Children, Racial Disparities and Status of

HEALTH DISPARITIES IN THE UNITED STATES

VIOLENCE

TRENDS IN REFUGEE STATUS

SCHOOLING

BIBLIOGRAPHY

The U.S. Census Bureau has released data that reveals racial disparities in areas that impact upon the fortunes of children in diverse racial/ethnic groups in America (Table 1). These data reveal that Hispanics are least likely to hold a high school diploma or a bachelor’s degree compared with all groups. Even though African Americans have a high rate of securing a high school diploma, they have a low economic return on that level of educational attainment. That is, they have the lowest median household income and home ownership rate, and highest poverty rate, of all groups.

Racial disparities in poverty rate affect children and their future. Children are poor because they live in poor families. Arloc Sherman (1997) has pointed out that poverty matters in a number of significant child outcomes related to health and education. In the area of health, poor children are at a higher risk of suffering death in infancy, premature birth (under 37 weeks), and low birth weight. They are also more likely than non-poor children to have no regular source of health care, and to receive inadequate prenatal care. In education, children who are poor have a risk, at ages seven to eight, of math scores that are five test points lower and reading scores that are four test points lower. Poor children are twice as likely to repeat a grade; are 3.4 times more likely to be expelled from school; are 3.5 times as likely to be a dropout at ages sixteen to twenty-four; and are half as likely to finish a four-year college (Sherman 1997, p. 1).

The Children’s Defense Fund (CDF) compared poverty between African American children under eighteen

years of age and children of all other races (CDF 2003). They found that 4.0 percent of children among all races live in extreme poverty, whereas 8.4 percent of African American children live in extreme poverty. CDF describes a deepening of the severity of poverty for already-poor children in the wake of the 1996 welfare law. More than eight in ten black children on Aid for Dependent Children (AFDC) were already poor in 1995, the year before the law was signed. Even though there was no change in the official poverty rates, nearly one million black children were found to live in “extreme poverty” with after-tax income of less than half of the poverty line. The percentage of black children in extreme poverty in 2001 was at a near record high, the highest level in twenty-three years. Also, fewer and fewer extremely poor children of all races receive cash public assistance.

HEALTH DISPARITIES IN THE UNITED STATES

The Children’s Defense Fund (2003) has identified disparities in health for poor and minority children, especially black and Latino children. They continue to lag behind white and affluent children in almost every health indicator. Most of the current research is focused upon eliminating health disparities in health care for adults. Research on children indicates “that disparities persist in the areas of infant mortality, immunizations, asthma, dental care, lead poisoning, and obesity, to name a few of the conditions that affect children” (p. 2). These conditions can affect children’s development and functioning before birth, in adolescence, and over the course of a lifetime.

Socioeconomic status is a strong determinant of health outcomes because it affects access to insurance and health services. The population groups with the worst health status are those with the highest poverty rates and the least education. As pointed out earlier, racial minorities do not compare well with whites on a variety of socioeconomic indicators that are the strongest predictors of health. In addition to the aforementioned indicators, minorities have fewer employment opportunities. Black and Hispanic unemployment rates are much higher (sometimes over two times higher than whites) (CDF 2003, p. 3). As a result, minorities are less likely to have employer-sponsored health insurance and are more likely to be uninsured. The health coverage a person has governs how quickly the person will get health care and whether it is the best care available. Blacks are almost twice as likely and Latinos almost three times as likely to be uninsured as whites. A 2005 study (Lillie-Blanton and Hoffman) shows that these disparities would be significantly reduced if black and Latinos were insured at levels comparable to those of whites.

According to CDF (2003), there is a growing body of published research that indicates that racial and ethnic minority patients receive a lesser amount of care and a lower quality of care for the same illness, even when they are at the same income level and insurance coverage level as white patients.

Infant Mortality and Prenatal Care . One of the most important indicators of children’s health is infant mortality and birth weight rates in different populations. Although overall infant mortality rates dropped as of 2002, the gap between the white and black infant mortality rate has not narrowed. According to Matthews, et al. (2004), in 2002 there were more than 28,000 infant deaths in the United States, more than all the deaths among children between the ages of one and nineteen. Black infants were more than twice as likely to die as white infants.

Low birth weight is the leading cause of infant mortality among all races. It is the greatest cause of death for black infants. According to Martin, et al. (2003), non-Latino black infants were almost twice as likely to be born at low birth weight as were non-Latino white infants (13.4% versus 6.9%).

