The need to improve resource access and availability is vital, especially when addressing circumstances for which there is an additional burden placed upon children resulting from factors out of their control. Children are especially vulnerable to the outcomes that appear as a direct result of the socioeconomic status (SES) and/or income level had by their family. One such example presents itself even before children are enrolled in formal education, demonstrated by the literacy gap among youth of varying levels of SES (American Psychological Association, 2017). SES levels have the ability to steer the direction of an individual’s lifepath; this requires immediate action be taken to identify, prevent, and hopefully eliminate the growing education, resource, and opportunity gaps that are often seen.
The well-being and lives of individuals, and the trajectory they take show considerable variability—this is the result of the considerable disparities, inequities, and inequalities experienced among different groups of people and demonstrates the lasting effect of differences in socio-economic status (i.e., house-hold income). This is a not just a local or even national issue, but rather a global one. It is proven that social class significantly affects a number of different areas within a child’s life including their education attainment, career aspirations, cognitive capability, familial resources, and level of health and income incurred as adults (APA, 2017). Effects on children growing up with low SES include unequal resource distribution which has been shown to result in lower educational achievement, lower quality of life, negative psychological health outcomes, and increased morbidity and mortality (APA, 2010). The needs of low-income children are myriad and include improved quality of early childhood education (ECE); better teachers, schools, and education systems; cleaner and safer neighborhoods and environments; food security and healthy food options; access to basic needs (e.g., shelter, food, clothes); financial stability, increased wages/incomes, better employment opportunities; and access to quality healthcare (APA, 2010; APA 2017). A study on increasing the resources available to low-income parents found that health education alone was not enough to improve outcomes affecting their children’s health, but rather, a combination of health education, policy advocacy, and social action challenging the political and socioeconomic conditions that negatively affect health are necessary to produce effective change (Williamson & Drummond, 2000). A report by Heather & Yang (2018) discussed factors that have a role in the events and circumstances that lead children to be raised by low-income families, such as parental employment and education level, race/ethnicity, and economic insecurity—all health-related needs (e.g., public, social, economic) that are difficult to overcome have the ability to trap families in low SES (i.e., the poverty trap).
According to the National Center for Education Statistics (NCES) (2018), high school dropout rates were 9.7% for youths in the lowest quartile of family income and 2.6% for youth from the highest quartile of family income. The highest and lowest quartiles are separated by a 7.0% gap. Moving a step further, in 2016, 65.4% of low-income students enrolled in college after graduating high school compared to 82.5% of high-income students (NCES, 2017). As demonstrated by the NCES data, there was a noticeable difference in the high school graduation rates and proportions enrolled in post-secondary education between youth from the lowest and highest income brackets. School and community-based Initiatives are popular and critically in need of policies when addressing the education, learning, and graduation gaps between social classes (Garcia & Weiss, 2017). Examples of school and community-level Initiatives include Communities in Schools, OneGoal, and The Education Trust (CIS, n.d.; Ed Trust, n.d.; OneGoal, n.d.). Federal Initiatives such as Head Start, and Title I offer grants from the US government to agencies that implement equal education Initiatives in their local communities (Head Start, 2019; Title I, 2018). An emerging practice that has gained noticeable popularity since the mid 2000’s uses the idea of improving enrollment and quality of early childhood education, in hopes of bridging the learning gap early—before the SES impact on child performance has been established (Magnuson & Duncan, 2016; Nelson, 2006). All Initiatives and approaches described in this paragraph align with the Boys and Girls Club of America’s, Boys and Girls Club of Hawaii’s, and What’s Next’s missions and visions, which are to encourage youth—especially those who need a bit more help (e.g., low SES youth)—to graduate high school on time with a plan for their future, and to leave the Initiative possessing the knowledge and skills needed to fulfil their full potential in adolescence and adulthood (BGCA, n.d.; BGCH, n.d.a.).
The Boys and Girls Club of Hawaii (BGCH) is an organization that provides school-aged children with resources, care, activities, education, and more. The Hawaii chapter (BGCH) of the Boys and Girls Club of America (BGCA) was founded in 1976 in just a single room which has since expanded into nine chapters spanning across Oahu and Kauai (BGCH, 2020b). The mission of the BGCH is to enable all young people (youth and adolescents) to be the best versions of themselves by gaining the skills necessary to be caring, productive, and responsible citizens who fulfill their true potential (BGCH, 2020e). The BGCH’s also aims to give these children a memorable Club-Experience that encourages character growth, future planning, and other important life lessons these children will assimilate and keep with them forever (BGCH, 2020e). The BGCH offers a variety of plans—both local and domestic—to club youth that cover a variety of topics including character and leadership development, education and career development, sports, fitness, and recreation, arts and culture, and health and life skills (BGCH, 2020d).
The BGCH represents a public health agency in multiple aspects. First, as a non-profit it represents a public health setting in itself. This organization also identifies, investigates, and manages the differing Social Determinants of Health (SDOH) affecting communities and children. Finally, the BGCH focuses on the pursuit of health education and promotion which is a very prominent and important public health topic. This organization serves as a suitable internship site as the project being conducted is a public and community health-based Initiative. Allowing this agency to serve as a graduate project site will allow education to be gained from an organization with first-hand experience in designing a public health-based Initiative. This agency has also agreed to allow me to design a process evaluation plan with the potential to be implemented as part of the What’s Next Initiative. The BGCH is the perfect candidate for an internship site and has the potential to offer exceptional public health related education and experience.
