Addressing Racial and Ethnic Disparities in COVID-19 Among School-Aged Children: Are We Doing Enough?

Arica White, PhD, MPH; Leandris C. Liburd, PhD; Fátima Coronado, MD, MPH

Disclosures

Prev Chronic Dis. 2021;18(6):e55 

In This Article

Implementing Strategies to Advance Health Equity Through Partnerships

Community-based public and private sector partnerships are a cornerstone of community health promotion, chronic disease prevention, and a range of health equity initiatives. In addressing COVID-19 disparities and consequent social and health inequities, we borrow from the evidence base and experience of other public health interventions. Dicent Taillepierre and colleagues identified several elements in program design that enhance health equity, including consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation.[47] Considering these elements and other experiences that support the benefit of community-based partnerships, we propose immediate actions that can be taken to respond to the pandemic, as well as to establish and track outcomes.[34,47]

We propose 4 evidence-based approaches to form community-based partnerships, including initial collective work, outcome-based activities, and communication efforts, that collaborators can use to improve health equity among students from racial and ethnic minority groups (Table 2). First, education departments should identify organizations with the mission and expertise to support tailored efforts to ameliorate education inequities among children and teens who are experiencing systemic disadvantage and falling behind academically. Multiple sectors and community actors such as clergy and faith-based organizations, YMCA, YWCA, Boys & Girls Clubs of America, Head Start programs, federally qualified community health centers, and parent–teacher associations can be effective community-based partners to protect students and support access to equitable education (Table 2).

Relevant community partners can supplement available resources and sponsor critical activities to meet students' unique needs.[48] Participating community-based organizations should be aware of the characteristics of a community, including language, race, ethnicity, countries of origin, and other factors that could affect health status, access to health care, and the provision of culturally and linguistically responsive prevention messages.[52]

Second, to facilitate successful collaborations, initial collective work by partners is needed to define the problem and create a shared vision to achieve specific outcomes. Assessments to inform policy, systems, and environmental change are needed. These assessments can include public health data describing the impact of COVID-19 in the community of interest, particularly among children and teens enrolled in school; school system equity plans to mitigate exposure and transmission of COVID-19; and reviews of the school system's digital learning capacities. Place-based approaches can align community members, businesses, institutions, and others in a collaborative and participatory process to address health and contextual factors influencing the social well-being of children within a defined community.[49] For example, these efforts planned with community members offer an opportunity to strategically assess and monitor trends in population health status and the needs and assets of a community.

Third, it is important for partners to take the lead or facilitate activities that focus on outcomes they have the capacity to achieve. For example, the Boys & Girls Club of America can provide tutoring services and other extra-curricular activities to minimize academic delays and poor performance on standardized tests. Later, rigorous program evaluations can document the effectiveness of these strategies post-pandemic.[50]

Finally, communication is one of the core components for promoting and improving public health.[51] Ongoing communication between schools, parents, and community-based organizations is essential. Particularly, a commitment to transparency is needed so that parents and the larger community are kept apprised of partnership efforts and informed when outcomes are on track. Partners can leverage various media outlets, including social media, to disseminate tailored prevention messages as well as connect students and parents to health care services. For example, existing digital platforms can be used for tutoring small groups or individual students. Telemedicine, including telehealth technologies, can be used to provide counseling to families about coping with stress. Although these evidence-based approaches are not new to public health, there are new opportunities to scale these approaches for greater reach and impact in communities disproportionately impacted by COVID-19.

Because of their critical role for all children and the disproportionate impact that school closures can have on those students experiencing systemic disadvantage, it is crucial that K-12 schools open safely and remain open for in-person learning.[53] Community engagement and partnerships are foundational to public health and its core value of social justice.[54] Partnerships can help facilitate delivery of quality virtual learning, policies, and systems changes that keep classrooms safe for in-person learning, and they can facilitate communication strategies that ensure the dissemination of scientifically sound public health prevention strategies that build community confidence in the safe reopening of schools. In addition to facilitating and sustaining in-person learning, partnerships can help prevent further exacerbation of educational inequities, support parents' full return to work and more everyday activities in different settings, and fuel economic recovery. Because the needs, risk factors, assets, and resources vary across communities, local public health departments and school boards of education should work with local organizations that can help provide tailored support. Moreover, local organizations are more likely to be perceived as trustworthy and credible by communities.[52] Recent federal funding opportunities can help facilitate and sustain these partnerships. The American Rescue Plan Elementary and Secondary School Emergency Relief Fund, with funds totaling $122 billion, supports efforts by states, Puerto Rico, and the District of Columbia to reopen K-12 schools safely and to equitably expand opportunity for students experiencing disadvantage.[38] These funds can be used to implement strategies, including evidence-based interventions, to meet the social, emotional, mental health, and academic needs of students. Furthermore, the Centers for Disease Control and Prevention (CDC) is providing $10 billion to states to support COVID-19 screening and testing for K-12 teachers, staff, and students.[38] Partnerships can leverage these funding opportunities and aid the implementation of rapid response efforts needed to facilitate learning.

The COVID-19 pandemic has not only exposed longstanding health and social inequities in the US but also revitalized efforts to achieve authentic community engagement in promoting mitigation efforts to end the pandemic. Partnerships between local health departments, local school systems, and other public and private organizations can offer immediate support to these children and teens during the COVID-19 pandemic and over the long term as we move into the recovery phase.

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