Unplanned School Closures in the United States: Evaluation of Economic and Social Costs and Consequences for Students' Families
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Unplanned School Closures in the United
States:
Evaluation of Economic and Social Costs
and Consequences for Students’
Families
Yenlik Zheteyeva, MD, MPH
Centers for Disease Control and Prevention
ISDS Conference, Philadelphia PA, December 10-11, 2014
National Center for Emerging and Zoonotic Infectious Diseases
Division of Global Migration and QuarantineSchool Closures: Background
q Children play a significant role in transmitting influenza in
communities
q Preemptive coordinated school closures may be implemented
during influenza pandemics to slow down disease spread
q Recommended as a mitigation measure for severe pandemics*
q Balance between benefits and potential harms unclear for pandemics of
lesser severity*
q Concern: Unintended consequences for students, households,
schools and communities — would potential harms outweigh
benefits?
q Sparse evidence base about harms (unintended consequences) of
school closures
* Full statement and recommendation of the US Community Preventive Services Task Force available at:
http://www.thecommunityguide.org/emergencypreparedness/schooldismissals.htmlUnplanned School Closures
United States, 2011-2013
q 20,723 unplanned school closure events
lasting ≥1 day identified from August 1, 2011
to June 30, 2013
q >27 million students and >1 million teachers
affected
q 48% (IQR: 26–70%) of students in closed
public schools eligible for free/reduced price
lunch
Wong KK, Shi J, Gao H et al. (2014) Why Is School Closed Today? Unplanned K-12 School Closures in the United
States, 2011–2013. PLoS ONE 9(12): e113755.doi:10.1371/journal.pone.0113755Closure events widespread
2011–2012 School Year 2012–2013 School Year
(n=4,390) (n=16,333)
School days lost: 1–20 School days lost: 1–12
Wong KK, Shi J, Gao H et al. (2014) Why Is School Closed Today? Unplanned K-12 School Closures in the United
States, 2011–2013. PLoS ONE 9(12): e113755.doi:10.1371/journal.pone.0113755School closure events by number of
school days lost, U.S., 2011-2013
(N=20,723)
20000
18000
16000
Number of closure days
14000
12000
10000
8000
6000
4000
2000
0
1 2 3 ≥4
Number of days lost
Date of re-opening unavailable Date of re-opening available
*Where school re-opening date was not available, the closure was assumed to last only one day
Wong KK, Shi J, Gao H et al. (2014) Why Is School Closed Today? Unplanned K-12 School Closures in the United
States, 2011–2013. PLoS ONE 9(12): e113755.doi:10.1371/journal.pone.0113755Objective
q Describe economic and social costs and
consequences of prolonged (≥4 days)
unplanned school closures
q Provide recommendations to school and
public health administrators
* Full statement and recommendation of the US Community Preventive Services Task Force available at:
http://www.thecommunityguide.org/emergencypreparedness/schooldismissals.htmlMethods
q Household surveys
§ Paper questionnaires distributed to parents/
guardians through student backpacks in each
participating school
§ One survey per household
§ Questions included:
• Perception of difficulties
• Childcare arrangements
• Employment and income interruptions
• Difficulties related to interruption of subsidized school meals
• Additional expensesMethods
q Estimated overall perception of difficulty, difficulty in
providing food and arranging childcare
q Calculated additional household expenses
q Analyzed factors associated with overall difficulty,
difficulty in providing food and arranging childcareEconomic and Social Costs of Unplanned
School Closures, USA, 2012-2013
Portland, ME
Elementary School
427 students
Elbert County, MS Electric fire and
School district
Beardstown, IL flooding
3 schools, 204 students
High absenteeism due to School district
ILI 4 schools, 1534 students
Preparation for flood
Rural school district, KY
3 schools, 524 students
High absenteeism due to
ILI
Harrison County, MS
School district
20 schools, 14,368 students
Hurricane preparednessStudy Population
Location Mississippi Kentucky Colorado Illinois Maine
Settings Urban-rural school Small rural district Suburban school Rural school district (4 Urban elementary
district (20 (3 schools) in district (3 schools) schools) school
schools) on the Western KY 20% of the town 19% of school
Gulf coast population are population is refugees
immigrants and immigrants
Number of 14,368 524 427 204 1,534
students enrolled
in surveyed
schools
Completed 2,229 (29%) 99 (33%) 35 (31%) 208 (25%) 129 (38%)
questionnaires
Eligible for free/ 45-90% 100% 32% 72% 39%
reduced price
school lunches
Annual 32% 45% 9% 29% 14%
household
incomePerceived Difficulty of
Unplanned School Closures
Mississippi Kentucky Colorado Illinois Maine
100
98%
90
Proportion reporting difficulty
80
70
60
50
49%
40
30
20 25%
20%
18%
10
0
