Inquiry Magazine Northwestern School of Education and Social Policy

FALL 2010

Lindsay Chase-Lansdale
Lindsay Chase-Lansdale

As director of Cells to Society, SESP professor Lindsay Chase-Lansdale emphasizes interdisciplinary research in the quest for overcoming the impact of social differences on health.

Diane Schanzenbach
Diane Schanzenbach

An expert on the school lunch program, SESP professor Diane Schanzenbach found that students who eat school lunches had higher obesity rates than their peers.

Cells to society workshop

Cells to Society Workshop
Photo by Jim Ziv

At a Cells to Society workshop, associate professor Thomas McDade teaches social scientists a blood sampling technique for their research that connects health to characteristics like socioeconomic status.

how schools shape health

"It looks like school lunches are definitely part of the problem, and if we made school lunches healthier, we would expect to see a small but measurable improvement," she asserts. She explains that while the government does require that the lunches meet basic nutritional criteria, these requirements are weak. For example, schools must provide at least a certain number of calories, but there is no rule about maximum calories.

Rx for Social Disparities in Health

Jennifer Beck
Rx for Social Disparities in Health Photo by Jim Ziv

While it's no secret that growing up in poverty can have a profound influence on a child's quality of life, pinpointing remedies for the problem can be difficult. From the womb to the classroom and beyond, research at the School of Education and Social Policy and Northwestern University is exploring ways to overcome the negative impact of social disparities on health and well-being.

The role of early influences on adult health and well-being is a field currently experiencing "an explosion of exciting research," according to Lindsay Chase-Lansdale, SESP professor and director of Cells to Society (C2S): The Center for Social Disparities and Health at Northwestern's Institute for Policy Research. This approach looks across the life span to understand how social differences may impact health over time.

At C2S, for example, studies are investigating the connection between early stressors and development throughout life. They are considering how factors like poor nutrition or psychological stress experienced by the mother during and after pregnancy may affect the baby's health and well-being in the short and long term. This field of research also extends to understanding the consequences of disparities in education on health. Regarding inequality in education, Chase- Lansdale says, "I think it is the most pressing policy issue in this country today."

How schools shape health

In her own research, Diane Schanzenbach, SESP associate professor, is examining some of these critical links between education and health. She is looking at how the health of low-income students may be compromised during the school day, leading to problems like childhood obesity. While she emphasizes that there are many reasons disadvantaged children tend to weigh more, she believes there is a connection between school lunches and being overweight.

An expert on the school lunch program, Schanzenbach found that students who eat school lunches had higher obesity rates than their peers. She compared the weights of children at the beginning of kindergarten and again at the end of first grade. Initially, their obesity rates were similar, whether or not they would go on to eat the lunches. However, by the end of first grade, that had changed.

Gym and recess to the rescue

In addition to nutrition, Schanzenbach cites other health-related issues tied to social disparities in education. Nationally, there has been a reduction in physical education and recess time, she notes. She argues this is related to the emphasis No Child Left Behind (NCLB) places on reading and mathematics. In fact, Schanzenbach identified a troubling connection between student weight gain and schools in danger of NCLB sanctions. "The kids gain more weight in the years their school is close to failing," she explains. While it is not clear exactly why, one possibility includes cutting back on physical activity to focus on the subjects NCLB assesses. Disadvantaged children are more inclined to be impacted since they are more likely to attend schools facing NCLB penalties.

It is essential that public policies for low-income children take into account the possibility of unintended consequences that might create more problems for them, Schanzenbach emphasizes. Even better would be eliminating this possibility altogether. "We need to reduce social disparities by making sure everyone has access to a quality education," she says. While there is no single cure-all at this time, she does see a need for better policies.

She calls this "an exciting time" in her area of research due to the upcoming reauthorization of both the school lunch program and NCLB. Particularly, she would like to see health outcomes added to NCLB, bringing accountability to a broader range of important issues. In addition, she applauds the attention Michelle Obama has brought to childhood obesity and nutrition. "Mrs. Obama is calling for public policies that I think will help," notes Schanzenbach. She also appreciates the emphasis Michelle Obama is placing on the family's role. She hopes this will encourage families to make healthier choices in their daily lives.

A healthy start

Another bright spot Schanzenbach identifies is the connection between learning and better access to public health insurance. "Broadly, that's one of the success stories over the last 20 years," she explains. In her research, Schanzenbach found that test scores improved with greater health care availability. Specifically, she looked at student achievement for children in states with broader health insurance eligibility compared to those in states with narrower guidelines. "Test scores have gone up a little," she says. Children entering school with disadvantages were better able to learn when they had access to health care, she sums.

According to Chase-Lansdale, access to early childhood education programs has also been shown to help disadvantaged children, especially when preschool education is aligned with high-quality elementary school education, now called preK–3rd. In particular, a quality early childhood education allows children to become better prepared for school. Unfortunately, if these children transition into inadequate elementary schools, the early gains diminish, and the gap begins to widen again over the years, she notes.

Overall, she emphasizes the value of examining multiple aspects of health and well-being in the quest for solutions. The unique, interdisciplinary approach used at C2S does this by uniting the social, life and biomedical sciences. Current research themes at C2S include social disparities, stress and health; family relationships and health; and early influences on adult health. Bringing together multidisciplinary perspectives is the best way to understand all of the issues at play, asserts Chase-Lansdale.

Bioethics in Uganda

Senior Daniel Basco Aims to Boost Health Care
Daniel Basco

Daniel Basco's interest in health policy has led him to travel to Uganda, research with medical fellows and intern with the nation's top health agency. Through Northwestern's Public Health in Uganda program, the social policy senior studied the prevention of diseases that plague disadvantaged people. He also spent time at the largest community-based HIV/AIDS research study and did a research project on Ugandan bioethics.

"It was heartbreaking at times to see parents lose their children to diseases that don't exist here in the United States. At the same time, it was uplifting to see the all the work that local health professionals and researchers are doing to improve health in their country," he says. While in Uganda, he worked with a nonprofit that runs an orphanage and outreach programs for street children.

Daniel Basco
Basco's boethics research has earned him publication in a journal and an invitation to present a poster at the American Society for Bioethics and Humanity conference. Both stem from his six months of research with Northwestern's Oncofertility Consortium, where he studied health insurance laws that impact reproductive options for cancer patients.

This fall, Basco will continue his work in health policy at the National Institutes of Health (NIH). At NIH, he is helping to develop systems to measure the return on investments from federal research funding for health.

"Health is fundamental for people and nations to thrive," says Basco. "In Uganda, for example, over 50 percent of the population is under the age of 18 due to death from disease and war. ...I applaud anyone who is working to enable people to live healthier lives."