The Boys and Girls Club of Hawaii focuses on setting children up for success while teaching them important lessons and character traits that promote healthy behaviors and lifestyle choices. This organization focuses on creating equal opportunities for children from lower SES and provides them with resources, education, and experiences equivalent to those experienced by other children. This nonprofit organization identifies and analyzes the SDOH present in different communities and environments and works to raise awareness and arrange solutions to reduce the effects of inequality. In this internship with the Boys and Girls Club of Hawaii, I will be working as part of a team designing the What’s Next Initiative, which recognizes the hurdles from SDOH that children from low-income households and other limiting factors experience and creates a plan to work alongside these children to progress health education and promotion. This fits my career goals because I want to work in the nonprofit sector, preferably doing something that involves helping to reduce the differences in SDOH between different vulnerable and marginalized communities, such as working on/in a community-health Initiative/project.
Since it first opened over 40 years ago, the BGCH has touched the lives of over thousands of children ages 7-17 years through the Hawaii chapter alone (BGCH, 2019). The July 2020 Dashboard Report/Board Meeting tallied the number of youth and broke down BGCH’s service population into different demographics including age, sex, race, and income (BGCH, 2020c). The board meeting had membership statistics stating that in the month of July [2020] alone, the BGCH had served 12,231 youth of their community, even with the shift towards online/computer interaction (BGCH, 2020e). The age category was split into two groups with 42% of BGCH youth being teens (13-18 years) and 58% youth (5-12 years); 43% of youth were considered female with 57% considered male; a graph showing the diversity of BGCH youth ranked ethnicities from most to least common: 53% were Native Hawaiian (NH)/Part NH, 22% were Asian, 12% were White, 8% were Other Pacific Islander, 3% were Black or African American, and the two least common ethnicities both tallied at 1% were American Indian or Alaska Native (AI/AN) and Other. Income [household] was broken down into five categories: extremely low (19%), very low (24%), low (18%), other (21%), and “care not to provide” (18%) (BGCH, 2020e). According to the BGCH website, 83% of club children come from low to very-low-income families. Other statistics include, one in five Hawaii youth will not graduate on time with their class, 10% of high school students in Hawaii have attempted suicide, and 25% of children are from single-parent households (BGCH, 2020f).
As the BGCH is a non-profit organization, it requires special needs and capacities to keep things running smoothly and efficiently. In the 40 years since the BGCH was founded, its capacity has increased to serve over 14,000 children (BGCH, 2019). There are multiple routes a non-profit can take to increase its capacity; such methods may include: grants, fundraisers, volunteers, and online-based or in-person training. For the past three years, the BGCH has applied for a federally based grant, the purpose stated that the funds were to be used for repairing the Clubhouses and making them safer as to increase the organization’s capacity, and increase the number of youths, activities, and resources it can provide (BGCH, 2019). The health-related needs of the BGCH include more funding and repairs to furniture, wiring, roofs, entrances, utilities, and security devices for multiple Clubhouses (BGCH, 2019).
Each member of the BGCH has their own set of factors and social determinants that create a unique situation. These determinants impact how individuals experience health status, education, and promotion. These factors/determinants can vary by household, environment, education, and more. Some examples include income level, gender inequity, educational opportunities, early childhood experiences, food insecurity, and access to housing (NEJM Catalyst, 2017). The Boys and Girls Club is a very popular, well-known, non-profit organization with no shortage of corporate and clubhouse partners. These partners range from local to national companies and from large corporations to small businesses. Some of their corporate partners include Disney, Buffalo Wild Wings, Hawaii Medical Service Association (HMSA), and Microsoft; some clubhouse partners include Hawaiian Brian’s, Kamehameha Schools, the NFL, and Ross (BGCH, 2020a).
Trying to find research and data on populations similar to the organization’s service population at a state or national level has proved difficult as there is a significant absence or gap in research on low-income children in Hawaii as well as research on the local or national low-income Native Hawaiian and Pacific Islander (NHPI) population. For an already disadvantaged population, representation is vital—research regarding the severity, extent, and potential consequences from the public health issue remain unknown. This population also has different approaches to its state versus national efforts. For example, a result of the colonial school system put in place following the illegal annexation of Hawaii by the United States in 1898 resulted in cultural disparities between its Native Hawaiian and Western-introduced populations (Kukahiko et al., 2020). This created considerable levels of cultural dissonance resulting in inequitable outcomes for NHPI students across multiple academic and disciplinary areas (e.g., suspension rates, graduation rates, proficiency) that are still experienced to this day (Kukahiko et al., 2020). National statistics obtained by the American Community Survey (ACS) (2016) on the percentage of low-income children (under 18 years) broken down by race/ethnicity found that of the 19% of children living in poverty, Pacific Islanders made up the third largest demographic at 23% (NCES, 2019). Considering the large number of individuals affected within this population (as denoted through the previous statistic), the lack of research and resources from federal and national organizations is concerning and requires extensive attention going forward. The BGCH acknowledges the inequalities present across different SES and aims its efforts at addressing the education and learning gaps across these income levels by providing its youth with education, skills, and experience to lead successful lives.