Learning and Health

The Obama administration is working on what it calls “sweeping change” in the No Child Left Behind law inherited from the Bush administration. The reforms seem to center on changing the incentive system and standards for school and student performance. Although tests in math and reading are still at the core of the law’s implementation, the goal has shifted from being narrowly focused on proficiency in reading and math as measured by standardized tests to include something referred to as being college-ready.

When my oldest daughter Laural started school almost 35 years ago, a pleasant woman asked her what she was learning. Laural, without much hesitation, said she was learning how to stand in line and how to take tests. Little seems to have changed. And for good reason: the education system then and now has the goal of training productive citizens—meaning employable and well-behaved.

If health is the capacity to have a full, rich life, as we discuss in our book Too Much Medicine, Not Enough Health, then learning has to be at the core of that capacity. But just as health care institutions are really not about health but about medical diagnosis and treatment, the institutions of education are not really about learning but about training children for the worlds of work and civic responsibility.

This shouldn’t be news to anyone. The New York Times article that described the Obama administration’s bold moves was filled with the views of administration officials, Congressional Democrats and Republicans, union representatives for teachers (they weren’t happy because teachers are handed all of the responsibility for making the new plan work while receiving none of the powers they’d need to actually make it work), and a representative of the Business Roundtable (quite thrilled about the focus on increasing the quality of future employees). In other words, these dramatic changes are about politics and supplying the labor market.

There was no discussion of how social inequity affects educational outcomes. There was no discussion of the actual college prospects for freshly minted, college-ready high school graduates. Nor was there a discussion of the actual labor market that the resulting surplus of freshly-minted college graduates will encounter. And even if they were taken into account, having a full, rich life consists of far more than preparation for a fulfilling job at a living wage—to the extent that such things exist and to the extent that a child’s access to them is affected by race, ethnicity, social class, income, gender, and sexual orientation. In fairness, neither social inequity nor conditions in the labor market are the responsibility of education institutions. It’s not their job. Besides, many children have plenty of direct experience in these matters outside the classroom from which to learn.

Science was also missing from the Times article—no discussion of whether this mode of education is actually productive. For example, one of the perverse effects of the old, bad No Child Left Behind was the obsessive focus on reading and math scores to the detriment (and defunding) of other areas—music, the fine arts, and the humanities. The new, improved No Child Left Behind promises to accommodate these other areas while still focusing on reading and math for performance standards.

Consider music lessons in school. It is persistently underfunded or not funded at all through the regular school budget. Now consider the sizable body of research that demonstrates better cognitive development and spatial reasoning among children who regularly play a musical instrument. So why doesn’t No Child Left Behind fund music classes as a core part of the curriculum? Is it because music isn’t a core skill like reading and math? Is it because music doesn’t obviously develop core skills such as standing in line and taking tests? On the contrary, it encourages harmony, literally and figuratively—certainly not suitable preparation for competition in college and the labor market. It doesn’t make students college-ready, it doesn’t make them job-ready, it doesn’t add to their productivity as citizens. It does, however, enrich their lives and enhance their capacity for doing so.

Doesn’t this remind you a little too much of the health care system? What happens when you go to a doctor’s office or hospital? You stand in line and take tests. You are being made diagnosis- and treatment-ready—since your job as a patient is to be diagnosed and treated.

As I’ve said before, the purpose of an institution is social stability, no matter what its actual area of concern—whether it’s the education of the young or the care of the sick and infirm. I hasten to say that social stability is extremely important. But it’s not what we live for. That would be something like music. The gift that is the capacity to learn, that is an essential capacity for health and for the power to have a full, rich life, is that the capacity to learn enables us to know, among many other things, when social stability for its own sake is good for us and when it’s not and what to do instead.