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A social determinants of education framework

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Title:
A social determinants of education framework
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Sammen, Haley C. ( author )
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English
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1 electronic file (59 pages) : ;

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Master's ( Master of science)
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University of Colorado Denver
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Department of Sociology, CU Denver
Degree Disciplines:
Social science

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Education ( lcsh )
Education ( fast )
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bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )

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Research shows that out-of-school factors potentially have a greater impact on student outcomes yet our interventions remain focused on in-school factors. This thesis proposes that education reform efforts should learn from the widely accepted social determinants of health framework. The social determinants of health framework has lead to great strides in health equity in the us. Us education however remains deeply rooted in inequitable origins despite centuries of efforts to improve outcomes. Through a literature review of the impact of social forces on educational outcomes a "social determinants of education" framework is proposed. The social determinants of education are proposed to be economic, food, physical environment, social environment, and health. This framework aims to coalesce education reform conversations around a common language of equity.
Thesis:
Thesis (M.S.S.)--University of Colorado Denver, 2017.
Bibliography:
Includes bibliographical references.
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System requirements: Adobe Reader.
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by Haley C. Sammen.

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University of Colorado Denver
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Auraria Library
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on1006906312
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Full Text
A SOCIAL DETERMINANTS OF EDUCATION FRAMEWORK
by
HALEY C. SAMMEN B.A., The Evergreen State College, 2008
A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the degree of Master of Social Science Social Sciences Program
2017


ii
This thesis for the Master of Social Science degree by Haley C. Sammen has been approved for the Social Sciences Program by
Danielle Varda, Chair Omar Swartz, Advisor John Brett Alan Davis Arthur McFarlane
Date: July, 29 2017


Sammen, Haley (MSS, Social Sciences)
A Social Determinants of Education Framework
m
Thesis directed by Associate Professor Omar Swartz
ABSTRACT
Research shows that out-of-school factors potentially have a greater impact on student outcomes yet our interventions remain focused on in-school factors. This thesis proposes that education reform efforts should learn from the widely accepted social determinants of health framework. The social determinants of health framework has lead to great strides in health equity in the us. Us education however remains deeply rooted in inequitable origins despite centuries of efforts to improve outcomes. Through a literature review of the impact of social forces on educational outcomes a social determinants of education framework is proposed. The social determinants of education are proposed to be economic, food, physical environment, social environment, and health. This framework aims to coalesce education reform conversations around a common language of equity.
The form and content of this abstract are approved. I recommend its publication.
Approved: Omar Swartz


IV
TABLE OF CONTENTS
I. INTRODUCTION............................................................1
The Social Determinants Of Health Framework..............................3
II. SITUATING AMERICAN EDUCATION...........................................9
A Historical Perspective.................................................9
A Student Outcomes Perspective..........................................15
A Theoretical Perspective...............................................20
III. A CRITICAL FRAMEWORK.................................................24
Terminology............................................................24
Methodology............................................................25
Findings...............................................................27
Discussion.............................................................40
Proposed Social Determinants of Education Framework.....................41
Conclusion.............................................................43
REFERENCES
47


1
CHAPTERI INTRODUCTION
Despite many accomplishments in its 200-year history, the United States education system struggles to reconcile whether the intended outcome of its efforts is to educate all students or to educate all students well. Given the extensive federal policies designed to eliminate achievement gaps and bring all students to proficient levels, it appears that the goal of our education system is indeed to educate all students well. However the persistence of racially and economically divided outcomes indicates that we are not getting closer to achieving that. If we want different results we need to either change our intentions or our practices, and likely both. This thesis proposes a social determinants of education framework that can facilitate this necessary shift. A framework situated in a review of the existing literature will provide education reform conversations with a more specifically defined common language to build upon.
When compared to other wealthy and academically high scoring nations (Canada, China, Finland, France, Germany, Italy, Japan, and United Kingdom) the US is ranked first for the outcomes of our system, when system outcomes are defined as years of schooling completed, and proportion of adults with high school diploma and bachelors degrees (Horace Mann League of the USA & National Superintendents Roundtable, 2015). Additionally, US students Program for International Student Assessment (PISA) scores are top ranking for students who come from low poverty schools, when compared to other low poverty nations (Riddle, 2014). Our education system is doing a good job at educating and graduating lots of students. Yet, a great body of research shows that we also do a remarkably


2
poor job at educating a large number of our students. The same 2015 report by the Horace Mann League of the USA and the National Superintendents Roundtable, titled The Iceberg Effect, that found the US to be first for education system outcomes also found us to be fifth of eight for student outcomes which they defined as reading levels, school graduation rates, and achievement gaps. And our PISA scores elaborate this result by showing that students from high poverty schools score near the bottom internationally (Riddle, 2014).
Most reforms du jour target principal and teacher improvement, and curriculum and testing improvement. Second tier interventions include improving nutrition, attendance, parent involvement, and social and emotional learning. The Iceberg Effect (2015) report argues that what is below the surface of the data on system and student outcome levels is issues of equity and equality, social stress and violence, support for families, and support for schools. While the US system ranked fourth of eight in the support for schools category, it was the worst for social stress and support for families, and only China ranked lower than the US on economic equity. This analysis that below the surface social factors are driving student outcomes is surprisingly robust, as is the result that the US ranks rather poorly on social and economic equality, support, and stress. Some theorists believe that these categories that we fall behind in are where our reforms must focus in order to undo achievement gaps. Their hypothesis includes that to educate all students well requires equity, or the deliberate undoing of structural barriers to equality through social policy.
Moving beyond equal access, or equality, to equity requires acknowledging that legacies of injustice are not simply dissolved by outlawing them (Marmot, Friel, Bell, Houweling, & Taylor, 2008). Initiative on this daunting task was undertaken in recent decades by the global public health sector to address disparities in health outcomes. Through


3
the use of a social determinants of health framework, they argue that a number of social factors and environmental factors including economic equality, neighborhood safety, transportation and housing, food access and security, social integration and support, and race and gender discrimination have a greater impact on an individuals health outcomes than their personal health choices or the health care they receive (Marmot, et al., 2008). The data this framework is based upon and the research that emerged since its inception are forcing policy makers and health care providers to rethink how they provide services (Kaiser Family Foundation, 2015).
This thesis demonstrates why the education reform conversations should borrow this concept and proposes a social determinants of education framework around which to design primary interventions and reforms. Specifically, the proposed framework is developed through a review of education literature followed by systematically coding for alignment with the existing social determinants of health framework. The resulting framework demonstrates the similarity of education and health determinants as well as highlights some areas where education differs. The proposal of this framework offers a starting point from which to further define the concept of social determinants of education.
The Social Determinants of Health Framework
Similar to the questions faced by the education system, public health advocates are insisting that addressing disparate health outcomes requires an equity approach and equity stems from awareness of the social, economic and environmental factors below the surface. Less than a decade ago, the movement for health equity developed a framework around which to shift the conversation and goals of their work. The framework of social determinants of health emerged in 2008 from an international commission of policy makers,


4
researchers, and civil society. The Commission on Social Determinants of Health published an agreed upon logic model that explains how social factors contribute to an individuals health outcomes (Marmot et al., 2008). Marmot et al. (2008), writing on behalf of the Commission, declared that, social injustice is killing people on a grand scale (p. 1661). The principle behind this framework is that these social factors have a greater impact on health than individual behaviors.
The social determinants of health framework was not born of groundbreaking new research about the links between health and various social factors. Rather it was bom of the accumulation of decades of research documenting these effects, and a global agreement to put them at the forefront of the movement. The framework of the social determinants of health does not dispute that healthy choices and quality health care are essential to good health outcomes, but rather acknowledges that the social factors influencing a persons life have the potential to be overpowering, and thus must be addressed. Broadly they have been defined as the social, economic, and environmental structures and conditions in which you are bom, grow, live, work or age (Marmot, et al., 2008).
The Commissions 2008 report detailed these barriers to health equity globally. They called them the causes of the causes, (CSDH, 2008, p. 42) which are broken into two categories: daily living conditions and distribution of power and resources. The distribution of power and resources is also called socioeconomic and political factors and includes governance, policy, and cultural and societal norms and values. The daily living conditions include social position (including education, occupation, income, gender, and ethnicity/race), material circumstances, and social cohesion. Citing the Commissions report, the Center for
Disease Control defines social determinants of health as:


5
[t]he complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world. (NCHHSTP, 2014)
Many of these factors are tied to stress and the negative effects stress has on health. Stress can negatively affect health when it is experienced at levels that the person feels exceeds their resources for coping (Robert Wood Johnson Foundation, 2011). Thus the factors of stress social position, material resources, social resources are considered factors of health outcomes.
When the Commission on Social Determinants of Health published their initial 2008 report, it included the logic model in Figure 1. The concepts of this model have been taken up by many, ranging from academicians to county level public health departments, and turned into a wealth of visualizations.
Sodoecofiomt & pdltfcal ccnlext
Governance
Pdcy
(Macroeconomic, Social, Health)
Cultural and societal norms and values
Distribution ol health and well-being
Health-Care System
Figure 1. Commission on Social Determinants of Health Conceptual Framework,
CSDH, (2008)


6
Figure 2 shows an additional way of conceptualizing social determinants, which portrays current thinking on the magnitude that social and environmental factors play as determinants of health and well-being.
Figure 2. Impact of Different Factors on Premature Death, Schroeder, (2007)
Also important to the usefulness of the framework is expanded definitions and specificity of
the determinants. Figure 3 is a version of these details presented by the Kaiser Family
Foundation.
Economic Stability Neighborhood and Physical Environment Education Community Food and Social Context
Employment Housing Literacy Hunger Social integration
Income Transportation Language Access to healthy Support
Expenses Debt Safety Parks Early childhood education options systems Community
Medical bills Playgrounds Vocational training engagement
Support Walkability Higher education Discrimination
Health Care System
Health
coverage
Provider
availability
Provider linguistic and cultural competency
Quality of care
Health Outcomes
Mortality, Morbidity, Life Expectancy, Health Care Expenditures, Health Status, Functional Limitations
Figure 3. Subcategories of the Social Determinants of Health, Kaiser Family Foundation, (2015)


Figure 4 from the Bay Area Regional Health Inequities Initiatives displays a robust expansion of the original framework that clearly details the work currently being done and where policy and intervention actions should be targeted.
7
A PUBLIC HEALTH FRAMEWORK FOR REDUCING HEALTH INEQUITIES BAY AREA REGIONAL HEALTH INEQUITIES INITIATIVE
*******
SOCIAL
INEQUITIES
Class
Race/Ethnicity Immigration Status Gender
Sexual Orientation
mm >
INSTITUTIONAL
LIVING CONDITIONS
INEQUITIES
Government Agencies Schools
Laws & Regulations
Not-for-Profit
Organizations
Physical Environment
Land Use
Transportation
Housing
Residential Segregation Exposure to Toxins
Employment
Income
Retail Businesses Occupational Hazards
Social Environment
Experience of Class, Racism, Gender, Immigration Culture Ads Media Violence
Service Environment
Health Care Education Social Services
Community Capacity Building Community Organizing Civic Engagement
ft ft
RISK BEHAVIORS
Smoking ( Poor Nutrition Low Physical Activity Violence Alcohol & Other Drugs
Sexual Behavior
DOWNSTREAM
DISEASE & INJURY
* Chronic Disease
MORTALITY
Infant Mortality Life Expectancy
Emerging Public Health Practice Current Public Health Practice j

Figure 4. Policy and Intervention Planning Tool, Bay Area Regional Health Inequities Initiative, (2015)
The progression of these four figures over the decade they span shows the expansion of the
concept and its usefulness.
The social determinants of health has become a common thread throughout health
reform efforts. US federal health policies and state and local initiatives recognizing and
addressing the social determinants are growing in number. Additionally, the conversation is
expanding across sectors, by informing decision-makers of the health equity consequences of
all policies in areas of economic and community development such as issues of
transportation, education, and food access. The US spends similar amounts on health care
and social services compared to other Western countries, however our spending falls heavier
on health care than social services and since we consistently have worse outcomes despite


8
our high spending, advocates cite the body of research that demonstrates that increased social services will improve outcomes (Kaiser Family Foundation, 2015). Consequently, a great deal of work is being done to increase cross-sector collaboration and link clinical and community services in order to improve population health (Towe, Leviton, Chandra, &
Sloan, 2016). However, as in education, the health advocates face pushback to their equity approach. The Affordable Care Act promoted this shift in policy and practice but its longevity is in question due to political pressures to reduce federal government involvement.


9
CHAPTER II
SITUATING AMERICAN EDUCATION A Historical Perspective
Our education system was built upon prejudices that persist today as structural racism. American education is emblazoned with debates over every aspect of the act of educating such as textbooks, curriculums, teacher compensation, testing standards and the philosophy of schooling such as school size, segregation, parental involvement, funding, music and arts, and choice of enrollment. The system itself is speckled with an abundance of alternative models attempting to achieve better results. But perhaps why these debates remain heated and alternatives remain isolated is because we do not fundamentally agree on the purpose of American public education. Adopting a social determinants of education framework necessitates inspection of this social contract. To do so we must look back to the beginnings of our schooling system to make plain for what purpose it started and why it has the structure it does. In doing so what becomes clear is that we are trying to produce cutting edge results, while clinging to an unsophisticated history of education. Despite 200 years of debates and struggles, for many the intents of the U.S. public school system are blatantly the same as they were at its origins.
Public education was born with the intended outcome of inculcation of a singular vision of moral values, deference for authority, and basic social and literacy skills (Collins, 1979). The United States burst into a young nation through unprecedented immigration throughout the 18th and 19th centuries. As a response to the expanding geographic and cultural diversity of the population, in the early 1800s upper and middle-class professionals


10
in the New England states began to require townships provide free public elementary schools. The white Anglo-Protestant leaders were trying to maintain social control over the growing nation and their traditional moral culture that was perceived to be under attack simultaneously from incoming immigrants as well as the hard to reach western frontier. The movement for public schools was championed by the reformers who were also heralding the societal benefits of social welfare, public hospitals, and child labor restrictions, as well as rallying against slavery, war, harsh penal conditions, and harmful labor conditions. Resistance came from many angles, including from rural farmers and urban workers resistant or apathetic to being subjected unnecessarily to upper-class notions, and manufacturers and merchants hesitant of the increased taxes. Labor unions indirectly supported the idea through their efforts to reduce the competition from child labor (Collins, 1979). After the Civil War, Reconstruction efforts facilitated the creation of public schools throughout the South, mandated through state constitutions as the North had already done. As in the North, while the intention of schooling was a strong, inclusive democratic society, the influence of a singular moral vision was persistent. More explicitly, educating freed blacks was supported for simultaneously civilizing and controlling them (West, 1982; Tyack, 1986). Within a few years the northerners abandoned their efforts in the South in the face of extreme white supremacist violence (Tyack, 1986). The origins of our school system are firmly rooted in narrow and hostile intentions.
Many efforts have been made to expand the humanist origins of American public education towards greater inclusiveness, but the foundation persists. We are thus not certain if we educate for the purpose of developing young people into their individual potential or to mold them into a dominantly accepted singular vision of America. Some desire it to be both


