CSHE Bulletin

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For our January issue on racism as a public health crisis in schools, visit the Bulletin archive.


February: Reconnecting Youth — Public Health Imperative

In 2019, more than 4 million youth in the US ages 16 to 24 were out of school and out of work — a statistic that should ring alarm bells for the public health community. After just six months of disconnection, these youth are three times as likely to suffer from depression than their connected peers; they are also one sixth as likely to obtain a high school or college degree, hindering lifetime earnings, heightening reliance on health and income security entitlements and increasing the risk of premature death from preventable conditions such as high blood pressure, diabetes and stroke. Although significant progress was achieved over the last decade in reducing the youth disconnection rate, the COVID-19 pandemic has reversed this trend with as many as 9 million youth disconnected in May 2020.

Elsewhere in the world, disconnected youth are often referred to as "NEET," an acronym that provides the straightforward information that this population is not in in education, employment or training. In the US, they are more commonly referred to as "opportunity youth," a phrase honoring the dual reality that disconnected youth are both in search of opportunities and inherently offer an opportunity to society — one that we have an obligation to invest in with an emphasis on equitable outcomes. In line with broader disparities in the US, risk for youth disconnection is inequitably distributed across racial and ethnic groups with disproportionately high rates of disconnection for Native, Black and Hispanic youth in both rural and urban areas. As a result, addressing youth disconnection in the US should be considered not only a public health priority but a core consideration in efforts to address racial inequity across policy areas.

A Federal Pathway Towards Reconnection

Research demonstrates that prioritizing opportunity youth and youth at risk of disconnection — especially those who are Black, Hispanic or Native, as well as those who are disabled, highly mobile, LGBTQ+ or adolescent mothers — serves to strengthen overall health, well-being and socioeconomic stability. In response to this evidence, the American Public Health Association and the Bloomberg American Health Initiative have partnered on the development of a federal policy agenda specifically focused on both preventing youth disconnection and improving experiences for existing opportunity youth.

Informed and supported by a coalition of youth-centered and youth-serving organizations, "Reconnecting Opportunity Youth: A Public Health Priority" includes a series of policy recommendations targeting the myriad and intersecting systems that touch the lives of opportunity youth, both contributing to their initial disconnection and hindering their ability to reconnect with vital supports. At the macro level, the agenda touches on six core recommendations:

  1. Universal Access to Quality Early Education: Opportunity youth are nine times more likely to drop out of school than their peers, but evidence shows that early childhood education is one of the earliest and most effective interventions to increase the likelihood of high school graduation. Unfortunately, the prohibitive cost of private preschool programs makes them inaccessible to many low-income families — disproportionately Black, Hispanic and Native — and publicly funded options such as Head Start receive insufficient funding to meet the resulting need. The federal government can commit to making quality early childhood education universally accessible and strengthen access to two-generation programs supporting full families.
  2. Comprehensive Sex Education and Reproductive Care Access for All Youth: Access to comprehensive and confidential sex education and reproductive care is imperative to keep young people safe, healthy and engaged in school and work. Despite this, the federal government continues to invest millions of taxpayer dollars in incomplete and inaccurate programming that creates a hostile learning environment for many students, including LGBTQ+ youth and Black girls. Congress and the Department of Health and Human Services can increase funding for confidential, comprehensive, affirming and evidence-based sex education and work to reduce barriers to the full scope of reproductive health care and contraceptive access.
  3. Equitable and Restorative Approaches to Justice in and Out of School: Research on exclusionary school discipline is clear: every year, millions of students who are disproportionately Black, Hispanic, disabled or LGBTQ+ are suspended or expelled from school in response to minor infractions that pose no threat to students and staff, and each subsequent exclusion increases the odds that these students will disconnect. These same disparities can be seen outside of schools in the prison system, which continues to detain a significant number of Black, Hispanic and Native youth despite an overall drop in youth incarceration. The executive and legislative branches can work in tandem to replace exclusionary approaches to discipline and justice with those focused on restorative outcomes, harm reduction and reentry.
  4. Policies, Systems and Structures Supporting Youth Transitions: While there are an array of policies, systems and structures that aim to reduce youth disconnection, these services are often too misaligned, outdated or underfunded to meet the needs of opportunity youth and those most at risk of disconnection. The federal government can prioritize investment in programs aimed at critical transition points and work to fine-tune these supports to increase the opportunities available to youth.
  5. Consistent — and Expanded — Access to Comprehensive Support Services: Stronger support services are needed to ensure healthy, supportive and stable environments for youth who have been historically underserved by all levels of government and are, as a result, at heightened risk of disconnection. To fully engage opportunity youth in reconnection efforts and lessen the risk of disconnection for future generations, the federal government can ensure access to comprehensive health services and work to meet the social needs of disconnected youth.
  6. Data Collection Around the Pathways to and Predictors of Disconnect: The disconnected status of opportunity youth inherently means that institutional tracking systems miss them, but this challenge should not impede efforts to collect meaningful data. To help public health advocates, professionals and legislators identify programs and policies most responsive to the unique needs of opportunity youth, federal agencies can cooperate on making complete demographic data available in real time.

Looking Ahead

The formation of a cross-sector federal policy agenda with a focus on public health outcomes is a critical step in both supporting opportunity youth and working upstream to address the root causes of disconnection. As we work towards advancements at the national level, there is also significant opportunity at the tribal, state and local level to parallel, complement and even surpass federal efforts; such opportunities are addressed in part in "Creating the Healthiest Nation: Opportunity Youth" and "Creating the Healthiest Nation: Prioritizing Youth at Risk of Disconnection," both fact sheets from APHA.

To learn more about how APHA is engaging with issues connected to youth disconnection, sign up for the CSHE newsletter and follow us on Twitter. Public health professionals looking for additional information about best practices for supporting opportunity youth should consult these organizations, coalitions and projects:


C. Pluff is the program manager for the Center for School, Health and Education at APHA.