Closing the Opportunity Gap for Young Children (2023) / Chapter Skim
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Pages 175-229
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As with exclusionary discipline and corporal punishment, there is no federal law prohibiting these practices, while a patchwork of state laws limit or place parameters around their use (Meek et al., 2020)
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Positive critical teacher–child relationships, and all of their associated processes, are related to third-grade achievement and to children's perceptions of school, including feeling more positive about school and more excited about learning (Birch & Ladd, 1997; NICHD Early Child Care Research Network, 2002; Pianta & Stuhlman, 2004; O'Connor & McCartney, 2007)
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. Together, these factors drive gaps in the quality of teacher–child relationships and daily interactions, which can contribute to opportunity gaps.
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. Studies have shown as well that White compared with Black teachers are more likely to recommend exclusionary discipline and special education placement for Black children (Achilles, McLaughlin, & Croninger, 2007; Skiba et al., 2011; Wiley et al., 2013; Sullivan et al., 2014)
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found that after the second infraction, teachers were more likely to label Black relative to White children as "troublemakers," which may imply attribution of the behaviors in the report to factors internal to the children and the belief that there was a higher likelihood that the behaviors would continue. Teachers were also more likely to recommend exclusionary discipline for Black children compared with their White peers after the second infraction (Okonofua & Eberhardt, 2015)
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Overall, this body of work indicates that Black children, and in many cases Latino, Indigenous, immigrant, and dual language learner children, are subject to bias across an array of domains, including perceptions of behavior, expectations, and empathy. This bias contributes not only to the quality of teacher–child relationships and interactions but also more generally to reduced opportunities in learning settings that can shape children's learning experiences.
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. Community schools offer an "integrated focus on academics, health and social services, youth and community development, and community engagement" (Coalition for Community Schools, 2020, p.
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. Other research has found that even when researchers control for children's academic profiles, test scores, and socioeconomic backgrounds, Black children are still underreferred (Grissom & Redding, 2016)
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The shift to remote schooling during the pandemic introduced changes that were not conducive to social and academic learning (Weiland et al., 2021) , and had a significant impact on children's learning opportunities and academic outcomes (EmpowerK12, 2020)
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. The Centers for Disease Control and Prevention surveyed parents of children aged 5–12 between October and November 2020 and found that, compared with parents of children attending school in person, parents of children receiving remote instruction were more likely to report higher levels of emotional distress, conflict between working and providing child care, and difficulty sleeping (Verlenden et al., 2021)
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Well-funded, high-quality experiences in the early grades that follow well-funded and aligned ECE experiences can improve students' academic performance and in the longer term can lead to more positive outcomes, such as higher graduation rates and reduced adult poverty. It is important to ensure that these early elementary experiences are aligned with the latest science and are specifically designed to close opportunity gaps and ensure that all students succeed, particularly those who have been historically marginalized.
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. Issue: School-age child care: Afterschool programs are a critical resource for working families.
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. Within-group diversity in minority disproportionate representation: English language learners in urban school districts.
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. Child care and early education for infants and toddlers.
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. The effect of school funding on opportunity gaps for students with disabilities: Policy and context in a diverse urban district.
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Early Childhood Research Quarterly, 37. https://doi.org/10.1016/j.ecresq.2016.02.007 Downey, D., & Pribesh, S
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. Teacher race and racial disparities in special education.
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. School-age child care: Overlooked and un der-resourced.
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Early Childhood Research Quarterly, 61, 190–208. https://doi.org/10.1016/j.ecresq.2022.07.005
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The persistent, painful and problematic practice of corporal punishment in schools. Southern Poverty Law Center and The Center for Civil Rights Remedies.
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. Unpacking the logic of compliance in special education: Contextual influences on discipline racial disparities in suburban schools.
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. Teacher–child relationship quality and aca demic achievement of Chinese American children in immigrant families.
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. Young dual language learners in the United States and by state.
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The National Academies Press. https://doi.org/10.17226/10128 NICHD Early Child Care Research Network.
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. Head Start impact study: Final report.
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. Advancing an ecological ap proach to chronic absenteeism: Evidence from Detroit.
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. Disparate access: The disproportionality of African American students with disabili ties across educational environments.
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. The roles of teacher expectations and school composi tion on teacher–child relationship quality.
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Early Childhood Research Quarterly, 49, 28–39. https://doi.org/10.1016/j.ecresq.2019.05.007 Zeng, S., Corr, C.P., O'Grady, C., & Guan, Y
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Yet there are vast disparities in physical health in the United States. From prenatal and infant health to adolescent health, children from low-income, racial/ethnic minority, and rural backgrounds are more likely to experience health problems.
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. The second section of this chapter reviews existing research on potential solutions to some of the drivers of the opportunity gaps in physical health and health care.
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Research is clear that a pregnant person's access to health insurance can influence the use and timing of prenatal care; that adequate prenatal care is associated with healthier birth outcomes, such as a longer period of gestation and healthier birthweight (Creanga et 1The committee uses the terms "woman" and "mother" in this report; however, we recognize that the terms "pregnant woman," "woman," "mother," and "maternal" may not reflect how some pregnant individuals or others seeking reproductive health care may identify.
