Perspectives

There is a complex interplay between education and health, beginning at a very early age. For white or more advantaged children, health and education may influence each other in positive ways that set the child up for a healthy, productive and long life. For children of color and disadvantaged children, this mixture often results in a “double whammy” of poor outcomes.

How do health and education intersect in children of color and disadvantaged children versus their white or more advantaged peers? I would suggest that this intersection takes five forms:

• Early health status influences later educational success, and vice versa
• Health and educational performance may influence each other concurrently
• Common root causes may result in both poor educational and health outcomes
• Prevention and intervention strategies to address one may also be appropriate for the other
• The health or educational status of one generation may influence the health or educational status of another generation within a family.

The developmental perspective recognizes that human development begins at birth, and continues throughout the lifespan. Events that occur at one stage of development have a profound effect on future development. The developmental perspective is particularly relevant to understanding the intersection of education and health. For example, considerable research suggests that a healthy start to life is critical for later learning and school success. Individuals’ educational attainment (such as earning a high school diploma or graduating from college) predicts whether an individual will experience chronic health conditions in later life. And new research suggests that exposure to significant stress in early childhood – such as that experienced by children already prone to negative outcomes – can actually alter brain structures and increase children’s risk for disease in adulthood. These examples also illustrate the first of the five ways that health and education intersect – one predicts the later occurrence of the other.

The ecological perspective recognizes that children and families do not operate in a vacuum. Rather, their development is affected by interactions between the many parts of the world around them, from the immediate family to neighborhood and community people and systems, to larger systems, policies and societal influences. For example, a child who arrives at school each day hungry or with untreated dental caries or an ear infection is likely to have problems learning.  Children who are struggling in school are likely to suffer mental health issues that are frequently expressed in disruptive behavior. Young children who witness domestic violence in their homes often have difficulty with social relationships, including those in pre-school and later schooling. These examples illustrate the second way that health and education intersect – health status and educational success influence each other at any given time.

The children most likely to feel the double whammy of educational and health disparities are children who experience, or whose parents experienced, the profound but sometimes unrecognized influences of injustices such as racism and poverty.  To take one example, for decades families of color faced discrimination in the housing market. As a result, they found themselves segregated within communities that had few resources such as good schools and access to fresh and nutritious food as well as considerable risks associated with crowding, environmental toxins, community violence, and other safety concerns. The community context has profound influence on both health and educational success, and these disparities can be sustained for generations. Although there have been policy advances that prohibit discrimination by real estate professionals, housing segregation persists, as will its health and educational impacts. Young children who live in these environments carry that stress both to school, and potentially to their overall health down the road. This example illustrates the third way that health and education intersect – common root factors may influence both education and health.

Both educational and health outcomes might improve if all individuals and families, regardless of place, had access to quality educational opportunities, good health care, safe and walkable neighborhood environments and nutritious food. Public and private policies could also make a difference. If workplaces provided opportunities (optimally paid opportunities) for working parents to be involved in their children’s early childhood experiences, and if workplaces provided health care that allowed parents to make sure their children receive the best care from birth on, children would start school healthier and more ready to learn.  Public policies that support the family system in its ability to provide quality health care and early childhood experiences would result in better outcomes for both education and health. These represent the fourth way that health and education intersect – given that education and health outcomes may be influenced by similar factors and variables, they may respond to similar prevention and intervention efforts.

Children of parents who achieve higher levels of education tend to be better educated and in better health. The health of parents also influences the educational and health outcomes of children. The reverse is also true. For instance, the stress related to caring for a child with significant health or school-related problems can cause mental and physical health issues for parents. In addition, when families experience generational poverty, the negative impacts are also passed from one generation to the next, and it is very difficult to break the cycle. These examples reflect the fifth way that health and education intersect – educational and health outcomes in one generation can influence the health and educational outcomes of another generation in the family.

The roots of children’s learning and health begin in early childhood.  From birth on, children’s life experiences contribute to their outcomes. Families are the locus for most of those experiences, but they must be supported by informal networks, communities that recognize and support the critical involvement of families in children’s educational and health outcomes, policies that support and strengthen the family system in carrying out its roles, rather than focusing on the individual, and funding for prevention efforts and quality early childhood experiences.