Stepping outside of the classroom
Background: Early life and learning experiences have the potential to influence a person’s health throughout the lifespan. These influences, for children of low socioeconomic status in the United States, are compounded by the existence of racial and socioeconomic disparities exist in both child health and development. One of the pathways through which early life and learning experiences affect adult health is through educational attainment, which is initially exhibited through school readiness (i.e. how prepared children are for school). Research in this area traditionally focuses on early learning environments and family level dynamics as predictors of school readiness, although evidence suggests that non-academic factors, like child health, and even more distal factors such as neighborhood structural and social context, contribute to how ready a child is for school. While many have theorized about the relation between both physical health and school readiness and neighborhood social context and school readiness, empirical evidence is limited. Objective: The objective of this research was to investigate non-academic factors related to the behavioral and cognitive domains of school readiness (language and literacy, social-emotional, numeracy/cognitive) including physical health and neighborhood social context. Methods: The research was conducted as a mixed methods design: 1) a longitudinal, retrospective matched cohort study, using data from the Educare Learning Network’s 2007-2015 data set which included data from 26,810 children enrolled in 20 Educare schools across the United States with children propensity matched on exposure, either by health status (see Aim 1 p. 15) or parental perceived neighborhood support (see Aims 2-3 p 16); and 2) a qualitative study conducted with parents of children ages 0-5 in New Orleans, Louisiana and aimed at a deeper understanding of parent perceptions of school readiness, neighborhood, child health and the intersection of these concepts. Results: Results from Paper 1 indicate that there is an association between asthma and school readiness outcomes, however this may be confounded by child and family level factors and may also differ by child race or sex. Paper 2 Quantitative results indicate that there is an association between perceived neighborhood support and child health and school readiness, particularly social emotional development, and that these results may differ by child race and sex and that there are significant interactions between neighborhood and race playing a role. Qualitative analysis in Paper 2 indicated common themes of perception of neighborhood, neighborhood safety, and stress and these discussed in relationship to their impact on their children. Paper 3 Results indicate that parental stress and parent-child relationship, individually and in sequence, are mediators of the relationship between perceived neighborhood support and receptive vocabulary scores, but mediation was not significant for other child cognitive, language, and physical health outcomes. Conclusions: Findings from this study contribute to the current understanding of external factors, outside of the early learning environment, that contribute to disparities in child health and school readiness in a vulnerable population. Not only as they relate to childhood, but also to adult health and well-being across the life course. The data will provide empirical evidence to inform programs and policies related to external factors that may impact school readiness for a high quality early education programs.