11
while others insist those are not compatible. American public education through the 20th century is scarred with the push and pull of this debate. In the wake of World War II, a 1945 publication called General Education in a Free Society by a committee of Harvard faculty proposed a philosophical standing on general education when the tenants of democracy were being questioned:
Past notions of liberal education for an elite were placed aside to focus on education for all general education in a free society where knowledge became a venue to develop traits of mind, those being effective thinking, clear communication, ability to make relevant judgments, and the clarification of values. (Kridel, 2010, p. 401)
However the decades that followed were not marked by education policies that fostered this.
Rather achieving social unity continued to be attempted through imposing social sameness
not critical thinking about the origins of dominant culture and social norms.
One of the most widely recognized moments defining American public education was
the judicial ruling that states could no longer sanction racial segregation of public facilities.
This 1954 Supreme Court ruling in the Brown v. Board of Education case, of course, meant
that states had to allow public schools to integrate. The basis of the upheld complaint was
that the schools could not achieve equality of economic resources while segregated, thus
violating the fourteenth amendment of the U.S. Constitution protecting persons from
receiving unequal protection of the laws. The issue of state-sanctioned separate but equal that
this decision overturned was not only prominent in the Southeast where the case was fought,
but also in Mexican American, Asian American and Native communities. These communities
also faced state-sanctioned inequality with the proclaimed intent of civilizing the students,
though not to elevate the students individual agency through education, rather to mold them
into proper laborers and service workers for the white elite (Fleming, 2002; Lomawaima &
McCarthy, 2006)


12
Movement to end segregation in the West began prior to the Brown decision due to legal challenges from Mexican American families. The local case of Mendez v. Westminster, upheld by the Ninth Circuit Court of Appeals in 1947, gained national support from the NAACP, the League of United Latin American Citizens, the Japanese American Citizens League, and the Jewish Congress and provided precedent for the victory Brown at the Supreme Court. In 1964, a decade after Brown, 98% black students in Southern states were still in segregated schools and thousands of school districts defied the courts and resisted integration (Orfield, 2001). The 1952 petitioners brief preceding the Brown case, included as an appendix a statement by leading race relations social scientists that outlined key elements of successful desegregation. Their recommendations included desegregation being simultaneously introduced into all units of a social institution (Carter, Marshall & Robinson, 1953). Additionally they insisted successful desegregation need a climate with limited competition, chances to learn about each other as individuals, and equivalency of positions and functions within the institution. The Court however did not specify the ways in which the states should facilitate desegregation. And a decade later little progress had been made. President Kennedy and the 1964 Civil Rights Act instigated significant consistent pressure to facilitate desegregation. Additionally, education reform took on a new face when the Congress passed the 1965 Elementary and Secondary Education Act, the 1968 Bilingual Education Act and the 1972 Indian Education Act, all of which aimed to make schools more equitable and inclusive to different cultures. But the struggle over the ideology of American education persisted.
The Brown ruling began to be undermined by two cases in the early 1970s. San Antonio Independent School District v. Rodriguez in 1973 said that the constitution did not


13
provide for education to be a fundamental right and thus unequal financing of schools was not a violation of the fourteenth amendment. Followed by Milliken v. Bradly in 1974 that ruled that segregation was tolerable if it was not deliberate. After decades of local and legal battles over dismantling segregated and creating integrated schools, researchers began to see the benefits come to fruition. Student outcomes were improving for both white and black students, including reducing the racial gap in achievement (Orfield, 2001). Additionally, students of color had greater success in college if they had gone to an integrated high school (Camburn, 1990). Public opinion even held support for integration efforts as found by a 1999 Gallup Poll. The Poll reported that a majority believed that integration was important and had improved education for both white and black students. A majority also said that the government should do more to make sure schools are integrated, and that children should learn about race relations through school coursework. This support even came from white parents whose children were participating in bussing (Orield, 2001). Despite these measurable benefits and public sentiments desegregation efforts were abandoned in the face of political and judicial pressure, and since the height of integrated schools in the mid-1980s segregation rates have grown (Orfield, 2001).
As desegregation was dismantled, a new solution to the problem of racially divided achievement was to instead focus on high expectations and standards at all schools through required courses and testing. However in the period following this, the racial gap in achievement began to widen again after previously narrowing during desegregation efforts (Orfield, 2001). Despite battles to alter the system in order to make it hospitable to all students, political efforts remained steadfast in retaining a system, the product of which was racially divided achievement. As William Bennett, Secretary of Education for Ronald


14
Reagan in the mid-1980s, expressed it, the US was experiencing a cultural deconstruction of
our schools and the neo-conservative educational policy he prescribed to insisted that
individual experience is an obstacle to be overcome through schooling, rather than a starting
point or resource for instruction (Fletcher, 2000, p. 15). For Bennett individual experiences
could not be useful in teaching appropriate educational content nor could it result in worthy
moral lessons. Just as had been the desire of the education system from its inception, public
intellectuals and political leaders continued to demand public schools create a culture of
unity by teaching only one dominant understanding of American identity and history.
However, as Anderson (2005) explains this sentiment:
Racial domination was not the flaw in the [American] dream, it was the dream itself. Our past is characterized by different and contradictory dreams, and whatever common ground we stand on today is the consequence of intense conflict and at times unanticipated coalitions, not the triumph of long-standing shared commitment and cultural unity, (p. 129)
The sentiments of inculcating a singular moral vision has not been shaken from the center of American education policy. This discriminatory belief is the major obstacle to creating education policies that can address the social determinants. If we do not yet agree that the purpose of education is freedom, agency, intellectual stimulation, and critical thinking, then we cannot move to finding ways for schools to address the societal inequities that are creating the education gap. A social determinants of education approach would require a revisioning of the purpose of the education system towards a policy that the schools can and should be the place to address social inequities. Despite a lack of historical political will for American education to embrace and address childrens backgrounds and social realities a priori to successful classroom learning, there is both empirical and theoretical foundations
for it.


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A Student Outcomes Perspective
Our understanding of the relationship between the achievement gap and poverty necessitates a paradigm shift. One consequence of the battle over the fundamental intent of our education system is made plain by the results we achieve on average. The recent results from the 2015 PISA exam that surveys 15-year olds from 69 developed nations on their ability to apply knowledge showed that U.S. students remain at or below the global average for math, science and reading despite being one of the highest spenders on education (Ripley, 2016). The United States is one of the top spenders on the education system. Of the 34 OECD countries that participate in PISA, the US was the second highest spender, after Luxemberg (OECD, 2010). Yet just as the PISA scores demonstrate, our high spending does not produce high results. Rather, we have what has long been called an achievement gap. That is, a persistent disparity in outcomes based on race and socioeconomic status (SES). African Americans and Latina/os when compared to whites achieve lower on test scores, graduation rates, enrollment in honors courses and admittance to colleges (Landson-Billings, 2006). The same gap exists between low-SES and high-SES students. And importantly, the racial gap holds even for children of comparable SES (Landson-Bilings, 2006). Much effort has been put into understanding and solving this gap. Decades of research has confirmed that the gap is widening (Reardon, 2013), that intelligence does not account for the gap (von Stumm, 2017), and out-of-school factors are drivers of the gap (Rothstein, 2013). Yet our policies for addressing the gap remain largely in-school interventions of expectations and accountability.
Some efforts to address the achievement gap have tried addressing the burden of poverty from students lives. In a mid-1990s federal public housing experiment called


16
Moving to Opportunity gave vouchers to low-income families in public housing to move from their high-poverty neighborhoods to a low-poverty neighborhood. Many analyses have been conducted on this program over two decades. Improvements were found initially, such as reduced behavioral problems, yet follow-up research showed that moving had not improved test scores (Chetty, Hendren, & Katz 2016; Levanthal, 2005). In a 2005 analysis, it was hypothesized that lack of improvements were possibly due to students continuing to attend rather disadvantaged and segregated schools, families did not receive any financial support other than the move, or the shock of the move out-weighed any improvements in the neighborhood (Leventhal). However, in 2016 new results showed that the change in neighborhood actually did produce significant outcome improvements by increasing earning and college attainment for the children now in adulthood if they moved before the age 13 (Chetty, Hendren, & Katz, 2016). These varied results show that poverty alleviation can improve results, but also that life in poverty and movement out of it is nuanced and thus requires inspection and policy from many angles. Chetty and Hendren (2015), for example, found in a parallel national analysis of the impacts of neighborhoods on intergenerational mobility, that high rates of upward mobility was found in neighborhoods with five common characteristics: less segregation by income and race, lower levels of income inequality, better schools, lower rates of violent crime, and more prevalence of two-parent households. Simply moving people away cannot solve these structural factors.
Poverty is traditionally defined in economic terms as an equation of income and expenditures for basic survival. However there are broader definitions of poverty that allow us to better understand the perpetual gaps within society and education. For some researchers, poverty also encompasses a lack of social belonging, cultural identity, respect


17
and dignity, and information and education. Furthermore, these social exclusion factors
prevent groups of people from moving out of poverty (Engle & Black, 2008). More
specifically, The World Bank found in a case study analysis, Voices of the Poor, the
experience of poverty commonly described as:
Experiences of ill-being including material lack and want (of food, housing and shelter, livelihood, assets and money); hunger, pain and discomfort; exhaustion and poverty of time; exclusion, rejection, isolation and loneliness; bad relations with others, including bad relations within the family; insecurity, vulnerability, worry, fear and low self-confidence; and powerlessness, helplessness, frustrations and anger. (Narayan & Petesch, 2002, p. 12)
In addition to working with an expanded, and nuanced understanding of poverty, the connection between poverty and education achievement needs a similar paradigm shift. The common understanding of the relationship between poverty and achievement is that there is a gap in outcomes. However, because this gap has been seen to narrow and re-widen in the span of a decade, it becomes clear that looking too closely at year by year results is not uncovering the true link between poverty and education outcomes. Gloria Landson-Billings, in a 2006 address as the president of the American Educational Research Association, proposed instead the concept of an education debt faced by non-white students. In doing so she cites that research is showing that even the combination of socioeconomic and family conditions, youth culture and student behaviors, and schooling conditions and practices do not fully explain changes in achievement gap (p. 5). In order to eliminate the persistent gap in achievement between poor and wealthy students and students of color and white students, the debt that students come to their schooling with must first be lifted.
Landson-Billings (2006) breaks education debt into four parts: historical debt, economic debt, sociopolitical debt, and moral debt. The historical debt is compiled of the overt, racist legal measures to forbid blacks from receiving education, remove Indian


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children from their communities in order to kill the Indian within them, systematic denial of Latinos from pubic school admittance, and other targeted racist policies and practices. These policies were based on the social understanding that non-White races were inferior and the centuries of exclusion from education were deliberately designed to maintain them as labor and servant classes. The economic debt faced by non-Whites is explained through the levels of school spending per pupil, parents earnings ratios relative to years of schooling completed, and the cumulative effects of those on wealth and assets. Because non-White families have fewer resources in their communities and schools, and receive lower wages than White counterparts, they in turn have less access to quality housing, neighborhoods, and schools. The sociopolitical debt was created by generations of Black, Latino and Native communities being legally excluded from civic processes in their communities, as well as their advocacy efforts being muted and marginalized. The moral debt, Landson-Billings explains, is the disparity between what we know is right and what we actually do (2006, p. 8). We can easily see that this nation is indebted to the civil rights leaders of the 20th century, to the 200,000 Black men who fought with the Union Army in the Civil War, to the indentured laborers from Hawaii to the Southern states who fueled our economic growth, and to the indigenous people that faced being physically and culturally eradicated from their homeland. The American response to this moral debt was simply set them free and expect them to catch up in a race that had already started and they had not trained for, as the metaphor goes.
While Landson-Billings paradigm is profound in its shifting of focus, it is also consistent with the considerable amount of research that points to out-of-school factors as the culprits of both poor and high academic achievement. Another public declaration of this


19
issue was made by prominent education policy thinker and former Assistant Secretary of Education, Diane Ravitch. Recently, she became known for publicly denouncing the testing and accountability policies she had previously spent her career working towards. Instead she insists that evidence shows that out-of-school factors far outweigh in-school factors and that there is no evidence that high testing standards serve to close the achievement gaps (Ravitch, 2014). Beyond education research and politics other disciplines concerning human development are versed in the realities of social influences. In the 1970s Uri Bronfrenbrenner radically altered developmental psychology by situating a childs potential within a constellation of forces cultural, social, economic, political and not merely psychological (Ceci, 2016, p. 173). His theory of the ecology of human development is a mainstay today across disciplines and public sectors. Our education system is awash in the evidence of what impacts learning, but we have not chosen to align our schooling strategies with it.
Regularly toping the PISA charts is Finland, and thus is often heralded as an
exemplary model (Duncan, 2010; Shalberg, 2012). However we cannot aim for Finlands
results unless we are willing to adopt the same philosophical approach to education. In the
1990s the Finnish education system was not unlike many around the globe today. It
produced reasonably average scores but was increasingly challenged because of endemic
failure to provide adequate learning opportunities to all children (Shalberg, 2012, p. 20).
The action the country chose to take that has lifted them to a model globally was to create a
system of equitable education and where all children learn well:
The equitable Finnish education system is a result of systematic attention to social justice and early intervention to help those with special needs, and close interplay between education and other sectorsparticularly health and social sectorsin Finnish society. (Shalberg, 2012, p. 21)


20
This approach indeed produces commendable results, and does so by acknowledging that the desired goal of education is for children to learn well, which requires first that their basic and social needs are addressed, and that process takes an equity, not simply equality, mandate.
A Theoretical Perspective
An equity approach to education should be situated in a critical social theory framework. Over the centuries of American education, regardless of intentions or politics, its purpose originated as and remains social cohesion through common understandings. This notion alone is not problematic. What is plaguing the system is that historical issues of race and class cannot be erased by the inculcation of a singular understanding of history or culture. The prolific education philosopher of the early 1900s, John Dewey, while living in a tumultuous historical period, urged a model of education that achieved social cohesion through deep understanding of differences. While industrialization, immigration, war and fascism were rampant, Dewey understood that dialogue and critical engagement with others as individuals and expanding our understanding of shared interests would not lead to a fusion of perspectives but of horizons (Dill, 2007; Waks, 2007). And he believed finding this shared horizon was the purpose of classrooms and education. But he also understood that this form of social cohesion would be achieved by starting from our differences and collectively creating something better.
The French sociologist Pierre Bourdieu offers us a way to understand what it is we are instead creating through our current system. In the 1970 and 80s Bourdieu contributed to social reproduction theories through an analysis of class and what he called cultural capital.
A persons cultural capital consists of their cultural background, knowledge, disposition, and skills that they acquire from previous generations. What Bourdieu offered beyond this


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understanding of cultural capital, was the concept of habitus. According to Bourdieu, a person internalizes their cultural capital as their habitus, which then defines their attitudes, actions and aspirations to fit within the norms of their social group or class. The habitus regulates the cyclical relationship between the structures of society and a persons practices. As Bourdieu (2001) puts it, [t]he schemes of thought and expression he has acquired are the basis for the intentionless invention of regulated improvisation (p. 534). He continues, [t]he habitus is the universalizing mediation which causes an individual agents practices, without either explicit reason or signifying intent, to be none the less sensible and reasonable (p. 534). So while individuals act with agency in their daily lives, they are nonetheless acting within boundaries of the groups perception of normalcy. People experiencing the same daily and historical conditions as others in their group are led by their habitus to see others actions as intelligible (p. 534) and practices to be harmonized (p. 535) with the group norms.
In addition to the habitus facilitating people acting and feeling comfortable in their own group, it also works to prevent different groups from interacting with as much ease. This mediated relationship between society and a persons actions also serves to define dominant, upper-class values and experiences as the natural ones because upper-class cultural capital is valued higher by society. Consequently, schools serve as a trading post where socially valued cultural capital is parlayed into superior academic performance (MacLeod, 2009, p. 14) because of the students comfort with the upper-class cultural capital that defines the norms of the institution. This high academic achievement is translated into economic capital, which is subsequently passed onto a persons descendants as cultural capital. Thus schooling operates as the ultimate mechanism for the reproduction and legitimation of social inequality (MacLeod, 2009, p. 16). According to Bourdieus reproduction theory, social


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cohesion is actively occurring but not across groups, and instead we are rampantly allowing the differences to perpetuate divisions of achievement.
In order to move beyond understanding towards changing this divisive social relationship, we need to investigate our institutions and structures at their roots. While Bourdieus, and Bronfrenbrenners, theories changed the understanding of the impact of social structures on individuals, they are not oriented towards changing the patterns. This has been the task of critical social theory since the early years of Nazi Germany, when the theory originated with the philosophers of the Frankfurt School. Critical theory meant to penetrate the world of objective appearances to expose the underlying social relationships they often conceal (Giroux, 2003, p. 28,). The aim was to better understand the link between institutions and structures of society and how they interact with our everyday lives. To do so they rejected universalizing forms of rationality and instead sought to show how society was made up of historically contingent contexts mediated by relationships of domination and subordination (Giroux, 2003, p. 28).
At the center of this investigation was the importance of easing the suffering of others. It was imperative to them that human existence be improved by reflection on the constraints on our thinking imposed by the structures of society that are accepted as invisible truths. The Frankfurt School theorists called for a rejection of blind allegiance to notions of social harmony. Rather, the pressure of civilization [has] multiplied to an unbearable degree and [t]he only education that has any sense at all is an education toward critical self-reflection (Adorno, 1998, p. 193). According to critical social theory the ailments of society are created and fueled by the fallacies of social cohesion and universal truths.


