Photo: Alessandra Hartkopf for Strategies for Children

“Healthier students are better learners.” This was the message that Charles E. Basch, a professor education at Teachers College, Columbia University, delivered at a recent Boston Public Schools forum on health and the achievement gap. Basch, the author of numerous articleson the relationship between health and educational achievement, was the keynote speaker at the event in the auditorium of the Boston Public Library.

In determining which health factors are educationally relevant, Basch considers the extent of health disparities, the causal effects on educational outcomes, and the feasibility of school-based programs and policies. Using this lens he comes up with seven “educationally relevant health disparities [that] impede motivation and ability to learn through at least five causal pathways: sensory perceptions; cognition; connectedness and engagement with school; absenteeism; and dropping out.”

• Vision. Vision problems affect an estimated 20% of American youth.
• Asthma. Asthma affects an estimated 14% of Americans under age 18. Among children, age 5-14, asthma affects 8.8% of white youth, 12.8% of black youth and 21.5% of Hispanic youth whose ethnicity is Puerto Rican.
• Inattention and hyperactivity. An estimated 8.4% of school-aged youth have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and millions more, Basch says, display symptoms of inattention or hyperactivity.
• Aggression and violence. Among high school students, 4% of white, 6.6% of black and 9.6% of Hispanic pupils report missing school because they feel unsafe on their way to school or in school. More than a quarter (28%) of adolescents report being bullied at school.
• Physical activity. Two-thirds of young people do not get enough exercise.
• Breakfast. An estimated one-fifth of youth skip breakfast.
• Teen pregnancy. An estimated one third of U.S. adolescent girls is expected to become pregnant. The birth rates per thousand females, age 15-17, are: 11.8 for white females, 36.1 for black females and 47.9 for Hispanic females.

Some health factors, Basch notes, affect one pathway, while others affect multiple areas. For instance, a student who struggles cognitively could also feel disconnected from school and stop attending regularly. Many children, particularly children from low-income families, are affected by multiple health-related problems.

“Urban minority youth from low-income families are disproportionately affected by all of these problems. The lowest ‘performing’ schools have a particular need to address these health factors as a fundamental part of their mission. If these factors are not addressed, the benefits of other educational innovations will be jeopardized,” Basch writes in the Journal of School Health.

“The causal connections between multiple health factors and motivation and ability to learn will be greater than the effects of individual factors. This is based on the expectation that at least some variance would be additive. However, it is reasonable to believe that the functional effects of reducing multiple impediments to motivation and ability to learn (eg, breakfast, physical activity, sleep) would be not only additive but also synergistic; therefore, school health programs must focus on multiple educationally relevant health disparities to maximize the educational yield from investments. Schools cannot address all of the conditions that cause educational or health disparities, but proven and promising approaches exist and must be applied to help close the achievement gap.”

The forum was held a few weeks after the statewide summit on early childhood convened by the Massachusetts Chapter of the American Academy of Pediatrics and co-sponsored by Strategies for Children, the Massachusetts Society for the Prevention of Cruelty to Children and the Boston Children’s Museum. Together the forum and the summit remind us of the importance of educators and health providers working together on behalf of the commonwealth’s children, both in delivering services and in advocating for policies and resources to secure a bright future for all Massachusetts children.