HJAR Nov/Dec 2020

HEALTHCARE JOURNAL OF ARKANSAS I  NOV / DEC 2020 23 Educational Attainment, Social Mobility and Health Multiple publications have illustrated how the COVID-19 pandemic has further revealed the growing health disparities that exist along racial, ethnic and economic lines in the U.S. 4,5 Health disparities are not new and have been known to exist for decades. The presence of COVID-19 only serves to highlight and ex- acerbate the issue. Much of what we see concerning the current pandemic regarding health disparities is directly related to socio- economic status or level of poverty, which severely limits access to healthcare. Although socioeconomic status plays a major role in individual and population health, large gaps in health and healthcare exist that are inde- pendent of socioeconomic status. These gaps are due to multiple factors including struc- tural or institutional racism. In large part, health disparities are a product of a social structure built on discrimination and racism dating back to slavery and extending through reconstruction, the Jim Crow era, separate but equal, civil and voting rights and today’s biased and restrictive immigration policies. This nowmanifests as part of a social climate that seems to normalize racism, sexism, ho- mophobia, xenophobia, white supremacy, inhumanity, and in some cases, hatred—all barriers to the economic stability and social mobility of people of color. COVID-19 is about muchmore than health and healthcare. It’s about education, food in- security, joblessness, safety, access to a virtual world, and the future job markets. Currently, the educational system is under tremendous strain with overwhelming uncertainty as to how best to reopen. Many colleges and uni- versities have opted to remain primarily or fully online for the fall with a gradual reintro- duction of classroom activities in the spring, while others have developed and imple- mented in-person or hybrid (combined on- line and in-person) reopening plans that are institution-specific and depend a great deal on the willing participation of students, their strict adherence to Center for Disease Control (CDC) recommendations and guidelines and ongoing testing and tracking by each col- lege. 6,7 The University of Arkansas at Fayette- ville is one of 279 four-year public colleges that are primarily online. Out of nearly 3,000 colleges, 30 percent are fully online, 30 per- cent are fully in-person and 30 percent are undetermined. 6 In some cases, due to clus- ters of COVID-19 outbreaks, several college campuses have been forced to close, reassess and move to an online format. 8 In the case of reopening primary and secondary schools, current CDC guidelines are extensive and require curricular changes including virtual learning and, in order to maintain social dis- tancing, a reduction in class size. 7 The move to online educational platforms has put many students at a disadvantage, particularly those fromminority and disad- vantaged backgrounds. These students often come from low-income households that do not own a computer or have broadband ac- cess, and under the current circumstances, one or both parents may be unemployed or furloughed. In addition, many of these stu- dents have other household responsibilities – working to supplement their family’s income, taking care of younger siblings or an older family member, and cooking and cleaning. They also often lack a quiet place to study or interact in remote classroom activities. All of these factors put them at a disadvantage and hinder their total engagement and benefit from online classes. Students from minority and low-income groups will suffer most as we emerge from a global pandemic whose effects will be long- term and multisectoral. The lack of resources targeting the academic progression of this very vulnerable group will only serve to wid- en racial and ethnic educational attainment gaps, leading to reduced income (socioeco- nomic status) and a population that lacks economic mobility and is stuck in low-wage jobs. This, in turn, will result in a population that cannot afford safe and adequate hous- ing and quality healthcare and is stuck in a cycle of poverty. This ultimately leads to poor individual and population health, com- pounding health disparities and increasing mortality rates in communities of color due to catastrophic events like COVID-19. This scenario is all too familiar, repetitive; and its occurrence is most obvious during times of social, political and economic crisis. Perhaps the most powerful determinant of health over one’s lifetime is educational attainment. How far we go in school will largely determine our income, the neighborhoods in which we live and our access to healthcare. 9 Recommendations Now is the opportune time to invest in the educational achievement of students from minority and disadvantaged communities, starting at the K-12 level and extending to postsecondary and graduate training. Underrepresented racial and ethnic minorities are disproportionately represented among those lacking a postsecondary education. This may be due to the lack or shortage of educational materials, services or access that in many cases are available to middle and upper- class families—books in the home, access to quality pre-K programs, well-resourced schools and after-school and summer programs, tutoring services or access to pre-AP courses—all factors contributing to success at every point along the academic pipeline (K-12 and postsecondary education). Strategies to mitigate the historical and long- term effects of structural racism coupled with the negative effects of COVID-19 on the educational system can be implemented at multiple sites along the academic pipeline. 10-12 K-12 Education Over several decades, summer academic enrichment programs have effectively assisted underrepresented and disadvantaged students by providing them with role modeling, mentoring, coaching, networking, shadowing and exposure to career paths, all of which increase their social capital and help them overcome academic deficits. 13 These programs have also helped to reduce the academic regression or summer slide experienced by students over the summer. 14-16 The current COVID-19 pandemic has, in essence, extended the summer break, putting students at risk for an even greater degree of academic regression. During the current pandemic, and extending into the regular school year, there should be an increase in federal and state funding at the K-12 level. This could include providing broadband access and