Published Online: May 15, 2012
Published in Print: May 16, 2012, as Later School Start Times Are a Public-Health Issue

Commentary

Push Back High School Start Times

Since the late 1990s, school boards across the United States have been asked repeatedly to delay predawn school start times and bus schedules, and some—including schools in Decatur, Ga., and Amherst, Mass.—appear poised to move in that direction. Just last month, the Fairfax County, Va., school board set a goal of starting its high schools no earlier than 8 a.m. to promote student sleep and health.

These recent developments, while encouraging, are baby steps on a road marked by considerable idling and even reversals. They join a plethora of both new and decades-old campaigns, including ones championed by a Florida pediatrician; a Wisconsin research librarian; district superintendents in Louisiana and Massachusetts; students in California, New Hampshire, and Missouri; and parents in Washington state and my own state of Maryland.

Most of these efforts fail, primarily for systemic reasons. The science is there; the will to change is not. Today you'd be hard-pressed to find a health professional, sleep scientist, or educator who would defend starting high schools in the 7 a.m. hour, now the norm for many U.S. high schools, as good for physical or mental health, safety, or learning. But politics and human nature typically keep schools from prioritizing student health and well-being when they draw up the academic schedule.

Given the science, the idea of starting high schools later is a no-brainer. Waking before sunrise means teens must be asleep by about 8:30 p.m. to get the approximately nine hours of sleep per night their growing brains and bodies require. Even disregarding homework, extracurriculars, and electronics, physiologic changes mean most adolescents can't fall asleep before 11 p.m. Shifted circadian rhythms make 7 a.m. in teens (and younger teachers) equivalent to 4 a.m. in their parents.

The federal Centers for Disease Control and Prevention's, or CDC's, 2011 Youth Risk Behavior Survey estimated that 70 percent of U.S. teens are sleep-deprived, with nearly 40 percent getting six or fewer hours of sleep per night—setting them up for a sobering litany of health and learning problems.

Safety is an issue, too. With bus runs starting in the 5 a.m. hour, students wait in the pitch black, often with no sidewalks or even shoulders of the road, or they drive themselves drowsily to school. Because these early-start school days end around 2 p.m., teenagers come home to hours of unsupervised time, which, together with sleep deprivation, predisposes them to risk-taking and delinquent behavior.

Many state and local medical societies have advocated later start times in the past two decades. CDC researchers have confirmed that delaying school start times is a demonstrated strategy to promote sufficient sleep among adolescents. A Harvard School of Public Health forum on America's sleep deficit, held in March, emphasized the need to start schools later, and the American Academy of Pediatrics is developing a policy statement about safe and healthy start times for middle and high schools.

Aligning start times with student body clocks decreases dropout rates, truancy, moodiness, car crashes, depression, and related medication needs, and it improves school performance and increases the amount of sleep students get per night. Brookings Institution economists recently showedRequires Adobe Acrobat Reader that early school start times reduce performance among disadvantaged students by an amount equivalent to having a highly ineffective teacher. They estimated that delaying middle and high school start times from 8 a.m. to 9 a.m. would increase academic achievement by 0.175 standard deviations, with a corresponding increase in student lifetime earnings of approximately $17,500—a benefit-to-cost ratio of at least 9-to-1.

"We must start regarding 7 a.m. start times as just as unacceptable as refusing to heat schools when the temperature drops."

Ironically, the widespread push several decades ago toward what sleep scientists have called deleterious, cruel, and even abusive start times coincided with growing understanding of adolescent sleep requirements, circadian rhythms, and the critical function of sleep itself. Data about school start times (and bus runs) are poor, but in many communities the change was implemented gradually and without public input, primarily to save money by reusing buses to ferry students to schools with different opening times. The change may also, in part, be related to an expansion of business hours. Today we have a much more 24/7 view of life than we used to have, and the concept of 9 to 5 as "normal" work hours seems to be going the way of family dinners and nonworking vacations.

Whatever the explanation, returning to more traditional 9 a.m. school bells is now virtually impossible in many districts. Even the best-organized reform efforts fall to entrenched interests that have adapted to early hours, as well as the human tendency to make a virtue of (perceived) necessity. Because communities revolve around school schedules, too, there is inevitably outcry that later start times will wreak havoc on life as we know it. This outcry typically includes kneejerk and misinformed reactions, some reflecting our society's disregard for sleep itself.

Tellingly, identical objections arise no matter what the existing or proposed school hours, and recur even when superintendents propose making changes to save money on transportation. It's not so much the new start time that people fear, but change itself.

Communities with the will to change have found ways to do so as shown in the rare, but revealing, success stories in districts including Wilton, Conn.; Edina, Minn., and Minneapolis; and Palo Alto, Calif. Concerns about the impact on sports, jobs, day care, and so forth turn out to be groundless; everything in the community adjusts to the new school times, just as when schools or families change start times for other reasons.

Red herrings or not, community concerns remain a powerful force. A superintendent or school board member who suggests, or even supports, later start times has to be almost suicidal because merely raising the issue mobilizes opposition. By the time communities have been familiarized with the ever-growing literature on the topic, the cohort of kids in question has graduated.

If we genuinely believe the research about the impact of our extremely early school hours and associated sleep deprivation, continuing to throw this issue back to lay school boards and administrators is nothing short of negligent. Tolerating baby steps is equally negligent, given that we're dealing with human lives. We need a sea change in our approach, and, as several leading public-health experts have noted, this will require collective action on a scale much larger than the local school system.

We must start regarding 7 a.m. start times as just as unacceptable as refusing to heat schools when the temperature drops or as exposing children to secondhand smoke. This may take federal, state, and/or local laws or regulations to ensure safe, healthy school hours for all students, in much the same way that federal regulations already restrict times school lunch can be served.

Specific school hours must be determined at the community level. But setting reasonable parameters is a matter of public health and safety and will make it easier for local districts to prioritize the health and well-being of students and communities alike when they set their particular schedules.

Vol. 31, Issue 31, Pages 25,27

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