The most critical component of reducing the incidence of infant mortality and low birth weight is prenatal care for pregnant women. The level and timing of such care is used as a proxy for access to care and birth outcomes. There are racial and ethnic differences in the timeliness of prenatal care. In 2002, 75.2 percent of non-Latino black and 76.7 percent of Latino women received prenatal care in the first trimester, compared to 85.4 percent of non-Latino white women (Martin, et al. 2003). Non-Latino black and Latino women were more than twice as likely as nonLatino white women to have late or no prenatal care (6.2% and 5.5% respectively, versus 3.1%).

Hunger . The U.S. Department of Agriculture (USDA) defines “food security” as having access to enough food for active healthy living (Nord, Andrews, and Carlson 2003). Families without enough food are often referred to as “food insecure” households. Most food insecure households avoid hunger by limiting the types of food they buy and relying on public assistance food programs. However, in about one-third of food insecure households, one or more household members are hungry at some time.

Children who are hungry and food insecure are at greater risk for deficits in cognitive development and academic achievement. According to the USDA, in 2003, 28.5 percent of African American and 28.1 percent of Hispanic households with children experienced food insecurity, compared with 11.3 pernt of white households.

VIOLENCE

According to the U.S. Centers for Disease Control and Prevention, 2,827 children and teens in the United States died from gunfire in 2003. There were 1,822 who were homicide victims; 810 committed suicide; and 195 died in accidental or undetermined circumstances. Of this number, 2,502 were boys and 325 were girls (CDF 2006).

Of the children and teens who were victims of violence, 1,554 were white; 1,172 were black; 51 were Asian or Pacific Islander, and 50 were American Indian or Alaska Native. Additionally, 553 of the children and teens across all of the races were identified as Latino. The age breakdown for the victims was: 378 under age fifteen; 119 under age ten, and 56 under age five; the remainder were fifteen to nineteen. In addition to the death toll, four to five times as many children and teens suffered non-fatal bullet wounds.

The Children’s Defense Fund (2006) has pointed out that black children and teens are more likely to be victims of firearm homicide, whereas white children and teens are more likely to commit suicide. They also note that children are more likely to be killed by adults than by other children. They state further that “The rate of firearm deaths among children under age fifteen is far higher in the United States than in twenty-five other industrialized countries combined” (p. 2).

TRENDS IN REFUGEE STATUS

Refugees escaping war often move in large groups and flee the same conditions within the same time frame. Those persons are often accorded refugee status on a group prima facie basis. According to the United Nations High Commissioner for Refugees (UNHCR), ten asylum countries reported the arrival of more than 1,000 prima facie refugees during 2005, including Chad (32,400), Benin (25,500), Uganda (24,000), Ghana (13,600), and Yemen (13,200) (UNHCR, 2006). The article reported data on 28 industrialized countries with available data. The major receiving countries were the United Kingdom, Austria, Switzerland, the Netherlands, Germany, and Norway. Together these five asylum countries accounted for 73 percent of all claims lodged by unaccompanied and separated children. There were six countries of origin that produced more than 10,000 prima facie refugees in 2005: Togo (39,100), Sudan (34,500), the Democratic Republic of the Congo (15,600), Somalia (13,600), the Central African Republic (11,500), and Iraq (10,500).

Data has been collected by UNHCR (2004) on the status of “unaccompanied” and separated children seeking asylum in industrialized countries. They define unaccompanied children as “persons under eighteen years of age who have been separated from both parents and are not being cared for by an adult who by law or custom is responsible to do so” (p. 2). UNHCR advocates the usage of the term “separated” children as a more precise international definition for this phenomenon. There are children who are being cared for on some level by extended family members, so they are not “unaccompanied” in the true sense of the word. They do, however, face risks in that they are separated from their parents.

UNHCR (2004) reports that, “Asylum flows to most countries in Central and Western Europe have been dominated by children from Asia (Afghanistan, Iraq). Some countries in Western Europe have reported important inflows of children from Africa” (pp. 5–6). According to UNHCR (2004), Africa is overrepresented in the numbers of unaccompanied and separated children seeking asylum, but the reverse is true for children from Asia, Europe, Latin America, and the Caribbean. Of the 39,900 unaccompanied and separated children seeking asylum between 2001 and 2003, only 13 percent originated from Europe (while 24 percent of all asylum seekers were from Europe).

