Social Determinants of Health: Education Access and Quality
Published on Mar 21, 2024. Updated on Jun 11, 2024.
When we talk about staying healthy, we often think about eating well, exercising, and getting enough sleep. But did you know that our level of education also significantly affects our health? Let's explore how education affects our lives and how it relates to the Social Determinants of Health (SDOH).
Understanding the Role of Social Determinants of Health
Each of us faces a unique combination of factors that play a pivotal role in shaping our health and well-being. Some of us have nearly effortless access to vital resources, while more than half of the world's population faces severe limitations or no access to essentials like education. As a result, there are observable inequities, or disparities, for both individuals and communities.
The CDC defines SDOH as the conditions in which people are born, grow, work, live, and age, encompassing factors like socioeconomic status, education, neighborhood and physical environment, employment, and social support networks. SDOH are meaningful because they provide a way to understand how non-medical factors contribute to our well-being and overall health. SDOH also help us manage those interconnected factors by helping identify and implement strategies to address underlying inequities, promote access to resources, and empower communities to improve their health outcomes and overall well-being. As we look deeper into the impact of education, it becomes evident that it's intricately linked to factors that determine health outcomes. Understanding this intersection between education and health is essential for comprehending SDOH.
How does education affect our health and well-being?
Our education gives each of us the essential tools we need to lead fulfilling lives, enable personal growth, and engage with our communities. Education opens doors to higher-income employment opportunities and increases our access to better quality healthcare, nutritious food options, and safer living environments. Higher education levels are associated with healthier behaviors, leading to lower rates of chronic disease, longer life expectancies, and higher levels of subjective well-being.
In the US, the landscape of public education is shaped by a complex mix of politics, how taxes are distributed, and who's representing us. But it's not just about the classroom—inequality in education has far-reaching effects. It doesn't just influence grades; it limits future job opportunities, access to healthcare, and even the food on our tables. And when access to quality education is unequal, it fuels economic instability, poverty, and social tension. So, if we want to tackle vital issues like crime rates and economic stability, we've got to address educational disparities.
As a result, educational disparities perpetuate a cycle of disadvantage, hindering efforts to promote health equity and social justice within communities. To tackle disparities and achieve fairness and equity in healthcare, we need to fully understand how education, social factors, and public health interact while actively working to dismantle systemic barriers and promote inclusivity across all levels of society.
Education's Influence on Health, Well-Being, and Community
As noted earlier, individuals with higher levels of education tend to have better health outcomes, with lower rates of chronic disease, higher life expectancy, and improved mental health. Because education promotes health literacy, it also empowers individuals to make informed decisions about their health.
Education also improves socioeconomic status, providing access to better job prospects, higher income opportunities, and necessary resources such as healthcare, housing, and healthy food options. It also fosters critical thinking, problem-solving skills, and resilience, which are essential for navigating life's challenges and maintaining overall well-being. This close association demonstrates that investing in education benefits individuals and contributes to healthier, safer, and more prosperous communities.
When it comes to achieving a higher level of education, there's improvement in health and well-being, lowering the risk of premature death, especially among college graduates. With financial stability comes a more secure and stable quality of life, healthier lifestyle choices and activities, lower alcohol consumption, and other proactive health-related pursuits. In fact, pursuing education later in life yields health benefits by providing social interaction and intellectual stimulation.
Ensuring Equitable Access to Education
Education plays an undeniably vital role in promoting well-being and fostering personal growth. By striving for equity in education, we can bridge the gap between health disparities and community well-being, emphasizing the importance of not just school attendance but also the quality and inclusivity of the learning environment in addressing the social determinants of health. However, without equitable access to educational resources and opportunities, the potential positive outcomes may remain beyond reach for many individuals.
Equitable access to education means every student has the same opportunity as any other while acknowledging that access to quality education is crucial for addressing health differences and improving community well-being. In the context of SDOH, it's not simply about improving school attendance but the opportunity to access high-quality education with support services and inclusive learning environments.
