College campus healthcare access: HBCUs vs PWIs

Posted By: S. Moore on December 20, 2022

The Grand Canyon-sized gap in funding of public PWIs (predominantly white institutions) and HBCUs (Historically Black Colleges and Universities) is nothing new. But how does it impact students on a daily basis in terms of their access to campus healthcare and wellness opportunities?

Before attempting to answer that question, it is important to note the funding inequities in terms of real numbers and real institutions. In 2019, the Defender reported on the generational funding inequities between the University of Texas at Austin (UT) and Texas Southern University (TSU), which was created to be an �equal� to UT for the purposes of maintaining the state�s commitment to segregation.

The report revealed that the projected equality of institutions was undercut immediately by legislated funding inequality in spite of laws on the books to the contrary.

Here is what that article revealed.

FUNDING INEQUITIES

For generations, Black people in Houston have speculated in casual conversations that TSU has been grossly underfunded by the state of Texas, especially when compared to the funding received annually by UT.

However, the study, �Quantifying Racism: Comparing Two Texas Universities of the First Class,� authored by Professor Marcia Johnson (Thurgood Marshall School of Law) and Dr. Johnnie Williams (TSU�s Jesse H. Jones School of Business), documents that this purposeful underfunding of Houston�s HBCU has existed for decades, to the tune of $15 billion at the very least.

ORIGINS OF RESEARCH

�The topic started with the curiosity of Thurgood Marshall School of Law professor Marcia Johnson, who was heading TSU�s Urban Research and Resource Center at that time,� said Williams. �She wanted to understand what was going on in terms of quantifying the differences between the University of Texas and Texas Southern.

�[Originally] the legislature had decided that they would allocate funds to have TSU be the Black equivalent of UT. It was stated that TSU would be a university of the first class. Of course, we saw a divergence in terms of the way the two universities evolved. We thought this was important because we would like to become what we were meant to be. And that�s why this is important. And in this age of COVID where we�re looking at disparities that are race-driven and socioeconomic-driven, we feel like it�s really important to say, �Look, higher education is not immune to what�s going on in the rest of the country.� And we want to show the way in which it�s occurred because there�s been lots of conversation over time, but not any real attempt to quantify it,� said Williams.

IMPACT OF UNEQUAL FUNDING

Dr. Michael O. Adams, a professor in TSU�s Barbara Jordan � Mickey Leland School of Public Affairs, says the impact of this funding inequity is devastating.

�For university success, there always has to be three important ingredients: one, financial support for both students and faculty; two, academic support; and three, a kind of welcoming environment that can be defined through infrastructure investments in campus beautification and student services,� said Adams. �If you have the resources, you can do those things well� If TSU had started equal, and if we were on an equal playing field, certainly we could have done more. And I think, HBCUs are often asked to do more with less, and we�re also criticized in terms of our performance, and acknowledgment is never there to talk about issues like this in terms of unequal funding.�

Dr. James Douglas, a professor at TSU�s Thurgood Marshall School of Law, agrees.

�If the state had fully funded us, TSU would today look like UT Austin, and the University of Houston, which was originally a small, private school, would look like it was Huston-Tillitson (a small HBCU in Austin). That�s the difference in funding,� asserted Douglas.

SWEATT VICTORY & UNEQUAL FUNDING

Douglas points out that the unequal funding was specifically a racist endeavor, and cited two pivotal civil rights cases and their aftermath to pinpoint the origins of the unequal funding.

�Prior to 1939, if you were an African-American and you lived in one of those southern states, there was no place for you to get a law degree, a medical degree, a PhD. You had to go someplace outside of the South. [Then] the Supreme Court decided in Missouri that Missouri had to make legal education available within the state of Missouri for an African-American who sought admission to the law school,� said Douglas, who added that when an African American mailman from the Houston area, Heman Sweatt, applied for UT, the state of Texas understood that they were going to have to make legal education available within the state for African-Americans, otherwise, they were going to have to let Sweat in UT.

�So, the decision was �Let�s create a university like UT, so that when this case reaches the Supreme Court, we�ll be able to prove that African Americans have a university equivalent to UT.� And the state infused a lot of money into Texas State University for Negroes (which later became TSU), because they knew they had to try to prove that it was equivalent to UT.

�When [the Sweatt case] got to the US Supreme Court, they forced UT to integrate. That was in 1950. After 1950, when it was clear that there was no longer a legal reason to force the state of Texas to create a university for African Americans that was equivalent to UT, the state of Texas intentionally decided to reduce the funding to Texas State University for Negroes. You don�t reduce a university�s funding by almost 40%, unless it�s intentional,� added Douglas.

SLAVERY�S IMPACT

Williams contends the funding and resource disparity between PWIs and HBCUs began long before Sweatt.

