Fiscella Kevin, Kitzman Harriet
University of Rochester, 1381 South Ave, Rochester, NY 14620, USA.
Pediatrics. 2009 Mar;123(3):1073-80. doi: 10.1542/peds.2008-0533.
Recent data suggest that that the United States is failing to make significant progress toward the Healthy People 2010 goal of eliminating health disparities. One missing element from the US strategy for achieving this goal is a focus on gaps in child development and achievement. Academic achievement and education seem to be critical determinants of health across the life span and disparities in one contribute to disparities in the other. Despite these linkages, national policy treats child education and health as separate. Landmark education legislation, the No Child Left Behind Act of 2001, is due for Congressional reauthorization. It seeks to eliminate gaps in academic child achievement by 2014. It does so by introducing accountability for states, school districts, and schools. In this special article, we review health disparities and contributors to child achievement gaps. We review changes in achievement gaps over time and potential contributors to the limited success of the No Child Left Behind Act of 2001, including its unfunded mandates and unfounded assumptions. We conclude with key reforms, which include addressing gaps in child school readiness through adequate investment in child health and early education and reductions in child poverty; closing the gap in child achievement by ensuring equity in school accountability standards; and, importantly, ensuring equity in school funding so that resources are allocated on the basis of the needs of the students. This will ensure that schools, particularly those serving large numbers of poor and minority children, have the resources necessary to promote optimal learning.
近期数据显示,美国在实现《健康人民2010》消除健康差距目标方面未能取得显著进展。美国实现这一目标的战略中缺少的一个要素是对儿童发展和成就差距的关注。学业成就和教育似乎是贯穿一生的健康的关键决定因素,其中一个方面的差距会导致另一个方面的差距。尽管存在这些联系,但国家政策将儿童教育和健康视为 separate。具有里程碑意义的教育立法《2001年不让一个孩子掉队法案》即将由国会重新授权。该法案旨在到2014年消除儿童学业成就方面的差距。它通过对各州、学区和学校引入问责制来实现这一目标。在这篇专题文章中,我们回顾了健康差距以及儿童成就差距的影响因素。我们回顾了成就差距随时间的变化以及《2001年不让一个孩子掉队法案》取得有限成功的潜在影响因素,包括其无资金支持的任务规定和无根据的假设。我们最后提出了关键改革措施,包括通过对儿童健康和早期教育进行充分投资以及减少儿童贫困来解决儿童入学准备方面的差距;通过确保学校问责标准的公平性来缩小儿童成就方面的差距;以及重要的是,确保学校资金的公平性,以便根据学生的需求分配资源。这将确保学校,特别是那些为大量贫困和少数族裔儿童服务的学校,拥有促进最佳学习所需的资源。