For example, let's look at the findings concerning early childhood development in education. Studies indicate that the first five years of life impact our social, cognitive, emotional, and physical development throughout our lives. Children who receive quality education and support during their early years experience better physical well-being, cognitive development, and emotional health. These crucial early years profoundly influence a child's lifelong development, encompassing social, cognitive, emotional, and physical realms.
The close link between education and various facets of life—life expectancy, health, access, quality, and attainment—underscores education's pivotal role in shaping opportunities, employment, and income. Therefore, improving education quality boosts critical thinking skills and social connections and empowers us to address systemic barriers affecting their health and emotional well-being.
Factors Influencing Access to Education
Access to quality education is shaped by four pivotal factors: cultural barriers, geographical location, socioeconomic status, and early childhood development. In addition, budgeting, which is overseen by local, state, and federal governments and involves a larger number of regulations controlling allocation, affects access to education. As these factors are malleable, mitigating or eliminating them and enhancing educational opportunities can facilitate optimal learning and development for every child, fostering a healthier lifestyle. Let's delve into each factor and examine its significance.
Cultural Barriers
In the US, language barriers pose significant challenges to accessing education and healthcare. For those who use English as a second language, navigating standard educational materials or communicating with teachers can be daunting. Moreover, cultural norms and beliefs may discourage marginalized groups from pursuing educational opportunities. Language barriers hinder educational achievement and limit access to vital healthcare services, exacerbating health disparities within linguistically diverse communities.
In the context of health, language barriers and the lack of adequately trained interpreters and culturally competent healthcare providers limit health literacy and increase risk, especially in life-or-death situations. The CDC reports those with limited English proficiency may need help understanding and following emergency protocols like evacuation procedures. Similarly, those who need better media literacy skills may need help identifying reliable information sources in a crisis, hindering their response in an emergency. Rural and lower-income residents may need help accessing essential emergency skills training, affecting their crisis response capabilities.
Additionally, the ability to understand information is crucial for its effective use and application, highlighting the vital role of inclusive education in fostering reading, writing, and comprehension abilities. Consequently, navigating the healthcare system and medical information poses more significant challenges for individuals whose first language isn't English or who have experienced low-quality (or no) education opportunities.
Geographical Barriers
Geographical barriers in education refer to the limits and challenges students face based on where they live and include factors like distance, remoteness, limitations to infrastructure, and cultural or socioeconomic disparities. For example, students in rural areas tend to live further away from school, potentially impacting daily attendance and graduation rates. Additionally, disparities in the quality of educational resources and infrastructure between urban and rural areas can affect students' overall educational experience and opportunities, contributing to inequalities in academic and health outcomes.
Socioeconomic Barriers
Socioeconomic barriers are obstacles related to our financial and social status that hinder access to education, resources, and opportunities. An example of a socioeconomic barrier is poverty, made more difficult by varying degrees of physical and psychosocial stressors like overcrowded conditions, food insecurity, and unsafe living/working conditions, as well as chronic stress, stigma, and discrimination. Additional socioeconomic obstacles include limited access to educational resources, lack of parental support, housing instability, and disparities in access to quality healthcare and proper nutrition.
Socioeconomic barriers and socioeconomic status (SES) are key predictors of financial stability, security, income, and education. For example, research shows that kids from lower-income backgrounds can take longer to pick up academic skills than those from higher-income backgrounds due to the lack of exposure to other, more foundational skills due to under-resourced schools and communities.
So, how does a parent's SES affect their child's health as an adult? Higher-income families often have better access to quality healthcare services and resources for preventive care, laying the foundation for better health. In contrast, lower-income families tend to face barriers like a lack of insurance coverage and limited healthcare facilities in their area. Income also influences other important health behaviors, with higher-income families having better access to nutritious foods and opportunities for physical activity. In contrast, lower-income families experience higher rates of food insecurity and challenges with access to limited resources in their neighborhoods.
