The Maldistribution of Pediatric Providers as a Potential Driver of Reduced Educational Outcomes

Objective Despite evidence of a strong bidirectional connection between educational achievement and health, few studies have examined the link between these intertwining forces on a national level. This study takes advantage of a new population-level dataset to explicitly link child health access to academic outcomes in nearly every U.S. school district. Methods National data were used to construct and link district-level measures of child health access to district-level measures of third-grade achievement. Specifically, location data for over 256,000 practicing pediatricians and family physicians were linked to achievement data from 12,296 school districts. We include district-level rates of uninsured children as an additional measure of child health access. Results First, physician supply is unequally distributed across districts and their student populations. Second, districts that had higher physician supply tended to have higher test scores. This relationship is most pronounced for districts with relatively few pediatricians and family physicians. While the rate of uninsured children is largely correlated with community socioeconomic status, physician supply appears to operate independently of this measure. Conclusion Early childhood health and wellbeing are linked to cognitive performance and achievement in school. We provide evidence to illustrate an aspect of this relationship: children with less access to healthcare providers also do less well in school. The specific patterning of this finding suggests a need to reconsider how availability and access to pediatricians and family physicians is currently configured. Future research should examine whether a redistribution of the existing physician workforce could result in a net academic benefit for students.