School Dropout: A Public Health Issue?

An article released in the October 2007 issue of the Centers for Disease Control and Prevention (CDC) journal “Preventing Chronic Disease: Public Health Research, Practice, and Policy,” considers proposing school dropout as a public health issue. The article shows the cause and effect relationship between health and high school dropout.  Being unhealthy can interfere with high school completion, and dropping out of high school can be a predictor of poor health outcomes. 

The article reveals that education is one of the strongest predictors of health; the more schooling people have, the better their health is likely to be.  The research shows that more formal education is consistently associated with lower death rates, whereas less education increases one's risk for unhealthy behaviors such as smoking, being overweight, or having a low level of physical activity. 

Pathways by which graduation contributes to improved health are discussed and include, for instance, that the more schooling people have, the more money they earn, allowing them to purchase better housing in safer neighborhoods, healthier food, better medical care and health insurance, and more education. 

High dropout rates are increasingly concentrated among low-income and black and Latino students, and the rate at which students leave school between grades 9 and 10 has tripled.  The article also shows that graduation rates in the nation’s largest cities are still low.  In 2001, 6 out of the 10 largest cities in the U.S. had overall graduation rates of less than 50%. 

According to the article, there are several factors associated with high school dropout and that no single type of intervention can end the nation’s dropout crisis.  Health problems associated with dropping out can include: substance abuse; psychological, emotional, and behavioral problems; and pregnancy – the leading cause of dropping out of school for adolescent women. 

The authors list some health interventions that may improve school achievement and reduce school dropout rates such as coordinated school health programs; health clinics; mental health programs; and pregnancy prevention programs, among others.  Nevertheless, they state that these interventions are seldom coordinated, and do not target reducing school dropout rates as an outcome.  Moreover, evaluation studies that assess the impact of health programs on school dropouts are rare, and, as a result, a comprehensive framework showing the mechanisms by which various types of health programs reduce dropout rates is currently not available. 

In addition, five priorities for action for school leaders, researchers, and public health professionals are provided and include:

• Target schools and cities with the most serious dropout problems for intensive intervention;
• Develop, implement, and evaluate health interventions to improve school completion rates;
• Strengthen support for health education teachers;
• Advocate for evidence-based interventions that can improve health and reduce dropout rates; and
• Put reducing high school dropout rates on the public health agenda. 

The article concludes by stating that it is not possible to eliminate health disparities without reducing disparities in educational achievement. 

Source: “Reframing School Dropout as a Public Health Issue,” Nicholas Freudenberg, DrPH, and Jessica Ruglis, Preventing Chronic Disease: Public Health Research, Practice, and Policy, Volume 4: No. 4, October 2007.