Additionally, a lower socioeconomic status statistically increases the chances of exposure to environmental hazards, further shaping health outcomes. In other words, income disparities in our society significantly contribute to health disparities, highlighting the importance of addressing socioeconomic inequalities to improve our overall population health.
Factors That Affect Education Quality
Education is categorized as a fundamental SDOH because it also impacts other social determinants. For example, because our level of education is linked to our level of job attainment and income, it influences the neighborhood we live in and the social groups we interact with.
In fact, the quality of our education is vital to ensuring inclusive, equitable, lifelong learning that fosters academic readiness, community engagement, and individual well-being. For example, well-trained teachers with smaller classes (far more common in higher-income neighborhoods) create and nurture early childhood development, education programs, and schools.
When done well, a high-quality education includes a range of elements, including the relevance of the curriculum, teaching methods, access to learning resources, and the overall learning environment. It extends beyond basic academic achievement to life skills such as critical thinking, creativity, and an established, continuous learning practice. Most importantly, a high-quality education promotes and provides essential support and resources for communities, leading to a safer, supportive environment for everyone.
Policy Recommendations for Education Access and Quality
Several stakeholders, including members of government organizations and lawmakers, are involved in creating education policy. These stakeholders play a crucial role in addressing disparities by implementing policies that prioritize access to quality education. Strategies like community engagement and support programs, along with early childhood development initiatives, are critical for improving access and quality and ensuring everyone has equitable opportunities for education.
Furthermore, integrating education into broader public health policies is vital for addressing the root causes of health disparities and promoting overall well-being. By recognizing the interconnectedness of education and health, policymakers can develop comprehensive strategies that address SDOH and promote health equity for all.
The crucial role of government and policymakers in addressing health disparities linked to education is undeniable. School boards are at the heart of community representation and change advocacy, acting as the people's voice. Often affiliated with a school district and governed by local policies, school boards play a crucial role in implementing positive transformations. As government entities, these districts provide public elementary and secondary education to students within a specified region, adding a touch of civic responsibility to the education fabric.
These are examples of how factors can vary based on where you live and grow up. Certain districts and schools have more resources than others. Hence, Head Start and ESOL (English for Speakers of Other Languages) programs work to ensure that children are included in their development. Being informed and advocating for change isn't always easy, but it is necessary. Getting involved in your community's education policies by way of Parent Service Agreement (PSA) or Parent Teacher Associations (PTA)—whether it's through volunteering, supporting your local school, or voting for local officials who want to improve the quality of education and access to it—enhances the learning experience for children in your area and improves the overall well-being of your community.
Strategies to Address Educational Disparities
A multifaceted approach is essential to addressing disparities in education and fostering health equity. By working together to implement targeted strategies like early childhood education, equitable resource allocation, and community engagement, we can pave the way for a more inclusive educational system that uplifts all individuals and promotes overall well-being.
Here are some strategies for addressing disparities:
Early Childhood Education: Ensure universal access to high-quality early childhood education programs to address and prevent disparities in cognitive development.
Equitable School Funding: Advocate for fair distribution of resources and funding to schools in underserved communities to improve access to educational resources.
Teacher Training and Support: Provide comprehensive training for educators on culturally responsive teaching practices to address diverse student needs.
Community Partnerships: Foster collaboration between schools, families, and community organizations to provide additional support services and promote overall health and well-being.
Language and Cultural Support: Implement strategies to address language and cultural barriers, such as language interpretation services and culturally relevant curriculum materials.
Targeted Interventions: Develop tailored interventions for vulnerable populations, such as low-income students, students with disabilities, and English language learners.
Policy Advocacy: Actively advocate for policy changes to address structural inequities, such as equitable school funding and expanding access to early childhood education, and make sure to vote for local, state, and national candidates who actively support funding education.
Data Collection: Collect and analyze educational outcomes, health disparities, and SDOH data to inform evidence-based interventions and monitor progress.
