The nation’s health care concerns are not just about coverage, but also about having healthier citizens – and healthy lifestyles begin in childhood. One way to increase child health is to increase their parents’ access to healthcare
—parents who are proactive about their own health are often better at getting their kids preventative care too, rather than just going to hospital emergency rooms when problems emerge. Although nearly all children in families with incomes under 200 percent of poverty are eligible for either Medicaid or the State Children’s Health Insurance Program (SCHIP), the parents of these poor and near-poor children often lack health insurance.
Parents who leave welfare normally lose coverage after one year unless their employer provides it, and many employers of low-wage workers do not offer health insurance. As a result, many of the working poor and near-poor have no coverage at all, and the idea of losing Medicaid even discourages adults from working. More available and affordable health care would both remove this disincentive from work and benefit children’s health. Beyond increasing health care coverage for parents, a government plan should also educate parents as “the primary gatekeepers for their children’s health.” Even if health care is available, parents must learn how to make the best use of preventative care and medical information.
Health issues of low-income children have major consequences for both them and society at large. These children may miss more classes or be less able to concentrate on studies, ultimately making them less likely to stay in school. Education challenges and health issues persisting into adulthood may decrease earnings and socioeconomic status. This has wider consequences, as lower-income families may require more state support while contributing fewer tax dollars. In addition, education is often seen as “the great equalizer” and the means by which the American Dream operates, so if the poor health of lower-income children limits their social mobility then America may not be living up to its full promise. These situations are problems for all of society, not just those most directly affected, so health care reform that improves child health should be universally appealing.
To make this strategy work, however, high schools must help low-income students prepare for and succeed in college. A recent Future of Children
policy brief , “A New Goal for America’s High Schools: College Preparation for All,”
outlines steps that high schools should take to ensure that disadvantaged youth see post-secondary education as a realistic and attainable option.
First, high schools should boost students’ subject matter knowledge and study skills. As several papers in The Future of Children: America’s High Schools
point out, many districts and states have changed their performance standards and course requirements to include college preparatory classes and passing high-stakes tests. In tandem with these initiatives, districts, states, and even the federal government should be encouraged to devise new and effective ways of convincing low-income students to take and work hard in tough courses.
Second, high schools should counsel students on how to select colleges and obtain financial aid. Every high school – particularly those serving advantaged and disadvantaged youth — should have sufficient numbers of trained counselors and teachers to help students select and apply for both college and financial aid. The current system in which schools serving predominantly low-income and minority students have more than 1,000 students per counselor does not work. States and local school districts should do everything possible to ensure that disadvantaged students have adequate access to effective counseling beginning at least by the ninth grade.
Finally, to increase schools’ accountability, school districts should build data tracking systems capable of following students from kindergarten through postsecondary education. States are fully aware of the importance of accountability for postsecondary performance and have begun taking steps toward developing the necessary achievement tests and data systems.
To meet these three goals, the authors of the FOC policy brief make a proposal. The $1.7 billion a year that the federal government currently provides for a wide range of efforts aimed at helping disadvantaged students should be re-allocated competitively (to public schools, postsecondary schools, nonprofit and for-profit organizations, and coalitions of these organizations). Priority would be given to applicants who are able to show how they will track student progress in reading and math, how they will respond with additional instruction or other assistance when students fall below grade level in either subject, and, where appropriate, how they will track their students’ progress in postsecondary education and modify their college preparation program based on the evidence. Recipients should be required to reapply for funding every three years, and programs that do not increase college enrollment and graduation rates should lose their funding. Preference would go to programs that have effective procedures for enrolling truly disadvantaged students and boosting their achievement and college enrollment and graduation rates. Similarly, preference should go to proposals that provide for rapid response as soon as disadvantaged students begin to fall below grade norms. Finally, the Statewide Longitudinal Data System should be expanded to all states while ensuring that state systems are capable of following students through the college years.