Why Can’t Education Progress Like Medicine Does?

I recently saw an end-of-year article in The Washington Post called “19 Good Things That Happened in 2019.” Four of them were medical or public health breakthroughs. Scientists announced a new therapy for cystic fibrosis likely to benefit 90% of people with this terrible disease, incurable for most patients before now. The World Health Organization announced a new vaccine to prevent Ebola. The Bill and Melinda Gates Foundation announced that deaths of children before their fifth birthday have now dropped from 82 per thousand births in 1990 to 37 in 2019. The Centers for Disease Control reported a decline of 5.1 percent in deaths from drug overdoses in just one year, from 2017 to 2018.

Needless to say, breakthroughs in education did not make the list. In fact, I’ll bet there has never been an education breakthrough mentioned on such lists.

I get a lot of criticism from all sides for comparing education to medicine and public health. Most commonly, I’m told that it’s ever so much easier to give someone a pill than to change complex systems of education. That’s true enough, but not one of the 2019 medical or public health breakthroughs was anything like “taking a pill.” The cystic fibrosis cure involves a series of three treatments personalized to the genetic background of patients. It took decades to find and test this treatment. A vaccine for Ebola may be simple in concept, but it also took decades to develop. Also, Ebola occurs in very poor countries, where ensuring universal coverage with a vaccine is very complex. Reducing deaths of infants and toddlers took massive coordinated efforts of national governments, international organizations, and ongoing research and development. There is still much to do, of course, but the progress made so far is astonishing. Similarly, the drop in deaths due to overdoses required, and still requires, huge investments, cooperation between government agencies of all sorts, and constant research, development, and dissemination. In fact, I would argue that reducing infant deaths and overdose deaths strongly resemble what education would have to do to, for example, eliminate reading failure or enable all students to succeed at middle school mathematics. No one distinct intervention, no one miracle pill has by itself improved infant mortality or overdose mortality, and solutions for reading and math failure will similarly involve many elements and coordinated efforts among many government agencies, private foundations, and educators, as well as researchers and developers.

The difference between evidence-based reform in medicine/public health and education is, I believe, a difference in societal commitment to solving the problems. The general public, especially political leaders, tend to be rather complacent about educational failures. One of our past presidents said he wanted to help, but said, “We have more will than wallet” to solve educational problems. Another focused his education plans on recruiting volunteers to help with reading. These policies hardly communicate seriousness. In contrast, if medicine or public health can significantly reduce death or disease, it’s hard to be complacent.

Perhaps part of the motivational difference is due to the situations of powerful people. Anyone can get a disease, so powerful individuals are likely to have children or other relatives or friends who suffer from a given disease. In contrast, they may assume that children failing in school have inadequate parents or parents who need improved job opportunities or economic security or decent housing, which will take decades, and massive investments to solve. As a result, governments allocate little money for research, development, or dissemination of proven programs.

There is no doubt in my mind that we could, for example, eliminate early reading failure, using the same techniques used to eliminate diseases: research, development, practical experiments, and planful, rapid scale-up. It’s all a question of resources, political leadership, collaboration among many critical agencies and individuals, and a total commitment to getting the job done. The year reading failure drops to near zero nationwide, perhaps education will make the Washington Post list of “50 Good Things That Happened in 2050.”

This blog was developed with support from the Laura and John Arnold Foundation. The views expressed here do not necessarily reflect those of the Foundation.