Addressing Barriers to Education Access
Several factors affect the quality of education. As noted above, SES plays a significant role, as families with lower income levels have less access to well-funded schools and fewer resources for educational support. Neighborhood and community characteristics are also important, with areas subject to higher poverty levels dealing with fewer resources and lower academic achievement.
Access to early childhood education is crucial, but not everyone gets the same treatment; recognizable disparities exist based on income, race, and location. Sufficient school funding and resources are essential for maintaining high-quality programs, hiring qualified teachers, and providing safe learning environments. In addition, teacher quality and experience, as well as family and parental involvement, further impact educational outcomes. Addressing these factors is essential for promoting educational equity and improving academic success, ultimately contributing to better health outcomes within the framework of SDOH.
Teaching Methods and Resources
Educational disparities arise from a range of challenges that prevent schools from implementing effective instructional strategies and limit access to essential resources. For example, US public schools are subject to funding changes that are directly affected by shifts in political will. Those shifts often result in unequal distribution of resources among schools, with more affluent areas receiving more investment in education than their less affluent neighbors. That inconsistent distribution of resources and funding has, over time, led to substandard school facilities, out-of-date technology, and aging textbooks, as well as the underfunding or eradiation of programs like after-school care that are vital for improving academic achievement, offering enrichment activities, and providing a safe environment outside of school hours.
In addition, underfunding education leads to inadequate support for educators, resulting in high student-to-teacher ratios and limited professional development opportunities. Those circumstances hinder effective instruction and contribute to teacher burnout, which has led to more than 270,000 educators (about half the population of Wyoming) leaving the profession since 2016.
To begin working toward equitable resource distribution and education funding in the US, it’s a good time to consider re-evaluating and reforming our existing property tax-based funding models, which, as they’re structured today, perpetuate disparities. To help address those disparities, we need to determine how to prioritize need-based allocations and make targeted investments in underserved communities. However, addressing these issues requires equitable resource distribution across regions, in addition to targeted investment in teacher training and the political will to ensure all students have access to a quality education, regardless of their region’s socioeconomic status.
Curriculum Relevance
Teachers also need an improved and relevant curriculum to engage their students in learning experiences that address real-world challenges and support their unique learning needs. However, with the existing emphasis on standardized testing in the US, many educators are forced to bypass the teaching of critical thinking skills and cultural diversity, hindering their students' understanding of health disparities within their communities. Inclusive curriculums that integrate relevant, timely health content and foster critical thinking skills are essential to addressing these challenges.
School Infrastructure
Providing a safe environment that promotes student engagement and academic success is vital for maintaining education quality. However, limitations in school infrastructure, influenced by budget constraints and other factors, can lead to disparities in educational outcomes.
An adequately funded education system can lead to safer and more supportive environments for all students and have positive effects on society's health by boosting health literacy and encouraging preventive healthcare behaviors, leading to healthier communities overall.
Conclusion
Research confirms that education plays a crucial role in shaping health outcomes and overall well-being through its impact on socioeconomic status, health literacy, and lifestyle choices. Disparities in education access and quality perpetuate systemic inequalities, hindering societal progress and leading to adverse health outcomes.
To foster a healthier society, we must advocate for policies promoting equitable access to quality education from early childhood through adulthood. Investing in education enhances individual opportunities and strengthens communities. Collaboration among government entities, community stakeholders, and educational institutions is essential to developing comprehensive strategies prioritizing education as a fundamental determinant of health.
We can build a healthier, more prosperous society by recognizing the interconnectedness of education and health and taking decisive action to ensure equitable access and quality. Let's commit to creating a future where everyone can thrive, regardless of their background or circumstances.
Reviewers
Antoinette Leonard Jean Charles, MS, MD/EdD Candidate (Antioch University), Content ReviewerKelsey LaFayette, DNP, ARNP, FNP-C, Nursing Content Manager
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