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Education as a Social Determinant of Health

Updated: Aug 26, 2020

Need for Educational Reform to Increase the Odds for All

Education exerts a significant influence on many aspects of health. Studies show that the level of educational attainment is a strong predictor of quality of life, SES, physical health, employment, and zip code. Additionally, there is growing evidence that level of education is inversely correlated with mortality regardless of race or gender. Despite this knowledge, there are considerable educational inequities between White children and ethnic and racial minority children in the United States. As a result, minority youth on average are underperforming in school, placing them at risk for not reaching their fullest potential in life.


Achievement Gaps and Outcomes

While some achievement gaps such as school dropout rates have decreased overtime, significant educational inequities remain. These inequities are reflected in measures of academic achievement (e.g., standardized test scores, grade repetition, involvement in gifted programs, and enrollment in higher education) as well as in behavioral markers of adjustment (e.g., disciplinary action, suspension, and expulsion). Prior to the COVID-19 crisis, the effects could be seen in differences in unemployment rates (e.g., Blacks have an unemployment rate of 8% compared to 4% among Whites), and post-secondary education rates for example. These disparities have substantially increased due to the uneven impacts of the crisis on minority populations.


Various underlying causes of educational disparities are identifiable because they are similar across ethnic and racial minority groups. Here, we focus on four domains: early childhood education, diversity, school opportunities, and teacher-student dynamics. While tackling each domain is important in reducing educational inequities among minority youth, conclusions are that focusing on teacher-student dynamics and implicit biases will exert the most significant and immediate impact.


Equal Footing: The Role of Early Childhood Education (ECE)

School readiness is critical to educational achievement over time. Disadvantaged children, particularly racial and ethnic minorities, more often enter kindergarten lacking the skill sets (e.g., academic, social and emotional skills) necessary to be successful in school. ECE programs have been found to help narrow educational gaps associated with poverty. However, ECE programs can differ significantly in quality and/or may not be directed toward the complexities of the intended population.


Even when racial and ethnic minority students enter school with a knowledge base similar to their White counterparts, they struggle with institutional discrimination that directly impedes their academic success. One of the most impactful challenges minority children encounter originates from teachers’ biases.


Teacher diversity matters

There is a significant disparity between teacher and student diversity across the United States. In 2012, Blacks represented 45% of public school student population in the US while 82% of their teachers were White. Because White teachers are more likely to discipline, give lower grades, and provide fewer opportunities for non-white students than White students, this disparity often translates to hurdles encountered by non-white students that have adverse consequences for their educational achievement.


Student Diversity Matters

Increasing student diversity within schools has been shown to reduce achievement gaps. After controlling for student background characteristics (e.g., SES and school factors), black and Brown children attending high minority schools had lower literacy and math skills than their counterparts who attended ethnically diverse schools. Additionally, diversity helped to improve social competence and behavior problems irrespective of the overall quality of the classroom interactions.


School Matters

Blacks and Brown people more often reside in high-poverty areas than Whites, where there are fewer qualified teachers and greater teacher turnover. According to the US Department of Education, minority students are four times more likely than Whites to attend schools with a significant proportion of uncertified teachers. Additionally, these students have limited access to high level math and science courses, and they are significantly underrepresented in these programs, from high school into college and the workforce as a result. According to the U.S. Department of Education, Office for Civil Rights, Black and Latinx students represented only 26% of students enrolled in gifted and talented education programs. Enrollment in these gifted programs and access to challenging math and science courses is fundamental to the ability to achieve and prepare for college.


Teachers as the Bridge to Success

Teachers play a crucial role in students’ academic success and development as a primary source of socialization and as models that shape attitudes toward educational attainment. Students of color are similarly affected by teachers, however differential treatment by teachers--including racial biases, reduced placement into gifted programs, harsher disciplinary action, and lowered expectations--impede child development and achievement and create distress in ways that set them apart from White students. Not only does this unjust treatment affect grades, but it can result in poorer health outcomes, reduced engagement and motivation, and lower self-image. Perhaps not surprising is that this differential treatment of minority students exists even after controlling for social class.


Addressing Challenges, Creating Solutions


As established by the research cited herein, various features of the educational setting (e.g., ECE, diversity, school opportunities, and teacher-student dynamics) measurably affect achievement and long-term outcomes for minority youth. Given the strong influence that teachers have on early development, academic achievement, and the long-term success of their students, the evidence suggests that addressing implicit teacher biases will produce teachers with the ability to benefit a greater number of students. If teachers are trained to recognize their own implicit biases and the effects of discriminatory practices on minority student outcomes (e.g., achievement gap, educational attainment, and quality of life), they have potential to play a protective role for minority students facing adversities. In the midst of a pandemic that is disproportionately impacting people of color, policies that concertedly address sources of educational discrimination and marginalization are especially crucial.


Resolving teacher biases is complicated and challenging. Strategies to reduce biases against ethnic and racial minorities include:


  1. Increasing staff diversity with a goal to improve representativeness with the communities they serve;

  2. Requiring implicit bias, diversity and empathy training prior to employment and refreshed at regular intervals;

  3. Modifying hiring process to ensure that certified teachers are employed;

  4. Identifying staff biases using measures such as the Implicit Association Test to increase self-awareness of implicit bias; and

  5. Offering ongoing professional development programs;

  6. Fostering an educational environment conducive to open communication and cross-group relationships.

It is important to note that strategies are not a one size fits all. What works for one community may not work for another. For this reason, stakeholder engagement (e.g., teachers, students, families, communities, local government, and the school district) is critical to develop effective, culturally sensitive and adoptable interventions. As seen in Figure 1, the process to improve teacher-student dynamics and equalize the playing field for minorities will continually evolve over time and adapt to a changing educational landscape. For example, experiencing a significant event such as a pandemic will directly challenge interventions that may have been successful at one point. It is, thus, paramount to reassess problems, solutions and outcomes, engage stakeholders to inform targeted improvements, and build in systems for accountability and tracking to make adjustments and, in turn, ensure that ALL children have the opportunity to succeed.


Ultimately, the goal is to foster cultural competence and sensitivity to ethnic and racial minorities in our teachers. Reducing implicit bias and creating a nurturing and challenging school environment are key to promoting positive student-teacher relationships with minority children, providing equitable instruction, and challenging these students by encouraging equal access to gifted and talented programs. These strategies will significantly boost educational attainment and advancement, and enable ALL students to thrive and reach their full potential.

Diana Eldreth Chute

MSPH Candidate, Johns Hopkins Bloomberg School of Public Health

And National Prevention Science Coalition to Improve Lives

Educational Disparities - final
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