Gene B. Sperling (2005) has pointed out that orphaned children are less likely to be enrolled in school than their peers who live with at least one parent. He states further that “Only 6 percent of children in refugee camps are enrolled in secondary education, and opportunities for internally displaced children are even more limited” (p. 1).

SCHOOLING

Preschool Education . An important descriptor of the educational fortunes of children is participation in pre-school education. Center-based early childhood education

programs include day care centers, Head Start programs, preschool, nursery school, and pre-kindergarten. According to the National Center for Education Statistics (NCES), a greater percentage of non-poor children ages three to five participated in center-based programs than poor children in the United States. In addition, a greater percentage of black and white children than Hispanic children participated in center based programs (NCES 2006). “In 2005, 66 percent of Black children and 59 percent of White children participated in such programs, compared with 43 percent of Hispanic children” (Indicator 2, NCES 2006a). White and Hispanic children who were not poor were more likely than their poor counterparts to participate in center-based programs in 2005. There was no difference found between poor and non-poor black children.

Latin America and the Caribbean lead the developing world in the provision of preschool education, according to UNESCO (2006). They report that half of the world’s countries have no early childhood care and education policy for children under age three. “Participation in preschool ranges from 62 percent in Latin America and the Caribbean compared to only 35 percent in the developing countries of East Asia and the Pacific, 32 percent in South and West Asia to 15 percent in the Arab States and 12 percent in Sub-Saharan Africa” (p. 1).

UNESCO (2006) reports further that there is universal preschool in most Western European countries. There was an enrollment decline in transition countries after the break up of the Soviet Union, but they are now recovering.

Primary and Secondary School . Just about every child of primary school age starts school in countries of the Organization of American States (OAS), however, far fewer actually complete their primary education. According to a UNESCO report (2005), Barbados and Chile are the only two countries out of twenty-seven with available data where more than 95 percent of enrolled children reach the final grade of primary school. The rate of completion of Mexico and Uruguay is about 90 percent. Less than 75 percent of primary school-aged children are expected to complete primary school by 2010 in Guatemala, Honduras, and Nicaragua. There are a large number of children who are starting school late and repeating grades.

According to the “Education for All Global Monitoring Report” (UNESCO 2005b), an average of 1.7 percent of primary students repeat a grade in the world’s richest countries; in the poorest, the average is 7.7 percent. In sub-Saharan Africa, the rate is nearly 20 percent. The report has not found any significant gender disparities at the primary level of education. At the secondary level they have found that boys and young men are disadvantaged with the exceptions of Bolivia, Guatemala, and Peru. Female enrollment rates are one-fifth higher than that of males in Dominican Republic, Saint Lucia, and Suriname.

There are eleven countries that have 75 percent of the appropriate age group enrolled in secondary education. Six additional countries—Belize, Bolivia, Peru, Trinidad, Tobago, and Uruguay—are close to achieving this level. However, secondary education enrollment dips below 65 percent in thirteen of the OAS countries, according to UNESCO Institute for Statistics (UIS) data (UNESCO 2006b).

In one out of four African countries, half of the children enrolled at the end of primary school do not continue their education in secondary school in the following year. According to the UIS (UNESCO 2006b), 85 percent of primary pupils make the transition in most countries of Europe, Asia, North and South America. According to the latest figures, Africa has the lowest primary school completion ratios in the world. Almost all of the countries in Europe have ratios exceeding 90 percent. Only eight (out of forty-five) African countries reach this level: Algeria, Botswana, Cape Verde, Egypt, Mauritius, Seychelles, South Africa, and Tunisia. In nineteen African countries, the ratios are 50 percent or lower. This means that at least every second child does not finish primary school.

According to the UIS, in one out of four African countries, half of the children who complete primary school do not transition to secondary school the following year (UNESCO, 2006b). Basically, few families can afford to continue sending their children to school. Girls are affected more severely than boys. In some countries, there are simply not enough spaces to accommodate eligible children, so the children are screened by public examinations and other methods.

A more accurate picture of the racial disparities in education internationally is given by an examination of the extent to which children are enrolled in upper as compared to lower secondary education. In some countries, lower secondary education (ages ten to fifteen) takes place in primary school and is treated as a part of basic education. Upper secondary education is more of a bridge to higher education and provides a curriculum that facilitates entry into the labor market.

The UIS (2005) documents that the lowest participation rates in upper secondary education are found in Africa, where the gross enrollment ratio is 45 percent. In half of the countries in Africa, the enrollment ratios are below 40 percent. This is compared with enrollment ratios reaching 100 percent in Europe; between 70 percent and 80 percent in the Americas; 40 percent in West Asia; and 48 percent in East Asia. In Africa, less than one-third of children (29%) are enrolled in upper secondary education.