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. These early opportunity gaps can widen opportunity gaps and outcomes over the life course.
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In these nonexpansion states, no childless adults are eligible for Medicaid, and the income eligibility threshold for parents varies from a low of 17% of the FPL in Texas to 100% of the FPL in Wisconsin, leaving millions of parents and prospective parents without access to health insurance, a resource that promotes healthier birth outcomes and health across the lifespan. The percentage of women who lack health insurance is much higher in states that have not expanded Medicaid.
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Access to quality maternity care is a critical component of maternal health and positive birth outcomes, especially in light of the high rates of maternal mortality and severe maternal morbidity in the United States. Yet nearly 15% of women in the United States -- ranging from a low of 5% of births in Rhode Island to nearly 25% in New Mexico -- do not receive adequate prenatal care.
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(See Chapter 6 for a more detailed discussion of opportunity gaps in social-emotional health and well-being.)
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. Adverse birth outcomes reflect the trauma resulting from discrimination and racism that many Black women have experienced across their life course, as well as their disproportionately lower access to financial security (Alhusen et al., 2016)
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. The medical home is significantly associated with positive child health outcomes regardless of household income.
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. Prior to preschool entry at age 3, child preventive care visits may serve as the only opportunity to screen for, identify, and intervene on a range of social, developmental, and health concerns that can have significant impacts on a child's health and well-being.
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. Pediatric health care visits have traditionally focused on regular immunizations, assessment of growth and developmental milestones, and anticipatory guidance for parents on child development and preventive care to reduce risk for injuries and promote social-emotional learning.
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. Racism and Culturally Responsive Care Racism is a pervasive stressor, which, like other stressors that operate through physiological pathways, may challenge one's ability to adapt and may increase health risks (Cohen, Kessler, & Gordon, 1997; McEwen, 2005)
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. Stress that occurs continually or is triggered by multiple sources not only shapes children's later emotional lives as adults but also affects their physical health and longevity.
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Adultification Childhood is a social construct that intersects with the social construct of race. As discussed in Chapter 3, relative to their White peers, Black children are more likely to be misperceived as older and more developmentally mature than they are.
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It is plausible that adultification informs one form of implicit bias that is associated with such disparate treatment and with physical health outcomes. Implicit racial bias toward Black children has been demonstrated at levels similar to those directed at Black adults (Johnson et al., 2017)
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Achieving health equity will therefore require addressing institutional, structural, and systemic racism in health care and public health, and race-based medicine is one area in which systemic racism manifests. It is also worth noting that, while pediatricians have often served as lead clinician in the pediatric medical home, a team-based approach to child health has emerged by which primary care is reconfigured to address access issues.
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. Implicit bias is thought to influence administrative decisions on insurance plans accepted, neighborhoods for establishing offices, and selection and inclusion of diverse students in medical education and training and among faculty (Ansell & McDonald, 2015)
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More equitable and antiracist care practices could be supported if providers had a deeper understanding of structural and institutional racism and interpersonal discrimination and their impacts on health, clinical encounters, and conditions. To date, however, literature conceptualizing structural racism has not been adequately integrated into medical education, and the majority of empirical studies of racism have focused on interpersonal discrimination rather than structural racism (Bailey et al., 2017)
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. As noted previously, implicit bias, stereotyping, and prejudice among health care professionals influence inequities in diagnosis, treatment, and care by race/ethnicity (Chapman, Katz, & Carnes, 2013; Hall et al., 2015; FitzGerald & Hurst, 2017)
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has recently taken steps to dismantle race-based medicine in clinical practice and medical education. To that end, it is examining and eliminating inaccurately applied "race corrections" or "race adjustment factors" that result in differential approaches to disease management and disparate clinical outcomes.
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. For example, increasing evidence indicates that the consumption of nutritious foods during the prenatal period affects the general health and well-being of children and may play a role in their cognitive and physical development (Guan et al., 2021)
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. Safe and Healthy Environments As discussed previously, young children exist within the contexts of their families and neighborhoods, including the places where they live, learn, and play, and these environments need to be safe and healthy if children are to achieve optimal physical health, growth, and development.
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The opportunity gap between very low- and very high-opportunity neighborhoods represents differences along important dimensions of neighborhood environment. Access to green space, for example, varies widely.
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Moreover, the number of physical health conditions examined was limited, and the sample was relatively small (4,604 families, with 98% of households headed by women) , restricted to only five U.S.
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Environmental contaminants have repeatedly been found to be associated with poor health throughout the life course, and the prenatal and early childhood periods represent particularly sensitive developmental windows in which individuals may be especially vulnerable to their effects. Young children may be exposed to thousands of potential contaminants, including through the air they breathe, the water they drink and use, the food they eat, and the consumer products with which they come into contact (Giudice, Woodruff, & Conry, 2017)
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