PUBLIC HEALTH
Education as health A partnership that is changing lives BY BRUCE CANTOR, MD, MS
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high school diploma or GED (General Educational Development) certificate is required for many jobs, and can boost future earning potential—with incomes rising even higher for those who attend college. Individuals who have completed their education also experience lower rates of preventable conditions and better overall health. One Minnesota health plan is partnering with a national organization to pave the way on all of these fronts for its Medicaid and MinnesotaCare patients.
Covering education as a health benefit UCare, a nonprofit, community-based health plan serving nearly 300,000 Medicaid and MinnesotaCare members, now works with GEDWorks—the official turnkey education benefit program from the creators of the GED— under a pilot project to serve its members in 18 counties. The program helps members in select counties improve their employment prospects by paying for their GED-related training, support, and exams. It was an untested concept at the time of development, but the program has already helped participants jumpstart their careers, life aspirations, and
financial security—and may result in better health outcomes for them and their families.
Local disparities While Minnesota often ranks high in quality-of-life measures, it has some of the worst disparities in the nation when it comes to education and health. Only 82% of Minnesota students earn a high school diploma within four years; this number is significantly lower for students of color and for immigrant populations. Eighty-seven percent of the state’s White (non-Hispanic) students finish high school on time, followed by Asian students (84%), Hispanic students (65%), Black students (65%), and American Indian students (53%). When compared with other states, Minnesota ranks 34th out of 50 for overall high school graduation rates, according to data from the U.S. Department of Education. The rankings differ by demographics: the state ranks 32nd for White students, 45th for Native Americans, 46th for Asian Americans, 48th for Black students, and 50th for Hispanic students. High school incompletion perpetuates the cycle of poverty for these students. According to state data, having a high school diploma or GED increases earning power by 37.5%—a nearly $10,000 per year median wage increase. Education clearly has the power to help lift people out of poverty.
Education and health How does poor education affect health? According to the American Public Health Association, adults who do not complete high school have poorer health and are more likely to die prematurely from preventable conditions such as cardiovascular disease, diabetes, and lung disease. Other outcomes for those with different educational histories:
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AUGUST 2020 MINNESOTA PHYSICIAN
Employment. Among Minnesotans 16 years and older, those with less than a high school diploma have unemployment rates of 13.1%. That rate is 3.1% for those with a bachelor’s degree. (Note: these figures predate the COVID-19 pandemic). Diabetes. Adults 18 years and older without high school diplomas or GEDs have diabetes rates of 11.1%, compared to 5.4% for those with college degrees. Prenatal care. Births without first-trimester prenatal care numbered 29% among mothers with a high school diploma or less. For those with more than 12 years of education, the rate was 13.6%. Smoking. Among those without a high school diploma or GED, smoking rates were 34.6%. Just 7.1% of college graduates smoke. The 2017 Minnesota Statewide Health Assessment stated: “Education is one of the clearest and strongest predictors of lifelong health. When we have more education, we are more likely to live longer, healthier lives. Success in school leads to higher earnings, and this improves our living conditions. Education allows us to find better-paying jobs, with healthier working conditions and benefits including health insurance and paid leave.” Children of educated parents are more likely to be healthy, too. Parents who are educated on the value of prevention are more likely to protect their