�Part of the legacy of slavery, those institutions that are white were rich in the beginning. When the University of Texas was formed, it was given a million acres in the Texas Constitution. And then once they agreed on where UT would be, it was given another million acres. Those funds have become the Permanent University Fund (PUF). Because of the land that was given to UT, this report (�Quantifying Racism: Comparing Two Texas Universities of the First Class�) doesn�t even begin to try to quantify the differences that would have occurred because of endowed funds. But I can tell you that the PUF funds, two-third go to only two university systems, UT and Texas A&M University (TAMU) and 16 or more universities share the rest, which is just a fraction. So, the wealth distribution, in terms of what has happened as part of the legacy of slavery, is just so pronounced that we can�t even begin to quantify that.�

LEGACY OF GI BILL

Williams adds that another driver of funding inequities when comparing PWIs and HBCUs was how GI Bill benefits were unequally distributed, leading to an undercutting of enrolled students at HBCUs�a huge source of any university�s revenue.

�In the late 40s, early 50s, the GI Bill funded a number of the men who had come home from the war, being able to go to college, which then led to a higher income� It was a major driver in terms of white wealth in the United States. A small fraction of those African Americans who served in WWII were able to go to college as part of the GI bill� They were not given the opportunity to attend majority schools and were oftentimes channeled to either HBCUs, which were very underfunded at the time, or into types of menial, training programs, where they would not be able to secure high-paying jobs.

�If you look at where enrollment diverges between the two schools (UT and TSU), you�ll see that happened around the early 50s with one of the drivers behind that being the GI Bill was rooted in Jim Crow. It was one of the few federal bills that were allowed to be administered at the local, at the state level. The Southern racists wanted to be able to administer the GI Bill because they wanted to be able to block African-Americans from being able to benefit from it.�

PAST EFFORTS TO GET EQUAL FUNDING

TSU and its advocates have consistently pushed to get equal funding. Douglas recalled one of those efforts roughly 40 years ago, in the early 1980s.

�At the time Mark White was the Texas governor and the state reached an agreement with the U.S. Department of Education to equalize funding� The state legislature was supposed to appropriate money, additional funding for TSU, and it never really came through,� said Douglas.

�The second consent decree was around the turn of the century, I think 2001, in which the state over a period of time gave some additional funding to TSU and to Prairie View (an HBCU roughly 45 miles outside of Houston), but nothing in the range that would be enough to make up for all the inequities that had happened and occurred in the past.

WHY JUST 1997 � 2019

The study conducted by Johnson and Williams only covered 1997 � 2019, even though generations of unequal wealth was being built up long before 1997.

Ironically, the funding disparities between UT and TSU undercut the scope of their work.

�We did not have access, nor do we have the resources to obtain data that went further back� So, we�ve gotten a snapshot, and the results of quantifying what happened during those 23 years is quite significant and quite startling. When you look at the fact that we�re looking at an ecosystem impact of $15 billion over that 23-year period, just looking at fall semesters only, we believe that the multiple of that value would be four or more [i.e. $60 billion-plus],� said Williams.

STUDY FINDINGS

Between 1997 to 2019, UT received $15 billion more than TSU in state funding, just looking at the fall semesters.

In biennium 2018-2019 UT was allocated 2/3 of the $1.8 billion in the PUF fund (roughly $1.21B). Conversely, TSU along with its 29 other cohorts were left to share a mere $787.5 million in the HEF fund.

BY 2019, UT grew to an enrollment of over 50,000 students, almost 3,000 faculty, 18 colleges and schools, 156 undergraduate degree programs, over 200 graduate and doctoral programs, 17 libraries and four museums on more than 400 acres of land.

For that same period, TSU grew to an enrollment less than 10,000 students, about 588 faculty, 12 colleges and schools, two libraries and one museum on 150 acres of land.

IMPACT ON STUDENT HEALTHCARE ACCESS
How has this generational inequity in funding impacted, if at all, today�s UT and TSU students regarding their access to campus healthcare and wellness?

Here is a comparison of the facilities, programs and services offered to students at both campuses:

