Beyond the Remit of Responsibility or Understanding
by Joey Feith
In a period of expected education funding cuts across all sectors and catastrophic health care expenditure forecasts, developed nations with universal health care should ask themselves to what extent education can be seen as a means of preventative health care. Especially given current data suggests that health care costs will continue to rise above inflation well into the next decade due to an ageing and growing population that has a growing waistline and increased prevalence of non-communicable diseases. For most Australians, this nexus of health and education is explored during the 11 years of compulsory schooling from Years K-10 during their Health and Physical Education studies.
In 2013, the Australian Curriculum Assessment and Reporting Authority (ACARA) released a statement that essentially wiped any educational responsibility for improving the health care status of Australians. The statement read;
It is beyond the remit of Health and Physical Education to solve problems or meet outcomes that sit beyond the education space.
According to ACARA and the Australian Government, education is not an answer to improving the health of Australians. They are right it’s not AN answer, it’s THE answer.
Apart from population size, very little separates the universal health care systems in Finland and Australia. According to the World Bank in 2012, Finland and Australia had comparable life expectancies from birth (about 82 years) and both countries spent 9% of their total GDP on health care.
However, education funding is very different. In 2010, Australia and Norway both spent 21% of GDP per capita on primary school education. As children enter secondary school, that spending gap widens with Australia spending less than 20% of GDP per capita compared with Norway’s spend increasing to 27% to keep kids in school. By the time our young Australians are ready to move into the tertiary education sector, Norway will spend over double Australia’s investment of 21% of GDP per capita to nearly 44% of GDP per capita.
Ask yourself, which country will be facing long term health care costs and preventing the effects of a growing and ageing population with increased prevalence of non-communicable disease? According to a group of leading scholars from the National Bureau of Economic Research in the US, there is a well known, large, and constant association between education and health. This has been observed in many countries and across several time periods and for a variety of health measures. The differences between the more and the less educated are significant. When you examine the age-adjusted death rate of high school leavers aged 25 to 64, they are more than twice as large as the death rate of those with some level of tertiary education.
For every $1 we spend on education, a yield $2.5-$7.2 in economic growth occurs through the additional life added to the population and its productivity. The current cash rate offered by the Reserve Bank of Australia is 2.5% p.a. This means investing in education capital has a minimum yield of 250% across the working life of an individual (which is currently to the age of 65 years). To put this in perspective, if we spent an extra $1000 on every student in school/university this year (2.4 million of them) or put the same money in the bank, to yield the same dividend to the economy the students of 2014 would take approximately 47 years and the Reserve Bank of Australia would take 100 years…and that is the most conservative estimate!
Better still, those who spend longer in school, cost less to the health care sector. This is not factored into the previous economic growth model and represents real health care budget savings. Those who are more educated have lower illness associated with nearly every non-communicable disease. Physical and mental performance is also better for the better educated. Those who spend longer in school are substantially less likely to report that they are in poor health, and less likely to report anxiety or depression. Finally, better educated people report fewer ‘sick days’ because of disease, and they have fewer functional limitations. An additional four years of education lowers five-year mortality by 1.8%; it also reduces the risk of heart disease by 2.2%, and the risk of diabetes by 1.3%. Four more years of schooling lowers the probability of reporting oneself in fair or poor health by 6% and reduces lost days of work to sickness by 2.3 each year.
In terms of the relationship between education and the various health risk factors such as smoking, drinking, diet/exercise, use of illegal drugs, safety, use of preventive medical care, and care for hypertension and diabetes (which are all studied during Health and Physical Education in Years K-10), the overall the results suggest very strong association where the better educated have healthier behaviours along virtually every margin. Those with more years of schooling are less likely to smoke, to drink heavily, to be overweight or obese, or to use illegal drugs.
Australian’s cherish a universal health care system and one where every Australian is entitled to the same level of care regardless of circumstance. This is a noble virtue on which our modern society thrives but may now be under serious threat from those without the vision (academically or politically) to invest in a course of action that ensures such a system to continue. Academics must not shirk our capability to be the single most effective intervention in reducing public health care expenditure and improving quality of life in the population.
Based on current media headlines, it appears many Australians care more about standardized test scores; if teachers are ‘dressed appropriately’ for work; or if their kids attend a private school. None of these ‘thin edge of the wedge’ conversations will keep kids in school longer, make them pursue further study, reduce health care costs or have any chance of safeguarding a long-term universal health care. An evidence-based Health and Physical Education (and The Arts, Humanities, Mathematics, Science and Languages) curriculum are our BEST answer to keeping the virtues, economy and health of a country intact. We cannot allow our politicians; let alone our own academics, be diverted from that conversation and that course of advocacy.
Dr Dean Dudley is a senior lecturer of health and physical education at Charles Sturt University in Australia.
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