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Both of these theories lend their support to a social determinants framework. They have a unique combination of utilities that neither holds alone. Together they teach us that individuals aspirations, actions, and outcomes are a nuanced amalgamation dictated by social structures and we must work to uncover those structural forces in order to improve peoples lives. Additionally, they explain how the influence of institutions and society create visions of normalcy that become destructive when people hold them to be the definition of right and natural. Bourdieu teaches us to understand this process by how it explicitly interacts with an individual and critical social theory teaches us to put alleviating the suffering of that person as the end goal of the theory. This is what a social determinants of education framework aims to achieve.


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CHAPTER III
A CRITICAL FRAMEWORK
Abundant current research documents links between various social factors and educational outcomes. In addition to potentially influencing a students ability to perform in the classroom, these social factors can also influence the brains ability to learn (Evans & Schamberg, 2009). Education reform is a pressing issue nationally, and understanding the importance of social factors on educational outcomes could have major implications for efforts to reform the system. Borrowing the successful social determinants of health framework to situate the various education conversations within one critical framework will provide a necessary tool to move education reform forward.
Terminology
The terminology behind the concept social determinants of education necessitates some clarification, specifically what is meant by determinants and education. First, the term determinants does not intend to supersede a persons agency with a deterministic future. The term is intended to facilitate policy conversations that recognize despite a persons best efforts they may not be able to overcome the influence of socially imposed forces and that we must investigate the structural barriers in order to alleviate this burden. Second, determinants must be understood as different from predictors. A persons race might be a predictor of their health or education outcomes, however their race is not the determinant. Rather structural racism and racial discrimination is the social force causing implication for the persons life, or the social determinant. Similarly, hunger might be a factor of a child having poorer educational achievements or suffer from remedial chronic health conditions, but policy


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makers and advocates need to investigate food access and food security systems and policies in that community that are leading to people experiencing hunger. As the Commission on the Social Determinants of Health (2008) explained it determinants are the causes of the causes. The point of naming them determinants is to move us beyond acknowledging simply the categorizations of people aligned with outcomes, and naming the structures as the cause. Third, determinants can also be experienced as positive, protective factors. For example, having quality, stable housing is a determinant of a person achieving good education or health outcomes.
The term education has many connotations, and it is important to distinguish them. In borrowing the term from health, it is important to note that they are not called the social determinants of health care, referring to the system of providing health services, or the social determinants of health outcomes. When looking for a term comparable to health, I first believed it would be learning, because I did not want education to be construed as the education system. However learning simply refers to the act, not also the long-term consequences of it. And educational outcomes only refers to the measurements we employ.
So by settling on the terminology social determinants of education, I mean to say the education that a person and a community embodies and owns for their lifetime.
Methodology
As a starting point for building a social determinants of education framework, a review of the existing education literature was conducted in order to determine to what extent the established social determinants of health framework could be used as a guide. Part of that review included determining which components of the current social determinants of


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health framework applied to the field of education, which did not, and whether any new domains emerged.
Table 1 presents a compilation of established health determinants as defined by Healthy People 2020 of the Office of Disease Prevention and Health Promotion, The Commission on Social Determinants of Health of the World Health Organization, and Bryant, Raphael, Schrecker, & Labonte (2011). In order to cross as many databases and journals as possible, searches were conducted via Google Scholar and the University of Colorado Denver library search engine. Results were limited to peer-reviewed articles from 1994 and later, and primarily regarding US students as well as a few from other developed, Western countries. Searches were conducted using a combination of the subcategories in Table 1 below and with terms education outcomes, learning outcomes, or student outcomes. This process produced 100 articles for consideration.
The literature selected avoided factors that were attributed to the student or parent personally, such as parent involvement in school or with homework. These factors are indeed strong predictors of students achievement, however the goal of this framework is to force us to look further upstream, to the economic and social structural factors impacting personal behaviors. The 100 articles were reviewed and coded in a Google Docs spreadsheet. Each article was coded for year, authors, general topic, type and source of data, qualitative or quantitative methods, the prominent conclusions drawn, and the subcategories in Table 1 that were addressed. The Table 1 subcategories were modified based on the prominent themes of the coding and are presented in Table 2 in the following Findings section. Of the 100 articles coded, 55 met the criteria of documenting a direct link between a social factor and student


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outcomes, and were used to define the social determinants of education framework presented in Figure 5.
Table 1. Social Determinants of Health Categories Under Consideration
Categories Subcategories
Economic Stability Employment and working conditions Income and income distribution
Neighborhood and Physical Environment Housing Transportation and Walkability Safety
Food Security Access to healthy options Hunger
Community and Social Environment Social integration and support Race and discrimination
Health Care System Health services and access
Quality of care
In the social determinants of health model, health care is considered a determinant. Similarly, the education system itself should be considered a determinant of education. However it was not included in this review because it currently consumes most of the intervention efforts and the goal of this thesis is to expand our view of the areas of research that are less prevalent in ongoing initiatives.
Findings
The social determinants of health are defined in various ways throughout the literature. Multiple definitions were consolidated to create the categories and subcategories presented in Table 1 above. These categories guided a review of education literature to define the social determinants of education. The results of the literature review suggested the categories and subcategories presented in Table 2. The differences between the health and education categories are discussed in the Discussion section.


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Table 2. Proposed Social Determinants of Education Categories
1 Categories Subcategories
Food Insecurity Hanger Diet Quality
Economic Employment Conditions Job loss Instability Work related hazards or stress
Assets Fluctuating work hours Lengthy commutes Unrewarding work Liquid Household net worth
Physical Environment Housing Neighborhood Homelessness High mobility Crowding Poor equality Community violence Incivilities Perceived safety Social vulnerability Low-prestige occupations Concentration of disadvantaged groups
Social Environment Support Network Social cohesion Trauma Exposure Social capital Education culture
Discrimination Colorism Racism
Health Physical Health Chronic Remedial Conditions
Health Culture Early Health
The literature reviewed varies by the type of data analyzed, the mediating factors
identified, and the outcome measurements explored. This variety of variables enhances the framework by demonstrating the many avenues social determinants infiltrate. Each of the eight subcategories listed in Table 2 were connected with education outcomes of both academic achievement and social emotional development. Among the literature supporting these eight categories, the most common academic outcome measurements were high school graduation rates, grade point average (GPA), grade repetition, college attendance and standardized test scores. The most common social emotional development measurements were external and internal behavioral problems assessments, and classroom engagement and


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self-esteem. The details of this literature are presented below by category. Each category discusses the data used and outcomes measured by each article and, where possible, groups findings by either academic or social emotional outcomes.
Food determinants: Food determinants, as detailed in Table 3, were found to be food insecurity, including hunger and diet quality. The issue of food security, as defined by the United National Food and Agriculture Organization in 1996, concerns the ability of all people, at all times, [to] have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life (FAO, 1996).
Table 3. Food Determinants
Food Determinants Findings
Authors
Insecurity
- Hunger
- Diet quality
Lower test score baseline and growth
Increased grade repetition
Increased aggression and problems getting along with others
Decreased social and emotional skills
Impaired approaches to learning
Increased suspensions
Increased absenteeism
Alaimo 2001; Belot, 2011; Florence 2008; Howard 2011; Jyoti 2005; Kleinman 1998; Knowles 2015; Winicki 2003
Investigating academic performance outcomes, Winicki and Jemison (2003), Florence, Asbridge, and Veugelers (2008), and Belot and James (2011) all demonstrate relationships between food insecurity and test scores. Winicki and Jemison used data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K) and found any level of food insecurity decreased math scores as well as yearly test growth. Florence, Asbridge, and Veugelers (2008) as well as Belot and James (2011) looked at the impact of diet quality. The former used Nova Scotia, Canada students data from the Childrens Lifestyle and School-performance Study to show that standardized literacy assessment scores were more


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likely to be lower for students with any indicator of poor diet quality. The latter studied the effects of a 2004 campaign to drastically improve the quality of school meals in one London, UK, neighborhood. They report that English and Science standardized assessment scores improved as compared to neighborhoods that did not receive improved food quality. Their results also indicated that for students receiving improved food quality, health related absences decreased, which was possibly a mediating factor of improved test scores.
Looking at non-cognitive classroom skills, Howard (2011) used ECLS-K and teacher skill rating questionnaires and produced the findings that food insecurity impairs childrens development of interpersonal relations, self-control, and their approaches to learning (exhibiting skills such as attentiveness, task persistence, eagerness to learn, learning independence, flexibility, and organization). Knowles, Rabinowich, Ettinger de Cuba, Becker, and Chilton (2015) also found through 51 semi-structured interviews with parents in Minneapolis and Philadelphia that a parents own toxic stress regarding food-insecurity negatively impacted their childrens social and emotional development.
A handful of studies found outcomes of both academic performance as well as social emotional issues linked to food insecurity. Jyoti, Frongillo, and Jones (2005) also used the ECLS-K to measure food insecurity and combined it with standardized test performance and teacher assessments of social skills. They report that students with food insecurity had decreased math and reading scores as well as poor measurements of social skills. Alaimo, Olson, Frongillo, and Briefel, (2001) studied data from the Third National Health and Nutrition Examination Study and found that 6-11 year old children in food-insufficient families had lower math scores, were more likely to have repeated a grade, have seen a psychologist, and have had difficulty getting along with others. Teenagers in food-


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insufficient households were more likely to have seen a psychologist, have been suspended, and have had difficulty getting along with others. Kleinman, et al. (1998) found from examining the Community Childhood Hunger Identification Project survey data from Pittsburgh and its surrounding county that children identified as hungry were more likely to display behavioral and emotional problems such as aggression and anxiety, as well as, academic problems such as repeating a grade.
Economic Determinants: The economic determinants, as detailed in Table 4, in the literature included employment conditions and assets. Employment conditions impacting education outcomes include job stability, work related hazards or stress, fluctuating work hours, lengthy commutes or unrewarding work. Assets refer to either liquid or household net worth.
Table 4. Economic Determinants
Economic Findings Authors
Determinants (Parental)
Employment Increased grade repetition Dunifon 2005;
Conditions Decreased college enrollment rates Felfe 2012; Huff
Job Lower scores on cognitive assessments Stevens 2011;
loss/Instability Increased Internal Behavior Problem and Johnson 2012;
Work related External Behavior Problem scores Kalil 2011;
hazards or stress Increased placement in special education Rokicka 2016
Fluctuating
work hours
Lengthy
commutes
Unrewarding
work
Assets Increase high school graduation rates Elliott 2011;
Liquid Increase college enrollment and Elliott 2013;
Household net completion Kaushal 2009;
worth Increased math and reading test scores Kim 2011; Nam
Increase participation in gifted programs 2009; Shanks
Increased participation in extracurricular activities 2009


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The employment conditions listed above are associated with both academic and social emotional outcomes. Measuring academic outcomes, Kalil and Wightman (2011) used the Panel Study of Income Dynamics that followed children through age 21 and found that students were less likely to obtain post-secondary education if their parents experienced job loss during their years at home, and this association was three times stronger for black students. Interestingly, this latter finding was largely explained by household wealth and long-run measures of family income. Huff Stevens and Shaller (2011) found that grade repetition was associated with parental job loss through their study of 2,710 children age 5-19 in the Survey of Income and Program Participation. And Rokicka (2016), using the British Household Panel Survey Youth Questionnaire with 2,049 students at age 16 and two years following, showed worse test scores when parents work long hours.
Employment conditions were shown to impact social emotional behaviors by Dunifon, Kalil, and Bajracharya (2005) in their study of non-family friendly work conditions faced by mothers leaving welfare, 372 children ages 5-15, studied over a five year period, had higher levels of internalizing problem behaviors and lower levels of positive behaviors with mothers had long commutes.
Looking at both social emotional and cognitive outcomes, Felfe and Hsin (2012) used data from the Child Development Supplement of the Panel Study of Income Dynamics and the Occupational Information Network, to look at 1,630 children age 5-17. They found that behavioral development was affected by parental work stress and cognitive development was affected when parents experienced work-related hazards. Johnson, Kalil, and Dunifon (2012) also showed findings of both academic performance and social emotional skills. Using five years of data from the Womens Employment Survey, they found behavior problems for the


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students associated with mothers job instability and fluctuating work hours. Mothers non-cognitive work and fluctuating work hours were also associated with students likelihood of repeating a grade or being placed in special education.
Assets were primarily associated with academic performance outcomes. Williams Shanks, and Destin, (2009) used the Panel Study of Income Dynamics, and the Child Development Supplement, to show that wealth, more so than income, was a predictor of education expectations, high school graduation, and college enrollment. Kim and Sherraden (2011) also found parental assets to be associated with high school graduation and college enrollment through their study of 632 children in the Child and Young Adult data supplement to the National Longitudinal Study of Youth 1979. They also found educational expectations to be a mediating factor of the influence of assets. Nam and Huang (2009) used the Panel Study of Income Dynamics and concluded that liquid assets are associated with high school graduation and college attendance. Elliott (2013) also used longitudinal data from the Child Development Supplement of the Panel Study of Income Dynamics to show that students in asset poor families have lower math and reading scores and are less likely to graduate high school, attend college, or graduate from college. Elliott, Destin, and Friedline (2011) conducted a meta analysis on the relationship between assets and education attainment. They included 34 studies, spanning 10 years, regarding students age 15-17. They found that assets were connected to math and reading scores, college attendance, and college completion. Only one study regarding assets and educational outcomes included a social emotional outcome in the form of participation in extracurricular activities. Kaushal and Nepomnyaschy (2009) found by studying the Survey of Income and Program Participation data of 16,000 children


