Reduce the likelihood of underrepresented high school students being admitted to selective colleges increases their risk of engages in unhealthy behaviors

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College affirmative action bans may adversely affect the health of underrepresented minority high school students, according to the results of a new study from researchers at Penn Medicine.

Between 1996 and 2013, nine U.S. states banned consideration of race and ethnicity in college admissions.

A new study in PLOS Medicine shows that the action bans had unanticipated effects, specifically resulting in increased rates of smoking among minority high school students.

The researchers also found evidence to suggest these effects could persist, as these students were also more likely to smoke into young adulthood compared to those who lived in states where an affirmative action ban was not enacted.

“We know that affirmative action bans reduce the likelihood of underrepresented high school students being admitted to selective colleges,” said lead author Atheendar Venkataramani, MD, Ph.D., an assistant professor of Medicine and Medical Ethics and Health Policy at in the Perelman School of Medicine at the University of Pennsylvania.

“What this study shows us is that reducing their chances to attend a top college – and potentially undermining their expectations of upward mobility, more generally -may also increase their risk of engaging in unhealthy behaviors, such as smoking or excessive alcohol use.”

The researchers analyzed data from the 1991-2015 U.S. National Youth Risk Behavior Survey to investigate health risk behaviors (tobacco and alcohol use) that persisted for more than 30 days among underrepresented minority teenagers, including those who self-reported their race as “Black” or who self-reported their ethnicity as “Hispanic” or “Native American.”

The researchers compared changes in self-reported cigarette and alcohol use among over 35,000 students residing in states enacting bans versus those residing in states without bans.

Currently, Arizona, California, Florida, Michigan, Nebraska, New Hampshire, Oklahoma, and Texas have bans on race-based affirmative action in college admissions.

Overall, self-reported rates of smoking among underrepresented minority 11th and 12th graders increased by 3.8 percentage points in the same years each of the states discussed, passed, and implemented the bans, compared to those living in states with no bans.

Though the findings were not statistically significant, the researchers also found apparent increases among underrepresented minority students in rates of alcohol use (5.9 percent), and binge drinking (3.5 percent).

In a separate analysis, the researchers analyzed data from the 1992-2015 Tobacco Use Supplement to the Current Population Survey to assess whether underrepresented minority young adults who were exposed to affirmative action bans during their later high school years had continued smoking cigarettes into young adulthood (ages of 19 to 30 years).

The researchers found that 1.8 percent more young adults who were in high school at the time an affirmative action ban was enacted in their state still smoked, compared to those living in states with no ban.

In contrast to their findings among underrepresented minority students, the researchers reported no change in smoking or alcohol use rates among white high schoolers and young adults in response to the affirmative action bans.

While the underlying mechanisms behind the health risk behaviors deserve further study, the authors point to several potential factors that could explain the spike in rates.

Affirmative action bans may signal to underrepresented minority teenagers that structural racism persists or that they are less valued, the authors said.

Increased competition for limited slots and academic stress among underrepresented minority students could also play a role.

“The findings align with a growing evidence base demonstrating that social policy is health policy,” said senior author Alexander C. Tsai, MD, Ph.D., an associate professor of Psychiatry at Massachusetts General Hospital and Harvard Medical School.

“In this specific case, our study shows that economic opportunity can have a meaningful impact on shaping population health.”

Venkataramani added, “when we evaluate the merits of social and economic policies, we tend to focus on social and economic benefits.

But ones’ potential health consequences should be considered, too.”


College and Course Counseling

College and course counseling activities include providing students with pertinent information about the college experience, guidance on course taking, assisting with the college search, application, and selection processes.

Contextual skills and awareness are a key component to students’ college preparation and readiness and can include knowledge of collegiate academic, social, and cultural expectations and norms, in addition to knowledge of the requirements necessary to garner admission to a postsecondary institution (Conley, 2007).

Research has consistently shown that risk factors such as low socioeconomic status negatively influence students’ access to this kind of information about postsecondary enrollment and experiences, and that limited access constrains students’ search, choice, and selection processes (Cabrera & La Nasa, 2000).

For example, the college-application process is complex, but it can be a particularly challenging task for at-risk students (Hoxby & Avery, 2012Roderick et al., 2008).

