Association for Public Policy Analysis & Management

There is an intuitive connection between education and health.  Education researchers know that characteristics of the school setting, including, for example, student composition, are associated with educational attainment.  In turn, public health researchers know that educational attainment is a key social determinant of health. However, little is known about the extent to which characteristics of the school setting, especially in the decades following court-mandated desegregation, are associated with health outcomes in adulthood.  I investigate the demographic composition of the high school student body and health outcomes at age 40 in a recent, nationally representative American cohort.

I analyzed data from the USA Bureau of Labor Statistics National Longitudinal Survey of Youth 1979 cohort. School administrators reported high school characteristics. I identified three measures of student composition: the percent of students classified as economically disadvantaged per Elementary and Secondary Education Act guidelines, the percent of students who were White (given that the distribution of minority groups differs across the US, this was the most consistent way to consider the presence of minority students nationwide), and the percentage of students who entered 10^th grade at the school but subsequently dropped out. I chose two measures of health at age 40: obesity and self-rated health. I calculated odds ratios using logistic regression (obesity) or ordered logistic regression (self-rated health) in Stata 11.2.

I found that high school socioeconomic composition, but not racial/ethnic composition or dropout prevalence, was weakly associated with both obesity and poor self-rated health at age 40. For self-rated health, while all of the bivariate ordered odds ratios were statistically significant, after adjusting for confounders, only percent of students classified as disadvantaged was statistically significantly inversely associated with self-rated health. The only odds ratio for obesity that remained statistically significant after adjusting for confounders was that the percent of students at the high school who are classified as disadvantaged is positively associated with obesity at age 40. However, this odds ratio, and all the other odds ratios, was quite close to null.

While high school student composition may have implications for educational outcomes, there do not appear to be substantial spillover effects onto adult health.  Nevertheless, socioeconomic composition was consistently (albeit weakly) associated with health in adulthood.  Building upon others’ findings of the health benefits of court-ordered racial desegregation (Johnson, 2010) and that socioeconomic position is of growing importance for education outcomes (Duncan & Murnane, 2011), it appears that now socioeconomic composition may be more relevant for health outcomes than racial/ethnic composition. Education policymakers have already identified economic disadvantage as an issue for educational outcomes, and developed policies like Title I and free and reduced-priced meals to attempt to target this population, but these findings suggest that more can be done to break the link between socioeconomically disadvantaged student bodies and negative health outcomes that can persist into adulthood.