“You Can’t Help a Child if You Don’t Know Something Yourself”: A Qualitative Study of Barriers to Education in an Underserved West Baltimore Community

Abstract

Volumes have been written describing research, theory and opinion as to the causes and correlates of disparities in health and educational outcomes in the United States. Still, there is little agreement on the etiology or resolutions of the inequality in opportunity and outcomes faced by many of our most vulnerable citizens, especially those citizens in under-resourced communities of color. There is, however, increasing agreement that health outcomes and educational achievement are influenced by factors outside of their respective sectors, such as social, family, and neighborhood conditions including poverty, structural racism, and environmental hazards (Chen, Martin, & Matthews, 2007; Evans, 2004; Murnane, 2007). The interdependence of health and educational attainment starts early and continues throughout someone's lifespan. For example, children with health challenges, such as asthma or diabetes tend to attend school less frequently and perform more poorly on measures of academic attainment (Haas & Fosse, 2008; Kearney, 2008). Children with lower levels of educational attainment tend to have less economic success and worse health across their lifespans (Case, Fertig & Paxson, 2005; Heckman, 2008; Lynch, Kaplan & Shema, 1997). Consequently, any effort to understand the drivers of health outcomes, educational attainment or poverty should begin with examining the relationship between the three. Using an ecological framework, this article describes the interaction of factors that focus groups participants note create barriers to health promotion and educational attainment in an underserved and under resourced community in West Baltimore.LITERATURE REVIEWUsing data from 12 nationally representative studies, Reardon (2013) found that the gap in standardized test scores of high- and low-income families has grown by about 40% over the previous three decades. The college enrollment and completion rates have displayed a similar trend, with increased rates of graduation for wealthy students but no improvements among poor families (Reardon, Baker, & Klasik, 2012). It seems, however that the income-achievement gap is present at the onset of schooling and persists, but does not increase, through the child's educational lifecourse. This would suggest that, above and beyond differences in school quality, environmental and social factors are contributing to the gaps in educational achievement and attainment observed between high- and low-income students. These findings are supported by other researchers who have identified academic achievement gaps by race and income that are present by the time a child enters kindergarten (Brooks-Gunn et al., 2003; Magnuson et al., 2004; Yeung & Pfeiffer, 2009). Although there have been many efforts to measure and address school readiness through remediation or improved access to early childhood education, affecting meaningful change may necessitate the purposeful alignment of health and educational programming in areas that are traditionally outside their sphere of influence. For example, there are many early interventions such as prenatal care to reduce low-birth weight (Avchen, Scott & Mason, 2001), responsive parenting programs (Barth & Liggett-Creel, 2014; Weisleder & Fernald, 2013), reduction in the incidence and impact of poverty and housing instability (Burgard, Seefeldt & Zelner, 2012; Fantuzzo et al., 2013) that have historically operated in silos, but have known impacts on child academic and health outcomes.A report by the National Research Council (NRC) and the Institute of Medicine (IOM) described the interplay of behavioral, environmental, systemic and social factors in the relatively poor health outcomes of U.S. citizens compared to the health outcomes for people in other developed nations (NRC and IOM, 2013). The authors also described disparities in health outcomes by gender, ethnicity and geography; with variations in mortality of up to 25 years by census tract (Kulkarni et al. …