Tag Archives: Education

Expanding Access to Preschool Could Improve Health and Equity in Cincinnati, August, 2016

One of my favorite things about doing HIAs and other projects at Human Impact Partners is the unexpected “Aha!” moments that occur, when we find something in the research that surprises us.

Today, Human Impact Partners and our partners from The AMOS Project are excited to release a report that examines the health and equity impacts of expanded access to preschool for children in Cincinnati. Our study concludes that expanding access to preschool would benefit the health and equity for children, families, and other residents of Cincinnati. That’s actually not an “Aha!” for me. I expected that improved education would have benefits to health and equity. But I didn’t exactly expect all of the connections we found.

To me, it makes sense that if children get a better chance at high-quality education earlier on in life, they will do better in school later on. What I didn’t expect was how far those ripple effects would reach. It makes sense that high-quality preschool education could improve reading and math scores in third grade. But interestingly, those impacts don’t always continue over time. By the fourth grade, children who had access to high-quality preschool don’t always show significantly different reading or math scores from those who didn’t. But, they are less likely to be held back to repeat a grade in school, and they are less likely to require special education services. Essentially, they are able to keep up. And this ability to keep up allows them to remain connected and engaged in the school system, which means that they stay in school. They graduate. And if they graduate, they have better job options with higher wages. Which means they are not as likely to become involved in the criminal justice system.

Higher wages and less crime because of preschool. Those are some far-reaching ripple effects!

Figure 1

And guess what else? I really didn’t expect this one, but it makes sense to me. Family relationships are better. Being a parent of a young child can be stressful. When parents don’t have resources to deal with that stress, a small proportion of the time it can unfortunately manifest in child abuse and neglect. But research suggests that high-quality preschool has some pretty impressive protective factors for this. High-quality preschools not only give parents a break from the stress of parenting, they give children an opportunity to learn social and emotional skills when interacting with other children, and they give parents structured and guided ways to interact with their children. In our study we predicted that nearly three out of ten children in Cincinnati who would have experienced abuse or neglect would not experience it if they were sent to preschool. And improved family relationships last over time as well. Forty-year-old adults who attended preschool as children are still more likely to say their family relationships are better than those who did not. Again – those are some far-reaching ripple effects!

Of course, increased education, improved wages, less crime, less stress, and better social relationships can all lead to improved health. And that’s a wonderful, amazing thing. But it turns out that preschool could also be a key factor in breaking the cycle of generational inequities. Due to multiple forms of structural discrimination, growing up in poverty, in a single-parent household, or with a parent who is incarcerated are all more common experiences for children of color. These experiences increase the odds of negative physical and mental health outcomes and lead to a vicious cycle that continues through multiple generations, further contributing to ongoing inequities. When preschools and the school systems that they feed into have a trauma-informed approach to discipline, focusing on the root causes of the problem behaviors, rather than zero-tolerance suspensions and expulsions, preschools could help break that cycle.

Figure 2

This is especially important for communities like Cincinnati, where many of these risk factors are nearly double the national rate.

Figure 3

Thus, based on our findings, our study recommends the following actions:
1. Expand access to high-quality preschool programs to all children
2. Prioritize to reach those most in need, such as children living in poverty
3. Assure high-quality preschools and teachers through adherence to preschool program and training features that research has proven to be successful
4. Utilize a trauma-informed approach to discipline that incorporates an understanding of the source of the behavior problem, in preschool and beyond, rather than zero tolerance policies such as suspensions and expulsions
5. Assure that high-quality preschools are geographically distributed throughout the city

This Health Impact Assessment was produced in partnership with our Advisory Committee members from Cincinnati Children’s Hospital, StrivePartnership, Interact for Health, Mercy Health, and United Way’s Success by 6.

Accommodating Trauma: Intended & Unintended Effects of an Unusual Legal Strategy

A group of high school students and teachers in Compton, California are taking their school district to court, claiming their schools are legally required to accommodate the ways that chronic poverty, abuse, and neglect affect their learning.

