Identify a policy that is not usually intended to be a health policy but that you think may have important health implications.
Assembly Bill 197, introduced in 2019, would require every public elementary school, including charter schools, to offer at least one kindergarten class the same length as 1st grade, beginning in the 2022-23 school year. Schools will be exempt if they don’t have enough kindergarten classrooms to offer a full-day class for all students, but will have to offer one part-day kindergarten class in the morning and one in the afternoon in the same classroom. Full-day kindergarten is defined as any program lasting more than four hours, not including recess time. This legislation may have important health and developmental implications in the children’s lives and also impact those of their parents. For instance, more time in the classroom can better prepare students for the next grade level through cognitive and behavioral learning. Full-day kindergarten is good for low-income families who don’t have the financial means to pay for extra hours of childcare. Lessening this burden may decrease mental and economic stress, allowing parents to save or re-invest this money on food, bills, or extracurricular activities.
Describe why an evaluation of that policy is informative (e.g., determining effects of the policy, or primarily a test of hypothesized mediators).
As discussed in the literature and this course, education can be a mediator in the pathway to better health outcomes, especially among certain racial and ethnic groups. Because this policy targets education at a critical time point in a child’s life, it is important to evaluate its effects. This policy also needs to be analyzed contextually to make sure that it is having a balanced positive impact in school districts that are less wealthy.
Specify the outcomes and populations you think most affected or least affected by the policy.
I believe one-parent and two-working parent households will benefit the most from full-day kindergarten in regards to being less worried/less stressed about coordinating day care hour and its expenses. Students whose parents are not native English speakers may also benefit from this policy, by observing in a improvement in language/reading levels. Teachers will also be greatly affected by this policy as they will have to taken on more work hours and potential stress (regarding lesson planning, managing a hectic classroom). As mentioned above, poorly funded districts may suffer from this policy the most if they are not provided with adequate financial support, or lack the infrastructure to make full-day kindergarten feasible.
Propose a study design to evaluate the policy.
To evaluate this policy, it would most likely require an prospective study or case-control by which students in full-day kindergarten are compared to those in part-time kindergarten. We could focus on longterm outcomes such as academic advancement (i.e college enrollment) and health status (i.e obesity, diabetes, smoking). This would definitely be a long term study, but a shorter one (cross-sectional design) could focus on cortisol levels among parents whose kids are in a full day program versus those who are not.
Describe biggest challenge to implementing and drawing inferences about the impact of the policy on health.
The biggest challenge in implementing this policy, as mentioned before, is the disproportionate resource availabilty in different school districts. While in some districts full-day kindergarten is doable, in others it may be impossible. Drawing inferences on the level of impact that this policy may have on health is also very difficult given that there may unknown confounders and mediators that are not taken into consideration in the analysis that may make the results un-generalizable to some populations.