The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, conducted a rapid HIA to inform the U.S. Department of Education’s proposed Title I regulations Section 200.21(c) regarding the content, procedures, and implementation of school-level needs assessments. Under the Every Student Succeeds Act, local educational agencies (LEAs) are required to conduct such assessments for schools designated by states as falling in the lowest-performing 5 percent; high schools failing to graduate one-third or more of their students; and schools with consistently underperforming subgroups of students. The assessments must be used to develop comprehensive support and improvement plans for each school.
Research suggests that if assessments do not consider health factors, the plans’ effectiveness may be limited. Many of the same social determinants that shape health, such as housing stability, food insecurity, and violence, also affect educational outcomes. In turn, educational attainment is a well-documented determinant of health outcomes and an area in which significant disparities exist by race, ethnicity, income, and other social and economic factors.
The HIA examined how needs assessments and improvement strategies, including family and community involvement, might affect achievement and related health outcomes across diverse student populations. The HIA team conducted a literature review, stakeholder interviews, and an examination of efforts in nine states and localities to illustrate a number of innovative approaches to needs assessment and school improvement strategies.
It found that of the more than 9 million children and teens enrolled in low-performing schools in 2013-14, nearly 70 percent were students of color and nearly three-quarters were eligible for free or reduced-price lunches, a common proxy for low family income. Research indicates that these students disproportionately encounter circumstances that can hurt their academic performance. The literature, interviews, and state and local examples suggest that LEAs could more effectively improve schools if they examined factors outside the classroom that affect academic achievement and if they established partnerships with social service agencies, public health departments, hospitals, and other community organizations to address identified problems. Although the HIA focused on needs assessments for schools already identified as low-performing, its findings can be used by any school, district, or state.
This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.