Joining electronic health records and school boundary data: a proof-of-concept for assessing school’s influence on health

Abstract

Despite evidence that school-based policies affect children’s health, methodological challenges remain in evaluating the impacts of these policies due to disparate school and health data. We used electronic health record data to spatially join a patient’s geocoded address to school and district boundary shape files. Of the 560,724 included children, 439,398 matched to 13,239 schools. Most (62.8%) only had one school match per school year. One-third (37.2%) had an address that fell into multiple school attendance boundaries. Among the 163,457 children who matched to multiple schools, the median number of matches was 3 (IQR: 2, 5); 95,996 (58.7%) matched to just one non-open enrollment school. There was variation across states in the number of schools that a patient was matched to. It is methodologically possible to link EHR-based address data to geographic-based school boundaries on a large scale. However, this method needs validation before wider implementation into child health research.