Where are our graduate schools of "Educational Public Health"?

"Schooling" and "Education"
Mark Twain famously said that he never let schooling interfere with his education (1).  That's an exaggeration, no doubt, but it gets at an important phenomenon. A lot of one's education--arguably, most of it--happens outside of school.  A researcher I admire, David Berliner, writes that the data show that 60% of educational achievement results from out-of-school factors, while only 20% of achievement, at most, is based on in-school factors. This jibes with what I see every day--but it's a truth that is usually ignored in discussion of educational achievement.  When people talk about "education", they almost always mean "school."  This is unfortunate, not only for children, but for teachers, too.  I wonder if part of the reason that our discussion about education is so limited and inadequate is that we simply don't have good terms with which to talk about it.

If teachers and doctors are somewhat comparable, is there a comparable issue in looking at health?  Is most of a person's health due to factors that have nothing directly to do with doctors or treatment?  Yes, definitely!  So, to understand the schooling/education distinction, it might be helpful to look more closely at the parallel issue in health care.

The study of health, unlike education, has a very clearly defined field, separate from "medicine", that looks at the larger social factors.  That field has its own prestigious schools that parallel medical schools, its own professors, its own vast academic literature.  It also has a handy name: not "medicine" but "public health."  Education has none of these things--no insitutions, no professors, not enough literature, no handy name--and it sorely needs them.  I'd love to see Harvard's GSE renamed the Harvard Graduate School of Schooling, and a new school established--but with what name?  The Harvard Graduate School of Public Education? Probably not.  The Harvard School of Educational Public Health?  Maybe...


How Medicine and Public Health are different
The distinction between medicine and public health is an important one.  To think in terms of medicine is to think about directly "treating" the individual "patient."  To think in terms of public health is to think what factors directly or indirectly affect larger populations.  A public health perspective sees cancer not so much as an illness of the individual patient, to be treated by means of knives and poisons, but rather as a result of large-scale societal factors including various kinds of pollution, diet, or the use of alcohol or tobacco.  Broadly speaking, the public health perspective thinks about preventing problems, while the medical perspective thinks about treating those problems.

Both of these perspectives are useful and necessary, but the public health perspective is arguably far more important.  Just as out-of-school factors contribute far more to educational achievement than in-school factors, public health factors contribute far more to health than medical factors.  The dramatic increase in life expectancy over the past couple of hundred years  is due far more to improvements in public health (clean water, safer foods, vaccination, etc.)  than improvements in medical care.  Citing a CDC report as an authority, my favorite website reports: "During the 20th century, the average lifespan in the United States increased by more than 30 years, of which 25 years can be attributed to advances in public health."

The distinction between medicine and public health is well-defined and well-known, but we don't, unfortunately, make the same distinction in education.  This is regrettable, because just as direct medical care is less important for health than larger social factors, so formal schooling is less important for education than larger social factors, but these larger factors are routinely ignored in the public discourse about "education".  When the Gates foundation attempts to "advance student achievement", or when the Presidential candidates talk about how educational achievement is a key to building the American economy, or when the New York Times makes the same point, the focus is entirely on schools, and there is not even a word, not even a nod, to the "Public Health" side of things.  At best, we get the oft-repeated truism that the teacher is "the most important in-school factor in student achievement"--a sneaky formulation which glosses over the fact that out-of-school factors are far, far more important.

Why Medicine and School get too much attention!
That formal schooling isn't as important as the extracurricular environment is not a new idea.  Americans have always been somewhat suspicious of school.  Our two most famous American autobiographies, by Ben Franklin and Henry Adams, are both explicitly about extracurricular education. Nevertheless, we don't have institutions devoted to studying the out-of-school factors and how to affect them--and we don't have a name for it.

Perhaps a new term wouldn't make a difference.  Even public health, which has a pretty good, pretty well-known name, is consistently--especially in America--underestimated, underfunded, and often ignored.  In both medicine and education, there are structural reasons for ignoring the "public health" side of things and focusing on the medicine side.

First, what would be best for the public as a whole is often in conflict with some individual's local interest, and can often be painted as conflicting with the value of "freedom."  Banning tobacco in bars is one example.  There was resistance to smoking bans from tobacco companies, from smokers themselves, and from the restaurants and bars (which didn't realize that the promise of disgusting air and ashtray hair was keeping more customers away than the freedom to smoke was drawing in). Often, too, the special interests will lose much more, per person than the public interest will gain.  Clean air regulations are an example: adding a year or so to everyone's life is a good thing, but that year is, at the individual level, uncertain and far away, while affected industries may lose millions of dollars in profits right away.  So public health initiatives face an uphill battle.

Attention to and funding for the medical approach, on the other hand, have far fewer structural barriers, especially in American culture.  The most highly energized advocacy groups are those made up of people directly affected by disease, and those groups tend, naturally, to focus on treatment and cure rather than on prevention.  If you or someone you love has breast cancer, you are most concerned with getting rid of it, not with decreasing the chances that others will get it in the future.  Doctors, too, perhaps especially in our system, are far more focused on treatment than on prevention.  There's more glory in it, there's more money in it, and there's probably more immediate human satisfaction in treating a person who's suffering than there is in helping a healthy person stay healthy.

The same structural factors are at work in education.  Even though, as I said, in-school factors generally account for only about 20% of educational achievement (and a key in-school factor, the other students in the building, might be considered an out-of-school factor!) while out-of-school factors account for about 60% of achievement, there is far more focus on schools--what we might call treatment--than on the extracurricular environment.  We are all worried about our own individual schools.  Students, parents, and teachers want to make our schools as good as they can be.  Nearly everyone living in Leafstrewn, even those without kids, wants the schools to be as good as they can be, because then Leafstrewn will be a more attractive place to live, property values will rise, richer people will move in, and so on.

Educational public health, on the other hand, has no particular constituency.  Sure, there are a few scattered folks at Ed. Schools who work on these matters, and a few here and there in psychology, public policy, economics or sociology departments, or at think tanks (2), and there are teachers and parents who are keenly aware that education is about much, much more than just school, but the idea lacks a coherent interest group.

A local habitation and a name
There is all the more reason, then, to come up with a term, to build institutions that will study it and advocate for it, and to make sure never to ignore it when we are discussing schools.

But what to call it?  Anyone have any ideas?


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Footnotes:
(1) Mark Twain was not alone.  Bruce Springsteen learned more from a two-minute record than he ever learned in school. Paul Simon had some choice words about what he learned in high school and how it affected his ability to think.  John Ashbery writes that in school "all the thought got combed out."  For these writers, school was not where education happened.  But even when education does happen in school, its effects are often dwarfed by out-of-school effects.
(2)  I have learned a lot from reading the work of, among many others, Christopher Jencks, Richard Rothstein, David Berliner, B.J. Biddle,  Helen Ladd, Stanley Aronowitz, Stephen Krashen, and Gerald Coles.  Of those, I think only Berliner and Krashen held positions in Ed. Schools, and Krashen started out in a Linguistics department.