Health and economic benefits of reducing the number of students per classroom in US primary schools

Reducing class sizes in the early grades of elementary school could be among the most cost-effective ways to reduce costs for health care and medical intervention, a new study has found.

“Medical care patches people up and releases them back out into the social conditions that caused their disease in the first place, but education addresses the root causes of health risks,” said lead researcher, Peter Muennig, M.D., an assistant professor in the Department of Health Policy and Management at Columbia University.

The study was prompted by previous findings that small class sizes increase high school graduation rates, especially among low-income students, and that people with higher levels of education are less likely to need Medicaid or Medicare before age 65.

The researchers estimate that reducing class sizes would mean an additional 72,000 to 140,000 students would graduate high school each year, producing net savings of $14 billion to $24 billion.

Muennig and his coauthor constructed a mathematical model using data from Project STAR, a study of 12,000 Tennessee students in kindergarten through third grade that began in 1985. The project comprised 329 classrooms in 46 school districts, assigning students and teachers randomly to classes with either 22 to 25 students or 13 to 17 students.

The study is available online and it will appear in the November issue of the American Journal of Public Health .

The researchers acknowledged “some uncertainty” about whether the results of the Tennessee study could be reproduced nationwide or could “produce substantive health benefits,” but said their analysis suggests that reductions in class sizes would save money from the societal perspective.

Every year, up to 800,000 students fail to graduate from high school by their 20th birthday

According to their mathematical model, the researchers found that a student graduating from high school after attending smaller classes gains $168,431 in lifetime net revenue compared to a high school dropout who attended regular-sized classes.

Pamela Herd, an assistant professor of sociology at the University of Wisconsin-Madison, called the study “a profound analysis of a longstanding problem,” although she said its “weakness” was that it was computer model-based.

Many know that education benefits an individual's health, Herd said, but “what's really important and interesting about this article is that they're attempting to estimate how an educational policy change on reducing class sizes can change health outcomes.”

Most of the emphasis in trying to deal with health and poverty has been on an individual's behavior such as smoking or access to health care, Herd said. “It's very rare that you see this kind of analysis.”

“At best, we can say that an investment in education is a better outlay for future health than an investment in health insurance is,” Muennig said.

The American Journal of Public Health is the monthly journal of the American Public Health Association. Visit www.apha.org for more information. Complimentary online access to the journal is available to credentialed members of the media. Contact Olivia Chang at APHA, (202) 777-2511 or [email protected]

Muennig P, Woolf SH. “Health and economic benefits of reducing the number of students per classroom in US primary schools.” Am J Public Health 97(11), 2007.