Surprisingly, they are using special education law in the American with Disabilities Act and the 1973 Rehabilitation Act, which specifically requires schools to serve students with physical and mental impairments.

Does trauma affect learning? In short, yes.

HIP reviewed the literature as part of our 2014 study of California’s change to finance education via the Local Control Funding Formula. We found that Adverse Childhood Experiences – such as abuse, neglect, exposure to violence, or living in a household with mental illness or an incarcerated family member – are an obstacle to learning and achievement in school. These experiences affect students’ concentration, absenteeism, aggression, and mental health. Children with multiple Adverse Childhood Experiences (often called ACEs) are more likely than their peers to abuse drugs and alcohol and to drop out of school before graduation.

For schools that want to support their students’ success, our top recommendation was to expand programs that address the trauma and stress of Adverse Childhood Experiences, such as School-Based Mental Health Programs and Services. You can read more detail in our full report, “When Health is the Root Cause of Poor Education Outcomes.”

The five high school students and three teachers who have brought forth the lawsuit are going beyond making recommendations. They are insisting that schools that don’t accommodate trauma are engaging in unlawful discrimination. The students’ trauma is complex; hearing their stories makes me wonder how anyone could even show up to school, much less excel, under their life circumstances:

“Peter grew up with physical and sexual abuse, lived in foster homes, and has witnessed more than 20 people get shot. In March and April, he slept on the roof of the high school because he was homeless. When he was discovered, he was suspended.

While trauma’s effect on student learning is clear, does disability law offer a promising legal avenue for students affected by complex trauma?

Some advocates for youth have expressed concern about the legal strategy. As Louise Godbold writes,

“We must be careful that trauma, this rage and numbness that is (as Bessel van der Kolk says in “The Body Keeps the Score”) ‘honestly come by’, does not become another label to stigmatize and to point blame at some perceived defect in the students, or worse still, a whole community.”

The legal system is an imperfect system for guaranteeing rights, in that it requires one to be characterized as different in order to receive support. Seeking legal remedy for rights that have been denied can appear to have an inherent tendency toward pathologizing or otherizing people. This very case, as made by the attorneys at Public Counsel, relies on stereotypes of Compton as a bad neighborhood. Were these students approached to participate in the lawsuit because they – and their entire community – are easy to pathologize?

Yet the history of the ADA and other civil rights legislation shows that the legislation doesn’t create stigma, so much as name stigma so that it can be remedied. When the discrimination is systemic – like with people with disabilities and students in Compton – civil rights legislation can shift the conversation from a focus on individual to a focus on the systems that disadvantage them. As my wheelchair-riding friend Patty Berne pointedly asks, “Is the problem with our bodies that need wheelchairs or with the buildings that only have stairs?”

The ADA has moved the focus toward building ramps and installing elevators, important changes to the built environment that help not only people with disabilities, but all of us. Who hasn’t been grateful to not be daunted by a flight of stairs when you are pushing your kid in a stroller or just carrying too many groceries home?

I get the sentiment in Godbold’s article that disability is often over-medicalized. Framing complex trauma as disability could lead toward fixing trauma only with a medical model (pills and maybe some meditation to cope better with stress) rather than a focus on changing the conditions that create trauma in the first place. But I also hear an undercurrent of concern that “disability” is a particularly worrisome label for kids with trauma, and I worry that the critique of this legal strategy stems from ableist attitudes rather than an assessment of whether this would serve students.

When discrimination is systemic – running more deeply than any one school district – who is responsible for remedying the problem? This particular lawsuit pins the blame on Compton Unified School District, an already under-resourced school district. Should the focus instead be increased state funding – already boosted via LCFF for foster children, low-income kids, and English learners – so schools can better support students with significant trauma? Or should efforts be directed toward undoing legislation like Proposition 13, which has been a stranglehold on education funding?

We’ll be watching this case — and its intended and unintended impacts on education justice — closely.

Education: the Key to Health and Success for Foster Youth

carleneThis week’s post is written by HIP’s Social Media, Research, and Data Collection Summer Intern, Carlene Ervin. She is a sophomore at Yale University and a resident of Oakland, CA. 

