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Review
. 2021 Oct:2:100032.
doi: 10.1016/j.lana.2021.100032. Epub 2021 Aug 6.

Health Equity, Schooling Hesitancy, and the Social Determinants of Learning

Meira Levinson  1 , Alan C Geller  2 , Joseph G Allen  2 ; Lancet COVID-19 Commission Task Force on Safe Work, Safe School, and Safe Travel
Affiliations
Review

Health Equity, Schooling Hesitancy, and the Social Determinants of Learning

Meira Levinson et al. Lancet Reg Health Am.2021 Oct.

Abstract

At least 62 million K-12 students in North America-disproportionately low-income children of color- have been physically out of school for over a year due to the COVID-19 pandemic. These children are at risk of significant academic, social, mental, and physical harm now and in the long-term. We review the literature about school safety and the conditions that shape families' and teachers' choices to return to in-person schooling. We identify four causes of schooling hesitancy in the U.S. even where schools can be safely reopened: high community transmission rates; the politicization of school re-openings; long-term racialized disinvestment in urban districts; and parents' rational calculations about their family's vulnerability due to the social determinants of health. Given the deep interconnections between the social determinants of health and of learning, and between schooling hesitancy and community vulnerability, stark inequities in in-person schooling access and take-up are likely to persist. We recommend that school districts invest in scientifically-based facilities upgrades, increased nursing and counseling staffing, and preparation for schools to serve as pediatric vaccination sites. School districts should also apply lessons from public health about addressing vaccine hesitancy to the challenge of schooling hesitancy by investing time in humble listening to parents and teachers about their concerns.

Keywords: COVID-19; Education; Health policy; Inequality; Inequity; Racial injustice; Schooling hesitancy; Social determinants of health; Social determinants of learning; Vaccine hesitancy.

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Conflict of interest statement

The author have no interests to declare.

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References

    1. Henderson MB, Peterson PE, West MR. Education Next; 2021. Pandemic Parent Survey Finds Perverse Pattern: Students Are More Likely to Be Attending School in Person Where Covid Is Spreading More Rapidly.https://www.educationnext.org/pandemic-parent-survey-finds-perverse-patt... published online Jan 19. (accessed March 7, 2021)
    1. Hojel AZ. Slate Magazine; 2021. The Damage of Mexico's Pandemic School Closures Has Been Catastrophic.https://slate.com/technology/2021/07/mexico-pandemic-school-closures.html published online July 8. (accessed July 19, 2021)
    1. Leone H. CPS opens its schools Monday to the most students since last March. Is it ready? Some principals say schools lack staff to resume in-person classes safely. chicagotribune.com. https://www.chicagotribune.com/coronavirus/ct-cps-reopening-second-wave-... (accessed April 12, 2021).
    1. Missing in the Margins Estimating the Scale of the COVID-19 Attendance Crisis. Bellwether Education. 2020 https://bellwethereducation.org/publication/missing-margins-estimating-s... published online Oct 21. (accessed March 7, 2021)
    1. Dorn E, Hancock B, Sarakatsannis J, Viruleg E. Mind the gap: COVID-19 is widening racial disparities in learning, so students need help and a chance to catch up. https://www.mckinsey.com/industries/public-and-social-sector/our-insight... (accessed March 7, 2021).
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