Large-scale disruptions and school / community resources: Children’s longitudinal health and education outcomes using linked administrative data

Principal Investigator

Amy Ellen Schwartz

Professor of Public Administration and Dean, Joseph R. Biden, Jr. School of Public Policy and Public Administration, University of Delaware

Principal Investigator

Brian Elbel

Professor of Population Health and Health Policy, Department of Population Health, New York University Grossman School of Medicine, and NYU Wagner School of Public Service

Co-Investigators

 

  • Sophia Day, Director of Surveillance, Office of School Health, NYC Department of Health and Mental Hygiene
  • David C. Lee, Assistant Professor of Emergency Medicine and Population Health, New York University Grossman School of Medicine
  • Kevin Konty, Director of the Office of School Health, NYC Department of Health and Mental Hygiene
  • Michah W. Rothbart, Assistant Professor of Public Administration and International Affairs, Syracuse University Maxwell School of Citizenship and Public Affairs
  • Lorna E. Thorpe, Professor of Epidemiology, Department of Population Health, New York University Grossman School of Medicine
  • Meryle Weinstein, Research Associate Professor of Education Policy, New York University Steinhardt School for Culture, Education and Human Development

Funded By

National Institute of Nursing Research (NINR)

The problem:

Three aims:

  1. Determine health and education changes among children 2-4 years after large-scale event onset compared to prior to the event using a new, comprehensive and powerful set of linked child-level administrative data.
  2. Determine how child-level, school-level and neighborhood-level mitigating factors influence the course of the response to the large-scale disruptions.
  3. Determine the role of neighborhood and school resources in exacerbating or mitigating health and educational outcomes due to large-scale disruptions.

The approach:

This project linked New York City Student Population Health Registry (SPHR) data with multiple health and education-oriented municipal data sources at the child level. This data linkage thus sits at the nexus of schools, education, and health to study the effects of large-scale events such as the COVID-19 pandemic and pandemicrelated policies on children—including all NYC public school students (approximately 1.1M / year pre-COVID).

The findings:

The research team found sustained increases in youth mental health emergencies, sharp rises in chronic absenteeism, and uneven recovery in well-child visits and vaccinations during the pandemic. COVID-19 vaccination uptake was shaped by peer effects, demographics, and community factors. While school funding policies boosted resources, impacts on attendance were limited. Overall, these findings offer a nuanced view of who faced greater COVID risk at school and highlight disparities in risk, vaccination, and absenteeism, showing how school and community contexts shaped children’s health and education during and after the pandemic.

Scatter plot titled “Elementary Schools” showing data points for vaccination rate (y-axis) versus space per pupil (x-axis). Data points are categorized into three groups: low-risk (green dots, in the upper right quadrant with high vax rate and high space), mixed-risk (blue dots, scattered mostly in the mid-range of both axes), and high-risk (red dots, in the lower left quadrant with low vax rate and low space). Dashed lines indicate a vaccination rate of 70 and space per pupil of 28. Legend at the bottom identifies dot colors for low-risk, mixed-risk, and high-risk categories.

Selected Publications & Presentations

Elbel, B., Zhou, G. E., Lee, D. C., Chen, W., Day, S. E., Konty, K. J., & Schwartz, A. E. (2022). Analysis of School-Level Vaccination Rates by Race, Ethnicity, and Geography in New York City. JAMA Network Open, 5(9), e2231849. https://doi.org/10.1001/jamanetworkopen.2022.31849

Elbel, B., Heng, L., Konty, K. J., Day, S. E., Rothbart, M. W., Abrams, C., Lee, D. C., Thorpe, L. E., & Schwartz, A. E. (2023). COVID-19 Vaccines for Children: Racial and Ethnic Disparities in New York City. Preventive Medicine Reports, 102357. https://doi.org/10.1016/j.pmedr.2023.10235

The researchers compared the health and educational outcomes of two groups of students who, although similar in age, became eligible for vaccination six months apart. Twelve- to 12.5-year-olds became eligible for the vaccine in May of 2021 while 11- to 11.5-year-olds didn’t become eligible for the vaccine until November of 2021. The researchers used the difference-in-difference instrumental variable framework to compare outcomes for vaccinated and unvaccinated children in the academic year of 2021-2022.