Universal Screening of Hunger, Tiredness, and Sickness: Racial/Ethnic Disparities and Implications for Kindergarten Readiness

• In Event: Early Childhood Research: Lessons From a Research-Practice Partnership

Abstract

The research community has long endeavored to better understand the determinants of racial/ethnic disparities in kindergarten readiness, which is a strong predictor of students’ future educational and life outcomes. Maternal health conditions and chronic diseases have been estimated to account for one quarter of racial/ethnic disparities in kindergarten readiness between Black and White children (Currie, 2005). However, little scholarship to date has explored how common, often overlooked health concerns like being hungry, tired, and sick during the school day relate to kindergarten readiness in large, racially/ethnically diverse samples.

Similarly interested in the relevance of students’ health for their kindergarten readiness, our school district partners began collecting teachers’ reports of three child health indicators––hunger, tiredness, and sickness––on their annual district-wide kindergarten readiness screener in 2017. Leveraging this unique data, this study investigated associations between students’ health concerns and academic and social-emotional skills at kindergarten entry. We additionally examined whether these health concerns partially explained longstanding racial/ethnic disparities in kindergarten readiness in our partner district.

The sample consisted of the entire population of 12,423 kindergarteners in the 2017–2018, 2018–2019, and 2019–2020 school years in our large Northern Californian partner district. Kindergarten teachers reported on students' health and readiness skills during the first six weeks of school. Health questions included whether students indicated they were hungry, appeared tired, or were sick in class. School readiness skills included three directly-assessed literacy items (e.g., letter recognition; = .78), three directly-assessed cognitive/motor items (e.g., counting to 20; = .73), and three teacher-observed social-emotional items (e.g., curiosity; = .75). Student demographic characteristics obtained from school administrative records were included as covariates.

We found that teacher-reported student hunger, tiredness, and sickness were each uniquely negatively associated with students’ academic and social-emotional kindergarten readiness skills. Heath concerns were common: approximately one in four students was identified by teachers as having at least one health concern. Nevertheless, these concerns were not evenly distributed across race/ethnicity. Specifically, relative to White students, Black and Latinx students were more likely to have health concerns, and Asian American students were less likely to have health concerns. Further, racial/ethnic disparities in hunger, tiredness, and sickness partially accounted for racial/ethnic disparities in kindergarten readiness skills, especially between Black and White students.

Our study suggests that teachers’ reports of students’ health can serve as meaningful indicators of early academic and social-emotional risk and shed light on racial/ethnic kindergarten readiness disparities. These findings are relevant for school practitioners, policymakers, and researchers alike. Within our partner district, results have been incorporated into teacher trainings to catalyze discussions about strategies to address students’ health-related needs in the classroom. From a policy perspective, our findings underscore the importance of childhood health for efforts to redress racial/ethnic educational inequality in students’ youngest years. For scholars and school administrators, our study demonstrates the feasibility and value of incorporating health measures into widely used kindergarten readiness screeners. School-based universal health screening holds promise for enhancing equity at the critical transition to kindergarten.

Authors

• Lily Steyer, Stanford University

• Carrie Townley Flores, Rapid Online Assessment of Reading (ROAR)

• Michael Sulik, Stanford University

• Jelena Obradovic, Stanford University