Article

County Variation in Children's and Adolescent's Health Status and School District Performance in California

School of Social Welfare, University of California at Berkeley, Berkeley, CA 94720, USA.
American Journal of Public Health (Impact Factor: 4.55). 03/2008; 98(12):2223-8. DOI: 10.2105/AJPH.2007.110239
Source: PubMed

ABSTRACT

We examined the association between county-level estimates of children's health status and school district performance in California.
We used 3 data sources: the California Health Interview Survey, district archives from the California Department of Education, and census-based estimates of county demographic characteristics. We used logistic regression to estimate whether a school district's failure to meet adequate yearly progress goals in 2004 to 2005 was a function of child and adolescent's health status. Models included district- and county-level fixed effects and were adjusted for the clustering of districts within counties.
County-level changes in children's and adolescent's health status decreased the likelihood that a school district would fail to meet adequate yearly progress goals during the investigation period. Health status did not moderate the relatively poor performance of predominantly minority districts.
We found empirical support that area variation in children's and adolescent's health status exerts a contextual effect on school district performance. Future research should explore the specific mechanisms through which area-level child health influences school and district achievement.

Full-text preview

Available from: aphapublications.org
  • Source
    • "Irrespective of the policy debate concerning appropriate applications of value-added methodology, studies including those that have been supportive of these systems have shown the influence of student background and community-level factors on student learning and achievement that have not usually been accounted for. They include factors like individual-level (Garcy 2009) and aggregate-level student health status (Stone & Jung 2008), whether a student was homeless (Meyer & Dokumaci 2010), or other exogenous, non-school, aggregate-level factors such as the community crime and violence rates, the degree of home ownership, or the level of area, marital dissolution (Berliner 2009, Berliner 2013). This study continues in the same vein testing the hypothesis that an outside-of-school factor i.e., discontinuous health insurance coverage, can lead to a deficit in math achievement. "
    [Show abstract] [Hide abstract]
    ABSTRACT: U.S. Federal and state education policies place considerable emphasis on assessing the effects that schools and teachers have on student test score performance. It is important for education policy makers to also consider other factors that can affect student achievement. This study finds that an exogenous school factor, discontinuous health insurance coverage, leads to a deficit in math achievement over time. A sample of Yuma County, Arizona public school students who experienced an illness or injury and whose health insurance coverage status was known were selected for inclusion into the study over five consecutive school years (1999 - 2003). The longitudinal math achievement trajectory of students who had private health insurance coverage was compared to students who had discontinuous coverage. Net of a student's poverty status and other background characteristics the findings suggest that students who experienced a health event when they had no healthcare insurance had the same growth rate but lower overall math achievement. The average achievement gap was a constant -8.84 scale score points. However, separate analyses for specific types of illness/injury suggest the achievement deficit varied considerably and is typically larger. Other important findings from the study suggest that students who maintained continuous health insurance coverage through the SCHIP/Medicaid program had steeper, positive achievement gains than either those with private coverage or those who experience coverage gaps.
    Preview · Article · Oct 2013 · Education Policy Analysis Archives
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In this study we examined geographic disparities in medical home access among US children with special health care needs (CSHCN) aged 0 to 17 years. The 2005-2006 National Survey of Children With Special Health Care Needs was used to estimate prevalence and odds of not having a medical home and 5 component outcomes according to state. Logistic regression was used to examine individual-level and state-level determinants of access. Medical home access varied substantially across geographic areas. CSHCN in Alaska, Arizona, Washington, DC, Florida, Illinois, Massachusetts, New Jersey, Nevada, and Virginia had at least 50% higher adjusted odds of not having a medical home than CSHCN in Iowa. The adjusted prevalence of CSHCN lacking a medical home varied from a low of 46% in Iowa and Ohio to a high of 59% in Alaska and 61% in New Jersey. CSHCN in several western and southwestern states experienced greater problems with access to a personal doctor/nurse, a usual source of care, specialty care referrals, care coordination, and family-centered care. Adjustment for age, gender, race/ethnicity, household socioeconomic status, language use, insurance coverage, and functional limitation reduced state disparities in access. CSHCN in states with higher immigrant and non-English-speaking populations had significantly lower medical home access. Increases in state health care expenditure and infrastructure and Medicaid/State Children's Health Insurance Program eligibility were associated with increased access to a personal doctor/nurse. Although individual-level sociodemographic and state-level health policy variables are important predictors of access, substantial geographic disparities remain, with CSHCN in several western and northeastern states at high risk of not having a medical home.
    Full-text · Article · Dec 2009 · PEDIATRICS
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Hearing loss is common and, in young persons, can compromise social development, communication skills, and educational achievement. To examine the current prevalence of hearing loss in US adolescents and determine whether it has changed over time. Cross-sectional analyses of US representative demographic and audiometric data from the 1988 through 1994 and 2005 through 2006 time periods. The Third National Health and Nutrition Examination Survey (NHANES III), 1988-1994, and NHANES 2005-2006. NHANES III examined 2928 participants and NHANES 2005-2006 examined 1771 participants, aged 12 to 19 years. We calculated the prevalence of hearing loss in participants aged 12 to 19 years after accounting for the complex survey design. Audiometrically determined hearing loss was categorized as either unilateral or bilateral for low frequency (0.5, 1, and 2 kHz) or high frequency (3, 4, 6, and 8 kHz), and as slight loss (> 15 to < 25 dB) or mild or greater loss (> or = 25 dB) according to hearing sensitivity in the worse ear. The prevalence of hearing loss from NHANES 2005-2006 was compared with the prevalence from NHANES III (1988-1994). We also examined the cross-sectional relations between several potential risk factors and hearing loss. Logistic regression was used to calculate multivariate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of any hearing loss increased significantly from 14.9% (95% CI, 13.0%-16.9%) in 1988-1994 to 19.5% (95% CI, 15.2%-23.8%) in 2005-2006 (P = .02). In 2005-2006, hearing loss was more commonly unilateral (prevalence, 14.0%; 95% CI, 10.4%-17.6%, vs 11.1%; 95% CI, 9.5%-12.8% in 1988-1994; P = .005) and involved the high frequencies (prevalence, 16.4%; 95% CI, 13.2%-19.7%, vs 12.8%; 95% CI, 11.1%-14.5% in 1988-1994; P = .02). Individuals from families below the federal poverty threshold (prevalence, 23.6%; 95% CI, 18.5%-28.7%) had significantly higher odds of hearing loss (multivariate adjusted OR, 1.60; 95% CI, 1.10-2.32) than those above the threshold (prevalence, 18.4%; 95% CI, 13.6%-23.2%). The prevalence of hearing loss among a sample of US adolescents aged 12 to 19 years was greater in 2005-2006 compared with 1988-1994.
    Full-text · Article · Aug 2010 · JAMA The Journal of the American Medical Association