Since I was five, my foster mom told me I would go to college. She never went to college herself but she wholeheartedly believed it was the only way to break the cycle of poverty, substance abuse, and violence. She did everything she could to get me there, including enrolling me in a college prep charter school. After a while, I had no doubt I was going to college and no one could stop me. It wasn’t until I was older that I realized my expectations were not common for most foster youth in California.

As an intern at Human Impact Partners, I was excited to see HIP has researched the educational experiences of foster youth. Last year, HIP completed a research project to inform California’s Local Control Funding Formula (LCFF), a 2013 bill that completely overhauled K-12 school funding. LCFF increases funding for all schools, but reserves the biggest funding increases for low-income children, English language learners, and foster youth. According to HIP’s analysis, one in 150 school-aged children in California are currently in foster care. Sixty-seven percent of foster youth are removed from their homes because of neglect, and another 18 percent because of abuse.

Both of my parents struggled with substance abuse and had disabilities that limited job opportunities. When I was placed in foster care at age five, I was old enough to know something was wrong but too young to understand what exactly happened. First, I was placed in two different foster homes within three months. My third foster home became my forever home, the place I still come back to for school breaks.

Once I was finally settled, I learned that I loved learning. School soon became a refuge because I could escape in the process of learning new things. While in school, I had some behavioral issues. And I wasn’t alone: according to HIP’s report, compared to the general population, foster children have more behavior problems, more anxiety/depression disorders, attention problems, and aggressive behaviors.

Foster youth also have higher levels of mental health problems. Early life and chronic stress can lead to mental health disorders and substance abuse. These issues make it harder for many foster youth to thrive in school. One study found that only about a third of teens in foster care graduate from public school, compared to almost 60 percent of their peers.

When I got accepted to Yale University, I couldn’t believe it. I didn’t know many people who attended an Ivy League school. Most foster youth don’t even make it to a four-year university. In general, only 1 in 10 of foster youth attend college and of those, fewer than a third graduate in 4 to 6 years. These statistics are especially troubling because of education’s long-term impacts. People with more education are likely to live longer, have healthier babies and children, have better social networks of support, and earn more money.

Now I see that given my history, I am lucky to value education, and how that benefits my health. Growing up, I always heard stories of former foster youth who ended up in jail or living on the street. Now I see the links between education, health, and quality of life.

Happily, the State of California seems to get this. In recent years California has taken steps to address the education deficits for some of the most vulnerable youth. In addition to the local control funding law, in 2012 California extended foster care to age 21.

Although the LCFF program has had a rocky start, I think it has great potential to help foster youth succeed in school if it provides services such as mentorship and/or counseling. Although these policies are still fairly new, with greater accountability on the state’s part, they can help foster youth have a chance to improve their education and ultimately their health.

What Happens to a Dream Deferred?

This week’s blog is a repost by Rachel Davis of Prevention Institute. She links efforts to prevent injury and death due to violence to many of the policy issues that we research at HIP, including incarceration, economic security, education, and housing policy. The article was originally published by “Nation of Change” on May 27, 2015.  

Earlier this month at the National Forum for Youth Violence Prevention’s fourth summit on preventing violence, Baltimore presented its city-wide blueprint, “B’More for Youth! Building Baltimore’s Cradle to Career Pipeline”. Read more …

Helping Communities Break The Cycle And Regain Their Power

Today’s guest blog post is by Ronald Day, Associate Vice President of the David Rothenberg Center for Public Policy (DRCPP), The Fortune Society. It was originally published by fortunesociety.org

I dropped out of high school in the 9th grade. A substantial number of teenagers in my poor community dropped out, too. Despite our limited knowledge of educational standards, we knew that the schools in our community were low-quality. Read more


Turning on the TAP: How Returning Access to Tuition Assistance for Incarcerated People Improves the Health of New Yorkers

Graphic illustrations by Rosten Woo. http://rostenwoo.biz/
Graphic illustrations by Rosten Woo. http://rostenwoo.biz/

Today, Human Impact Partners, the Education from the Inside Out Coalition, and our partners are excited to release a report that examines an often-overlooked aspect of providing college education for people in prison. Turning on the TAP: How Returning Access to Tuition Assistance for Incarcerated People Improves the Health of New Yorkers set out to answer the question: How will providing college education to people in prison affect the health and well-being of those people, their families, and their communities?

