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Does Attending a Segregated School Impact Child Health?

April 18, 2022

Editor’s Note: The article and commentary that are the subject of this blog discuss the impact of school segregation on child health. I thought that it would be helpful to have the perspective of a teacher. Elizabeth Zeichner is a former high school chemistry teacher. (In full disclosure, she is also my daughter.) Her experience corroborates the findings of this important article and commentary, and I am pleased that she agreed to write this blog.

-Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics

Before starting medical school, I was a high school teacher in South Los Angeles, California. The school where I taught is highly racially segregated (<1% of students are white). Class sizes are large, there is high teacher turnover, and limited resources. This is the case in many schools across the country.

After the Brown v. Board school desegregation orders in 1954, there was increased integration of schools, which was associated with overall improvement in Black peoples’ well-being. But, in the 1970s, and increasingly in the 1990s, school districts were released by the courts from desegregation orders, and schools became increasingly segregated.

Previous studies have shown racial inequities in child health and worse health outcomes among Black children. This week, Pediatrics is early-releasing a study from Guangyi Wang, PhD and colleagues at University of California-San Francisco and Stanford University, entitled, “School Racial Segregation and the Health of Black Children,” which investigates the impact of schooling environments on child health disparities (10.1542/peds.2021-055952).

The authors used data from the longitudinal Panel Study of Income Dynamics to look at the association of school segregation with health outcomes among Black children, specifically at 1,248 Black school-aged children who lived in districts that were released from desegregation orders from 1991 to 2014. You can go to the article to learn the details of the methodology, but the authors used statistical models to isolate health consequences of school resegregation from other confounders, such as residential segregation by race or income. They looked at parent-reported child health outcomes and behaviors likely affected by segregated schools, including asthma, obesity, and mental/emotional health.

They found an association between school segregation and increases in both behavioral problems and youth drinking behaviors, especially among girls.

This study explores school segregation as a continuing manifestation of systemic racism and provides some of the first evidence of school segregation’s harmful effect on child health. In the discussion, the authors describe factors, such as underlying family and neighborhood environments and harsh discipline and increased policing in schools, which further exacerbate stress in children who attend segregated schools. These stresses, combined with decreased academic and social-emotional support, negatively impact a child’s overall development and academic achievement. They emphasize that “school segregation-induced behavioral problems could exacerbate a harmful cycle of racial inequities in lifetime well-being.”

Dmitry Tumin, PhD, from East Carolina University, in an accompanying invited commentary, makes the point that the damage from school segregation persists and extends “beyond the schoolhouse walls,” discussing how virtual learning due to COVID-19 has led to increased segregation of the educational experience (10.1542/peds.2022-056416). Already existing structural inequities – such as lack of access to WiFi and technology and the need for older teens to care for younger siblings – make it more difficult, disproportionately affecting children who are already struggling. I saw this in my own classroom; I was teaching in March 2020, and as school became virtual, my students faced even more barriers to engage in school and thrive.

I encourage you to read this article and commentary; it will likely give you new insight into how school segregation has affected and continues to affect children’s health. There is still significant work that must be done to better understand and advocate for improving school conditions in all our communities, especially those affected by historical segregation.

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