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More Info: Healthy Students Healthy State Details

Strategy: Success in Stages

Listening & Learning
We started in 2014 with educators, since they are the “gatekeepers” regulating access to their schools.  They told us that the state school accountability system’s focus on reading, writing & math standardized test scores had in effect forced them to focus on those subjects—at the expense of others.

Since they were not given any additional resources, they “had to” slash recess, physical & health education, and arts education time—even school counselors & nurses—in order to increase instruction time for the subjects, for which they were held accountable.

(Making this even more catastrophic: as this had been happening at schools, screen-time and inactivity were increasing at home.  This “double-whammy” dramatically accelerated the decline in our children’s health & wellness.)

Meeting photo

Regulatory Change:  the State School Accountability System
So our initial policy focus was to convince the State Board of Education to add physical & health education to the state A-F accountability system for schools.  (This system assigns a grade of A, B, C, D or F to each public school annually—based overwhelmingly on reading, writing & math test scores.)

After an intense “rule-making” regulatory procedure from September 2016 to April 2017, we and advocacy allies we had brought together succeeded in officially starting the process toward a more balanced accountability system in the state, with a unanimous Board resolution.  When this process is complete, schools will be able to improve their A-F grade by improving physical & health education—as demonstrated in part by better student health-related outcomes. (This must be done while protecting student health data privacy.  So only aggregated anonymized information, with no individually identifiable student data, can leave the school.)

Voting info

Legislation: the Recess Law
We also co-led advocacy in the legislature for the state school recess law.  We succeeded in our second year with SB1083, receiving the support of more than 90% of legislators.  This major national breakthrough law requires all K-5 public schools to provide at least two recesses or one recess plus a PE session daily.  This law is increasing physical activity for children by 50%, eventually for about 250,000 elementary school students.

First Steps toward Assessments & Appropriations
After the State Board of Education approved its resolution in our favor, we co-led a workgroup for over a year with leaders of Arizona Health & Physical Education (AzHPE: the professional association for physical & health education teachers in the state), and others—in order to agree on one or more statewide assessment options.  We needed to be able to show the State Board, how schools could objectively and reliably yet affordably measure student progress in PE & health education in every public school, for the state’s school accountability system.

Probably the biggest issue we heard was how little time teachers had nowadays with their students—often only 30-45 minutes once per week, and often combining physical & health education in a single class session—in contrast with a total of 180 minutes per week recommended nationally and by the state of Arizona.  Teachers were very concerned that assessments would take up a major percentage of the little time that they still had left with students.

So in 2019, we began working with the legislature to start adding funds for physical & health education—beginning with professional development, in order to improve the quality of the little remaining health-related instruction time—and to start providing funds to develop time-efficient assessment systems.

One big issue we found in seeking appropriations was that—in a state at or near the bottom nationally for school funding, and with a legislature focused more on tax cuts than on increasing spending on children—many nonprofits were desperate for any new state monies for school-age children’s programs in education, health & human services.

As long as there was such a small pie of monies available in the state’s General Fund, children’s advocates would only be able to secure a small amount of new money—and since the legislature was more focused on “virtue-signaling” than in investing adequately to solve major long-term problems, a small amount of new state appropriations was going to be spread over too many things to have a real impact.

In brief, we needed major new long-term “sustainable” monies to invest in children’s health through schools.  To ensure lasting support at the scale needed, we decided to focus on health-related monies from public and private health plans and budgets:  the financial benefits from a healthier population would incentivize long-term support by health-related funder-stakeholders.

Founding Healthy Students Healthy State
As a result, during the pandemic, when both education & health leaders were focused on dealing with Covid-19, we built on everything we had learned and achieved over the prior six years to start developing Healthy Students Healthy State

With encouragement from key state leaders, we then began soft-launching a preliminary version.

The long-term goal is to bring $500M-$1B/year in sustainable new public-private money into schools.

In order to keep the costs low enough for long-term support by funders, we focused on a shared, public-private funding model. This will include roughly matching contributions from three main stakeholder groups:  the state legislature, federal Medicaid (AHCCCS), and private sector health plans.

