Tag Archives: Poverty

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.

Analysis: ‘Willful Defiance’ School Suspensions Have Health Impacts

We are re-posting an April 29, 2014 Reportingonhealth.org blog by Celia Harris.

In the 2012-13 school year, almost 260,000 student suspensions in California public schools — more than 40 percent of the total — were for “willful defiance” of authority. Willful defiance was the single most common reason for suspension and more students were suspended for willful defiance than for drugs, weapons and violence combined. Read more…


The Sequester: A Public Health Nightmare Waiting to Happen

The impacts of the budget sequester – the across-the-board spending cuts imposed when Congress and President Obama couldn’t come to agreement about how to reduce the deficit – hit home last week, when furloughs at the Federal Aviation Administration caused flight delays around the country. Cutbacks in air traffic control could have meant serious concerns for safe travel. Planes could have crashed, with loss of life more horrifying that an epidemic.

Because the airline industry and well-off executive travelers were hit, Congress rushed to fix the problem – within days, bipartisan legislation was drafted, passed and signed. A public health nightmare for the 1% was averted.

Governments around the world are embracing austerity, deeply cutting spending on everything from public health to education. These cuts are touted as a cure to real or imagined fiscal crises that are the result of bad choices about how to manage the economy. But the evidence supporting austerity has been discredited; many, including Nobel Prize-winning economist and New York Times columnist Paul Krugman, argue that austerity is actually the exact wrong thing to do.

What are the public health impacts of austerity broadly and the sequester in particular? We dodged the bullet on air safety for business travelers, but what about those who can’t get Congress’ attention? What about the unemployed, parents with kids in public school or preschool programs, or families who have trouble putting food on the table?

The Body Economic: Why Austerity Kills, a new book by David Stuckler and Sanjay Basu show how austerity is seriously bad for health. The numbers are startling: 10,000 suicides. Up to 1 million cases of depression. Tripling rates of HIV/AIDS, primarily as a result of increased drug abuse. Five million Americans who have lost access to healthcare. Ten thousand newly homeless families in the UK.

All of these scenarios are as scary as planes falling from the sky. Congress acted properly in moving quickly to ensure continued safe air travel. Perhaps Congress should think about other impacts before the impending public health nightmare becomes reality?