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Education and Community Health

By Sarah Moore on August 15th, 2019

A personal reflection on the relationship between education and place.

Education was my ticket out of poverty. More accurately, tickets, plural. For me, “education” was not a one-way trip with a degree at the end. It was instead a complex landscape of relationships, expectations, and opportunities that each subtly redirected the path of my life so that it pointed toward health and wellbeing.

Education is a social determinant of health, and one of the strongest indicators of life expectancy. College graduates live between five to 10 years longer than people who don’t finish high school.1, 2 And although the average health of Americans has improved in recent decades, the benefits were largely experienced by those who are most educated.3 In an issue brief on the relationship between education and health, the Robert Wood Johnson Foundation outlines three key drivers behind this relationship:

  • Education creates opportunities for better health by increasing the likelihood that a person will find a better job with benefits like health insurance and sick leave, as well as higher pay. Higher pay makes it possible to live in neighborhoods with lower crime, better schools, and more access to social services, healthy food, and opportunities to be active.
  • Poor health puts educational attainment at risk. When kids are hungry or have chronic illnesses like asthma, they don’t perform as well in school and are absent more often. This jeopardizes their academic performance over time.
  • Life experiences, especially in early childhood, affect both health and education. Conditions like socioeconomic status, housing, and social interactions can cause stress, illness, and reduced access to resources that support health and academic success.

My mother’s decision to become a teacher was an important turning point in my childhood, and it taught me to associate education with opportunity. While I was in middle school, she was working toward a bachelor’s degree as a single mother and as the first person in our family to attend college. Some nights, we both stayed up late completing homework. It sounds a bit romantic, but it wasn’t. My mother, younger brother, and I shared a one-bedroom apartment, which was all we could afford, with bunk beds on one side of the bedroom and her bed on the other. We lived in rural Georgia in an under-funded school district. The older siblings of some of my classmates had already been to jail. It was the kind of place where your best bet for a bright future was to keep your head down and stay out of trouble. But my mom gave us a sense of promise: after she finished school, things would get better.

And they did. My mom graduated and got a teaching job. She also met and married my step-dad, which prompted us to move to a new school district in South Carolina that was one of the best in the state. Two of my teachers had PhDs. Many of my new friends had parents who were also teachers or professors at the local university. None of my friends’ siblings had been to jail. To this day, my high school art teacher is a dear friend: when I broke down during my first year of graduate school, thinking that I couldn’t handle the stress, I called her. “You cannot quit,” she said. “You will finish this, and you’ll be glad you did.”

To be embedded in a community like that was life-altering. I was the same person, the same student, but because our family had moved, I suddenly found myself supported within a landscape of opportunity that made it easy to succeed.

I got lucky. But the fact that a golden ticket to a healthy ZIP code can mean a profound difference in years and quality of life reveals just how much work we still have to achieve the American “mission statement”: equality for all people. It also underscores how important it is to think about health in the context of place. Places shape the social determinants of health: built and natural environments, social and community contexts, access to healthcare, economic opportunity, and education.

At its best, the education system offers a pathway out of poverty. At its worst, it entrenches (or exacerbates) existing disparities. Because educational opportunity is closely tied to income and neighborhood, enduring challenges like income inequality and residential segregation converge in the classroom. And because educational opportunity is also closely linked with quality and length of life, an inequitable education system is an inherently unjust one.

A 2019 report from EdBuild, a nonprofit organization focused on fair funding of public schools, found that in 2016, overwhelmingly white school districts received $23 billion more in state and local funding than nonwhite districts despite serving similar numbers of students. The difference came down to school districts. The report noted, “Their borders can be used to either help remedy or further entrench a deep history of housing segregation. We can draw lines that equalize inherent disparities, or we can allow communities to isolate themselves behind unseen walls of wealth and prosperity—ensuring privilege remains solely within the grasp of the lucky few.”

Another report from EdBuild offers specific examples of how wealthy white neighborhoods across the country are creating their own school districts from scratch. How is this possible in a post-Brown vs. Board of Education nation? An overview of the report from Vox explains that a lesser-known ruling offered a loophole that not only enables ongoing segregation efforts, but may even have contributed to white flight from cities.

In short, inequitable places result in inequitable educational opportunities, which contribute to inequitable health outcomes.

That’s why our work at Healthy Places by Design is community-led and equity-driven, rather than tied to a specific content area or strategy. Since 2002, our team has helped more than 150 communities advance locally-driven action to improve health and wellbeing. The strategies that communities have implemented are an A-Z adventure in inspiring change, including active transportation, bike lanes, clinic-community collaboration, community gardens, farmers’ markets, food retail policies, joint-use agreements, parks, urban agriculture, and zoning updates. And, increasingly, we’ve witnessed local leaders implement “upstream” strategies that address social determinants of health like education, housing, and social inclusion.

John Muir wrote, “When we try to pick out anything by itself, we find it hitched to everything else in the Universe." He was talking about the interconnectedness of nature, but the longer I work within the healthy communities field, the more often this line echoes in my head. When we try to pick out any issue by itself, we find it hitched to health and to the all the places where people spend their lives.

Sarah Moore


Artist and advocate for natural places.