Gender Disparities . According to Sperling (2005), an estimated 110 million children—60 percent of them girls—between the ages of six and eleven will not attend school this year. Another 150 million are likely to drop out before completing elementary school. He points out further that more than half of all girls in sub-Saharan Africa do not complete primary school. Only 17 percent are enrolled in secondary school. For girls in rural areas, taking Niger as an example, 12 percent were enrolled in primary school compared with 83 percent of girls living in the capital city.

Sperling notes that extremely impoverished parents often feel they need their girls’ labor for extra income or just to help with grueling chores, such as the long hours spent collecting water and firewood or caring for younger children. He calls for policies that reduce the costs and increase the benefits of sending girls to school so that parents will choose a better future for their children. He points out the need to “develop and widely implement policies that work to align the temporary interests of parents with the long term well-being of their girls and their societies” (p. 2).

High School Dropout Rate and Exit Exams . The high school dropout rate represents the percentage of sixteen-through twenty-four-year-olds who were out of school without a high school credential. According to NCES (2006b), 10 percent of young people fell into this category in 2004 in the United States. There was also a difference by race/ethnicity. The status dropout rate was lowest for whites and highest for Hispanics. They point out that “the gaps between the rates of Blacks and Whites and between Hispanics and Whites both decreased from 1972 to 2004, but there was no measurable change in the Hispanic-Black gap over this period” (Indicator 26, NCES 2006b).

The CDF (2004) points out that by the year 2009, half of all U.S. states will use a single standardized test as the sole means of determining whether a student will graduate. It has been well documented (Center for Education Policy 2004) that standardized testing has led to negative outcomes, particularly for low-income and minority students. By 2009, eight out of ten minority public school students (compared to seven out of ten public students in general) will be denied a high school diploma because they did not pass a high school exit exam. CDF advocates for using multiple indicators of achievement for making important decisions about child educational progress.

Misidentification of Minority Youth in Special Education . In the United States, the disproportionate assignment of minority children to special education services is a significant impediment in their journey through school. There is a significant correlation between assignment to special education and dropout, drug addiction, incarceration, and unemployment of children from particular racial/ethnic groups.

According to David Osher, Darren Woodruff, and Anthony E. Sims (2002), in twenty-nine states black students are twice as likely as white students to be labeled with an emotional or behavior disorder. Black students are more than twice as likely to be labeled as mentally retarded in thirty-nine states. Native American children are more than twice as likely to be labeled as mentally retarded in ten states.

James Conroy and Edward Fierros (2002) point out that once labeled as disabled, minority students are disproportionately excluded from regular education classrooms. Among students classified with disabilities, black students are twice as likely as whites to be educated in a separate setting where 60 percent of the day is spent out of school. black and Latino children are significantly less likely than white children to receive special education services as mainstreamed students in an “inclusive” classroom.

There is considerable evidence that minority students classified with disabilities receive harsher discipline than their white peers. Black students with disabilities were more than three times as likely as whites to be given short-term suspensions (Osher, et al. 2002). They were also nearly three times more likely than white students to be suspended for more than ten days. Black, Latino, and Native American youths with disabilities were 67 percent more likely than white children to be removed from the school on grounds of dangerousness. Once removed from the classroom, black and Latino youths with disabilities were between two and four times more likely to be educated in correctional facilities than white youths who were similarly removed. Additionally, studies show that the designation of racialized special education categories results in minority children in special education receiving unequal services.

Jean Crockett and James Kaufman (1999) document the harmfulness of this treatment on minority youths. Twice as many black students categorized as having emotional and behavioral disorders drop out of school (58.2%) compared to those who graduate from high school (27.5%). Further, they find that 75 percent of black youths with disabilities, compared to 47 percent of white youths with disabilities, are not employed two years out of school. They point out finally that 40 percent of black students with disabilities are arrested after leaving high school, compared to 27 percent of white youths with disabilities.

This entry highlighted racial disparities and the status of children from an international perspective. A profile of disparities related to race are described in the areas of socioeconomic status, health, infant mortality, prenatal care, hunger, violence, trends in refugee status, schooling and gender comparisons. The data reveals that in every category, children of color within the United States experience the worst child outcomes. Only Hispanic children exceed African Americans in school dropout rate. Likewise, the data suggests that the fortunes of children from Africa suffer in comparison to children on all other continents.

