week 7 post 1

Week 7
David Kirp Video
  • Big ideas with definitive impact on children's lives
  • What happens to kids during first 5 years of their lives
  • Early education
  • Preschool, more likely to graduate high school, less likely to have been left back in school, morel likely to have gone to college, gotten a job, stay out of prison, and on average earned about 25% more than those who didn't go 
  • HUGE return on investment figure
  • Epidemiology, health outcomes are affected by access to education acces early on
  • Bad long term outcomes even with abuse within first 3 years, related to more diseases 
  • “Kids don't matter because kids don't vote”
  • Made more progress in past 15 years, a hopeful cause
  • Media can potentially do a good job, show success stories, and show the inadequacy but they need to show the whole story because for examples test scores of children are not the whole story
  • Should not just be fluff, show the larger context
  • Feel good generally and we can do bigger better things
  •  Education is the "balance wheel of the social machinery," argued Horace Mann, the first great advocate of public schooling. "It prevents being poor."
  •  an innovative early education program can make a marked difference in the lives of poor minority youngsters -- not just while they are in school but for decades afterward. The 123 participants in this experiment, says David Ellwood, dean of the Kennedy School of Government at Harvard and an architect of the Clinton administration's original welfare reform plan, "may be the most powerfully influential group in the recent history of social science."
  • During the previous decade, not a single class in the Perry elementary school had ever scored above the 10th percentile on national achievement tests, while across town, in the school that served the children of well-off professionals, no class had ever scored below the 90th percentile.
  • Even though prosperous children had thrived in similar settings for well over a century, 3-year-olds from poverty backgrounds had never had the same chance.
  •  the Perry study set records for longevity, but it also asks the truly pertinent question: what is the impact of preschool, not on the test scores of 7-year-olds but on their life chances? The answer is positive -- a well-designed program really works.
  • Perry children were less likely to be assigned to a special education class for the mentally retarded
  • high-school grade point average was higher. By age 19, two-thirds had graduated from high school, compared with 45 percent of those who didn't attend preschool.
  • the preschool group scored higher on tests of literacy. Now they are in their 40's, many with children and even grandchildren of their own. Nearly twice as many have earned college degrees (one has a Ph.D.). More of them have jobs: 76 percent versus 62 percent. 
  • Economists estimate that the return to society is more than $250,000 (calculated in 2000 dollars) on an investment of just $15,166 -- that's 17 dollars for every dollar invested.
Education Improves Public Health and Promotes Health Equity
  • equity, disparities, social determinant, health in all policies 
  •  The process of education occurs at home, in school, and in the child’s community. Children in the United States spend a relatively small proportion of their waking hours in school – approximately 1,000 hours per year or about one fifth of their waking hours.
  • an education is the array of knowledge, skills, and capacities (ie, intellectual, socio-emotional, physical, productive, and interactive) acquired by a learner through formal and experiential learning
  •  First, health is a prerequisite for education: hungry children or children who cannot hear well, or who have chronic toothaches, eg, are hindered in their learning.5
  •  Second, education about health (ie, health education) occurs within schools and in many public health interventions; it is a central tool of public health.6
  • Third, physical education in schools combines education about the importance of physical activity for health with promoting such activity
  • First, we propose that education as a personal attribute is a central conceptual component and essential element of health, similar to physical fitness. 
  • Second, we summarize the extensive literature demonstrating that formal education is a contributing cause of health.
  • , the 1978 Alma Ata International Conference on Primary Health Care defined “health” to include “a state of complete…mental and social well-being” – which we see as largely products of education. Attainment of a certain level of formal education by young adulthood affects lifelong health through multiple pathways.8,10
  •  educational achievement broadly should be a legitimate arena for public health intervention.
  • a broad concept of education as a personal attribute, which includes not only subject-matter knowledge, reasoning, and problem-solving skills, but also awareness of one’s own emotions and those of others and control of one’s emotions (ie, “emotional intelligence”)11 and associated abilities to interact effectively. “Education improves health because it increases effective agency, enhancing a sense of personal control that encourages and enables a healthy lifestyle
  • Basic Skills (reading, writing, arithmetic, mathematics, listening, speaking), 
  • Thinking Skills (creative thinking, decision making, problem solving, seeing things in the mind’s eye, knowing how to learn, reasoning)
  • Personal Qualities (responsibility, self-esteem, sociability, self-management, integrity/honesty)
  • EDUCATION IS AN ELEMENT IF HEALTH
  • So the state of education currently is tearing down the health of students and there is so much irony in that
  • “Education teaches a person to use his or her mind: Learning, thinking, reasoning, solving problems, and so on are mental exercises that may keep the central nervous system in shape the same way that physical exercise keeps the body in shape.”8(p738) A person is unhealthy who cannot conduct himself or herself effectively and achieve some level of “social well-being” – a critical element of the World Health Organization
  • teacher-assigned grades are an alternate, if not better, predictor of long-term outcomes than standardized tests because they reflect not only academic achievement, but also classroom social and learning skills that indicate abilities to learn and to interact successfully. 
  • Criteria to determine causality in public health developed by Sir Bradford-Hill in 196525 are still useful. They are:
  • Strength of association linking hypothetical cause and outcome (as assessed, eg, by the magnitude of relative risks)
  • Consistency of findings, eg, by different researchers in different settings
  • Specificity – the connection of specific, narrow causes to specific outcomes
  • Temporal sequence—the necessity of cause preceding consequence
  • Dose–response relationship
  • Plausibility in terms of current knowledge
  • Coherence – similar to plausibility, the fit with other contemporary knowledge
  • Experiment – offering the strongest support
  • Analogy – the comparability of postulated causality with causality in similar phenomena

