HEA011 Fluoride varnish for children leading to improved test scores and lifetime earnings

Number of participants: Reported by program.

Percentage of children receiving care due to program: [39%]. 61% percent of Minnesota children age 1 through17 living in low-income households (100% of the federal poverty level) had a dental visit in the last year ([1] Minnesota Department of Health, n.d.).

Q1: Impact of program on reducing cavities: [0.08 primary, 0.11 permanent]. This is estimated using the formula:

In this formula, ES is the effect size from the WSIPP meta-analysis results, which is [-0.198] for primary teeth and [-0.267] for permanent teeth (WSIPP, 2014) The base percentage is [0.63], which is the share of third grade students in public schools with high population of students who are eligible for free- or reduced-price lunch who have untreated or treated tooth decay ([2] Minnesota Department of Health, n.d.).

Q2: Improvement in English proficiency due to avoided cavities: [0.13]. This is the effect size estimated from an odds ratio of 1.5 from Seirawan, et al. (2012) using the formula:

These authors find significant results only in the case of English proficiency. To establish a relationship between academic proficiency (test scores) and earnings we expect to observe a stronger impact on test scores. For instance, this could be a significant impact on math AND reading scores. Due to the weak evidence found on the impact of cavities on academic performance, we discount the estimated effect size by 50%. We used the adjusted formula as follows: (ln(1.5)/1.65))  x 0.5 = 0.13

Q3: Impact of improved test scores on earnings: [0.013]. This is estimated based on a 10% per 1 effect size increase in test scores from Krueger, A. B. (2003) and Levin, H., et al. (2007). We use the standard deviation of the average score on the Minnesota Comprehensive Assessment Series 3 reading test (Reading MCA-III Test) of low-income children in Minneapolis [1.9] as the benchmark effect size. Thus, the impact of improvement in English reading proficiency (test scores) is estimated as [(0.13 x 10%) /1.9] = 0.013.

Average lifetime earnings of low-income individuals: [$514,000]. This is the average earnings of individuals with a high school diploma to approximate the lifetime earnings of low-income individuals (U.S. Census Bureau, 2016). These benefits are already discounted to present value.

Levin, H. M., Belfield, C., Muennig, P. A., & Rouse, C. (2007). The costs and benefits of an excellent education for all of America’s children. Retrieved from Columbia University Academic Commons:

Seirawan, H., Faust, S., & Mulligan, R. (2012). The impact of oral health on the academic performance of disadvantaged children. American Journal of Public Health, 102(9), 1729–1734.

U.S. Census Bureau. (2016). American Community Survey 5-year estimates – public use microdata sample, 2012-2016. Generated using Public Use Microdata Area (PUMA) in the Seven-county Twin Cities Metropolitan Area. Retrieved from http://factfinder.census.gov

Washington State Institute for Public Policy (2014). Oral health: Fluoride varnish treatment for permanent teeth. Retrieved from http://www.wsipp.wa.gov/BenefitCost/Program/490 (Permanent teeth)

Washington State Institute for Public Policy (2014). Oral health: Fluoride varnish treatment for primary teeth. Retrieved from http://www.wsipp.wa.gov/BenefitCost/Program/491 (Primary teeth).