ROI/Payback

Q. Why should state & federal governments and private health plans & providers be interested in investing in schools?

A. Because clinical settings alone have not been improving health behavior.

In spite of the constant admonitions of doctors & nurses, not to mention pervasive TV, clickbait & social media health advice, few adults permanently change their unhealthy lifestyles.  Instead, they are dependent on lifelong drug prescriptions and “disease management” care—at very high cost to themselves and others.

We all pay the price for our & others’ unhealthy habits—and that price is now 15% of our incomes, and averages out to $12,000 per person—and still increasing.  

(Business owners and employees with private health insurance pay a particularly high price:  The government won’t reimburse health care providers for the true cost of Medicare & Medicaid.  So health insurers must pass on the extra costs—with ever-higher premiums & deductibles.)

Students in FitKids of Northern Arizona physical activity program

We can reduce preventable chronic conditions and associated costs among the non-elderly adult population by an estimated 20%, through healthier state policies, the Plan-Develop-Evaluate model, and other K-12 approaches—sustainably funded with health sector monies.

Major health improvements and cost savings are guaranteed by 13 years of healthier habits K-12. Those 13 healthier years postpone the on-set and reduce chronic condition severity among young and middle-age adults.   Chronic diseases, which are currently starting in the teens, 20s & 30s, get deferred to later in life—even if young adults “fall off” a healthy track after their school years. Fewer years of inflammation, worsening blood pressure, arterial plaque build-up, muscular atrophy, unmitigated stress & trauma, etc. in childhood translate into a much more promising first several decades in adulthood.

Postponing On-set Guarantees Cost Savings

Of course, healthy habits developed in childhood must then be reinforced in the workplace and at home, in order to prolong habits learned at school into adulthood. We can do this, if we are able to build on a K-12 foundation of healthier habits. Follow-on policies & practices targeting young & middle-age adults can reduce long-term chronic health care costs up to a total of 50% less than projected future levels, given current health trajectories.

The huge cost savings potential is supported by a growing number of studies.

We are making significant progress toward increased health sector funding of quality, effective, evidence-based physical and health education, recess, physical activity, & toxic stress reduction at school. (When we say “health sector” here, we mean health-related government budgets such as Medicaid/AHCCCS, as well as the health care budgets of self-insured employers, and private health insurers.)

Good news for Arizona and other states adopting Healthy Students Healthy State:

Once public & private health plans step up to help reimburse these costs, with the legislature and Medicaid co-investing, we can eventually reach $500+ million per year in new money into Arizona schools—while reducing & preventing diabetes, severe obesity, high blood pressure, back & arthritis pain, many cancers, ADHD, anxiety & depression, & other chronic health conditions.

Other states will benefit proportionally, based on their size.

K-12: 1st Year/Every Year Payback

Due to the high prevalence of ADHD, obesity, anxiety & depression among children now, regular moderate-to-vigorous physical activity (MVPA) for all children at a school pays for itself rapidly. It can provide $30-50 in annual child health savings each year for each elementary student, and $50-75+/year for each middle & high school student. (Even if only 1 in 3 parents improve their health as a result of K-12 parental program components, these savings would double.)

This addresses health organizations’ central objection: that they are under extreme financial pressure, and find it difficult to invest now in children—if the payback is only later, in students’ adulthood.

This means, given the low cost per student of the Plan-Develop-Evaluate model—for schools with adequate quality physical education instruction time—health plans can pay back their investment in the first year. (Payback is longer when the health sector needs to fund adding more quality PE time, but the ROI is still rapid & high, as described below.)

Beyond K-12: Long-Term Health ROI

In addition, there is huge future upside for funders, from postponing the on-set and reducing the severity of later-life chronic conditions in adulthood. Through 13 years of K-12 whole-student-population preventive education and healthier behavior, we can expect future annual savings of thousands of dollars per lower-income adult.

Major health improvements and cost savings are guaranteed by 13 years of healthier habits K-12. Those 13 healthier years postpone the on-set and reduce chronic condition severity among young and middle-age adults.   Chronic diseases, which are currently starting in the teens, 20s & 30s, get deferred to later in life—even if young adults “fall off” a healthy track after their school years. Fewer years of inflammation, worsening blood pressure, arterial plaque build-up, muscular atrophy, unmitigated stress & trauma, etc. in childhood translate into a much more promising first several decades in adulthood.

Let’s look at these school-related savings by stakeholder group (This is calculated for Arizona—but scale up or down for your state based on its population relative to Arizona’s 7M+ residents):

No matter where you sit, this investment is medically & financially as well as ethically & morally compelling. 

Please see our latest slide deck for more details.