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between ages 6-17 that indicators of wealth have high associations with participation in extracurricular activities and gifted programs, as well as, with grade retention.
Physical environment determinants: The physical environment determinants, as detailed in Table 5, associated with education are housing and neighborhood. Housing includes experiencing homelessness or high mobility, crowding, and poor quality. Neighborhood determinants include violence or incivilities, perceived safety, social vulnerability, low-prestige occupations, and concentration of disadvantaged groups. Table 5. Physical Environment Determinants
Physical Environment Determinants Findings Authors
Housing Homelessness High mobility Crowding Poor quality Less likely to perform at grade level Lower scores on cognitive assessments Increased grade repetition Lower test score baseline and growth Decreased social and emotional skills Poorer classroom task engagement Increased External Behavioral Problems score Goux 2005; Fantuzzo 2012; Leventhal 2010; Levine Coley 2013; Obradovic 2009; Shinn 2008; Solari 2012; Zima 1994
Neighborhood Lower academic self-esteem Aaroson 1998;
Community Lower test score baseline and growth Ainsworth 2002;
violence/Inciviliti Poorer school engagement Aughinbaugh
es Increased grade repetition 2014; Baker
Perceived safety Decreased high school graduation rates 2015; Carlson
Social Lower GPA 2015; Daly 2008;
vulnerability Decreased college enrollment Glaster 2016;
Low-prestige Harding 2009;
occupations Johnson 2013;
Concentration of Milam 2010;
disadvantaged Nieuwenhuis
groups 2016; Wodtke
2011
Housing was connected to both academic and social emotional outcomes. Levine Coley, Leventhal, Doyle Lynch, and Kull (2013) using the longitudinal Three-City Study of low-income families in the wake of welfare reform, looked at 2,437 children age 2-21, and


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found that housing quality was associated with emotional and behavioral functioning, as well as, cognitive skills. These results operated in part through parental stress. Solari and Mare, (2012) used the Panel Study of Income Dynamics Child Development Supplement and Los Angeles Family Neighborhood Survey to show that crowding affects math and reading test scores as well as external problem behaviors. Crowded homes were also found by Goux and Maurin (2005), using the Labor Force Survey of France, to be associated with being held back a grade.
Looking at students experiencing homelessness and high mobility, Obradovic, et al. (2009) found in a study of 14,754 students in Minneapolis, grades 2-5, had lower achievement and slower growth on math and reading scores. Fantuzzo, LeBoeuf, Chen, Rouse, and Culhane (2012) used public school district as well as Office of Supportive Housing data to study third grade students in Philadelphia. They found that homelessness had an association with classroom engagement and mobility was associated with reading and math scores as well as classroom engagement. They report that absenteeism was a mediating factor of these results. Shinn et al. (2008) studied 770 formerly homeless children in New York City and through administering intelligence tests and standardized math and reading test, found that they were below cognitive and achievement norms for their age levels. Zima, Wells, and Freeman (1994) conducted interviews of 169 sheltered homeless children in Los Angeles County and found they experienced depression, exhibited behavioral problems, and were not at grade level for reading and vocabulary. Leventhal and Newman (2010) conducted a review of research and concluded that crowding is associated with health and mobility is associated with academic, social, and emotional problems.


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Studies of neighborhood characteristics and impacts on education explore many different elements of neighborhoods and show both academic and social emotional outcomes. High school graduation was frequently linked to various neighborhood characteristics. Harding (2009) found through Add Health survey data of 14,668 students, grades 7-12 that neighborhood violence is a strong predictor of high school graduation. Aaroson (1998) used sibling data of 2,178 individuals from the Panel Study of Income Dynamics to estimate neighborhood versus family influences and found high school graduation to be associated with neighborhood. Wodtke, Harding and Elwert (2011) studied 4,154 children from the Panel Study of Income Dynamics, age 1-17, and found that high school graduation is associated with neighborhood through sustained exposure. Aughinbaugh and Rothstein (2014) used data of 7,653 young adults in the National Longitudinal Survey of Youth and found that youth from disadvantage neighborhoods are less likely to graduate high school, attend college or graduate college regardless of cognitive skills.
Looking at test scores, Milam, Furr-Holden and Leaf (2010) used data from the Baltimore City Public School Systems annual School Climate Survey which captures student self-reported neighborhood safety, as well as an objective assessment of the neighborhoods and found an association with math and reading test scores. Carlson and Cowen (2015) found from studying 96,000 students in Milwaukee that test growth is impacted by neighborhood. Ainsworth (2002) used National Educational Longitudinal Study linked with census data, and found that neighborhood characteristics predict math and reading test scores with as much strength as family and school factors. Johnson (2013) conducted a meta analysis of 27 studies and found that neighborhood is associated with test scores and high school graduation rates, and that the presence of high income neighbors has


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an effect of greater magnitude than the effects of low SES. Glaster, Santiago, Stack, and Cutsinger (2016) surveyed Latino and African American youth age 12-18 living in randomly assigned Denver Housing Authority units and found that neighborhood impacts grades, grade repetition, and high school graduation rates for age 12-18. They report that this outcome was a factor of concentration of disadvantaged ethnicities, social vulnerability, occupational status or prestige in the neighborhood.
Exposure to neighborhood violence was found by Baker and Roberts (2015) to be correlated with academic self-esteem for 74 surveyed African American fourth and fifth graders. Similarly, perceived neighborhood incivilities was found by Daly, Shin, Thakral, Selders, and Vera (2008) to be predictive of school engagement for through a survey of 123 seventh and eighth grade urban adolescence of color. Lastly, in a meta analysis of 88 articles, Nieuwenhuis and Hooimeijer (2016), found that individual outcomes are a function of neighborhood poverty, education climate, concentration of disadvantaged groups, or social disorganization in the neighborhood.
Social environment determinants: The social environment determinants, as detailed in Table 6, associated with education outcomes are a students social support network and experiencing discrimination. Support network included social cohesion, trauma exposure, social capital, and education culture. Discrimination includes racism and colorism.


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Table 6. Social Environment Determinants
Social Environment Determinants Findings Authors
Support Network Increased grade repetition Behtoui 2016;
Social cohesion Lower GPA Dufur 2013;
Trauma Increased placement in special education Misra 2013;
Exposure Impact on test scores Nieuwenhuis
Social capital Protective factor of social capital 2016; Romano,
Education 2015; Rothon
culture 2011
Discrimination Decreased high school graduation rates Neblett 2006;
Colorism Decreased college enrollment or OHara 2012;
Racism completion Oates 2009;
Lower test scores Ryabov 2016
Decreased academic orientation,
curiosity, persistence, and expectations
Lower GPA
Varying degrees of a supporting social environment shows impact on academic education outcomes. Romano, Babchishin, Marquis, and Frechette (2015) found from a literature review of 20 articles that trauma was linked to being placed in special education, as well as, grade retention and lower grades. Rothon, Head, Klineberg, and Stansfeld (2011) used survey data from 2,790 students age 11-14 in London and found that bullied students were less likely to perform at grade level on tests. Behtoui and Neergaard (2016) showed that levels of extra-familial social capital predicted grades. Dufur, Parcel and Troutman (2013) used a sample from the National Longitudinal Education Study of 10,585 students and found social capital is linked to test scores, and that social capital from the family was a stronger association than social capital received from the school environment. Misra, Grimes and Rogers (2013) used Mississippi Department of Education and the Northeast Regional Center for Rural Development data paired with GIS mapping to show that levels of social capital predicts test scores.


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Racial discrimination shows effect on academic performance, as well as, levels of academic curiosity and persistence. Ryabov (2016) used National Longitudinal Study of Adolescent Health, and found that achieving some college education was more likely for white Asian Americans versus co-ethnic Asian Americans with light brown skin tone. OHara, Gibbons, Weng, Gerrard and Simons (2012) found among 750 fifth grade African Americans from the Family and Community Health Study, that perceived discrimination discouraged them from pursing college education. Oates (2009) found from the National Educational Longitudinal Study that students test scores are predicted by biased treatment from educators. Neblett, Philip, Cogburn and Sellers (2006) surveyed 548 African American adolescents, grades 7-10, from 11 schools, and found that discrimination was associated with a decrease in academic curiosity and persistence.
Health Determinants: Health determinants, as detailed in Table 7, were found to be physical health including chronic remedial conditions, health culture, and early life health. Sabia and Rees (2015) found from the National Longitudinal Study of Adolescent Health, that overweight leads to decreased self-esteem which is negatively related to GPA and probability of attending or completing college. Jackson (2015) used longitudinal data of 9,252 children from the British National Child Development Study and found that early health, such as birth weight, smoking exposure, and school-age health, are associated with test scores and growth. Additionally, longer duration of poor health decreases likeliness of catching up. Ickovics, Carroll-Scott, Peters, Schwartz, Gilstad-Hayden and McCaslin (2014) studied 940 students grades 5-6 from 12 randomly selected urban schools and found that health assets and a culture of health were associated with standardized test scores. Robert
Wood Johnson Foundation (RWJF) (2016) reported that chronic remedial conditions, such as


40
asthma, dental, vision, diabetes, obesity, and mental health, cause absenteeism, which makes students less likely to read at grade level and four times more likely to drop out.
Table 7. Health Determinants
Health Determinants Findings Authors
Physical Health Chronic Remedial Conditions - Health Culture - Early Health Increased absenteeism Less likely to perform at grade level Decreased high school graduation rates Lower GPA Decreased college enrollment or completion Lower test score baseline and growth Ickovics 2014; Jackson 2015; RWJF 2016; Sabia 2015
Discussion
A framework, presented in Figure 5, provides a foundation for policy, reform, and alternative models to approach issues and solutions from a common language. In this case, the social determinants of education framework aims to facilitate interventions that holistically address the cyclical and interdependent issues that so forcefully impact students learning and educational attainment. Rather than remaining in silos, physical environments, social environments, security and subsistence factors can be seen as pieces of the same puzzle. There are already many efforts nationwide reimagine schooling with these factors at the forefront. This framework aims to be a tool for the important work already being done.


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Proposed Social Determinants of Education Framework
Structural Policies and Practices Cultural & Social Norms & Values Social Environment
Social Cohesion Racism
Social Capital Trauma Exposure
Education Culture
Physical Environment
Homelessness Housing Quality Mobility Violence
Concentration of Social Vulnerability
Neighborhood
Safety
Economic Conditions
Job Stability Work Hazards & Stress Fluctuating Work Hours Lengthy Commute Unrewarding Work Assets & Net Worth
Health and Well-being
Chronic Remedial Conditions Health Culture Early Health
Food Security
Hunger Diet Quality
OCIAL
ERMINANTS

Attendance
Standardized Test Scores Grade Point Average Academic Growth
Social & Emotional Skills Classroom Efficacy
High School Graduation College Attendance College Graduation
Figure 5. Proposed Social Determinants of Education Framework


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This literature review sought to determine if the commonly used social determinants of health could also be used to create a definition of social determinants of education. The findings indicate there is evidence for each of the broad categories and the subcategories have some nuanced variations. The places where education differed from the health models are as follows. In the physical environment factors, the literature did not show significant evidence linking transportation and walkability to education outcomes. In the economic factors, income showed surprisingly little evidence likely because most research investigates socioeconomic status, which is a combination of parental income, education, and occupation. Socioeconomic status is of course a widely cited predictor of educational attainment (OECD, 2010) but to cultivate specificity for the framework I chose to investigate income and occupation separately. While income was less conclusive, assets and net worth emerged as important factors for the education model. Some literature discussing assets identified a link between educational expectations, assets, and outcomes. In the social environment category educational culture as well as exposure to trauma emerged as subcategories not named in the health models.
The category of health also diverged in important ways. Important to education outcomes were issues of chronic remedial health conditions. The literature focused on absenteeism, resulting in part from inadequate access to regular primary care that could minimize the burden of the condition. Mental health was also considered for the model but ultimately not included as its own subcategory because it could be included in the chronic remedial conditions that require regular access to care. Additionally, depression and selfesteem were seen as mediating factors for other subcategories.


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Further discussions could explore the inclusion of additional subcategories such as parental education or physical activity. I suggest that these would be called causes, and this model is attempting to look further upstream at the causes of the causes, or the social and structural factors that ultimately determine personal behaviors and choices. In addition to this upstream approach, the model also aims to define what is upstream with more specificity than the commonly cited issue of poverty or SES. With specificity, it is hoped that this framework can show increased paths for cross-sector interventions and collaborations.
Conclusion
As mentioned above, work is already being done to address these issues and hopefully this framework will build a common language to further the discussion. Two examples of note are community schools and promise neighborhoods. Community schools integrate the community into the school by coordinating supports and services for the families under their same roof. They work to cooperate with other institutions, involve parents and engage kids in extracurricular activities. The schools develop to meet the specific needs of their community so each are unique in their approach and model. They are all based on the recognition that inequality has more to do with policies and social/economic structures rather than with the characteristics of individual children and their families (Baquedano-Lopez, Alexander, & Hernandez, 2013, p. 171). Heers, VanLkaveren, Groot, and Maassen van den Brink (2016) found evidence that at community schools cooperation across agencies and increased parent involvement were associated with academic achievement and decreased risky behaviors and dropout rates. They also found that participating in extracurriculars was related to reduced dropout and risky behavior. Biag and Castrechini (2016) document improved attendance rates and academic achievement in


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association with participating in the extended learning programs and family engagement opportunities.
Another approach to reducing achievement gaps by reducing social and structural barriers is the federally funded promise neighborhood program. These are disadvantaged neighborhoods that are working to integrate the school into the surrounding community. Unlike most federal education policies, promise neighborhoods are based on the recognition of the importance of out-of-school factors. The concept is modeled after the Harlem Childrens Zone, and after a planning phase 12 implementation grants were awarded in 2011 and 2012 (Douglass Horsford & Sampson, 2014). Part of what the neighborhoods are working towards is breaking down agency silos, with the intent of fighting poverty by putting education at the center of local efforts.
While promise neighborhoods link improved education to alleviating poverty and social determinants of health link education to improving health, this framework documents the specific elements of poverty and health that are central to education. They are all indeed inextricably linked in bidirectional cycles. But this framework insists that we need to flip the intervention and instead work to improve education by alleviating poverty. We should think of our education system as a great resource in this work and take advantage of the uniqueness of a system that touches every family and child. Public health advocates have already begun to propose the concept of social determinants of education and my hope is that a defined framework will help expand the conversation in the education sector. One public health advocate that gained notoriety for his work on addressing social determinants of health in his community, Jeffrey Brenner, says of this work, [t]his is not about breaking down silos; this


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is about completely rethinking some basic assumptions about the culture of care in our country (Exit Interview, 2017).
Two things are important to note regarding this thesis. First, I have presented only a fraction of the evidence that exists on these issues. My aim was only to demonstrate its existence and propose a new way of conceptualizing this body of work. Second, I am not negating the importance of in-school and personal factors on education outcomes. This framework is intended to streamline the conversations on out-of-school factors by defining a common language of social determinants as well as propose further investigations of whether social determinants do in fact show causal evidence, and to what magnitude, of their impact on education. In arguing against the funding of promise neighborhoods, Whitehurst and Croft of the Brookings Institute (2010) conclude that [t]here is considerable evidence that schools can have dramatic effects on the academic skills of disadvantaged children without their providing broader social services (p. 10). The fact that schools can and do have dramatic effects is indeed likely true, but it does not exclude simultaneously addressing social determinants as an equally, if not more, important strategy.
Further research on the social determinants of education should take up refining and expanding the framework. Specific topics needing consideration include school segregation, education beyond K-12, issues facing people with disabilities and various gender identities. As well as investigating the compounding effect of people experiencing multiple factors of social determinants and also a broader global analysis. Defining the social determinants of education will hopefully help sustain the growing conversations over the decades ahead. This framework insists on a cross-sector approach, ideally forcing the task of addressing social determinants to be shared and no longer burdened by teachers and administrators alone.