Uncertainty about Difficult childcare Difficult childcare Uncertainty about Uncertainty about
duration of closure arrangements arrangements duration of closure duration of closure
Top 3 reasons Lost pay Expensive childcare Expensive childcare Difficult childcare Difficult childcare
for difficulty: arrangements arrangements arrangements arrangements
Difficult childcare Lost pay Lost pay Lost pay Expensive childcare
arrangements arrangementsDifficulty Providing Food
Mississippi Kentucky Colorado Illinois Maine
Annual
household 32% 45% 9% 29% 14%
incomeAlternative Childcare Arrangements:
Top 3 Options
Mississippi Kentucky Colorado Illinois Maine
Nonworking adult in Nonworking adult in Nonworking adult in Nonworking adult in Adult working outside of
house
household household household household
Adult working outside of Adult working outside Household member Adult working outside Nonworking adult in
house of house of house household
who works from home
Adult who does not live Adult who does not Child old enough to Child old enough to Adult who does not live
in the household live in the household in the household
care for him/herself care for him/herselfAdditional Expenses
Mississippi Kentucky Colorado Illinois Maine
Households that reported incurring
436 (20%) 16 (16%) 2 (6%) 44 (22%) 47 (39%)
additional expenses
Median amount of expenses $150 $100 $146 $100 $200
Median expenses per day of closure $37.5 $20.0 $36.5 $14.3 $33.3
(Duration of closure) (4 days) (5 days) (4 days) (7 days) (6 days)Factors Associated with Overall Perceived
Difficulty of Unplanned School Closures*
Mississippi Kentucky Illinois Maine
(N=2.229) (N=99) (N=208) (N=129)
OR (p-value) OR (p-value) OR (p-value) OR (p-value)
All adults in household are employed outside 1.70 (Factors Associated with Difficulty
Providing Food*
Mississippi Kentucky Illinois Maine
(N=2.229) (N=99) (N=208) (N=129)
OR OR OR OR
p-value p-value p-value p-value
All adults in household are employed - - - -
outside of home
At least one adult in household lost pay 2.22 (Factors Associated with Difficulty
Arranging Childcare*
Mississippi Kentucky Illinois Maine
(N=2.229) (N=99) (N=208) (N=129)
OR OR OR OR
p-value p-value p-value p-value
All adults in household are employed 3.59 (Cost of Childcare Options, Harrison County
School District, Mississippi, November
2012
Took children to work $93
Children left home without supervision $91
Childcare program $85
Adult who does not live in the household $76
Adult household member who works outside
$73
the household
Older sibling $49
Adult working from home $41
Non-working adult household member $23
Child old enough to care for him/herself $17
$0 $10 $20 $30 $40 $50 $60 $70 $80 $90 $100Limitations
q Response rate ~30%
q Timing of survey distribution may have caused
possible recall bias
q Findings may not be representative of other
locations and socio-economic groupsConclusions
q Unplanned school closure can cause difficulty to
families in some settings
q Primary challenges: childcare availability and cost,
lost pay and uncertainty about duration of school
closure
§ Particularly difficult for families where all adults are employed
outside of home, low income families and single adult families
q Missing subsidized school meals: difficult for only a
small proportion of families
§ However, can be challenging for families with >1 child, single
adult families and families where at least one adult lost payRecommendations
q School officials should anticipate closures and plan
to meet students’ and their families’ needs
§ Prepare back-up meal plan for students receiving assistance
(e.g., P-SNAP)
q Families should prepare back up plans for childcare
http://www.ideastream.org/news/feature/59633
http://www.fortwayne.com/apps/pbcs.dll/article?AID=/20140201/NEWS/320147204Acknowledgments
Field investigations
Centers for Disease q Erin Epson (CO)
Control and Prevention, Atlanta, GA q Elizabeth Russell (KY)
q Hongjiang Gao q Jonetta Johnson (MS)
q Kimberly Lane q Leigh Ann Miller (ME)
q Jeanette Rainey q Victoria Tsai (IL)
q Jianrong Shi q State Health Departments
q Amra Uzicanin q School administrators
q Karen Wong q Students and their familiesQuestions?
YZheteyeva@cdc.gov
Thank you
For more information, please contact:
Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone: 1-800-CDC-INFO (232-4636) / TTY:
1-888-232-6348
E-mail: cdcinfo@cdc.gov Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily
represent the official position of the Centers for Disease Control and Prevention.
National Center for Emerging and Zoonotic Infectious Diseases
Division of Global Migration and QuarantineBackup slides
Factors
associated
with
overall
percep1on
of
difficulty
of
school
closure.
Mississippi,
2012
OR
95%CI
p-‐value
Adjusted
OR
95%CI
p-‐value
All adults in household are employed outside of home
1.64
1.39-1.95
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