SEE ALSO Brazilian Racial Formations; Canadian Racial Formations; Caribbean Racial Formations; Cuban Racial Formations; Haitian Racial Formations; Social Problems; South African Racial Formations; Transnationalism; United Kingdom Racial Formations.

BIBLIOGRAPHY

Center on Education Policy. 2004. State High School Exit Exams: A Maturing Reform. Washington, DC: U.S. Government Printing Office.

Children’s Defense Fund. 2003. “Analysis: Number of Black Children in Extreme Poverty Hits Record High.” Available from http://www.childrensdefense.org.

———. 2004. “High School Exit Exams: Quick Facts.” Available from http://www.childrensdefense.org.

———. 2006. “Protect Children Not Guns.” Available from http://www.childrensdefense.org.

Conroy, James W., and Edward G. Fierros. 2002. “Double Jeopardy: An Exploration of Restrictiveness and Race in Special Education.” In Racial Inequity in Special Education, edited by Daniel J. Losen and Gary Orfield. Cambridge, MA: Harvard Education Press.

Crockett, Jean B., and James M. Kauffman. 1999. The Least Restrictive Environment: Its Origins and Interpretations in Special Education. Mahwah, NJ: Erlbaum.

Lillie-Blanton, Marsha, and Catherine Hoffman. 2005. “The Role of Health Insurance Coverage in Reducing Racial/Ethnic Disparities in Health Care.” Health Affairs 24 (2): 298–408.

Martin, Joyce A., Brady E. Hamilton, Paul D. Sutton, et al. 2003. “Births: Final Data for 2002.” National Vital Statistics Reports 52 (10): 1–116.

Matthews, T. J., Fay Menacker, and Marian F. MacDorman. 2004. “Infant Mortality Statistics from the 2002 Period Linked Birth/Infant Death Data Set.” National Vital Statistics Reports 53 (10): 1–32.

Nord, Mark, Margaret Andrews, and Steven Carlson. 2003. “Household Food Security in the United States, 2003.” Food Assistance and Nutrition Report FANRR42. Available from http://www.ers.usda.gov/publications/fanrr42/.

Osher, David, Darren Woodruff, and Anthony E. Sims. 2002. “Schools Make a Difference: The Overrepresentation of African-American Youth in Special Education and the Juvenile Justice System.” In Racial Inequity in Special Education, edited by Daniel J. Losen and Gary Orfield. Cambridge, MA: Harvard Education Press.

“Racial Division Still Permeates Key Areas of Life in U.S.: Census.” 2006. Jet Magazine 110 (22): 22.

Sherman, Arloc. 1997. Poverty Matters: The Cost of Child Poverty in America. Washington, DC: Children’s Defense Fund.

Sperling, Gene B. 2005. “The Case for Universal Basic Education for the World’s Poorest Boys and Girls.” Phi Delta Kappan, November. Available from http://www.cfr.org.

UNESCO. 2005a. “Educational Panorama 2005: Progressing Toward the Goals.” Available from http://www.uis.unesco.org.

———. 2005b. “Education for All Global Monitoring Report: The Quality Imperative.” Available from http://www.uis.unesco.org.

———. 2006a. “Early Childhood Care and Education the Forgotten Link.” Available from http://www.uis.unesco.org.

———. 2006b. “How Many Children in Africa Reach Secondary Education?” Available from http://www.uis.unesco.org.

UNESCO Institute for Statistics (UIS). 2005. The Global Education Digest. Available from http://www.uis.unesco.org.

United Nations High Commissioner for Refugees (UNHCR). 2004. “Trends in Unaccompanied and Separated Children

Seeking Asylum in Industrialized Countries, 2001–2003.” Available from http://www.unhcr.org.

———. 2006. “2005 Global Refugee Trends: Statistical Overview of Populations of Refugees, Asylum-Seekers, Internally Displaced Persons, Stateless Persons, and Other Persons of Concern to UNHR.” Available from http://www.unhcr.org.

United States Department of Education, National Center for Education Statistics. 2006a. “The Condition of Education 2006, Indicator 2” (NCES 2006–071). Available from http://nces.ed.gov.

———. 2006b. “The Condition of Education 2006, Indicator 26” (NCES 2006–071). Available from http://nces.ed.gov.

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Control and Prevention. “Web-based Injury Statistics Query and Reporting System (WISQARS).” Available at http://www.cdc.gov/ncipc/wisqars.

Janice E. Hale