Reducing Educationally Relevant Health Disparities: A Missing Link in School Reforms to Close the Achievement Gap of Urban Minority Youth

“Educationally relevant health disparities directly and indirectly affect students’ motivation and ability to learn. Reducing educationally related health disparities can favorably influence education outcomes and help close the achievement gap.”

 

“In the short-term, schools may be the best hope for addressing physical health and social-emotional needs of urban minority youth, and for helping them to succeed academically and in life.”

While most schools in the U.S. implement some programs or policies that address health, the extent and quality of these programs is limited and not sufficient to meet the needs of youth facing the greatest educational and health challenges.”

 

Six educationally relevant health factors—vision, asthma, teen pregnancy, aggression and violence, physical activity and breakfast—should be priorities for schools serving urban minority youth, because each disproportionately affects that population; because there is strong evidence each affects educational outcomes; and because the feasibility of school-based policies and programs that address them has been demonstrated. All are interrelated synergistically.

 

“To say that disparities in these six areas—and others—disproportionately affect disadvantaged children isn’t new, though there is value in documenting the extent to which that’s true and the causal links with educational outcomes. The key message is that we now have a track record of programs and policies that have been demonstrated to favorably influence these factors and help reduce the achievement gap.”

 

An estimated one in five school-aged youth has a vision problem. In a nationally representative sample of more than 48,000 youth, poor minority youth appear to be under-diagnosed and under-treated for eye-care problems. In another national sample of more than 14,000 children with special health care needs, black, Hispanic and multiracial children were 2 to 3 times more likely than whites to have unmet vision care needs.

Less than half of the states require that teachers be notified of the results of vision screening.

Between 2001-03, for youth between ages 5 and 14, annual prevalence was 45% higher for black children vs. white, as were asthma attacks. The rate of asthma-driven emergency room visits was three times higher for blacks.

Disturbed sleep is associated with decreased ability to learn and with educational outcomes. Compared with children who do not have asthma, children who do more likely to have disturbed sleep. Nocturnal asthma is associated with severity of the disease, but even youth with ‘stable asthma’ experience considerably more sleep problems than children who do not have asthma.

 

In a recent review of all studies examining asthma and school attendance, virtually every study found a positive a positive association between the disease and school absenteeism.

 

Teens who become pregnant are less likely to complete high school or college. Teens who have one pregnancy are at increased risk of having another. Children born to teen mothers are more likely to become teen mothers themselves. In all likelihood, an unmarried teen mother and her child will live in poverty, further perpetuating a cycle of poverty and subsequent non-marital teen births.

 

In 2006, the birth rate among 15-17 year-old Non-Hispanic black females was more than three times as high as the birth rate among Non-Hispanic whites (36.1 per 1,000) vs. 11.8 per 1,000), and the birth rate for Hispanic females was more than four times as high (47.9 per 1,000 vs. 11.8 per 1,000).

 

Compared with women who delay childbearing until age 30, teen mothers’ education is estimated to be two years shorter. Teen mothers are 10%-12% less likely to complete high school, and have 14%-29% lower odds of attending college.

 

Even small changes in the rate of non-marital teen births would have substantial effects on the numbers of children living in poverty. Most students receive some kind of sex education programs, but those with the greatest needs are least likely to receive these kinds of programs. Federal policies and legislation have increased the extent to which school based sex education programs focus on an abstinence only approach, despite the lack of evidence that this approach is effective.

 

“Physical activity affects metabolism and all major body systems, exerting powerful positive influences on the brain and spinal cord and, consequently on emotional stability, physical health and ability to learn… the strongest evidence supports direct effects of physical activity on cognition.”

 

The downward secular trends in physical activity and physical fitness among American adolescents are accompanied by a concurrent upward secular trend in incidence and prevalence of overweight and obesity. This is particularly so among minority female children and adolescents.

 

Overall about 20% more white high school students meet criterion for adequate physical activity than do blacks and Hispanics, and about 25% more of white female high school students. Prevalence for Hispanic females for not being physically active was about twice as high as for whites, and for black females, more than 150% as high.

 

Disparities in physical activity owe in part to uneven distribution of recreational facilities. Adequate investment is associated with greater opportunities for physical activity.

Aggression and Violence