International and Domestic Health Equity and Leadership (IDHEAL) UCLA Emergency Medicine

Social Emergency Medicine Teaching Modules
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Module 20
Dennis Hsieh, MD, JD


1. To understand how education impacts health.

2. To learn about the right to educational accommodations and individualized education plans
(IEPs) for children.

3. To discuss what resources are available for adults looking for additional educational

4. To be able to help patients with resources for education.


A 7-year-old male is brought to the ED on a psychiatric hold from school. The patient has been having behavioral outbursts at school and has been diagnosed with mild autism. Dad tells you that he has been asking the school to provide an environment to help his son learn but the school says that they do not have the resources. Instead, when he acts out, he has been suspended, placed in detention, or placed on psychiatric holds. The dad says he wishes he could just put his son into private school but he doesn't have the money. The dad did not finish high school and works as a janitor. The dad is trying to find a way to go back to school and get his GED so that he can earn a more money. Right now, between his two jobs and caring for his son, he just doesn't have the time or resources to do so.

Discussion Questions

1. How does this child's school environment affect his health?

2. What are the school’s obligations to accommodate the child's autism?

3. How does father's education affect his health?

Teaching Points

1. Lack of reasonable accommodations lead to many consequences such as suspension, expulsion, and psychiatric holds.

2. Schools have a legal obligation to accommodate health needs of children through the individualized education plan (IEP) process.

3. Educational attainment is directly correlated to a patient's health outcomes.

Practical Questions

1. What are the local resources available to assist with educational challenges for children?

2. What are the local resources available to assist with continuing education and training for

3. What resources are available in your clinic/hospital for education for children and adults?

Recommended Screening Question(s)
(See also legal needs – trouble at school)

1. For how many years did you go to school? (Record answer in years: ____)

2. Do you want help with school or training? For example, starting or completing job trainingor getting a high school diploma, GED or equivalent. (Yes/No)

Paired Reading

Robert Wood Johnson Foundation. Issue Brief: Why Does Education Matter So Much to Health? March 2013. Available at: rwjf403347.

Discussion Points from the Reading

1. Education influences health in many ways. It leads to better jobs, higher income and reduced risk of illness.

2. College graduates live on average five years longer than individuals who have not finished high school. Better-educated individuals are less likely to have chronic diseases and have more positive health behaviors. They also have access to healthier foods and safer homes.

3. College graduates earn nearly twice as much as high school graduates over the course of a lifetime.

4. Education has inter-generational effects, with infant mortality rates of women who never graduated from high school (8.1%) being nearly double that of women with college degrees (4.2%). Furthermore, only 13.3% of children whose parents do not have at least a college degree earn a bachelor’s degree, compared with nearly half of those whose parents are college graduates.

5. Current education trends pose a threat to the health of future Americans: nearly 46% of adults 25 and older have either not completed or pursued education beyond high school and 30% of high school freshman fail to graduate within four years.

Additional Readings

1. Ng SL, Lingard L, Hibbert K, et al. Supporting children with disabilities at school: implications for the advocate role in professional practice and education. Disabil Rehabil 2015;37(24):2282-90.

2. EB, Woolf SH, Haley A. Understanding the Relationship Between Education and Health. AHRQ 2015. Available at: curriculum-tools/population- health/zimmerman.html.

3. Hahn RA & Truman BI. Education Improves Public Health and Promotes Equity. Int J Health Serv 2014;45(4):657-78.