Our conclusion is that expanding access to college education for people in New York state prisons would benefit the overall health and well-being of the communities that formerly incarcerated people return to, as well as the individuals who receive the education, and their families. And yet, despite these benefits, funding through the state’s Tuition Assistance Program (TAP) – which provides grants to low-income New York residents to help them afford college – is unavailable to people who are incarcerated.

This wasn’t always the case. Until 1994, TAP and its federal equivalent, the Pell Grant Program, helped incarcerated people in prison enroll in courses offered by public and private colleges. Despite evidence of the benefits of correctional education, as part of the “tough on crime” wave that engulfed federal, state, and local policy-making in the early to mid-1990s, Pell and TAP grant eligibility was rescinded for people in New York State prison. After such funding was eliminated, in-prison college education programs in New York almost disappeared.

Today, there are approximately 53,000 people in New York state prisons, 59% of whom have a verified high school diploma and could therefore be eligible for TAP funding if it were made available to them. Legislators in New York State are considering S975/A2870 (2015), a bill that would repeal the ban on incarcerated people receiving financial aid for college education through TAP. Should the legislation pass, people in prison would have increased access to educational resources and, ultimately, experience increased educational attainment.

Data generated through the project shows how such legislation would be good for health and health determinants:The benefits of in-prison college education mean that when students return to the community, they engage in lower rates of crime and have a higher level of civic engagement when compared to other formerly incarcerated people returning to the community.

  • College teaches critical thinking skills that help people better understand and take responsibility for the consequences of their actions. It also improves their chances of getting a job, reuniting with their families, finding their place in society, not committing new offenses, and not returning to prison.
  • Benefits of in-prison college education include improved parenting behaviors, higher family income, increased likelihood that children and family members achieve higher levels of education, and reduced likelihood that children experience behavioral problems and get involved in the criminal justice system themselves.
  • College education improves relationships and reduces conflicts, resulting in a safer prison environment.
  • In-prison college education is a cost-effective investment in reducing crime and recidivism. Every $1 million spent on building more prisons prevents about 350 crimes, but the same amount invested in correctional education prevents more than 600 crimes.

Data from existing college education programs surveyed through the project show that lack of resources is one reason that only one-third of prison applicants are accepted for college study. If tuition assistance funding was restored, existing programs would be able to enroll over 3,200 people a year.

Based on such findings, the report makes a series of recommendations to ensure that such health benefits actually accrue – foremost among these is a recommendation to restore TAP funding for incarcerated people.

The report was produced in partnership with our Advisory Committee members from the Vera Institute of Justice, the Correctional Association of New York, the Fortune Society, Syracuse University, and the New York City Department of Health and Mental Hygiene. Over the past few weeks, these partners have released a series of blog posts focused on the issue of college education in prison. They were written from a variety of perspectives – including about recidivism and cost savings, human rights, community impacts, college environment impacts, and health impacts. Each of these partners has a compelling case to make about the value of providing college education to people in prison and the benefits to families and communities.

Our report – which ties these perspectives together – was released at an event today in Albany, NY. Speakers included:

Visit TurnOnTheTAPNY.org for a full electronic version of the report, as well as an executive summary, and links to all of the previous blog posts of our partners. Be sure to follow #TurnOnTheTAPNY to find out more about any additional activities related to these findings.


Public Health and Criminal Justice: Shared Root Causes


Today’s guest blog is by Jasmine D. Graves MPH, Special Assistant, Office of the Commissioner, New York City Department of Health and Mental Hygiene

As the public health community focuses on the root causes of ill health and inequities, there is a growing recognition that criminal justice, and the policies that inform our criminal justice system, are public health issues. The same structural inequities that contribute to poor overall health and well-being – economic insecurity, low education, inadequate housing, exposure to violence, and racism – also contribute to the disproportionate incarceration of low-income communities and communities of color.