Research indicates that relative to their peers, at-risk students are less likely to receive college-application help from their parents (Choy, 2001Choy, Horn, Nuñez, & Chen, 2000).

However, some students report that school-based resources are helpful for encouraging the completion of necessary college-going tasks such as submitting applications (Farmer-Hinton, 2008).

School counselors are one key resource available to students throughout the college-going process.

The literature is clear on their potential to positively influence college enrollment, and students commonly report having conversations with school counselors about the college-going process, including financial aid and academic planning and alignment (Horn, Chen, & Chapman, 2003). McDonough (20042005) argues that school counselors are the single most important school-based professional for improving college-going rates.

Counselors often guide students through the course selection process as enrollment in higher level math and science classes in high school is a critical component of college matriculation (Riegle-Crumb, 2006).

They are able to affect college information sharing activities, communicate with parents regarding their place in the college-going process, support academic preparation, assist student college choice, and play an instrumental role in sharing financial aid information (Hossler, Schmidt, & Vesper, 1999McDonough, 2005).

Even though research shows counselors’ ability to influence college-going, student access to school counselors can be limited.

School counselors must meet multiple demands outside of college counseling, including offering personal and behavioral counseling, attendance obligations, scheduling, and administering testing processes (Perna et al., 2008).

Additionally, structural constraints, such as high student-to-counselor ratios, as well as variations across and within high schools resulting from external federal, state, and local policy pressures also hinder school counselors’ ability to offer robust college-going support services (McDonough, 2005Perna et al.; 2008).

Further, while college counseling is widely understood as an obligation of school counselors, school counselor degree and certification programs often lack specific training in the area (McDonough, 2005).

Academic Tutoring

At-risk students are less academically prepared for postsecondary education than their peers (Hossler, Schmidt, & Vesper, 1999Perna, 2000).

As a result, many college outreach programs (79%) report having a goal to improve academic skills (Educational Policy Institute, 2012).

They offer a wide array of services ranging from skill-based supports such as study skills training and test-taking skills to instruction in math, science, reading, and writing (Educational Policy Institute, 2012).

Although some evidence suggests that these programs are effective at improving students’ academic achievement (Perna, 2002), it is unclear whether this kind of programming is effective at increasing college-going.

Further, even less is known about individual components of academic-oriented college outreach programs and their effect on long-term student college-going outcomes.

Financial Aid Assistance

College outreach programs often use financial aid assistance as a strategy to promote college-going.

This includes providing students with information about college costs, helping students and families complete the Free Application for Federal Student Aid (FAFSA), and providing support for scholarship applications awarded by institutions, organizations, foundations, and communities.

Accurate and accessible financial aid information is a key area of college outreach because the college financial aid process is complex and can be especially difficult for at-risk students.

Research suggests that students from low income families overestimate college costs, particularly at public colleges and universities, and their families are less aware of college costs than the families of their higher income counterparts (Avery & Hoxby, 2004Bettinger, Long, Oreopoulos, & Sanbonmatsu, 2012).

In addition to having less information about what college costs, low income students may find out about financial aid awards too late in the college-choice process (Heller, 2006).

Further, while low income families display less knowledge of college costs and payment options, they face a financial aid process that is complex and unfriendly to the neediest students.

In a review of the federal aid system, the Advisory Committee on Student Financial Aid found that many students find the intricacies of the financial aid process overwhelming, and that the financial aid process can serve to discourage rather than encourage access to postsecondary institutions (ACSFA, 2005).

This complex system results in many Pell Grant-eligible students (more than 10%) failing to complete necessary financial aid forms. There is some evidence that providing information on college costs and FAFSA completion assistance can improve FAFSA completion rates and college-going for low-income students.

 Bettinger et al. (2012) found that providing low income families with assistance filing taxes and completing the FAFSA, along with information about college costs, increased the rate by which students complete 2 years of college by 8 percentage points.


More information: Venkataramani AS, Cook E, O’Brien RL, Kawachi I, Jena AB, Tsai AC (2019) College affirmative action bans and smoking and alcohol use among underrepresented minority adolescents in the United States: A difference-in-differences study. PLoS Med 16(6): e1002821. doi.org/10.1371/journal.pmed.1002821

Journal information: PLoS Medicine
Provided by Perelman School of Medicine at the University of Pennsylvania

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