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Education: A Key Social Determinant

Graduation from high school is a strong predictor of better health. However, according to the U.S. Department of Education's National Center for Education Statistics, in the 2008–09 school year, the national on-time high school graduation rate was only 75.5%, and significantly lower for some racial and ethnic minorities. To combat low graduation rates and to improve academic performance, the Institute for Research and Reform in Education developed a comprehensive school reform initiative, First Things First (FTF). The FTF framework aims to engage students intellectually and emotionally in their schools through instructional improvement, small learning communities, and family and student advocacy systems.

The instructional components are designed to improve student engagement by equipping teachers with research-based teaching strategies and high-interest content. Also, all students have a teacher advocate in their small learning community who supports them emotionally and logistically, and helps them address barriers to their education. Schools continually improve their efforts by using process and outcome data to evaluate the program and identify priority areas. Finally, throughout this effort, school- and district-level leadership involves community leaders and representatives to help support the program and the students.

FTF is currently implemented in schools throughout the country, reaching over 60,000 students and successfully increasing high school graduation rates.1 In Kansas City, Kansas School District, FTF was a welcome and timely answer to their academic challenges. In 1996, Kansas City's graduation rates were below the national and state averages. FTF merged disparate reform efforts into a single comprehensive reform strategy that improved graduation rates and academic performance in participating schools. Overall, the graduation rate in Kansas City increased from 48% in 1999–2000 to 69% in 2002–03.2 An external evaluation of schools implementing FTF in Kansas City found that the average graduation rates in the program's schools were significantly higher than in control schools, and the difference between the program and control schools increased each year in the first 4 years of the program.3

Kansas City serves as an exemplar of how schools can implement education-based strategies to improve graduation rates. Today, years after start-up funding ended, the First Things First framework is alive and well and helping students in the district's schools.

1"Strengthen Instruction." Institute for Research and Reform in Education.  (accessed September 10, 2012).

2Gambone, M. A., A. M. Klem, et al. (2004). Turning the Tide: The Achievements of First Things First Education Reform in Kansas City, Kansas Public School District. Philadelphia, PA, Youth Development Strategies, Inc.

3Quint, J., Bloom, H., et al. (2005). The Challenge of Scaling Up Educational Reform: Findings and Lessons from First Things First Final Report. New York, NY, MDRC.

Date Posted:
Organization Name: Institute for Research and Reform in Education
Program Name: 

First Things First (FTF) - Kansas City, Kansas School District

2010 N. 59th Street
Kansas City, KS 66104
United States
Healthy People 2020 Topic Area(s) addressed: 
Healthy People 2020 Objective(s) addressed: 
Healthy People 2020 overarching goal addressed: 
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Gambone MA, AM Klem, et al. (2004). Turning the Tide: The Achievements of First Things First Education Reform in Kansas City, Kansas Public School District. Philadelphia, PA, Youth Development Strategies, Inc. Accessed from
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