The importance of adequate sleep is gaining recognition in public health circles. The Centers for Disease Control and Prevention have described sufficient sleep as an “essential aspect of health promotion and chronic disease prevention in the public health community.”
Like diet and exercise, sleep may seem entirely personal at first blush, a matter of individual choice. But as with healthy eating and active living, when you scratch the surface, a myriad of ways in which the environment shapes our individual choices become apparent. Laws and policies at the federal, state, and local level may make it easier – or more difficult – to make healthy choices about sleep.
For good health, teens should get 8 to 9.5 hours of sleep each night, but most teens get far less sleep than that. The shortfall is worse among girls, African-American and Hispanic teens, and teens with lower socio-economic status.
Adjustments to high school start times as a policy lever to address chronic sleep deprivation among teens have been part of the national conversation for about 20 years. But later school start times have been viewed primarily as a means to improved academic achievement. Recent research has demonstrated a broader range of potential health impacts and benefits, in terms of physical health, mental health and safety, as well as academic performance.
Based on the compelling evidence, the American Academy of Pediatrics issued a policy statement in favor of later high school start times. A just-published national survey underscores the importance of educating parents about the health benefits of adequate sleep for teens and the correlation between delayed high school start times and increased sleep for teens.
Shifting high school start times may appear to be a simple legal matter. The decision-maker (whether a school principal, a superintendent, or school board) must follow the appropriate decision-making protocol to establish that the new high school start time will be, for example, 8:30 a.m. However, a number of changes flow from delayed start times, and these ripple effects vary greatly across schools and school districts. They include changes to transportation policies and schedules, schedules for athletics and extracurricular activities, and before and after school programs, including school breakfast programs. Amendments to contractual arrangements with other parties may be necessary when school start times are adjusted. As a practical matter, financial implications must be considered.
Leadership from decision-makers as well as support from parents, teachers, coaches, transportation providers, local businesses and others is critical. For this reason, experts suggest allowing for at least a year of public discussion, informational forums, planning and preparation before implementing later high school start times.
Local schools and school districts have traditionally had autonomy when it comes to school start times. Yet regional or statewide approaches may be beneficial in order to build public understanding and overcome shared challenges. As directed by the state legislature, the Maryland Department of Health and Mental Hygiene and the Maryland State Department of Education issued a 2014 report addressing safe and healthy school hours. While recognizing local autonomy, the Maryland agencies agreed that the State Department of Education should encourage local school systems to conduct feasibility studies regarding later start time policies. The Education Commission of the States suggests that a “major shift” in public understanding of school start times is already underway, and considers whether their legal duty of care compels schools to adjust start times in light of the evidence.
Resources from those who have successfully changed high school start times provide valuable insight into the process. A team from the Children’s National Medical Center has engaged in an intensive process with the public schools in Fairfax, Virginia to create a “blueprint for change,” including key lessons learned from other school districts. Later school start times will be implemented in Fairfax Public Schools (one of the largest school districts in the country) in the 2015-2016 school year.
The process of considering and implementing later school start times provides an opportunity to engage in community conversations about health, to build bridges across sectors, and to achieve multiple health benefits through a single policy intervention. Public health professionals and researchers in particular may play an essential role in measuring and evaluating the health outcomes of existing and delayed high school start times.
The Network will be examining policies to promote healthy sleep, including delayed high school start times, in the coming year. If you are working on these issues and would benefit from legal technical assistance, please let us know.
This blog post was prepared by Jill Krueger, J.D., director of the Northern Region of the Network for Public Health Law at the Public Health Law Center at Mitchell Hamline School of Law.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.