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California’s Central Valley is arguably the most productive agricultural region in the world. Despite making up only 1% of all farmland in the United States, it produces 250 different crops that make up a quarter of all food consumed in the U.S., including close to half of all fruit, nuts, and table foods. The map included below shows the variety and intensity of this kind of cultivation. This level of agricultural production has been made possible by the dominance of industrial agriculture interests at all levels of government, resulting in one of the most physically altered landscapes in the world. These alterations focused in large part on water, the biggest limiting factor for industrial agriculture in a region technically classified as a desert. Over the course of the 20th century, the largest body of freshwater west of the Mississippi–Tulare Lake–was drained to make more land available, the Central Valley Project and State Water Project built thousands of miles of canals and tens of dams to control the supply of water for irrigation, and massive groundwater aquifers were pumped nearly dry during drought years. These transformations were accomplished through the utilization of rhetoric that emphasizes the centrality of the farmer identity to the American political imaginary (despite the massive distance between Californian industrial agriculture and the Jeffersonian agrarian ideal) and the unique importance of providing the nation’s food. This kind of exceptionalism has characterized agriculture across the United States since its inception and has repeatedly produced other forms of social injustice (e.g., the exclusion of agricultural laborers from U.S. labor protections) that compound the hazardous effects of its environmental injustices.

Source

Vo, Katie, Taranjot Bhari and Margaret Tebbe. 2023. Industrial Agriculture in California's Central Valley. In 4S Paraconference X EiJ: Building a Global Record, curated by Misria Shaik Ali, Kim Fortun, Phillip Baum and Prerna Srigyan. Annual Meeting of the Society of Social Studies of Science. Honolulu, Hawai'i, Nov 8-11.

California’s Central Valley is arguably the most productive agricultural region in the world. Despite making up only 1% of all farmland in the United States, it produces 250 different crops that make up a quarter of all food consumed in the U.S., including close to half of all fruit, nuts, and table foods. The map included below shows the variety and intensity of this kind of cultivation. This level of agricultural production has been made possible by the dominance of industrial agriculture interests at all levels of government, resulting in one of the most physically altered landscapes in the world. These alterations focused in large part on water, the biggest limiting factor for industrial agriculture in a region technically classified as a desert. Over the course of the 20th century, the largest body of freshwater west of the Mississippi–Tulare Lake–was drained to make more land available, the Central Valley Project and State Water Project built thousands of miles of canals and tens of dams to control the supply of water for irrigation, and massive groundwater aquifers were pumped nearly dry during drought years. These transformations were accomplished through the utilization of rhetoric that emphasizes the centrality of the farmer identity to the American political imaginary (despite the massive distance between Californian industrial agriculture and the Jeffersonian agrarian ideal) and the unique importance of providing the nation’s food. This kind of exceptionalism has characterized agriculture across the United States since its inception and has repeatedly produced other forms of social injustice (e.g., the exclusion of agricultural laborers from U.S. labor protections) that compound the hazardous effects of its environmental injustices.

Vo, Katie, Taranjot Bhari and Margaret Tebbe. 2023. "Industrial Agriculture in California's Central Valley." In 4S Paraconference X EiJ: Building a Global Record, curated by Misria Shaik Ali, Kim Fortun, Phillip Baum and Prerna Srigyan. Annual Meeting of the Society of Social Studies of Science. Honolulu, Hawai'i, Nov 8-11.

Creators of the Student Health Index recommend using the tool in combination with qualitative data collection and stakeholder/community engagement (e.g. working with school leaders, local community leaders, and healthcare providers).

A full guide to using the dashboard is available here.

Data sources utilized by the index are not always the most current due to data collection limitations (e.g. covid-19 has caused disruptions in the collection of CDE data).

The Index is limited in that it does not offer data for schools that were not large enough to warrant the construction of a School-based Health Center. Thus, schools that did not meet specific enrollment targets were excluded from the dashboard. This includes rural schools (designed as such by the USDA) with an enrollment under 500 students, urban schools (without a high school) with less than 500 students, and urban schools (with a high school) with less than 1000 students. California had more than 10,000 active public schools in 2020-21. The final dashboard for the Student Health Index includes 4,821 schools.

