Racism as a Public Health Crisis in Schools

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This issue of the Bulletin is from January 2022. To view all issues of the Bulletin, including the most recent, return to the main page.

Structural and systemic barriers in the US subject Black, Hispanic and Native students to ongoing segregation in poorly resourced schools, restricting their access to advanced coursework, experienced educators and high-quality wraparound services. As a result, the public high school graduation rate was 93% for Asian American students and 89% for white students during the 2018-2019 school year, but 82%, 81%, 80% and 74% for Hispanic, Pacific Islander, Black and Native students, respectively.1 Even before graduation, these students face significant barriers to on-time advancement, with Black students twice as likely to be held back in ninth grade as all other students combined.

These disparities are a troubling academic outcome, but they also point to a pressing public health issue. Of the social determinants, educational attainment is the single greatest predictor of health and well-being across the lifespan, and high school graduation is a particularly stark indicator. Compared to high school and college graduates, adults who do not complete high school are at higher risk of poor health and more likely to die prematurely from preventable conditions such as high blood pressure, diabetes and stroke. In order to reach their full potential and live their fullest lives, students need access to race-aware policies and practices designed to give them an equitable shot at high school graduation.

Health Impacts of School-Based Racism on Students

Unfortunately, many districts operate from an assumption that all students access school in the same way, have the same opportunity to learn once in the classroom and benefit from the same funding, materials and programming. But efforts centered on equality rather than equity, or those operating from a place of color-blindness, ignore the realities of racial disparities that undermine the physical, mental and educational well-being of students of color.

Exclusionary school discipline — including suspensions, expulsions and actions involving law enforcement — offers perhaps the most striking example. Black, Hispanic, Native and Pacific Islander students bear the brunt of exclusionary discipline in schools and are more likely than their white peers to be referred for subjective offenses, including disrespect, defiance and noise. Such disparities form a school-to-prison pipeline, with students enrolled in schools with higher suspension rates up to 20% more likely to face arrest and incarceration as adults whether or not they themselves were suspended; suspension can also double the risk of high school dropout, which in turn triples the risk of justice involvement. While outcomes are worse in schools with police presence — increasing arrests for "disorderly conduct" more than fivefold — the share of schools with security staff increased sharply between 2013 and 2017 while the average ratio of students to school-based mental health providers continued to lag considerably behind recommended levels.

Academic tracking, which places students on defined curricular paths based on standardized test results, similarly serves to deepen existing racial disparities in schools. Standardized tests have been shown to favor white students, serving as a better predictor of class and privilege than intelligence, but they are still used across the country to determine academic programming. As a result, Black, Hispanic and Native students are disproportionately assigned to lower tracks that do not prepare them for advanced-level college preparatory courses and subject them to lower quality curriculum, less experienced teachers and less rigorous expectations. Because of this, academic tracking can have a profound effect on students' self-esteem and self-efficacy, putting them at risk of both immediate and long-term mental and physical health concerns, as well as school dropout.

The self-esteem and self-efficacy of students is also impacted by teachers' individual perceptions, which are themselves shaped and reinforced by institutional policies and practices. The assumption that underachievement is related to a students' identity rather than systemic inequalities — a false understanding entrenched by policies like academic tracking — continues to contribute to the over-designation of Black, Hispanic and Native students as "at-risk" and their underrepresentation in gifted and talented programs, even when their performance is objectively the same as their white peers. Decades of research have documented the impact of educator expectations on student achievement, with low expectations of Black students contributing to declining literacy in grade school and lower enrollment in four-year colleges.

Compounding this are additional instances of institutional racism, including the centering of core curriculum on a Eurocentric version of American history and culture. Across the US, academic programming tends to reflect a white — and whitewashed — understanding of the world with other cultural norms, values and viewpoints largely restricted to electives and advanced placement courses, the latter of which are often out of reach for Black, Hispanic and Native students. This practice invalidates students, with research finding that curricula teaching realities inconsistent with the lived experiences of students can leave them feeling demotivated, devalued and disengaged, increasing their risk of dropout.

