compared with these national data's potential. Despite the wealth of public health information that educational data can offer, educational variables (e.g., grades, attendance, and test results) as indicators for health outcomes often remain sidelined in health studies and are commonly used only in health fields such as educational psychology and school-based health (see the Appendix for further reading, available as a supplement to the online version of this article at https://www.ajph.org). In fact, in a 2011 review conducted by the World Health Organization (WHO), there were only 53 studies that examined the association between health and education indicators in high-income countries.3 This scarcity in research has persisted over the years, hindering the integration of educational outcomes as proxies for health in research endeavors, despite the wealth of accessible data in educational systems, which include grades, standardized test results, attendance records, and dropout rates. The underuse of these readily available educational data in health research is a missed opportunity and hampers our ability to comprehensively understand and