Aug 24, 2017

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The Social Determinants of Education: Reflections of a Fourth-Year Teacher

Editor’s note: With school going back in session, this is the first in a three-part series about challenges in low-income schools by Renée Swick-Ziller, a Denver English teacher. Swick-Ziller is a native of Pueblo and a proud alumna of the University of Northern Colorado.

My first year of teaching was 7th grade writing in Denver’s Montbello neighborhood. I didn’t think I had what it took to teach in a low-income, urban neighborhood, but as a first-year-teacher desperate for experience, I dove-in. I had memorized textbook techniques for increasing student engagement in tired classrooms and ideological philosophies about student learning. I was excited to finally be a teacher.

Upon entering the field, the all-important, high-stakes PARCC test, which is being phased out of the state in favor of an abbreviated, updated exam, was my chance to “quantify” how I was doing as a teacher. This standardized test, used to measure student achievement and growth, contributes to the school’s overall rating that many parents consider when choosing a school for their child. These scores were also a serious factor in whether or not a school would face possible closure or remain open. Needless to say, the test results are a big deal and extremely public — and factor into half of my pay raise every year. This test is “personal” to my students, my school, my pride and my income.

That spring, after hours of training, a school year of preparation, and some fever dreams the night before, the first session of PARCC testing began. I scanned the room assessing the students’ focus. What I saw had little to do with the test and more to do with what I had learned about them throughout the year.

Rather than hearing the scribbles of pencils, I saw heads laying on desks deep in sleep. Other students fiddled with scrap pieces of paper and some were staring at blank walls. While most would say these behaviors are not evidence of academically engaged students, I knew that the kids who were sleeping did so because they had slept on a friend or an aunt’s couch the night before. One student, who fiddled with her scrap piece of paper, was struggling to focus because she was hungry and came in late missing breakfast in the classroom. She would need to wait for lunch in order to receive her first meal that day. One student gazing at a blank wall was consumed with fear because her mom and dad were recently deported to El Salvador. She knew the dangers to which they were returning, and didn’t know what was next for herself. When the test results of students were published, their performance and growth was disappointing. Because of the school’s low performance, I earned the minimum pay raise, saw more administrators and teachers leave the school, and was not assured whether or not the school would even exist the following year. The struggles I saw in the classroom that day were so much bigger than a test result, and frankly, so much bigger than my toolbox of teaching tricks.

I am now entering my fourth year of teaching, and the stories of students continue to weigh heavy on my heart. I find myself coming home every night not thinking about how I can improve my lesson plans, but thinking about how I can connect families with affordable immigration lawyers or Google organizations that can help direct families to meals during summers when food at school is no longer an option.

I became a teacher because I felt that education was the solution to so many problems, but I’ve continued to teach under the realization that what students need is not always found in a school. The pressures of this reality have dominated conversations at my job. Our building provides multiple meals a day, counseling for mental health, social workers advocating and working with families, and registered nurses for physical health concerns. That doesn’t even cover the traditional academic and social offerings provided by any school. Despite all of these supports, our communities still struggle.

This summer, I started knocking on the doors of policy groups in Denver. I know that there is work being done to address poverty in our state, but to be honest I didn’t know exactly what they were doing. All I knew is that while education is a key factor in transforming neighborhoods, it is not capable of being the only antidote. There needs to be a holistic approach to the issues at hand. When the school day is done and summer break kicks off the lives of our most vulnerable do not pause, and when the morning bell rings and class begins, the concerns of our communities are not set aside in the closed lockers of students. They are everywhere I look when I stand in front of the chalkboard.

I reached out to the Colorado Center on Law and Policy because I know that change will not come to our communities if we only focus on a single issue. We have to problem-solve a multitude of struggles that our neighborhoods face and acknowledge that no solution is more important than the next. Rather, it is the collection of efforts and their effects on each other.

As this next school year approaches, I am filled with excitement to meet the students that will walk through my door. What makes them laugh? What makes them angry? What makes them kids? What makes them struggle will inevitably be revealed, but it’s the perseverance they show that motivates me to wake up on weekday mornings and unlock our classroom door.

— By Renée Swick-Ziller

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To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.


Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.


Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.


Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.