July 21, 2014
News Review From Harvard Medical School -– Teens at Top High Schools Take Fewer Health Risks
Going to a top-performing public high school can reduce very risky health behaviors among low-income teens, a new study suggests. These behaviors include binge drinking, substance use at school, risky sex and joining a gang. The study included high school students from low-income neighborhoods in Los Angeles who applied to top-performing charter schools. These schools choose students through a lottery. All of the students had similar test scores. They also came from similar family backgrounds. Researchers surveyed the health behaviors of two groups of students. One group included 521 students who got in to one of these top schools through the lottery. The other group included 409 students who applied but did not get in. The survey showed that 36% of the charter-school students compared with 42% of the other students admitted to very risky behaviors. However, students from both groups were just as likely to engage in risky behaviors, such as smoking cigarettes, using marijuana or drinking alcohol. The students at the top-performing schools were less likely to switch schools or drop out. They also did much better on standardized math and English tests. The journal Pediatrics published the study. HealthDay News wrote about it July 21.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
The high school a teen goes to matters — in ways that can't always be controlled and aren't always fair.
Researchers in Los Angeles were interested in how going to a more successful high school affected the choices teens make in terms of risky healthy behaviors. This is very hard to study in general, because there are so many "confounders." Confounders are factors that muddy the waters of a study and make it harder for researchers to understand the results. When it comes to successful schools and risky behaviors, what most commonly confounds studies is that successful schools tend to be in communities where parents have higher incomes and more education. So if kids do better, it's hard to know if it was the school or the parents that made a difference.
To try to sort this out, the researchers looked at two groups of teens that had many similarities. They were from similar ethnic backgrounds and came from families with similar income and educational backgrounds. And their families were motivated to help them succeed. All the teens also applied to lotteries to get into successful public charter schools. The difference between the two groups was that one group got into the schools, and one group didn't. The researchers compared math and English test scores, school retention and risky health behaviors between the two groups. They divided the risky health behaviors into two groups: risky (alcohol, tobacco or drug use, unprotected sex) and very risky (binge drinking, substance use at school, risky sex, gang participation).
The teens that got into the charter schools had higher test scores, were more likely to stay in school, and were less likely to have very risky behaviors than those who didn't get in. When it comes to risky behaviors, while there was a difference (those who got in seemed to have fewer), it wasn't statistically significant. Which isn't all that surprising. No matter where they go to school, teens are still teens — and a certain amount of risk-taking comes with the territory.
There are many reasons this could happen. Here is what the researchers suggest:
- Teens who learn more, and have better grades, may make better health decisions.
- The school environment may make a difference. For example, being in a higher-performing school may mean less exposure to kids who are making risky decisions — so the peer pressure to do so may be less.
- Getting better grades may give kids more opportunities and more hope for their future, which may lead to less interest in taking risks.
- Being in school or doing more homework may leave less time to get into trouble.
What Changes Can I Make Now?
Whatever the reason for the difference, this study certainly underlines what we have known for some time: better schools can lead to better futures for kids. That's why it's really important that we do everything possible to improve schools, especially in low-income areas, and especially for children whose parents may be less able to support them and advocate for them.
It's also very important for parents to do everything they can to get their children into the best-performing school possible. This is most important for low-income families and those with less education. As much as possible, they should avail themselves of every resource possible, and try to get their children into charter schools and other better-performing schools, and even private schools that offer scholarships. Teachers, doctors, coaches, family members and friends should try to educate and support parents in any way they can in this process.
What Can I Expect Looking to the Future?
The divide between rich and poor has been widening in this country. Unless we pay attention to the findings of this study and others like it, and do something, the gap will widen further. This is a matter of social justice; hopefully we can come together to do the right thing for all children.