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In this current political climate it is hard to believe that this concept will find a place in the strained world of education reform. The work of educational equity has a long history with many obstacles. Our task is to stay vigilant to the vision of educating all children well and joining our horizons for a vibrant democracy.


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A SOCIAL DETERMINANTS OF EDUCATION FRAMEWORK by HALEY C. SAMMEN B.A., The Evergreen State College, 2008 A thesis submitted to the Faculty of the Graduate School of the University of Colorado in partial fulfillment of the requirements for the de gree of Master of Social Science Social Science s Program 2017

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ii This thesis for the Master of Social Science degree by Haley C. Sammen has been approved for the Social Science s Program by Danielle Varda, Chair Omar Swartz, Advisor John Brett Alan D avis Arthur McFarlane Date: July, 29 2017

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iii Sammen, Haley ( MSS Social Sciences ) A Social Determinants of Education Framework Thesis directed by Associate Professor Omar Swartz ABSTRACT Research shows that out of school factors potentially have a greater impact on student outcomes yet our interventions remain focused on in school factors. This thesis proposes that education reform efforts should learn from the widely accepted social determinants of health framework. The social determinants of health frame work has lead to great strides in health equity in the us. Us education however remains deeply rooted in inequitable origins despite centuries of efforts to improve outcomes. Through a literature review of the impact of social forces on educational outcome s a "social determinants of education" framework is proposed. The social determinants of education are proposed to be economic, food, physical environment, social environment, and health. This framework aims to coalesce education reform conversations aroun d a common language of equity. The form and content of this abstract are approved. I recommend its publication. Approved: Omar Swartz

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iv TABLE OF CONTENTS I. INTRODUCTION ................................ ................................ ................................ ................. 1 The Social Determinants Of Health Fra mework ................................ ................................ .. 3 II. SITUATING AMERICAN E DUCATION ................................ ................................ .......... 9 A Historical Perspective ................................ ................................ ................................ ....... 9 A Student Outcomes Perspective ................................ ................................ ........................ 15 A Theoretical Perspective ................................ ................................ ................................ ... 20 III. A CRITICAL FRAMEWORK ................................ ................................ ......................... 24 Terminology ................................ ................................ ................................ ........................ 24 Methodology ................................ ................................ ................................ ....................... 25 Findings ................................ ................................ ................................ .............................. 27 Discussion ................................ ................................ ................................ ........................... 40 Proposed Social Determinants of Education Framework ................................ ................... 41 Conclusion ................................ ................................ ................................ .......................... 43 REFERENCES ................................ ................................ ................................ ....................... 47

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1 CHAPTER I INTRODUCTION Despite many accomplishments in its 200 year his tory, the United States education system struggles to reconcile whether the intended outcome of its efforts is to educate all students or to educate all students well. Given the extensive federal policies designed to eliminate achievement gaps and bring al l students to proficient levels, it appears that the goal of our education system is indeed to educate all students well. However the persistence of racially and economically divided outcomes indicates that we are not getting closer to achieving that. If w e want different results we need to either change our intentions or our practices, and likely both. This thesis propo ses a "social determinants of e ducation framework that can facilitate this necessary shift. A framework situated in a re view of the existi ng literature will provide education reform conversations with a more specifically defined common language to build upon. W hen compared to other wealthy and academically high scoring nations (Canada, China, Finland, France, Germany, Italy, Japan, and Unit ed Kingdom) the US is rank ed first for the outcomes of our system when system outcomes are defined as years of schooling completed, and proportion of adults with high school diploma and bachelor's degrees ( Horace Mann League of the USA & National Superint endents Roundtable, 2015 ). Additionally, US students Program for Int ernational Student Assessment (PISA) scores are top ranking for students who come from low poverty schools, when compared to other low poverty nations (Riddle, 2014). Our education system is doing a good job at educating and graduating lots of students. Yet, a great body of research shows that we also do a remarkably

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2 poor job at educating a large number of our students. T he same 2015 report by the Horace Mann League of the USA and the Natio nal Superintendents Roundtable, titled The Iceberg Effect that found the US to be first for education system outcomes also found us to be fifth of eight for student outcomes which they defined as reading levels, school graduation rates, and achievement ga ps And our PISA scores elaborate this result by showing that students from high poverty schools score near the bottom internationally ( Riddle 2014 ) Most reforms du jour target principal and teacher improvement, and curriculum and testing improvement. Second tier interventions include improving nutrition, attendance, parent involvement, and social and emotional learning. The Iceberg Effect (2015) report argues that what is below the surface of the data on system and student outcome levels is issues of e quity and equality, social stress and violence support for families, and support for schools. While th e US system r anked fourth of eight i n the support for schools category, it was the worst for social stress and support for families and only China ranked lower than the US on economic equity. This analysis that below the surface social factors are driving student outcomes is surprisingly robust as is the result that the US ranks rather poorly on social and economic equality, support, and stress. Some theorists believe that these categories that we fall behind in are where our reforms must focus in order to undo achievement gaps. T heir hypothesis includes that to educate all students well requires equity, or the deliberate undoing of structural bar riers to equality through social policy. Moving beyond equal access, or equality, to equity requires acknowledging that legacies of injustice are not simply dissolved by outlawing them (Marmot, Friel, Bell, Houweling, & Taylor 2008). Initiative on th is daunting task was undertaken in recent decades by the global public health sector to address disparities in health outcomes Through

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3 the use of a social determinants of health framework they argue that a number of social factors and environmental factors including economic equality, neighborhood safety, transportation and housing, food access and security, social integration and support, and race and gender discrimination have a greater impact on an individual's health outcomes than their personal hea lth choices or the health care they receive ( Marmot, et al. 2008 ) The data this framework is based upon and the research that emerged since its inception are forcing policy makers and health care providers to rethink how they provide services ( Kaiser Fam ily Foundation 2015 ) This thesis demonstrates why the education reform conversations should borrow this concept and proposes a s ocial determinants of education framework around which to design primary interventions and reforms. Specifically, the propos ed framework is developed through a review of education literature followed by systematically coding for alignment with the existing social determinants of health framework. The resulting framework demonstrates the similarity of education and health determ inants as well as highlights some areas where education differs. The proposal of this framework offers a starting point from which to further define the concept of social determinants of education. The Social Determinants of Health Framework Similar to th e questions faced by the education system, public health advocates are insisting that addressing disparate health outcomes requires an equity approach and equity stems from awareness of the social, economic and environmental factors below the surface. Less than a decade ago, the movement for health equity developed a framework around which to shift the conversation and goals of their work. The framework of social determinants of health emerged in 2008 from an international commission of policy makers,

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4 resea rchers, and civil society. The Commission on Social Determinants of Health published an agreed upon logic model that explains how social factors contribute to an individual's health outcomes (Marmot et al., 2008). Marmot et al. (2008) writing on behalf of the Commission, declared that, "social injustice is killing people on a grand scale" (p. 1661). The principle behind this framework is that these social factors have a greater impact on health than individual behaviors. The social determinants of health framework was not born of groundbreaking new research about the links between health and various social factors. Rather it was born of the accumulation of decades of research documenting these effects, and a global agreement to put them at the forefront of the movement. The framework of the social determinants of health does not dispute that healthy choices and quality health care are essential to good health outcomes, but rather acknowledges that the social factors influencing a person's life have the pote ntial to be overpowering, and thus must be addressed. Broadly they have been defined as the social, economic, and environmental structures and conditions in which you are born, grow, live, work or age (Marmot, et al., 2008) The Commission's 2008 report d etailed the se barriers to health equity globally. They called them the "causes of the causes," (CSDH, 2008, p. 42) which are broken into two categories: daily living conditions and distribution of power and resources. The distribution of power and resource s is also called socioeconomic and political factors and includes governance, policy, and cultural and societal norms and values. The daily living conditions include social position (including education, occupation, income, gender, and ethnicity/race), mat erial circumstances, and social cohesion. Citing the Commission's report, the Center for Disease Control defines social determinants of health as :

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5 [t] he complex, integrated, and overlapping social structures and economic systems that are responsible for mo st health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors. Social determinants of health are shaped by the distribution of money, power, and resources throughout local communities, nations, and the world ( NCHHSTP," 2014 ) Many of these factors are tied to stress and the negative effects stress has on health. Stress can negatively affect health when it is experienced at levels that the person feels exceeds their resources for coping ( Robert Wood Johnson Foundation, 2011 ). Thus the factors of stress social position material resources, social resources are considered factors of health outcomes. When the Commission on Social Determinants o f Health published their initial 2008 report, it included the logic model in Figure 1. The concepts of this model have been taken up by many ranging from academicians to county level public health departments, and turned into a wealth of visualizations. Figure 1. Commission on Social Determinants of Health Conceptual Framework CSDH (2008)

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6 Figure 2 shows an additional way of conc eptualizing social determinants, which portrays current thinking on the magnitude that social and environmental factors play as determi nants of hea lth and well being Figure 2. Impact of Different Factors on Premature Death Schroeder, (2007) Also important to the usefulness of the framework is expanded definitions and specificity of the determinants. Figure 3 is a version of these details presented by the Kaiser Family Foundation. Figure 3. Subcategories of the Social Determinants of Health Kaiser Family Foundation (2015 )

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7 Figure 4 from the Bay Area Regional Health Inequities Initiatives displays a robust expansion of the original framework that clearly details the work currently being done and where policy and intervention actions should be targeted. Figure 4. Policy and Intervention Planning Tool Bay Area Regional Health Inequities Initiative, (2015) The progressi on of these four figures over the decade they span shows the expansion of the concept and its usefulness. The social determinants of health has become a common thread throughout health reform efforts. US federal health policies and state and local initiat ives recognizing and addressing the social determinants are growing in number. Additionally, the conversation is expanding across sectors, by informing decision makers of the health equity consequences of all policies in areas of econo mic and community dev elopment s uch as issues of transportation, education, and food access. The US spends similar amounts on health care and social services compared to other Western countries, however our spending falls heavier on health care than social services and since we consistently have worse outcomes despite

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8 our high spending, advocates cite the body of research that demonstrates that increased social services will improve outcomes ( Kaiser Family Foundation, 2015 ) Consequently, a great deal of work is being done to increase cross sector collaboration and link clinical and community services in order to improve population health (Towe Leviton, Chandra, & Sloan 2016). However, as in education, the health advocates face pushback to their equity approach. The Affordabl e Care Act promoted this shi ft in policy and practice but it s longevity is in question due to political pressures to reduce federal government involvement.

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9 CHAPTER II SITUATING AMERICAN EDUCATION A Historical Perspective Our education system was built u pon prejudices that persist today as structural racism American education is emblazoned with debates over every aspect of the act of educating such as textbooks, curriculums, teacher compensation, testing standards and the philosophy of schooling su ch as school size, segregation, parental involvement, funding, music and arts, and choice of enrollment. The system itself is speckled with an abundance of alternative models attempting to achieve better results. But perhaps why these debates remain heated and alternatives remain isolated is because we do not fundamentally agree on the purpose of American public education. Adopting a social determinants of education framework necessitates inspection of this social contract. To do so we must look back to the beginnings of our schooling system to make plain for what purpose it started and why it has the structure it does. In doing so what becomes clear is that we are trying to produce cutting edge results, while clinging to an unsophisticated history of educat ion. Despite 200 years of debates and struggles, for many the intents of the U.S. public school system are blatantly the same as they were at its origins. Public education was born with the intended outcome of inculcation of a singular vision of moral va lues, deference for authority, and basic social and literacy skills (Collins, 1979). The United States burst into a young nation through unprecedented immigration throughout the 18 th and 19 th centuries As a response to the expanding geographic and cultura l diversity of th e population, in the early 1800 s upper and middle class professionals

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10 in the New England states began to require townships provide free public elementary schools. The white Anglo Protestant leaders were trying to maintain social control ov er the growing nation and their traditional moral culture that was perceived to be under attack simultaneously from incoming immigrants as well as the hard to reach western frontier. The movement for public schools was championed by the reformers who were also heralding the societal benefits of social welfare, public hospitals, and child labor restrictions, as well as rallying against slavery, war, harsh penal conditions, and harmful labor conditions. Resistance came from many angles, including from rural f armers and urban workers resistant or apathetic to being subjected unnecessarily to upper class notions, and manufacturers and merchants hesitant of the increased taxes. Labor unions indirectly supported the idea through their efforts to reduce the competi tion from child labor (Collins, 1979). After the Civil War, Reconstruction efforts facilitated the creation of public schools throughout the South, mandated through state constitutions as the North had already done. As in the North, while the intention of schooling was a strong, inclusive democratic society, the influence of a singular moral vision was persistent. More explicitly, educating freed blacks was supported for simultaneously civilizing and controlling them (West, 1982; Tyack, 1986). Within a few years the northerners abandoned their efforts in the South in the face of extreme white supremacist violence (Tyack, 1986). The origins of our school system are firmly rooted in narrow and hostile intentions. Many efforts have been made to expand the huma nist origins of American public education towards greater inclusiveness, but the foundation persists. We are thus not certain if we educate for the purpose of developing young people into their individual potential or to mold them into a dominantly accepte d singular vision of America. Some desire it to be both

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11 while others insist those are not compatible. American public education through the 20 th century is scarred with the push and pull of this debate. In the wake of World War II, a 1945 publication calle d General Education in a Free Society by a committee of Harvard faculty proposed a philosophical standing on general education when the tenants of democracy were being questioned: Past notions of liberal education for an elite were placed aside to focus o n education for all general education in a free society where knowledge became a venue to develop traits of mind, those being effective thinking, clear communication, ability to make relevant judgments, and the clarification of values ( Kridel, 2010, p 401) However the decades that followed were not marked by education policies that fostered this. Rather achieving social unity continued to be attempted through imposing social sameness not critical thinking about the origins of dominant culture and so cial norms. One of the most widely recognized moments defining American public education was the judicial ruling that states could no longer sanction racial segregation of public facilities. This 1954 Supreme Court ruling in the Brown v. Board of Educatio n case, of course, meant that states had to allow public schools to integrate The basis of the upheld compl a i nt was that the schools could not achieve equality of economic resources while segregated, thus violating the fourteenth amendment of the U.S. Con stitution protecting persons from receiving unequal protection of the laws. The issue of state sanctioned separate but equal that this decision overturned was not only prominent in the South east where the case was fought, but also in Mexican American, Asia n American and Native communities. These communities also faced state sanctioned inequality with the proclaimed intent of civilizing the students, though not to elevate the students' individual agency through education, rather to mold them into proper labo rers and service workers for the white eli te (Fleming, 2002; Lomawaima & McCarthy, 2006)