  • strong values, promote both academic achievement and self-protective behaviors, or that academic achievement is associated with knowledge, which leads to risk avoidance. Another explanation is that underlying psychological or environmental conditions are associated with risk behavior and academic problems. Causation in both directions is likely. 
  • Wages and income are not health outcomes, but are closely linked with health outcomes because they provide access to health-related resources, such as healthy food, a safe environment, and healthcare
  • Self-assessed health is a well-established index of morbidity and predictor of mortality.32,33
  • Controlling for basic demographics and income, those with less than a high school education in the United States are 2.4 times as likely as high school graduates and 4.1 times as likely as those with post-secondary education to rate their health as poor. 
  • Rates of major circulatory diseases, diabetes, liver disease, and several psychological symptoms (sadness, hopelessness, and worthlessness) show higher rates among adults with lower educational attainment.
  • Evidence also exists of a strong association between educational attainment and mortality from many diseases.
  • The parallel relationship for three heterogeneous groups of illness or injury again suggests an underlying connection unrelated to the specific etiologic pathways of each cause of death (Figure 3).37
  • High/Scope Perry Preschool Program
  • In 1972, healthy infants at risk of academic difficulties because of their demographic circumstances (eg, poor, minority, single parents) were randomly assigned to the Carolina Abecedarian Project or a control intervention (offered social services, nutritional supplements, and healthcare services, but no educational program)
  • By age 21 years, participants in the early childhood education intervention (combining those with and without the strengthened primary school programming) had better health behaviors and better health than those who did not receive the early childhood education intervention.41

  • The Fallacy of the Endowment Hypothesis

  •  innate intellectual and associated ability – rather than educational attainment is the “fundamental cause” of socioeconomic inequalities in health, a proposal referred to as the “endowment hypothesis.”49 NOOOOOO
  •  intelligence affects education and income, and both of these socioeconomic status characteristics in turn affect intelligence; a summary of research on this linkage51 indicates that a year of education is associated with a gain of between 2 and 4 IQ points. In both study cohorts, intelligence during high school is measured by standardized and validated tests, the Henmon-Nelson test and the Wechsler Adult Intelligence Scale
  • ^psychosocial evaluation
  • MAKE EDUCATION AND PUBLIC HEALTH A PRIORITY

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