The lack of available data on health indicators at a school-level restricted the Student Health Index to using proxies for the health outcomes. Some health indicators are included, but they are not school-specific, instead linked to specific schools geographically through the census tract. However, community-level data does not always accurately reflect the characteristics of a school’s population. As a result, school-level indicators in the Index were weighted more heavily than community-level indicators.

Additionally, race was not included as a measure in the Student Health Index because of California’s Proposition 20, which prohibits the allocation of public resources based on race and ethnicity. However, the dataset does contain measures of non-white students at each school. 

The Index has also been limited as a quantitative measure of need, which may overlook the influence of other factors that might be better illuminated through qualitative evidence (e.g. stakeholder engagement, focus groups, interviews, etc.).

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The Student Health Index can produce visualizations that represent data on conditions, school characteristics and risk factors that affect education outcomes and could be improved through access to school-based health care. These visualizations can be used to demonstrate need for expanding school-based health care access in California.

In addition to maps, the index can also be used to generate graphs and visual displays of data (e.g. ratio of highest need schools to all schools, by county).

The visualizations can be used to demonstrate the correlations between final need scores and race, the impact of specific indicators in health, and the concentration of need to certain regions of California (hot spot analysis).

The Student Health Index enables users to identify where SBHCs will have the most impact for students. The index uses 12 indicators, each of which can be scored from 1 to 4 for any given school. These scores are generated using percentiles and represent relative values. The 12 indicator scores are combined into a Need Score, which is calculated using percentiles along a scale of 1 to 4. Schools with a score of 4 (in the 4th quartile) have the highest Need scores relative to other schools in California.

The index is composed of 12 diverse indicators (percentages, rates, and index values) that have been transformed using percentiles in order to enable comparisons on a common scale. These indicators are divided into 3 categories: health indicators, school-level indicators, and socioeconomic indicators.

Health Indicators

1. Diabetes
2. Asthma ED admissions
3. Teen birth
4. Health Professional Shortage Areas (HPSA)

Socioeconomic Indicators

1. Poverty among individuals under 18
2. Uninsured among under 19
3. Healthy Places Index

School-Level Indicators

1. Percent FRPL (students eligible for free or reduced-price meals)
2. Percent English Learners
3. Percent Chronically Absent
4. Percent experiencing homelessness
5. Suspension rate

Other Data

1. Mental health hospitalization rate
2. Percent in foster care

Indicator selection was guided by CDC estimations on the primary contributing factors that shape health (social determinants of health, medical care, and health behaviors). The indicators included in the index are all either directly associated with the absence of health services that could be provided at a school level, act as proxies for health behaviors, or represent social determinants of health that could be addressed through access to school-based health services.

Indicator selection was influenced by recommendations from the Research Initiative of the Campaign for Educational Equity at Columbia Teachers College, which found that seven health disparities affecting school-aged youth could be addressed through school health programs. These disparities include: (1) vision, (2) asthma, (3) teen pregnancy, (4) aggression and violence (including bullying), (5) physical activity, (6) hunger, and (7) inattention and hyperactivity.

More detailed description of the rationale shaping indicator selection is available here.

Census tract, school-level

The Student Health Index draws from data that is publicly available and up to date on a statewide level. Sources include the University of California San Francisco Health Atlas, the American Community Survey, the U.S. Census Bureau, the California Department of Education’s Downloadable Data Files site, and the CDC.

Detailed list of sources:

PLACES Project, CDC (available through the UCSF Health Atlas)

CalEnviroScreen (available through the UCSF Health Atlas)

Opportunity Atlas (available through the UCSF Health Atlas)

Health Resources and Services Administration (available through the UCSF Health Atlas)

American Community Survey (available through the UCSF Health Atlas)

California Department of Education’s Downloadable Data Files site

Kidsdata.org