Declaring Racism a Public Health Crisis in Schools

In order to address these disparities, schools first need to acknowledge the ongoing harms caused to students by the racism perpetuated within their walls. As of December 2021, at least six public school districts — in Rialto, California; Ferndale, Michigan; Lowell, Massachusetts; Akron, Ohio; and both Champaign and Decatur, Illinois — have adopted resolutions acknowledging the long history of racism, discrimination and segregation in the US, noting its negative impact on the health, educational and economic outcomes of many racial groups and declaring racism as a public health crisis adversely impacting students, families and staff.

As with those passed by city officials and local public health organizations, many of the resolutions developed by education entities begin with a commitment to establishing, supporting and sustaining a culture of anti-racism. While the commitment itself is important in terms of messaging, more critical are the specific and actionable steps that an entity agrees to take in order to establish, support and sustain such a culture. For Akron, Champaign, Decatur, Ferndale and Rialto — all of which take a more action-oriented approach in contrast to what is a largely retrospective statement from Lowell — these proposed steps fall into four broad categories:

  1. Diversify the histories, cultures and traditions reflected in materials and programming. Specific actions include implementing a racial equity policy aimed at reducing the effects of racism on not only students, but also families, staff and the school community; developing or revising policies that integrate racially and culturally relevant content into the curriculum alongside anti-racism instruction; identifying recommendations around the implementation of a culturally responsive social-emotional learning curriculum; recognizing Juneteenth and Indigenous Peoples Day on district calendars and working with students, families, staff and community members on the inclusion of important cultural holiday; and honoring the lives and contributions of Native communities in the curriculum while strengthening policies around the use of offensive imagery and terminology.
  2. Counter individual bias through hiring, training and retention practices. Specific actions include conducting or expanding mandatory diversity, equity, inclusion and implicit bias training for all administrators, teachers, staff and volunteers; recruiting and committing to the professional development of teachers and staff who reflect the diversity of students; reviewing volunteer requirements to increase the racial diversity of other adults who engage with students; and consulting with administrators, teachers and staff to develop and implement employee resource groups
  3. Center student well-being in discipline and school safety plans. Specific actions include working with administrators, teachers, students and families to revise discipline and safety systems with an emphasis on culturally responsive restorative justice and minimal involvement by local police departments; publishing students rights and responsibilities around engagement with school resource officers; increasing training for administrators, teachers and staff surrounding their responsibility to provide fair and equitable discipline; engaging students in a conversation about the role of police in schools when any school resource officer contract is under consideration; and reviewing multi-tiered systems of support with a culturally responsive lens and an emphasis on engaging students in restorative practices
  4. Introduce mechanisms for public accountability. Specific actions include publicly reporting on educational outcomes for Black, Hispanic and Native students — including those related to curriculum, discipline, opportunities and school climate — alongside recommendations for meaningful interventions and releasing annual reports on complaints related to racial bias, the status of accompanying investigations and broad outcomes

While not exhaustive, actions such as these are critical to creating empowering and equitable learning environments for students of color, ones that allow them to fully engage in the classroom, graduate from high school, pursue higher education or professional training, make connections to careers and ultimately live longer, healthier lives. For all students, such actions are necessary to support the development of the critical thinking skills — and historical grounding — necessary to work towards a more just society.

To better center student well-being in discipline and school safety plans, Washington state sets an example by limiting the length of suspensions and expulsions, prohibiting their use in response to certain mental health concerns and publicly reporting disciplinary data disaggregated by race, socioeconomic status and gender. In Ohio, suspension and expulsion can only be used in limited circumstances for students in preschool through third grade, and no K-12 student can be expelled for disruption or defiance in California. In states including Arkansas, Rhode Island, Oregon, North Carolina, Nevada and New Mexico, legislation limits the use of exclusionary discipline in response to chronic absenteeism. Following the police killing of George Floyd in May 2020, at least 33 districts pledged to end school security contracts with local police departments and reimagine safety plans. Public school systems in cities like Chicago, Saint Paul and Los Angeles developed toolkits to help educators talk with students about racism, police violence and the Black Lives Matter movement.