Cost-Benefit Breakthrough: ROI by Funding-Stakeholder Group
This required innovative new cost-benefit/ROI analysis for each key stakeholder group, in order to demonstrate how each stakeholder-funder would benefit from investing in preventive K-12 education and associated services.

This analysis showed high ROI with rapid payback for all key funding-stakeholder groups—by increasing federal, state & private sector investment in evidence-based K-12 school health & wellness—including quality PE, health ed, physical activity, and mental health.  This is critical to ensuring enduring stakeholder support to fund and implement Healthy Students Healthy State.

Annual Savings graphic

(For health stakeholders and others, here is more information on the Top 10 Benefits for Health Organizations, and more details.)

(Also here is more information specifically for legislators & political leaders, business people & economic developers, health care professionals, veteransgrandparents/seniors, and nonprofits & community organizations. [add links to new web pages for Veterans and for Grandparents/Seniors] This factors in the cost in GDP & tax revenue loss of unprevented chronic disease, the potential for more business growth & profits, and the benefits for other groups—from a healthier population.)

Oped with Heritage Foundation
We also co-authored a nonpartisan opinion piece in 2020 in the Washington Examiner (conservative counterpart to the Washington Post) with one of the most powerful conservative influencers nationally, the Heritage Foundation.

This oped was co-authored with Heritage’s national defense group leader, Lt. Gen. Thomas Spoehr (Ret.), who along with hundreds of active & retired generals & admirals, is extremely concerned with insufficient health and fitness among potential military recruits.  After more than a decade of warnings by these military leaders, in 2022 the Army fell an alarming 25% short of its recruitment goals—and the Navy & Air Force fell short as well. 

(This oped also had to be approved by both the education and health care policy groups at Heritage, demonstrating broad support there.)

As a highly respected voice among many red-state leaders, Heritage’s support through this opinion piece is expected to significantly assist our advocacy.  It helps build credibility & backing for our work among red-state & Republican leaders.  It also demonstrates the nonpartisan nature, national relevance, and increasing visibility of our work and thought leadership. 

Washington Examiner page screenshot

Co-Founding & Expanding Arizona School Health & Wellness Coalition
During the pandemic, we also helped increase the size of the Arizona School Health & Wellness Coalition, which we had helped co-found just before the pandemic.  Scott served as Co-Lead of the Coalition’s Advocacy/Policy Action Team, and helped expand the size & impact of the Coalition more than 4x to over 400 health & education professionals.

We also concluded a partnership with the largest state parent organization, Arizona PTA, which became an early supporter of Healthy Students Healthy State as well.  This was an example of the powerful pressure coalition that we can grow to make a compelling “offer you can’t refuse” political case to the legislature.

Future:  Legislating and Voter Initiatives
For voter initiatives, we are trying to learn from both recent failed initiatives, and earlier successful ones.

A note of caution on direct voter initiatives, which attempt to bypass the legislature:

  • Some groups have gotten fed up with legislative inaction, particularly in K-12 funding, and pursued direct voter initiatives.
  • But voter initiatives without some basic understanding and support (or at least, no desire to strongly oppose) by a significant portion of the legislative majority can be futile.
    • The legislature almost inevitably works to undermine initiatives it opposes—when legislators have not been adequately educated on the issues underlying voter initiatives, and especially when advocates seem to legislators to be ignoring & circumventing the legislature.
First Things First logo

The main exception in recent decades in Arizona seems to have been creating First Things First in 2006, the new state agency for children ages 0-5 including preschools. First Things First was created by a direct voter initiative. Following a narrow Yes vote by the public, the legislature then unsuccessfully tried to undermine it with its own voter proposition. However, by the time the legislature referred its own proposition to the ballot, First Things First had developed a powerful political and public coalition throughout the state to protect itself—and the legislature’s proposition failed by a large margin.

We will work hard to both educate & persuade legislators and to pressure the legislature to do the right thing, to support Healthy Students Healthy State

Healthy Future US is building on its existing informal network to develop this coalition. We are also fund-raising to invest in more internal and external resources to accelerate this progress.