Context: This study contributes to understanding how social and environmental factors are associated with health status and learning outcomes. It developed from a larger community-based participatory research study based in Columbus, Ohio. United States census data serves as rationale for this study, as it shows that adverse health outcomes are magnified in the vulnerable Columbus neighborhoods on the Near East Side when compared to Columbus city proper, Franklin County, and/or the state of Ohio. Environmental exposures and neighborhood factors influence these health outcomes. These exposures and factors include air pollution and sociodemographic characteristics, such as race and ethnicity, age, and income. It has also been shown that exposures to environmental stressors from the built, natural, and social environments can impact early childhood development. A community engagement model referred to as E6, Enhancing Environmental Endeavors via e-Equity, Education, and Empowerment was developed. Using this model, a multidisciplinary stakeholder team was established, and community engagement meetings were held to assess the needs of local community residents and identify potential environmental hazards associated with adverse health outcomes in those census tracts. This stakeholder team included Columbus Early Learning Centers, an early childhood education and care provider in Columbus, Ohio. Our community engagement efforts spanned from November 2019 through March 2020, as the Coronavirus disease (COVID-19) "shutdown" began. Since then, COVID-19 has disrupted life and learning for everyone, particularly children living in higher-risk communities. Current national standardized test data reveals that COVID-19 has contributed to greater learning loss than the typical summer learning loss in elementary aged children. This has been termed the "COVID-19 developmental slide". It is unknown how these trends persist in pre-kindergarten aged children as they do not take standardized tests. Without the reporting of standardized test scores, learning trajectories of pre-kindergarten cohorts are not being assessed to the same extent that elementary cohorts are. In collaboration with Columbus Early Learning Centers, a stakeholder on the team, a study was implemented to investigate the timely concern of COVID-19 and place-based associations on learning outcomes in the understudied pre-kindergarten demographic. This relationship provided a rare and unique opportunity to access test score data for a pre-kindergarten cohort.
Objective: The objectives of this study are to refine and establish a community engagement model and stakeholder team and to identify environmental and sociodemographic variables with evidence of effects on children's learning development and to investigate and model the associations of the COVID-19 developmental slide, environmental exposures, and neighborhood factors with test scores of children aged 3-5 years in a pre-kindergarten cohort in Columbus, Ohio.
Methods: A preliminary analysis was conducted for variable identification. The final variables for the model are percent of population who are low income, percent of population who are people of color, percent of population with less than a high school education, percent of population unemployed, percent of population under 5-yrs old, percent of population over 64-years old, percent population in linguistic isolation, percent pre-1960 housing, concentration of particulate matter of 2.5 micrometers or less in diameter (PM2.5), ozone, diesel particulate matter, proximity to National Priorities List superfund sites, proximity to facilities with risk management plans, hazardous waste proximity, number of underground storage tanks in block group, wastewater discharge, transportation density, toxic chemical release (EPA Risk-Screening Environmental Indicators model), impervious surfaces, percent tree canopy, and over 80th percentile Environmental Justice Index. A local pre-kindergarten cohort was used to explore reading and mathematics scores across the COVID-19 pandemic. The COVID-19 pandemic spanned from March 11, 2020 to May 11, 2023. Correlations and linear mixed regression modeling of the environmental and neighborhood variables and reading and mathematics outcomes were carried out for this pre-kindergarten cohort.
Results: A significant difference was found in pre-COVID-19 and post-COVID-19 average reading test scores but not in pre-COVID-19 and post-COVID-19 average mathematics scores for this pre-kindergarten cohort. Clustering of low reading scores was discovered near one CELC location. A mixed linear regression model revealed significant associations between reading and mathematics test scores and environmental and sociodemographic variables. It was found that there was a significant difference in pre-COVID-19 and post-COVID-19 reading scores. Environmental and sociodemographic variables were statistically significantly associated with reading and mathematics scores.
Discussion: This study adds COVID-19 and place-based knowledge to the literature for learning outcomes in pre-kindergarten children. It serves as a unique cohort for investigating these associations. It has brought to light limitations in conducting research within the early childhood space due to difficulties with inconsistent record keeping and data collection and inconsistent assessment administration within educational institutions. Thus, a major takeaway from this study is informing better practices for data management at the institutional level for early childhood environmental and COVID-19 associated outcomes to be explored more robustly and on a larger scale. This study interrogated research questions that can inform policy makers to promote public health and early childhood education initiatives. This research serves as a launchpad for future longitudinal environmental monitoring studies to investigate the effects of learning loss, as seen during the COVID-19 syndemic, and environmental exposures and neighborhood factors influence learning outcomes.