Legislative Threat of "Divisive" Labeling

Declarations like those passed by the school districts above are critical to ensuring supportive and empowering schools for all students, especially in light of mounting legislative efforts to limit discussion of race and racism in classrooms across the country. In September 2020, the Trump administration issued a memo directing federal agencies to identify any staff training focused on critical race theory (CRT) or white privilege, describing such programming as "divisive, anti-American propaganda" sowing "division and resentment" amongst the workforce. This memo was quickly followed by an executive order restricting the federal government and contractors from conducting diversity training addressing systemic racism, white privilege and other issues involving race and gender bias. Although the executive order was revoked on the first day of the Biden administration, it set the stage for a wave of state and local efforts aimed at curtailing discussion of race and gender in other settings, notably public schools. As of November 2021, 32 states — including Michigan and Ohio2 — had proposed legislation, executive actions or resolutions banning or limiting the teaching of principles attributed to CRT in schools, arguing that such concepts demoralize white students and create divisions. By the end of 2021, at least nine states had passed so-called "anti-CRT" efforts.

While some states like Kansas and Missouri have sought to distance their schools from CRT while assuring families that students are taught diversity, equity and inclusion, such efforts perpetuate a false narrative that CRT somehow works against equity instead of underlying it. CRT, a legal and academic framework originating in the 1970s, is premised on the fact that race is a social construct that has been weaponized in systemic ways — in both the past and present — to maintain white supremacy. By framing CRT and any related analysis of power structures in the US as an attempt to create divisions rather than acknowledge their longstanding existence, anti-CRT legislation aims to stifle any discussion surrounding the ongoing impact of racism on social, political and economic systems. This, in turn, serves to maintain the status quo of racial disparities in and outside of schools.

Public Commitments & Commitments to Change

By December 2021, at least nine states had also passed legislation to expand education on racism and other topics painted as "divisive" by policymakers behind anti-CRT efforts. For many states — including Connecticut, Maine, Minnesota and Wyoming — this legislation centers on diversifying social studies standards to include Black, Hispanic and Native history. In Louisiana, HB 635 extends eligibility for a post-secondary state scholarship program to students who complete a Black studies course. In Colorado, HB 19-1192/SB 21-067 requires that schools teach the history, culture and social contributions of Black, Hispanic and AAPI communities, religious minorities and LGBTQ+ people of color. In Illinois — which has two district-level declarations on the books — SB 648 mandates AAPI history for elementary and high school students alongside updates to existing Black history curriculum to incorporate events predating the slave trade, the vestiges of slavery in the US and the rise of the civil rights movement. In Delaware, schools must now integrate Black history into subjects beyond social studies, and educators in New Jersey must provide instruction on diversity, inclusion and both the individual and societal consequences of unconscious bias and economic disparities.

It is imperative that public health professionals working at the state and local level — including within schools — push back against this narrative and recommit to equitable curricular, health and safety policies in order to ensure the health of Black, Hispanic and Native students. Part of this work takes the form of public commitments, which can and should include declarations by educational institutions of racism as a public health crisis, but it also entails direct policy action to change the learning environment.

To support these efforts, we recommend the following resources:

C. Pluff is the program manager for the Center for School, Health and Education at APHA.

1 Because state-level reporting practices for data on Asian and Pacific Islander students vary, 81% represents the average high school graduation rate for Pacific Islander students in the 32 states where data is disaggregated for this population.

2 In both Michigan — where racism was declared a public health crisis by executive order — and Ohio — which is outpaced only by California in the number of local declarations introduced — efforts to prevent education about racism, sexism and other forms of systemic oppression can be seen as a direct response to growing public and political acknowledgment of this oppression.