Tuesday, August 4, 2009

Improving schools

Finding ways to significantly and sustainably improve the effectiveness of public schools in high poverty areas is one of the most urgent problems facing us -- particularly when we aim to reduce the inequalities that exist around race and poverty in our nation's cities. New thinking about schools and curricula has given rise to some practical strategies for achieving this kind of improvement.

For example, the Center for Social Organization of Schools at Johns Hopkins University is a particularly creative place for using research and development to find replicable ways of improving school success in high-poverty areas. Here is the mission statement for CSOS:

The Center for Social Organization of Schools (CSOS) was established in 1966 as an educational research and development center at Johns Hopkins University. The Center maintains a staff of full-time, highly productive sociologists, psychologists, social psychologists, and educators who conduct programmatic research to improve the education system, as well as full-time support staff engaged in developing curricula and providing technical assistance to help schools use the Center’s research. The Center currently includes the federally-supported Center for Research on the Education of Students Placed At Risk, and the Center on School, Family and Community Partnerships. link
The Talent Development Middle Grades Program (link) is one of the promising efforts that have been spearheaded by CSOS. This program attempts to implement school-level programs that substantially change the odds for the middle grade students who are at risk for dropping out. And the alarming fact is that likely high school dropouts can be identified by the sixth grade, based on factors such as attendance, poor academic progress, and behavioral problems. So reversing these factors early is key to improving high school completion rates six to eight years later. Mentorship for students, professional development for teachers, close teamwork within schools among teachers and principals, implementation of a challenging curriculum for all students, and extra-help labs to help students stay on track are the key strategies that work, according to CSOS research. School organization and climate are critical factors, and they can be addressed through district-level reform efforts (link).

What are the interventions that are shown to be effective? The CSOS Talent Development High Schools Program (link) provides quite a bit of useful research and program reform recommendations. Here is the mission statement for this program:
The Talent Development High School Model is a comprehensive reform model for large high schools facing serious problems with student attendance, discipline, achievement scores, and dropout rates. The model includes organizational and management changes to establish a positive school climate; curricular and instructional innovations to prepare all students for high-level courses in math and English; parent and community involvement to encourage college awareness; and professional development to support the recommended reforms.
The program reform model highlights curricula with high expectations, extended class periods, formal extra help programs, professional development and teaming for teachers, and family and community involvement.

Another important current initiative -- also inspired by research at CSOS -- is the Diplomas Now initiative that is underway in partnership with CityYear, Talent Development, and Communities in Schools. This program is a response to the severe high school dropout crisis our nation faces, especially in high-poverty cities. Here is a description of this program:
  • Diplomas Now pairs evidence-based, comprehensive school reform with national service teams to provide tutoring, mentoring, monitoring and engagement activities at the required scale, and integrated student supports for the highest need students.
  • Diplomas Now unites three organizations – Talent Development, City Year and Communities In Schools – each one with years of experience in youth service and third-party evidence of impact on helping students succeed. The Philadelphia Education Fund also serves as a national training and technical assistance partner. The partners complement each other and also collaborate well with local education reform efforts.
  • Diplomas Now works closely with school administrators and teachers to identify off-track youth and develop, implement and sustain comprehensive, targeted and customized strategies to get them back on track. Diplomas Now is deliberately designed to incorporate, complement and accelerate the impact of other promising and innovative efforts that aim to boost post-secondary success.
There are a number of promising initiatives underway across the country that are aimed at achieving significant and sustainable improvement in K-12 learning outcomes. It is important that schools find the partnership they need from government and foundations to implement the ideas that work. The Obama administration has committed quite a bit of energy and funds to this effort; let's hope that it pays off throughout urban America.

Monday, August 3, 2009

Health and mortality inequalities in the US

How unequal are we when it comes to inequalities of health and mortality? Richard Florida (CreativeClass) points to an important new study on this question by public health researchers at Harvard and UCSF. (This is one of many items that Florida references in his Twitter feed -- it's certainly worth following. This bears out the academic value of Twitter!) The study is "Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States". And the answer the researchers provide to the question above is -- very. The study is worth reading in detail.

The authors analyze mortality statistics by county, and they break the data down by incorporating racial and demographic characteristics. The data groups fairly well around the eight Americas mentioned in the title:

Here is how they describe their findings:

The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs.
And here is their conclusion:
Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.
For example, their data show that "the life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001." This is an enormous difference in longevity for the two groups; and it is a difference that tags fundamental social structures that influence health and risk across these two populations.

Here is a time-series graph of the behavior of longevity for the eight Americas:
So what are the factors that appear to create these extreme differences in mortality across socioeconomic and racial groups in America? They consider health care access and utilization; homicide; accidents; and HIV as primary potential causes of variations in mortality for a group. Most important of all of these factors for the large populations appear to be the health disparities that derive from access and utilization. And here they offer an important set of recommendations:
Opportunities and interventions to reduce health inequalities include (1) reducing socioeconomic inequalities, which are the distal causes of health inequalities, (2) increasing financial access to health care by decreasing the number of Americans without health plan coverage, (3) removing physical, behavioral, and cultural barriers to health care, (4) reducing disparities in the quality of care, (5) designing public health strategies and interventions to reduce health risks at the level of communities (e.g., changes in urban/neighborhood design to facilitate physical activity and reduce obesity), and (6) designing public health strategies to reduce health risks that target individuals or population subgroups that are not necessarily in the same community (e.g., tobacco taxation or pharmacological interventions for blood pressure and cholesterol).
These findings are squarely relevant to the healthcare debate currently underway in the United States. The country needs to recognize the severity of the "health/mortality justice" issue, and we need to reform our healthcare system so that these disparities begin to lessen.