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12 Movement to end segregation in the West began prior to the Brown decision due to legal challenges from Mexican American families. The local case of Mendez v. Westminst er upheld by the Ninth Circuit Court of Appeals in 1947, gained national support from the NAACP, the League of United Latin American Citizens, the Japanese American Citizens League, and the Jewish Congress and provided precedent for the victory Brown at t he Supreme Court. In 1964, a decade after Brown, 98% black students in Southern states were still in segregated schools and thousands of school districts defied the courts and resisted integration (Orfield, 2001). The 1952 petitioners' brief preceding the Brown case, included as an appendix a statement by leading race relations social scientists that outlined key elements of successful desegregation. Their recommendation s included desegregation being "simultaneously introduced into all units of a social ins titution" ( Carter, Marshal l & Robinson, 1953 ). Additionally they insisted successful desegregation need a climate with limited competition, chances to learn about each other as individuals, and equivalency of positions and functions within the institution. The Court however did not specify the ways in which the states should facilitate desegregation. And a decade later little progress had been made. President Kennedy and the 1964 Civil Rights Act instigated significant consistent pressure to facilitate dese gregation. Additionally, education reform took on a new face when the Congress passed the 1965 Elementary and Secondary Education Act, the 1968 Bilingual Education Act and the 1972 Indian Education Act, all of which aimed to make schools more equitable and inclusive to different cultures. But the struggle over the ideology of American education persisted. The Brown ruling began to be undermined by two cases in the early 1970's. San Antonio Independent School District v. Rodriguez in 1973 said that the con stitution did not

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13 provide for education to be a fundamental right and thus unequal financing of schools was not a violation of the fourteenth amendment. Followed by Milliken v. Bradly in 1974 that ruled that segregation was tolerable if it was not delibera te. After decades of local and legal battles over dismantling segregated and creating integrated schools, researchers began to see the benefits come to fruition. Student outcomes were improving for both white and black students, including reducing the raci al gap in achievement (Orfield, 2001). Additionally, students of color had greater success in college if they had gone to an integrated high school (Camburn, 1990). Public opinion even held support for integration efforts as found by a 1999 Gallup Poll. Th e Poll reported that a majority believed that integration was important and had improved education for both white and black students. A majority also said that the government should do more to make sure schools are integrated, and that children should lear n about race relations through school coursework. This support even came from white parents whose children were participating in bussing (Orield, 2001). Despite these measurable benefits and public sentiments desegregation efforts were abandoned in the fac e of political and judicial pressure, and since the height of integrated schools in the mid 1980's segregation rates have grown (Orfield, 2001). As desegregation was dismantled, a new solution to the problem of racially divided achievement was to instead focus on high expectations and standards at all schools through required courses and testing. However in the period following this, the racial gap in achievement began to widen again after previously narrowing during desegregation efforts (Orfield, 2001). Despite battles to alter the system in order to make it hospitable to all students, political efforts remained steadf ast in retaining a system, the product of which was racially divided achievement. A s William Bennett, Secretary of Education for Ronald

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14 Rea gan in the mid 1980s, expressed it, the US was experiencing a "cultural deconstruction of our schools" and the neo conservative educational policy he prescribed to insisted that "individual experience is an obstacle to be overcome through schooling, rather than a starting point or resource for instruction" ( Fletcher, 2000, p. 15). For Bennett individual experiences could not be useful in teaching appropriate educational content nor could it result in worthy moral lessons. Just as had been the desire of the education system from its inception, public intellectuals and political leaders continued to demand public schools create a culture of unity by teaching only one dominant understanding of American identity and history. However, as Anderson (2005) explains this sentiment: Racial domination was not the flaw in the [American] dream, it was the dream itself. Our past is characterized by different and contradictory dreams, and whatever common ground we stand on today is the consequence of intense conflict and a t times unanticipated coalitions, not the triumph of long standing shared commitment and cultural unity (p. 129) The sentiments of inculcating a singular moral vision has not been shaken from the center of American education policy. This discriminatory b elief is the major obstacle to creating education policies that can address the social determinants. If we do not yet agree that the purpose of education is freedom, agency, intellectual stimulation, and critical thinking, then we cannot move to finding wa ys for schools to address the societal inequities that are creating the education gap. A social determinants of education approach would require a re visioning of the purpose of the education system towards a policy that the schools can and should be the p lace to address social inequities. Despite a lack of historical political will for American education to embrace and address children's backgrounds and social realities a priori to successful classroom learning, there is both empirical and theoretical foun dations for it.

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15 A Student Outcomes Perspective Our understanding of the relationship between the achievement gap and poverty necessitates a paradigm shift One consequence of the battle over the fundamental intent of our education system is made plain by the results we achieve on average. The recent res ults from the 2015 PISA exam that survey's 15 year olds from 69 developed nations on their ability to apply knowledge showed that U.S. students remain at or below the global average for math, science and rea ding despite being one of the highest spenders on education ( Ripley, 2016). T he United States is one of the top spenders on the education system. Of the 34 OECD countries that participate in PISA, the US was the second highest spender, after Luxemberg ( OEC D 2010 ). Yet just as the PISA scores demonstrate, our h igh spending does not produce high results. Rather, we have what has long been called an achievement gap. That is, a persistent disparity in outcomes based on race and socioeconomic status (SES) Afri can Americans and Latina/o s when compared to whites achieve lower on test scores, graduation rates, enrollment in honors courses and admittance to colleges ( Landson Billings, 2006 ) The same gap exists between low SES and high SES students. And importantly the racial gap holds even for children of comparable S ES (Landson Bilings 2006 ). Much effort has been put into understanding and solving this gap. Decades of research has confirmed that the gap is widening (Reardon, 2013), that intelligence does not acc ount for the gap (von Stumm, 2017), and out of school factors are drivers of the gap ( Rothstein 2013). Yet our policies for addressing the gap remain largely in school interventions of expectations and accountability. Some efforts to address the achieve ment gap have tried addressing the burden of poverty from student's lives. In a mid 1990's federal public housing experiment called

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16 Moving to Opportunity gave vouchers to low income families in public housing to move from their high poverty neighborhoods t o a low poverty neighborhood Many analyses have been conducted on thi s program over two decades. Improvements were found initially, such as reduced behavioral problems, yet follow up research showed that moving had not imp roved test scores (Chetty, Hendre n, & Katz 2016 ; Levanthal, 2005). In a 2005 analysis, it was hypothesized that lack of improvements were possibly due to students continuing to attend rather disadvantaged and segregated schools, families did not receive any financial support other than th e move or the shock of the move out weighed any improvements in t he neighborhood (Leventhal) However, in 2016 new results showed that the change in neighborhood actually did produce significant outcome improvements by increasing earning and college attai nment for the children now in adulthood if they moved before the age 13 (Chetty Hendren, & Katz 2016 ). These varied results show that poverty alleviation can improve results, but also that life in poverty and movement out of it is nuanced and thus requir es inspection and policy from many angles. Chetty and Hendren (2015) for example, found in a parallel national analysis of the impacts of neighborhoods on intergenerational mobility, that high rates of upward mobility was found in neighborhoods with five common characteristics: less segregation by income and race, lower levels of income inequality, better schools, lower rates of violent crime, and more prev alence of two parent households Simply moving people away cannot solve these structural factors Po verty is traditionally defined in economic terms as an equation of income and expenditures for basic survival. However there are broader de finitions of poverty that allow us to better understand the perpetual gaps within society and education. For some res earchers, poverty also encompasses a lack of social belonging, cultural identity, respect

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17 and dignity, and information and education. Furthermore, these social exclusion factors prevent groups of people from moving out of poverty (Engle & Black, 2008). Mor e specifically, The World Bank found in a case study analysis, Voices of the Poor, the experienc e of poverty commonly described as: Experiences of ill being including material lack and want (of food, housing and shelter, livelihood, assets and money); hun ger, pain and discomfort; exhaustion and poverty of time; exclusion, rejection, isolation and loneliness; bad relations with others, including bad relations within the family; insecurity, vulnerability, worry, fear and low self confidence; and powerlessnes s, helple ssness, frustrations and anger. ( Narayan & Petesch, 2002, p. 12) In addition to working with an expanded, and nuanced understanding of poverty, the connection between poverty and education achievement needs a similar paradigm shift. The common un derstanding of the relationship between poverty and achievement is that there is a gap in outcomes. However, because this gap has been seen to narrow and re widen in the span of a decade, it becomes clear that looking too closely at year by year results is not uncovering the true link between poverty and education outcomes. Gloria Landson Billings, in a 2006 address as the president of the American Educational Research Association, proposed instead the concept of an education debt' faced by non white stu dents. In doing so she cites that research is showing that "even the combination of socioeconomic and family conditions, youth culture and student behaviors, and schooling conditions and practices do not fully explain changes in achievement gap" (p. 5). In order to eliminate the persistent gap in achievement between poor and wealthy student s and students of color and white students, the debt that students come to their schooling with must first be lifted. Landson Billings (2006) breaks education debt into four parts: historical debt, economic debt, sociopolitical debt, and moral debt. The historical debt is compiled of the overt racist legal measures to forbid blacks from receiving education, remove Indian

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18 children from their communities in order to kill the Indian" within them, systematic denial of Latino's from pubic school admittance and other targeted racist policies and practices These policies were based on the social understanding that non White races were inferior and the centuries of exclusion from education were deliberately designed to maintain them as labor and servant classes. The economic deb t fac ed by non Whites is explained through the levels of school spending per pupil, parents' earnings ratios relative to years of schooling completed, and the cumulative effects of those on wealth and assets. Because non White families have fewer resources in their communities and schools, and receive lower wages than White counterparts, they in turn have less access to quality housing, neighborhoods, an d schools. The sociopolitical debt was created by generations of Black, Latino and Native communities being legally excluded from civic processes in their communities, as well as their advocacy efforts being muted and marginalized. The moral debt, Landson Billings explains, is "the disparity between what we know is right and what we actually do" ( 2006, p. 8). We can easily see that this nation is indebted to the civil rights leaders of the 20 th century, to the 200,000 Black men who fought with the Union Arm y in the Civil War, to the indentured laborers from Hawaii to the Southern states who fuel ed our economic growth, a nd to the indigenous people that faced being physically and culturally eradicated from their homeland. The American response to this moral de bt was simply set them free and expect them to catch up in a race that had already started and they had not trained for as the metaphor goes While Landson Billings paradigm is profound in it's shifting of focus, it is also consistent with the considerab le amount of research that points to out of school' factors as the culprits of both poor and high academic achievement. Another public declaration of this

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19 issue was made by prominent education policy thinker and former Assistant Secretary of Education, Di ane Ravitch. Recently, she became known for publicly denouncing the testing and accountability policies she had previously spent her career working towards. Instead she insists that evidence shows that out of school factors far outweigh in school factors a nd that there is no evidence that high testing standards serve to close the achievement gaps (Ravitch, 2014). Beyond education research and politics other disciplines concerning human development are versed in the realities of social influences. In the 197 0's Uri Bronfrenbrenner radically altered developmental psychology by situating a child's potential within "a constellation of forces cultural, social, economic, political and not merely psychological" (Ceci, 2016, p. 173). His theory of the ecology of human development is a mainstay today across disciplines and public sectors. Our education system is awash in the evidence of what impacts learning, but we have not chosen to align our schooling strategies with it. Regularly toping the PISA charts is Fin land, and thus is often heralded as an exemplary model ( Duncan, 2010; Shalberg, 2012). However we cannot aim for Finland's results unless we are willing to adopt the same philosophical approach to education. In the 1990's the Finnish education system was n ot unlike many around the globe today. It produced reasonably average scores but was "increasingly challenged because of endemic failure to provide adequate learning opportunities to all children" (Shalberg, 2012, p. 20 ). The action the country chose to ta ke that has lifted them to a model globally was to create a system of equitable education and where all children learn well: The equitable Finnish education system is a result of systematic attention to social justice and early intervention to help those w ith special needs, and close interplay between education and other sectors particularly health and social sectors in Finnish society (Shalberg, 2012 p. 21 )

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20 This approach indeed produces commendable results, and does so by acknowledging that the desired g oal of education is for children to learn well, which requires first that their basic and social needs are addressed, and that process takes an equity, not simply equality, mandate. A Theoretical Perspective An equity approach to education should be situ ated in a critical social theory framework. Over the centuries of American education, regardless of intentions or politics, its purpose originated as and remains social cohesion through common understandings. This notion alone is not problematic. What is plaguing the system is that historical issues of race and class cannot be erased by the inculcation of a singular understanding of history or culture. The prolific education philosopher of the early 1900's, John Dewey, while living in a tumultuous historic al period, urged a model of education that achieved social cohesion through deep understanding of differences. While industrialization, immigration, war and fascism were rampant, Dewey understood that dialogue and critical engagement with others as individ uals and expanding our understanding of shared interests would not lead to a fusion of perspectives but of horizons ( Dill, 2007; Waks, 2007 ). And he believed finding this shared horizon was the purpose of classrooms and education. But he also understood th at this form of social cohesion would be achieved by starting from our differences and collectively creating something better. The French sociologist Pierre Bourdieu offers us a way to understand what it is we are instead creating through our current sys tem. In the 1970 and 80' s Bourdieu contributed to social reproduction theories through an analysis of class and what he called cultural capital. A person's cultural capital consists of their cultural background, knowledge, disposition, and skills that they a cquire from previous generations. What Bourdieu offered beyond this

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21 understanding of cultural capital, was the concept of habitus. According to Bourdieu, a person internalizes their cultural capital as their habitus, which then defines their attitudes, a ctions and aspirations to fit within th e norms of their social group or class. The habitus regulates the cyclical relationship between the structures of society and a person's practices. As Bourdieu (2001) puts it, "[t]he schemes of thought and expression he has acquired are the basis for the intentionless invention of regulated improvisation" ( p. 534). He continues, "[t]he habitus is the universalizing mediation which causes an individual agent's practices, without either explicit reason or signifying inte nt, to be none the less sensible' and reasonable' (p. 534). So while individuals act with agency in their daily lives, they are nonetheless acting within boundaries of the group's perception of normalcy. People experiencing the same daily and historical conditions as others in their group are led by their habitus to see others' actions as "intelligible" (p. 534) and "practices to be harmonized" (p. 535) with the group norms. In addition to the habitus facilitating people acting and feeling comfortable i n their own group, it also works to prevent different groups from interacting with as much ease. This mediated relationship between society and a person's actions also serves to define dominant, upper class values and e xperiences as the natural ones becaus e u pper class cultural capital is valued higher by society. Consequently, "schools serve as a trading post where socially valued cultural capital is parlayed into superior academic performance" (MacLeod, 2009, p. 14 ) because of the student's comfort with t he upper class cultural capital that defines the norms of the institution This high ac a demic achievement is translated into economic capital, which is subsequently passed onto a person's descendants as cultural capital. Thus schooling operates as the ulti mate mechanism for the "reproduction and legitimation of social inequality" (MacLeod, 2009, p. 16). According to Bourdieu's reproduc tion theory, social

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22 cohesion is actively occurring but n ot across groups, and i nstead we are rampantly allowing the differen ces to perpetuate divisions of achievement. In order to move beyond understanding towards changing this divisive social relationship, we need to investigate our institutions and structures at their roots. While Bourdieu's, and Bronfrenbrenner's, theories changed the understanding of the impact of social structures on individuals they are not oriented towards changing the patterns This has been the task of critical social theory since the early years of Nazi Germany, when the theory originated with the p hilosophers of the Frankfurt School. Critical theory meant to "penetrate the world of objective appearances to expose the underlying social relationships they often conceal" (Giroux, 2003, p. 28,). The aim was to better understand the link between institut ions and structures of society and how they interact with our everyday lives. To do so they rejected universalizing forms of rationality and instead sought to show how society was made up of historically contingent contexts mediated by relationships of do mination and subordination" (Giroux, 2003, p. 28 ) At the center of this investigation was the importance of easing the suffering of others. It was imperative to them that human existenc e be improved by reflection on the constrain t s on our thinking impose d by the structures of society that are accepted as invisible truths. T he Frankfurt School theorists called for a rejection of blind allegiance to notions of social harmony. Rather, "the pressure of civilization [has] multiplied to an unbearable degree" an d "[t]he only education that has any sense at all is an education toward critical self reflection" (Adorno, 1998, p. 193). According to critical social theory the ailments of society are created and fueled by the fallacies of social cohesion and universal truths.

