Transcript Education Inequities and Health Disparities: Child

Dina C. Castro, M.P.H., Ph.D.
Scientist, FPG Child Development Institute,
University of North Carolina at Chapel Hill
15th Annual Summer Public Health Research Videoconference on Minority Health,
University of North Carolina at Chapel Hill, June 9, 2009, www.minority.unc.edu
Health Disparities
• Disparities in health status and access to health
care between different racial, ethnic and
socioeconomic groups in the U.S. are a
demonstrated fact.
• There is increased awareness about health
disparities, and attempts to reduce them.
The Educational Gap (1)
• Likewise, there is abundant documented evidence
of the marked educational gaps between different
racial, ethnic and socio-economic groups .
• The education gap begins before children go to
kindergarten, and the gap widens as children
continue their schooling.
• The end results are low achievement and high
school dropout rates among minority populations.
The Educational Gap (2)
 Just like in the case of health, there have been
numerous efforts to increase awareness about
these problems, and attempts to reduce
educational inequities.
 Initiatives have included designing, testing and
training on selective interventions, and also
promoting progressive policy making at local,
state and national levels.
Are these, two different problems?
 This conference presents us the challenge of
looking at health disparities and education
inequities simultaneously.
 What can we say about both of them? What do
they have in common? Do they intersect?
How do child health disparities intersect
with the school readiness gap? (1)
 Research has shown that children learn better
when they are physically and emotionally
healthy.
 Also, new knowledge of early brain and child
development show that children early
experiences can affect their learning trajectories
(High, 2008).
How do child health disparities intersect
with the school readiness gap? (2)
 Health problems affect young children directly and
indirectly, example:
 Lead poisoning → child’s cognition, behavior
problems
 Racial differences in health conditions and in maternal
health and behavior may account for up to 25% of the
racial gap in school readiness (Currie, 2005).
 Minority children living in poverty are not only more
likely to have particular health conditions but they also are
less likely to be treated for them.
Are these, two different problems? (2)
• The evidence indicates that high-risk populations
for health problems are usually also high-risk for
educational problems, and vice-versa.
• Thus, beyond their particular characteristics,
health disparities and education inequities seem
to be two related outcomes of the same motherproblem: socio-economic inequities.
• And, as it is known, socio-economic inequities
affect racial and ethnic minorities harder than the
majority population.
What does the evolution of these two
problems tell us? (1)
• Recent reports show scarce progress in reducing
the educational gaps, and that declining
investments in education put America’s children at
higher risk.
• Likewise, recent data indicate that the U.S. is
failing to make significant progress toward the
Healthy People 2010 goal of eliminating health
disparities.
What does the evolution of these two
problems tell us? (2)
• Could that be just a coincidence? Probably not.
• Should these two problems continue being
addressed only from the scientific, applied clinical
and educational practices perspectives, we may be
going nowhere.
• Scientific, clinical or instructional considerations
are indeed necessary to understand and solve
these complex problems, but certainly are not
sufficient.
Strategic Considerations (1)
• The U.S. is undergoing an unprecedented effort to
rescue the economy with the hope that it will take
us to a better future.
• Let’s discuss how we can rescue the human
component of the current crisis through a
comparable vigorous effort, using all the scientific,
technological, financial and political resources
necessary to succeed.
Strategic Considerations (2)
• The present economic crisis could be a good time
and environment to sharpen the strategies that
may lead to significantly reduce health disparities
and education inequities.
• From the scientific and technical standpoints, it is
necessary to continue elucidating the best
practices to address child health disparities and
education inequities, with emphasis on
promotional and preventive approaches, rather
than remedial ones.
About child development and
school readiness (1)
• Based on the previous considerations, child
development and school readiness, are a clear
example of how health and education intersect,
and how these two are intertwined factors.
• Depending on how adequately they are
addressed, they may result in either a healthy,
high achieving, self-confident child, or a less
healthy, low achieving, insecure and emotionally
vulnerable child.
About child development and
school readiness (2)
 Health is considered a key component of getting
young children ready for kindergarten:
 National Education Goals Panel
 National School Readiness Indicators Initiative
 National Governors’ Association
 Evaluations of comprehensive approaches to early
childhood interventions have demonstrated the
need and importance of proactively supporting
child health.
What can be done?
 Increase access to high quality, comprehensive
programs such as: Head Start.
 Involve families and communities (Ready
schools, ready families, ready communities).
 Prepare educators and health professionals to
work as a team.
 Engage the community and society at large:
Commitment and support from leaders to make
investing in children’s well-being a priority.
Changing demographics
 Among minority children, Latinos are the fastest
growing group, and as with other minorities, they are
more likely to live in poverty than non-Hispanic white
children.
 Many of these children are from immigrant families;
however, most of them are U.S. citizens (93%).
 Nationally, young Latino children have the lowest
scores in measures of school readiness.
 They have the highest percentages of uninsured
children.
Changing demographics:
What can we do?
 Increase access to health care services and
child health insurance
 Information about available early care and
education programs
 Increase access to child care subsidies
 Family support programs that are culturally
and linguistically appropriate
 Training health and education personnel to
provide culturally responsive services
Reducing disparities:
What can we do?
 “To tackle…the inequities through political
commitment on the principles of ‘closing the
gap in a generation’ as a national concern”
 “..to contribute to the improvement of the daily
living conditions contributing to the health and
social well-being…involving all relevant
partners, including civil society and the private
sector”
62nd World Health Assembly (May, 2009)