Making Class Sizes Smaller May Be More
Cost-Effective Than Most Medical Interventions
October 17, 2007
Reducing the number of students per classroom in U.S. primary schools may be
more cost-effective than most public health and medical interventions, according
to a study by researchers at Columbia University Mailman School of Public Health
and the Virginia Commonwealth University. The study indicates that class-size
reductions would generate more quality-adjusted life-year gains per dollar
invested than the majority of medical interventions. The findings will be
published in the November issue of theAmerican Journal of Public Health.
The researchers estimated the health and economic effects of reducing class
sizes from 22-25 students to 13-17 students in kindergarten through grade 3
nationwide, based on an intervention tested in Project STAR (Student Teacher
Achievement Ratio), a large multi-school randomized trial that began in 1985.
Project STAR is considered the highest quality long-term experiment to date in
the field of education.
The study shows that a student graduating from high school after attending
smaller-sized classes gains an average of 1.7 quality-adjusted life-years and
generates a net $168,431 in lifetime revenue. "Higher earnings and better
job quality enhance access to health insurance coverage, reduce exposure to
hazardous work conditions, and provide individuals and families with the
necessary resources to move out of unfavorable neighborhoods and to purchase
goods and services," says Peter A. Muennig, MD, MPH, assistant professor of
Health Policy and Management at the Mailman School. "Regardless of class
size, the net effect of graduating from high school is roughly equivalent to
taking 20 years of bad health off of your life."
When targeted to low-income students, the estimated savings would increase to
$196,000 per additional graduate. "This is because low-income students seem
to benefit more from the additional attention afforded by small classes,"
noted Dr. Muennig. "Because we focused on a relatively expensive
intervention and examined outcomes over a range of values, our results should
provide a conservative framework for evaluating this and other interventions as
long-term data on educational interventions become more plentiful," he
commented.
The performance of students in the U.S. has been declining relative to the
performance of students in other countries. With health costs soaring and
student performance falling, the United States is in jeopardy of losing its
economic dominance.
The findings not only raise issues of whether investments in social determinants
of health can be more cost-effective than investments in conventional medical
care, "but more intriguing still, also bring up the idea that each dollar
invested in education could also potentially produce other long-term
returns," observes Dr. Muennig. He notes that further analysis will refine
models and produce more-precise estimates, but "these findings do point to
the importance of looking more broadly at the options available for improving
health outcomes -- including those outside the boundaries of clinical
medicine."
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Article adapted by Medical News Today from original press release.
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About the Mailman School of Public Health
The only accredited school of public health in New York City, and
among the first in the nation, Columbia University's Mailman School of Public
Health provides instruction and research opportunities to more than 950 graduate
students in pursuit of masters and doctoral degrees. Its students and more than
300 multi-disciplinary faculty engage in research and service in the city,
nation, and around the world, concentrating on biostatistics, environmental
health sciences, epidemiology, health policy and management, population and
family health, and sociomedical sciences. http://www.mailman.hs.columbia.edu/
Source: Stephanie Berger
Columbia
University's Mailman School of Public Health
Medical News Today: http://www.medicalnewstoday.com
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