The Landscape of Federal K-12 School Health Efforts, 2010-2020

Research BriefHealthy SchoolsAug 30 2021

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In 2020, Kaiser Permanente convened a group of national organizations to form the National School Health Collaborative (NSHC). The NSHC’s vision is to fundamentally shift how school health is integrated into—and supported within—school, district, state, and federal policies and programs to more directly improve student and staff health, particularly for those who have faced systemic barriers to receiving necessary supports and services.

As a first step in accomplishing this vision, Kaiser Permanente tasked Child Trends with comprehensively mapping how the U.S. federal government currently defines, funds, and supports school health. Specifically, Child Trends conducted a systemic review of federal programs, initiatives, and funding streams that support school health work to answer the following research questions:

  • What federal agencies support school health initiatives? To what degree do those agencies have formal working relationships?
  • How does federal funding for school health advance the Centers for Disease Control and Prevention’s (CDC) Whole School, Whole Community, Whole Child framework? How do programs overlap and/or present competing objectives?
  • How do federal school health efforts target improving outcomes among groups that have faced systemic inequities?

We identified 10 formal interagency groups, 13 formula grant programs, 91 discretionary grant programs, and 67 technical assistance centers and initiatives that supported school health from 2010 to 2020. Key findings include the following:

Key findings

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  • The U.S. Departments of Education (ED), Health and Human Services (HHS), and Justice (DOJ) each play a central role in federal school health efforts. ED, HHS, and DOJ each have significant formula and discretionary grant funding and technical assistance efforts. However, each agency approaches school health from different frameworks and with varying foci.
  • Existing school health-related interagency collaborations lack representation from all relevant agencies. For example, DOJ is not currently involved in the two interagency collaborations that are directly focused on school health. Moreover, interagency collaboration memberships largely do not include groups whose missions specifically focus on historically disadvantaged populations, such as the White House Initiative on Educational Excellence for Hispanics and the White House Initiative on Educational Excellence for African Americans.
  • Federal efforts to support students’ physical health are largely siloed from those focused on broader elements of school health, such as social and emotional climate. Whereas social and emotional climate—covered in nearly half of grant programs and 70 percent of technical assistance efforts—is well integrated into broader initiatives, students’ physical health is often only addressed in grant programs specifically focused on that issue. Far fewer discretionary grant programs and technical assistance efforts address physical health topics, which include school health services, health education, and physical education and physical activity.
  • Few federal school health efforts include a focus on employee wellness. Only three grant programs explicitly support efforts around employee wellness and only limited technical assistance efforts, primarily from the CDC, touch on the topic.
  • Federal school health efforts that make an effort to reach students who face systemic barriers to health and education are limited. Although 70 percent of grants include a focus on one or more target populations (primarily children from low-income families and communities, students with disabilities, military-connected children, and American Indian and Alaska Native students), only five grants (5%) specifically include a focus on students from historically marginalized racial/ethnic backgrounds other than those grants focused on American Indian and Alaska Native students. Moreover, most grants that include a targeted focus do so from a deficit lens, often labeling students or schools as “at-risk” or “low-achieving” rather than focusing on addressing specific systemic inequities.

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