In NYC, for example, the highest concentrations of premature mortality, poverty, and incarceration occur within the same neighborhoods – largely neighborhoods of color. In 2012, all cause and premature mortality rates for the 10 leading causes of premature mortality were 1.3 to 2.0 times higher in the very high poverty neighborhoods than in the low poverty neighborhoods . Additionally, young Black and Latino men – mostly from the same high poverty neighborhoods – are disproportionately represented in the criminal justice system, accounting for 81% of all persons arraigned within the last two years . Thus, when we discuss issues of incarceration in this city, we are also discussing issues of racial and income inequities in health.

Figure 1. GIS Maps illustrating geographic concentrations of poverty, premature mortality and incarceration in NYC

















Much of the discourse on the intersection of public health and mass incarceration has been centered on the disproportionate transmission of communicable diseases such as tuberculosis, HCV, and various sexually transmitted diseases and infections within correctional facilities and the communities to which people return. All of these are very important issues to address; however, we need to simultaneously address the adverse impact mass incarceration has on the social determinants of health. The burden incarceration places on individuals, families and a neighborhood extends far beyond the transmission of infectious disease. A recent report from the Vera Institute of Justice outlines the following implications of incarceration

  • Stagnating economic mobility and widening income inequalities
  • Diminishing the educational opportunities of youth
  • Restricting access to essential social benefits
  • Creating housing insecurity/ exacerbating homelessness
  • Altering the demographic composition of communities in ways that fracture family structures
  • Removing political capital from communities

For more details on each of the outlined implications please review the report here.

In 2014, a task force convened by New York City Mayor Bill de Blasio, which included the New York City Department of Health and Mental Hygiene, released an action plan for the city to reduce unnecessary incarceration by creating alternatives to detention for persons grappling with mental illness and substance use.

Furthermore, a new report, due to be released on May 12, finds that college education for people who are incarcerated can help protect against many negative health outcomes and provide additional mental and physical health benefits to the individuals who receive college education while in prison, their children, and the communities they return to.

Graphic illustrations by Rosten Woo. http://rostenwoo.biz/
Graphic illustrations by Rosten Woo. http://rostenwoo.biz/

There are many opportunities to apply a public health perspective to criminal justice as we work to address the root causes of both, deepening our understanding of prevention and broadening our goals for health equity. It is important to bear in mind that social issues, such as criminal justice policy, are tightly linked to overall health and well being.

To access the full report, visit: http://turnonthetapny.org/ on May 12, 2015.


College Education in Prison: Why it’s a Smart Choice for Everyone

Today’s guest blog post is written by by Marsha Weissman, Executive Director of Center for Community Alternatives and Sandy Lane, Professor of Public Health and Anthropology, Syracuse University

“In 1994, college education programs flourished in New York State – there were 23 colleges awarding degrees to people in 45 state prisons, funded partially through the national Pell grant program and its New York State equivalent, the Tuition Assistance Program (TAP).” Read more


Education is a human right: Opportunity to follow international law

Today’s guest blog post is written by Fred Patrick, Director on Center on Sentencing and Corrections, Vera Institute of Justice.

International laws declare education to be an inherent human right. The Universal Declaration of Human Rights and the International Covenant on Economics, Social and Cultural Rights both establish the right to free primary education that is accessible for all. Read more…


Saving New Yorkers Money by Turning on the TAP for Learning

Today’s guest blog post is written by Soffiyah Elijah, Executive Director of the Correctional Association of New York. 

Currently, there is a ban in New York State on incarcerated people receiving financial assistance from the Tuition Assistance Program (TAP) to pursue higher education while in prison. In this blog by the CA’s Executive Director Soffiyah Elijah, she describes the myriad benefits of restoring TAP for people who are incarcerated in New York State prisons. Read more…