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23 Both of these theories lend their support to a social determinants framework. The y have a unique combination of utilities that neither holds alone. Together they teach us that individual s aspirations, actions, and outcomes are a nuanced amalgama tion dictated by social structures and we must work to uncover those structural forces in order to improve people's lives. Additionally, they explain how the influence of institutions and society create visions of normalcy that become destructive when peop le hold them to be the definition of right and natural. Bourdieu teaches us to understand this process by how it explicitly interacts with an individual and critical social theory teaches us to put alleviating the suffering of that person as the end goal o f the theory. This is what a social determinants of education framework aims to achieve.

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24 CHAPTER III A CRITICAL FRAMEWORK Abundant current research documents links between various social factors and educational outcomes. In addition to potentially influ encing a students' ability to perform in the classroom these social factors can also influence the brain's ability to learn (Evans & Schamberg, 2009 ) Education reform is a pressing issue nationally, and understanding the importance of social factors on e ducational outcomes could have major implications for efforts to reform the system Borrowing the successful social determinants of health framework to situate the various education conversations within one critical framework will provide a necessary too l to move education reform forward. Terminology The terminology behind the concept social determinants of education necessitates some clarification, specifically what is meant by determinants and education First, the term determinants does not intend to su persede a person's agency with a deterministic future. The term is intended to facilitate policy conversations that recognize despite a person's best efforts they may not be able to overcome the influence of socially imposed forces and that we must investi gate the structural barriers in order to alleviate this burden. Second, determinants must be understood as different from predictors. A person's race might be a predictor of their health or education outcomes, however their race is not the determinant. Rat her structural racism and racial discrimination is the social force causing implication for the person's life, or the social determinant. Similarly, hunger might be a factor of a child having poorer educational achievements or suffer from remedial chronic health conditions, but policy

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25 makers and advocates need to investigate food access and food security systems and policies in that community that are leading to people experiencing hunger. As the Commission on the Social Deter minants of Health (2008) explai ned it determinants are the causes of the causes. The point of naming them determinants is to move us beyond acknowledging simply the categorizations of people aligned with outcomes, and naming the structures as the cause. Third, determinants can also be e xperienced as positive, protective factors. For example, having quality, stable housing is a determinant of a person achieving good education or health outcomes. The term education has many connotations, and it is important to distinguish them. In borrow ing the term from health, it is important to note that they are not called the social determinants of health care, referring to the system of providing health services, or the social determinants of health outcomes. When looking for a term comparable to he alth, I first believed it would be learning, because I did not want education to be construed as the education system. However learning simply refer s to the act, not also the long term consequences of it. And educational outcomes only refers to the measure ments we employ. So by settling on the terminology social determinants of education, I mean to say the education that a person and a community embodies and owns for their lifetime. Methodology As a starting point for building a social determinants of educ ation framework, a review of the existing education literature was condu cted in order to determi ne to what extent the established social determinants of health framework could be used as a guide Part of that review included determining whic h components o f the current social determinants of

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26 health framework applied to the field of educ ation, which did not and whether any new domains emerged. Table 1 presents a compilation of established health determinants as defined by Healthy People 2020 of the Office of Disease Prevention and Health Promotion, The Commission on Social Determinants of Health of the World Health Organization, and Bryant, Raphael, Schrecker, & Labonte (2011). In order to cross as many databases and journals as possible, searches were con ducted via Google Scholar and the University of Colorado Denver library search engine. Results were limited to peer reviewed articles from 1994 and later, and primarily regarding US students as well as a few from other developed, Western countries. Searche s were conducted using a combination of the subcategories in Table 1 below and with terms "education outcomes," "learning outcomes," or "student outcomes." T his process produced 100 articles for consideration. T he literature selected avoided factors that were att ributed to the student or parent personally, such as parent involvement in school or with homework. These factors are indeed strong predictors of student's achievement, however the goal of this framework is to force us to look further upstream, to the econ omic and social structural factors impacting personal behaviors. The 100 articles were reviewed and coded in a Google Docs spreadsheet Each article was coded for year, authors, general topic, type and source of data, qualitative or quantitative methods, t he prominent conclusions drawn, and the subcategories in Table 1 that were addressed. The Table 1 subcategories were modified based on the prominent themes of the coding and are presented in Table 2 in the following Findings section. Of the 100 articles co ded 55 met the criteria of documenting a direct link between a social factor and student

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27 outcomes, and were used to define the social determinants of education framework presented in Figure 5. Table 1. Social Determinants of Health Categories Under Consi deration Categories Subcategories Economic Stability Employment and working conditions Income and income distribution Neighborhood and Physical Environment Housing Transportation and Walkability Safety Food Security Access to healthy options Hun ger Community and Social Environment Social integration and support Race and discrimination Health Care System Health services and access Quality of care In the social determinants of health model, health care is considered a determinant. Si milarly the education system itself should be considered a determinant of education. However it was not included in this review because it currently consumes most of the intervention efforts and the goal of this thesis is to expand our view of the areas of resea rch that are less prevalent in ongoing initiatives Findings The social determinants of health are defined in various ways throughout the literature. Multiple definitions were consolidated to create the categories and subcategories presented in Table 1 above. These categories guided a review of education literature to define the social determinants of education. The results of the literature review suggested the categories and subcategories presented in Table 2. The differences between the health and edu cation categories are discussed in the Discussion section.

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28 Table 2. Proposed Social Determinants of Education Categories The literature reviewed varies by the type of data analyzed, the mediating factors identified, and the outcome measurements explored. This variety of variables enhances the framework by demonstrating the many avenues social determinants infiltrate. Each of the eight subcategories listed in Table 2 were connected with education outcomes of both academic achievement and social emotional development. Among the literature supporting these eight categories, the most common academic outcome measurements were high school graduation ra tes, grade point average (GPA), grade repetition, college attendance and standardized test scores. The most common social emotional development measurements were external and internal behavioral p roblems assessments, and classroom engagement and Categories Subcategories Food Insecurity Hunger Diet Quality Economic Employment Conditions Job loss/Instability Work related haz ards or stress Fluctuating work hours Lengthy commutes Unrewarding work Assets Liquid Household net worth Physical Environment Housing Homelessness High mobility Crowding Poor quality Neighborhood Community violence/Incivilities Perceived safety Socia l vulnerability Low prestige occupations Concentration of disadvantaged groups Social Environment Support Network Social cohesion Trauma Exposure Social capital Education culture Discrimination Colorism Racism Health Physical Health Chronic Remedial C onditions Health Culture Early Health

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29 self esteem. The details of this literature are presented b e low by category. Each category discusses the data used and outcomes measured by each article and where possible groups findings by either acade mic or social emotional outcomes. Food determinants: Food determinants, as detailed in Table 3, were found to be food insecurity, including hunger and diet quality. The issue of food security, as defined by the United National Food and Agriculture Organiz ation in 1996, concerns the ability of "all people, at all times, [to] have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life (FAO, 1996). Table 3 Food De terminants Food Determinants Findings Authors Insecurity Hunger Diet quality Lower test score baseline and growth Increased grade repetition Increased aggression and problems getting along with others Decreased social and emotional skills Impaired approa ches to learning Increased suspensions Increased absenteeism Alaimo 2001; Belot, 2011; Florence 2008; Howard 2011; Jyoti 2005; Kleinman 1998; Knowles 2015; Winicki 2003 Investigating academic performance outcomes, Winicki and Jemison (2003), Florence, As bridge, and Veugelers (2008), and Belot and James (2011) all demonstrate relationships between food insecurity and test scores. Winicki and Jemison used data from the Early Childhood Longitudinal Study Kindergarten Cohort (ECLS K) and found any level of fo od insecurity decreased math scores as well as yearly test growth. Florence, Asbridge, and Veugelers (2008) as well as Belot and James (2011) looked at the impact of diet quality. The former used Nova Scotia, Canada students data from the Children's Lifest yle and School performance Study to show that standardized literacy assessment scores were more

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30 likely to be lower for students with any indicator of poor diet quality. The latter studied the effects of a 2004 campaign to drastically improve the quality of school meals in one London, UK, neighborhood. They report that English and Science standardized assessment scores improved as compared to neighborhoods that did not receive improved food quality. Their results also indicated that for students receiving i mproved food quality health related absences decreased which was possibly a mediating factor of improved test scores Looking at non cognitive classroom skills, Howard (2011) used ECLS K and teacher skill rating questionnaires and produced the findings that food insecurity impairs children's development of interpersonal relations, self control, and their approaches to learning (exhibiting skills such as attentiveness, task persistence, eagerness to learn, learning independence, flexibility, and organizat ion). Knowles Rabinowich, Ettinger de Cuba, Becker, and Chilton (2015) also found through 51 semi structured interviews with parents in Minneapolis and Philadelphia that a parent's own toxic stress regarding food insecurity negatively impacted their child ren's social and emotional development. A handful of studies found outcomes of both academic performance as well as social emotional issues linked to food insecurity. Jyoti, Frongillo, and Jones (2005) also used the ECLS K to measure food insecurity and c ombined it with standardized test performance and teacher assessments of social skills. They report that students with food insecurity had decreased math and reading scores as well as poor measurements of social skills. Alaimo, Olson, Frongillo and Briefe l, (2001) studied data from the Third National Health and Nutrition Examination Study and found that 6 11 year old children in food insufficient families had lower math scores, were more likely to have repeated a grade, have seen a psychologist, and have h ad difficulty getting along with others. Teenagers in food

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31 insufficient households were more likely to have seen a psychologist, have been suspended, and have had difficulty getting along with others. Kleinman et al. (1998) found from examining the Commun ity Childhood Hunger Identification Project survey data from Pittsburgh and its surrounding county that children identified as hungry were more likely to display behavioral and emotional problems such as aggression and anxiety as well as academic problem s such as repeating a grade. Economic Determinants: The economic determinants as detailed in Table 4, in the literature included employment conditions and assets. Employment conditions impacting education outcomes include job stability, work related haza rds or stress, fluctuating work hours, lengthy commutes or unrewarding work. Assets refer to either liquid or household net worth. Table 4 Economic Determinants Economic Determinants (Parental) Findings Authors Employment Conditions Job loss/Instabilit y Work related hazards or stress Fluctuating work hours Lengthy commutes Unrewarding work Increased grade repetition Decreased college enrollment rates Lower scores on cognitive assessments Increased Internal Behavior Problem and External Behavior Problem scores Increased placement in special education Dunifon 2005; Felfe 2012; Huff Stevens 2011; Johnson 2012; Kalil 2011; Rokicka 2016 Assets Liquid Household net worth Increase high school graduation rates Increase college enrollment and completion Increas ed math and reading test scores Increase participation in gifted programs Increased participation in extracurricular activities Elliott 2011; Elliott 2013; Kaushal 2009 ; Kim 2011; Nam 2009; Shanks 2009

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32 The employment conditions listed above are associated with both academic and social emotional outcomes. Measuring academic outcomes, Kalil and Wightman (2011) used the Panel Study of Income Dynamics that followed children through age 21 and found that stud ents were less likely to obtain post secondary educat ion if their parents experienced job loss during their years at home, and this association was three times stronger for black students. Interestingly, this latter finding was largely explained by household wealth and long run measures of family income. Huf f Stevens and Shaller (2011) found that grade repetition was associated with parental job loss through their study of 2,710 children age 5 19 in the Survey of Income and Program Participation. And Rokicka (2016 ), using the British Household Panel Survey Yo uth Questionnaire with 2,049 students at age 16 and two years following, showed worse test scores when parents work long hours. Employment conditions were shown to impact social emotional behaviors by Dunifon Kalil, and Bajracharya ( 2005 ) in their study of non family friendly work conditions faced by mothers leaving welfare, 372 children ages 5 15, studied over a five year period, had h igher levels of internalizing problem behaviors and lower levels of positive behaviors with mother s had long commutes Looking at both social emotional and cognitive outcomes, Felfe and Hsin (2012) used data from the Child Development Supplement of the Panel Study of Income Dynamics and the Occupational Information Network, to look at 1,630 children age 5 17. They found th at behavioral development was affected by parental work stress and cognitive development was affected when parents experienced work related hazards. Johnson, Kalil, and Dunifon (2012) also showed findings of both academic performance and social emotional s kills. Using five years of data from the Women's Employment Survey, they found behavior problems for the

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33 students associated with mother's job instability and fluctuating work hours. M other's non cognitive work and fluctuating work hours were also associat ed with student s likelihood of repeating a grade or being placed in special education. Assets were primarily associated with academic performance outcomes. Williams Shanks and Destin, ( 2009 ) used the Panel Study of Income Dynamics, and the Child Develop ment Supplement, to show that wealth, more so than income, was a predict or of education expectations, high school graduation, and college enrollment. Kim and Sherraden ( 2011 ) also found p arental assets to be associated with high school gr aduation and c olle ge enrollment through their study of 632 children in the Child and Young Adult data supplement to the National Lo ngitudinal Study of Youth 1979. They also found educational expectations to be a mediating factor of the influence of assets. Nam and Huang ( 20 09 ) used the Panel Study of Income Dynamics and concluded that liquid assets are associated with high school gra duation and college attendance. Elliott ( 2013 ) also used longitudinal data from the Child Development Supplement of the Panel Study of Income Dy namics to show that students in asset poor families have lower math and reading score s and are less likely to graduate high school, attend college or graduate from college. Elliott, Destin, and Friedline (2011) conducted a meta analysis on the relationshi p between assets and education attainment. They included 34 studies, spanning 10 years, regarding students age 15 17. They found that assets were connected to math and reading scores, college attendance, and college completion. Only one study regarding ass ets and educational outcomes included a social emotional outcome in the form of participation in extracurricular activities. Kaushal and Nepomnyaschy (2009) found by studying the Survey of Income and Program Participation data of 16,000 children

