Project Summary
The project team leveraged existing data from an urban public school system in Tennessee to determine if locating a health clinic onsite and managing chronic conditions improved teacher health, retention, and productivity. The team also examined if this will in turn impact student academic performance.
Research Questions/Aims
- Do worksite health interventions improve teacher health?
- Does the health of teachers affect teacher retention and productivity?
- Does the health of teachers impact student academic performance?
Actionability
- Inform the design and implementation of similar interventions across sectors through a better understanding of the associated costs and benefits.
Results
School-based clinics reduce health care costs and illness-related absenteeism for teachers, but no significat differences were detected in self-reported health status or student academic achievement.
For teachers, using a school-based clinic rather than a community-based clinic for primary care was associated with significant reductions in:
- Primary Care Visits (1637 vs 2756, per 1,000 teachers annually)
- Inpatient Admissions (31 vs 53, per 1000 teachers annually)
- Annual Health Care Costs ($4,298 vs $5,043 in 2016 US dollars)
- Annual Absent Work Hours (61 vs 63)
Outcomes
Health: Health care utilization (inpatient admission, emergency room visits), total health care costs, biometrics (BMI, blood pressure, blood glucose, and cholesterol level), self-reported health status, job satisfaction, smoking status, physical activity, fruit consumption.
Other: Teacher retention, teacher absenteeism, student academic performance, teacher earnings, job performance score.
Methodology
An instrumental variable approach using the distance to the nearest clinic. A propensity score weighting method was applied for secondary analyses.