Comparison of the facilities
Focus	Texas Southern University	University of Texas @ Austin
Health	Campus Health Center with its Student Health Services (SHS), an acute care facility that treats illnesses and injuries, provides HIV and STI testing, vision screening, mental health referrals, TB skin testing, seasonal flu shots and a variety of year-round health awareness campaigns.	University Health Services (UHS), an accredited on-campus healthcare facility offering students general medicine, women�s health, urgent care, sports medicine, allergy and immunization clinics, radiology, nutrition services, physical therapy and travel medicine services for faculty and staff.
Counseling	University Counseling Center (UCC) provides counseling and support, crisis intervention, grief counseling, outreach, referral services, and consultation, education, training and prevention strategies to faculty, staff and the university community. Also offered are confidential short-term or ongoing counseling services that include, but are not limited to individuals, couples, family and/or group consultation, referrals, and public presentations for campus organizations and/or academic classes. The UCC staff consists of licensed mental health professionals from diverse clinical backgrounds. The UCC consults with psychologists, psychiatrists, and physicians when necessary.	The UT Counseling and Mental Health Center (CMHC) provides counseling, psychiatric, consultation, and prevention services that facilitate students� academic and life goals and enhance their personal growth and well-being. Services include single session or short-term counseling, groups and classes, the Counselors in Academic Residence Program (counselors located within 18 of UT�s colleges), contacts for off-campus counseling and mental health resources, the Alcohol and Other Drugs Program, Mindful Eating Program, Survivors of Sexual Violence services, Diversity Counseling and Outreach Specialists Program (provide counseling, support, and outreach for student populations with marginalized and underrepresented identities), telehealth services, psychiatric services and medication management, wellness workshops, Voices Against Violence violence intervention program, UT Body Project, virtual mindfulness and stress reduction activities, MindBody labs and more.
Fitness, Wellness & Recreation	TSU Recreation Center which includes 1) TSU�s Fitness & Wellness Department and 2) the Department of Campus Recreation	UT Recreational Sports manages seven facilities both on and off campus. These facilities include over 400,000 square feet of indoor and 40 acres of outdoor activity space. UT also offers the Longhorn Wellness Center (LWC) that promotes well-being for all students by providing evidence-informed resources and programs that enhance mental and physical health. The LWC supports the missions of University Health Services and the Counseling and Mental Health Center by addressing priority college health issues using multi-level, evidence-based prevention strategies such as peer education, social marketing, social norm campaigns, environmental changes, and strategic campus partnerships. The institution�s programs and initiatives include 1) AlcoholEDU & SAPU, alcohol risk reduction & sexual assault prevention; 2) Alcohol & Consent Project, 3) BASICS and CASICS, making safer decisions around substance use; 4) BeVocal, bystander intervention programs; 5) Be That One suicide prevention and mental health promotion and 19 others dealing with mental health, mindfulness, violence prevention, developing a healthier body image and more.

The above table does not adequately display the disparity in services, resources and facilities. However, one example, UT�s seven Recreational Sports facilities compared to TSU�s one (the Recreation Center) speaks to the overall pattern of inequality in terms of health and wellness services available to students at UT (a PWI) and TSU (an HBCU).

This university-level inequity further exacerbates the existing disparities between Blacks and whites regarding healthcare access and health outcomes for the general US population.

Check out these stats from the Center for American Progress� May 7, 2020 online article �Health Disparities by Race and Ethnicity (source: americanprogress.org)

Health coverage

In 2017, 10.6% of African Americans were uninsured compared with 5.9 percent of non-Hispanic whites.

89.4 percent of African Americans had health care coverage in 2017 compared with 93.7 percent of white Americans.

44.1 percent of African Americans had government health insurance coverage in 2017.

12.1 percent of African Americans under the age of 65 reported having no health insurance coverage.

Chronic health conditions

13.8 percent of African Americans reported having fair or poor health compared with 8.3 percent of non-Hispanic whites.

Eighty percent of African American women are overweight or obese compared to 64.8 percent of non-Hispanic white women.

In 2017, 12.6 percent of African American children had asthma compared with 7.7 percent of non-Hispanic white children. Forty-two percent of African American adults over age 20 suffer from hypertension compared with 28.7 percent of non-Hispanic white adults.

Mental health

In 2018, 8.7 percent of African American adults received mental health services compared with 18.6 percent of non-Hispanic white adults.

6.2 percent of African American adults received prescription medication for mental health services compared with 15.3 percent of non-Hispanic white adults.

In 2018, 3.8 percent of African American adults reported serious psychological distress.

Leading causes of death

The leading causes of death among African Americans are heart disease, cancer, and accidents.

African Americans have the highest mortality rate for all cancers combined compared with any other racial and ethnic group.

There are 11 infant deaths per 1,000 live births among Black Americans. This is almost twice the national average of 5.8 infant deaths per 1,000 live births.

11.4 per 100,000 African American men and 2.8 per 100,000 of African American women die by suicide.

According to a February 2022 �Black Students in Higher Education� fact sheet on the Postsecondary National Policy Institute (PNPI) website [pnpi.org], �In 2019, 29% of the Black population aged 25 to 29 held a bachelor�s degree or higher, compared to 45% of the white population in the same age range. And according to the National Center for Education Statistics, in 2020 9% of Black college students were enrolled in HBCUs.

Thus, it stands to reason that increasing healthcare access for these students will improve the overall healthcare outcomes for Black people in general, but still leave a lot of room for improvement before true equity is achieved.

SOURCE Defender Network
If you enjoyed this article, Join HBCU CONNECT today for similar content and opportunities via email!

S. Moore
N/A, Customer Success Engineer
Spelman College class of 2017
Member Since November 2022

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