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34 between ag es 6 17 that indicators of wealth have high associations with participation in extracurricular activities and gifted programs, a s well as with grade retention. Physical environment determinants: The ph ysical environment determinants, as detailed in Table 5, associated with education are housing and neighborhood. Housing includes experiencing homelessness or high mobility, crowding, and poor quality. Neighborhood determinants include violence or incivilities, perceived safety, social vulnerability, low pres tige occupations, and concentration of disadvantaged groups. Table 5 Physical Environment Determinants Physical Environment Determinants Findings Authors Housing Homelessness High mobility Crowding Poor quality Less likely to perform at grade level Low er scores on cognitive assessments Increased grade repetition Lower test score baseline and growth Decreased social and emotional skills Poorer classroom task engagement Increased External Behavioral Problems score Goux 2005; Fantuzzo 2012; Leventhal 2010; Levine Coley 2013; Obradovic 2009; Shinn 2008; Solari 2012; Zima 1994 Neighborhood Community violence/Inciviliti es Perceived safety Social vulnerability Low prestige occupations Concentration of disadvantaged groups Lower academic self esteem Lower test score baseline and growth Poorer school engagement Increased grade repetition Decreased high school graduation rates Lower GPA Decreased college enrollment Aaroson 1998; Ainsworth 2002; Aughinbaugh 2014; Baker 2015; Carlson 2015; Daly 2008; Glaster 2016; H arding 2009; Johnson 2013; Milam 2010; Nieuwenhuis 2016; Wodtke 2011 Housing was connected to both academic and social emotional outcomes. Levine Coley Leventhal, Doyle Lynch, and Kull ( 2013 ) using the longitudinal Three City Study of low income famili es in the wake of welfare reform, looked at 2,437 children age 2 21, and

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35 found that housing quality was associated with e moti onal and behavioral functioning as well as cognitive skills. These results operated in part through parental stress. Solari and M are, ( 2012 ) used the Panel Study of Income Dynamics' Child Development Supplement and Los Ange les Family Neighborhood Survey to show that c rowding a ffect s math and reading test scores as well as external problem behaviors. Crowded homes were also found by Goux and Maurin ( 2005 ), using the Labor Force Survey of France, to be associated with being held back a grade. Looking at students experiencing homelessness and high mobility, Obradovic et al. ( 2009 ) found in a study of 14,754 students in Minneapolis, gr ades 2 5, had lower achievement and slower growth on math and reading scores. Fantuzzo, LeBoeuf, Chen, Rouse, and Culhane ( 2012 ) used public school district as well as Office of Supportive Housing data to study third grade students in Philadelphia. They fo und that homeless ness had an associa tion with classroom engagement and mobility was associated with reading and math scores as well as classroom engagement. They report that absenteeism was a mediating factor of these results. Shinn et al. ( 2008 ) studied 7 70 formerly homeless children in New York City and through administering intelligence tests and standardized math and reading test, found that they were b elow cognitive and achievement norms for their age levels. Zima Wells, and Freeman ( 1994 ) conducted i nterviews of 169 sheltered homeless children in Los Angeles County and found they experienced depression, exhibited behavioral problems, and were not at grade level for reading and vocab ulary. Leventhal and Newman (2010) conducted a review of research and concluded that crow ding is associated with health and mobility is associated with academic, social and emotional problems

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36 Studies of neighborhood characteristics and impacts on education explore many different elements of neighborhood s and show both aca demic and social emotional outcomes. High school graduation was frequently linked to various neighborhood characteristics. Harding (2009) found through Add Health survey data of 14,668 students, grades 7 12 that neighborhood violence is a strong predictor of high school graduation. Aaroson (1998) used sibling data of 2,178 individuals from the Panel Study of Income Dynamics to estimate neighbo rhood versus family influences and found high school graduation to be associated with neighborhood. Wodtke, Harding and Elwert ( 2011 ) studied 4,154 children from the Panel Study of Income Dynamics, age 1 17, and found that high school graduation is associated with neighborhood through sustained exposure. Aughinbaugh and Rothstein (2014) used data of 7,653 young adults in the National Longitudinal Survey of Youth and found that youth from disadvantage neighborhoods are less likely to graduate high school, attend college or graduate college regardless of cognitive skills. Looking at test scores, Milam Furr Holden and L eaf (2010) used data from the Baltimore City Public School System s annual School Climate Survey which captures student self reported neighborhood safety, as well as an objective assessment of the neighborhood s and found an association with m ath and readin g test scores. Carlson and Cowen ( 2015 ) found from studying 96,000 students in Milwaukee that test growth is impacted by neighborhood. Ainsworth (2002) used National Ed ucational Longitudinal Study linked with census data and found that neighborhood charac teristics predict math and reading test scores with as much strength as family and school factors. Johnson ( 2013 ) conducted a meta analysis of 27 studies and found that neighborhood is associated with test scores and high school graduation rates, and that the presence of high income neighbors has

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37 an effect of greater magnitude than the effects of low SES. Glaster, Santiago, Stack, and Cutsinger (2016) surveyed Latino and African American youth age 12 18 living in randomly assigne d Denver Housing Authority unit s and found that neighborhood impacts grades, grade repetition and high school graduation rates for age 12 18. They report that this outcome was a factor of concentrati on of disadvantaged ethnicities social vul nerability, occupational status or prest ige in the neighborhood. Exposure to neighborhood violence was found by Baker and Roberts (2015) to be correlated with academic self esteem for 74 surveyed African American fourth and fifth graders. Similarly, perceived neighborhood incivilities was found by Daly, Shin, Thakral, Selders, and Vera (2008) to be predictive of school engagement for through a survey of 123 seventh and eighth grade urban adolescence of color. Lastly, in a meta analysis of 88 articles, Nieuwenhuis and Hooimeijer ( 2016), found tha t individual outcomes are a function of neighborhood poverty, education climate, concentration of disadvantaged groups, or social disorganization in the neighborhood. Social environment determinants: The social environment determinants as detailed in Ta ble 6, associated with education outcomes are a student's social support network and experiencing discrimination. Support network included social cohesion, trauma exposure, social capital, and education culture. Discrimination includes racism and colorism.

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38 Table 6 Social Environment Determinants Social Environment Determinants Findings Authors Support Network Social cohesion Trauma Exposure Social capital Education culture Increased grade repetition Lower GPA Increased placement in special education Im pact on test scores Protective factor of social capital Behtoui 2016; Dufur 2013; Misra 2013; Nieuwenhuis 2016; Romano, 2015; Rotho n 2011 Discrimination Colorism Rac ism Decreased high school graduation rates Decreased college enrollment or completion Lowe r t est scores Decreased academic orientation, curiosity, persistence, and expectations Lower GPA Neblett 2006 ; O'Hara 2012; Oates 2009; Ryabov 2016 Varying degrees of a supporting s ocial environment shows impact on academic education outcomes. Romano, Ba bchishin, Marquis, and Frechette ( 2015 ) found from a literature review of 20 articles that trauma was linked to being placed in special education as well as, grade retention and lower grades Rothon, Head, Klineberg, and Stansfeld ( 2011 ) used survey data from 2,790 students age 11 14 in London and found that b ullied students were less likely to perform at grade level on tests. Behtoui and Neer gaard (2016) showed that levels of extra familial social capital predicted grades. Dufur Parcel and Troutman (2013 ) used a sample from the National Longitudinal Education Study of 10,585 students and found social capital is linked to test scores, and that social capital from the family was a stronger association than social capital received from the school environment Misra Grimes and Rogers ( 2013 ) used Mississippi Department of Education and the Northeast Regional Center for Rural Development data paired with GIS mapping to show that levels of social capital predicts test scores.

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39 Racial discrimination shows effect on academic performance as well as levels of academic curiosity and persistence. Ryabov (2016) used National Longitudinal Study of Adolescent Health, and found that achieving some college education was more likely for white Asian Americans versus co ethn ic Asian Americans with light brown skin tone. O'Hara Gibbons, Weng, Gerrard and Simons (2012) found among 750 fifth grade African Americans from the Family and Community Health Study, that perc eived discrimination discouraged them from purs ing college ed ucation. Oates (2009) found from the National Edu c ational Longitudinal Study that students t est scores are predicted by biased treatment from educators. Neblett Philip, Cogburn and Sellers (2006) surveyed 548 African American adolescents, grades 7 10, fr om 11 schools, and found that discrimination was associated with a decrease in a ca demic curiosity and persistence. Health Determinants: Health d eterminants, as detailed in Table 7, were found to be physical health including chronic remedial conditions, he alth culture, and early life health. Sabia and Rees (2015) found from the National Longitudinal Study of Adolescent Health, that overweight leads to decreased self esteem which is negatively related to GPA and probability of attending or completing college Jackson (2015) used longitudinal data of 9,252 children from the British Na tional Child Development Study and found that early health, such as birth weight, smoking exposure, and school age health, are associated with test scores and growth. Additionally longer duration of poor health decreases likeliness of catching up. Ickovics, Carroll Scott, Peters, Schwartz, Gilstad Hayden and McCaslin (2014) studied 940 students grades 5 6 from 12 randomly selected urban schools and found that health assets and a c ulture of health were associated with standardized test scores. Robert Wood Johnson Foundation (RWJF) (2016) reported that chronic remedial conditions such as

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40 asthma, dental, vision, diabetes, obesity, and mental health cause absenteeism which makes stu dents less likely to read a t grade level and four times more likely to drop out. Table 7 Health Determinants Health Determinants Findings Authors Physical Health Chronic Remedial Conditions Health Culture Early Health Increased a bsenteeism Less likely to perform at grade level Decreased high school graduation rates Lower GPA D ecreased college enrollment or completion Lower test score baseline and growth Ickovics 2014; Jackson 2015; RWJF 2016; Sabia 2015 Discussion A framework presented in Figure 5, p rovides a foundation for policy, reform, and alternative models to approach issues and solutions from a c ommon language. In this case, the social determinants of education framework aims to facilitate interventions that holistically address the cyclical an d interdependent issues that so forcefully impact students' learning and educational attainment Rather than remaining in silos physical environments, social environments, security and subsistence factors can be seen as pieces of the same puzzle. There ar e already many efforts nationwide reimagine schooling with these factors at the forefront. This framework aims to be a tool for the important work already being done.

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41 Proposed Social Determinants of Education Framework Figure 5. Proposed Social Determina nts of Education Framework

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42 This literature review sought to determine if the commonly used social determinants of health could also be used to create a definition of social determinants of education. The findings indicate there is evidence for each of the broad categories and the subcategories have some nuanced variations. The places where education differed from the health models are as follows. In the physical environment factors, the literature did not show significant evidence linking transportation an d walkability to educati on outcomes. In the economic factors, income showed surprisingly little evidence likely because most research investi gates socioeconomic status which is a combination of parental income, education, and occupation. Socioeconomic sta tus is of course a widely cited predictor of educational attainment (OECD, 2010) but to cultivate specificity for the framework I chose to investigate income and occupation separately. While income was less conclusive, assets and net worth emerged as impor tant factors for the education model. Some literature discussing assets identified a link between educational expectations, assets, and outcomes. In the social environment category e ducational culture as well as exposure to trauma emerged as subcategories not named in the health models. The category of h ealth also diverged in important ways. Imp ortant to education outcomes were issues of chronic remedial health conditions. T he literature focused on absenteeism resulting in part from inadequate access to r egular primary care that could minimize the burden of the condition. Mental health was also considered for the model but ultimately not included as its own subcategory because it could be included in the chronic remedial conditions that require regular acc ess to care Additionally, depression and self esteem were seen as mediating factors for other subcategories.

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43 Further discussions could explore the inclusion of additional subcategories such as parental education or physical activity. I suggest that these w ould be called causes and this model is attempting to look further upstream at the causes of the causes or the social and structural factors that ultimately determine personal behaviors and choices. In addition to this upstream approach, the model also aims to define what is upstream with more specificity than the commonly cited issue of poverty or SES. With specificity, it is hoped that this framework can show increased paths for cross sector interventions and collaborations. Conclusion As mentioned a bove, work is already being done to address these issues and hopefully this framework will build a common language to further the discussion. Two examples of note are community schools and promise neighborhoods. Community schools integrate the community in to the school by coordinating supports and services for the families under their same roof. They work to cooperate with other institutions, involve parents and engage kids in extracurricular activities. The schools develop to meet the specific needs of the ir community so each are unique in their approach and model. They are all based on the recognition that "inequality has more to do with policies and social/economic structures rather than with the characteristics of individual children and their families" (Baquedano L—pez, Alexander, & Hernandez, 2013, p. 171). Heers Van Lkaveren, Groot, and Maassen van den Brink (2016) found evidence that at community schools cooperation across agencies and increased parent involvement were associated with academic achiev ement and decreased risky behaviors and dropout rates. They also found that participating in extracurriculars was related to reduced dropout and risky behavior. Biag and Castrechini (2016) document improved attendance rates and academic achievement in

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44 asso ciation with participating in the extended learning programs and family engagement opportunities. Another approach to reducing achievement gaps by reducing social and structural barriers is the federally funded promise neighborhood program. These are di sadvantaged neighborhoods that are working to integrate the school into the surrounding community. Unlike most federal education policies, promise neighborhoods are based on the recognition of the importance of out of school factors. The concept is modeled after the Harlem Children's Zone, and after a planning phase 12 implementation grants were awarded in 2011 and 2012 (Douglass Horsford & Sampson, 2014). Part of what the neighborhoods are working towards is breaking down agency silos, with the intent of f ighting poverty by putting education at the center of local efforts. While promise neighborhoods link improved education to alleviating poverty and social determinants of health link education to improving health, this framework documents the specific ele ments of poverty and health that are central to education. They are all indeed inextricably linked in bidirectional cycles. But this framework insists that we need to flip the intervention and instead work to improve education by alleviating poverty. We sh ould think of our education system as a great resource in this work and take advantage of the uniqueness of a system that touches every family and child. Public health advocates have already begun to propose the concept of social determinants of education and my hope is that a defined framework will help expand the conversation in the education sector. One public health advocate that gained notoriety for his work on addressing social determinants of health in his community, Jeffrey Brenner, says of this wor k, "[t] his is not about breaking down silos; this

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45 is about completely rethinking some basic assumptions about the culture of care in our country ( "Exit Interview ," 2017). Two things are important to note regarding this thesis First, I have presented onl y a fraction of the evidence that exists on these issues. My aim was only to demonstrate its existence and propose a new way of conceptualizing this body of work. Second, I am not negating the importance of in school and personal facto rs on education outco mes. T his framework is intended to streamline the conversations on out of school factors by defining a common language of social determinants as well as propose further investigations of whether social determinants do in fact show causal evidence, and to w hat magnitude, of their impact on education. In arguing against the funding of promise neighborhoods, Whitehurst and Croft of the Brookings Institute ( 2010 ) conclude that "[t]here is considerable evidence that schools can have dramatic effects on the acade mic skills of disadvantaged children without their providing broader social services" (p. 10). The fact that schools can and do have dramatic effects is indeed likely true but it does not exclude simultaneously addressing social determinants as an equally if not more, important strategy. Further research on the social determinants of education should take up refining and expanding the framework. Specific topics needing consideration include school segregation, education beyond K 12, issues facing people with disabilities and various gender identities. As well as investigating the compounding effect of people experiencing multiple factors of social determinants and also a broader global analysis. Defining the social determinants of education will hopefull y help sustain the growing conversations over the decades ahead. This framework insists on a cross sector approach, ideally forcing the task of addressing social determinants to be shared and no longer burdened by teachers and administrators alone.

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46 In th is current political climate it is hard to believe that this concept will find a place in the strained world of education reform. The work of educational equity has a long history with many obstacles. Our task is to stay vigilant to the vision of educating all children well and joining our horizons for a vibrant democracy.

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