Which school do you want to support?
School wellness programs play a significant role in making sure children have the support they need to succeed. And for good reason. According to the Centers for Disease Control and Prevention, “hunger, physical and emotional abuse, and chronic illness can lead to poor school performance." In turn, poor school performance is linked to "early sexual initiation, violence, and physical inactivity.” There is a powerful connection between education and health.
Food aid is one of the oldest and most basic interventions in public school systems. Children cannot concentrate on learning when they are hungry. School food service began in the 1930s and the National School Lunch Program was authorized in 1946. Over the years the program has been expanded and modified multiple times. About half of California’s students qualify for free or reduced price lunch, and statistics about this program provide a common metric of poverty. Many children in poverty depend on school for at least five meals a week.
Too many children in poverty do not eat well. Poor diet, combined with lack of exercise, contributes to obesity, with serious long term health impacts.
There is some good news. Although levels of obesity in preschool and school age children have more than doubled since 1980, in recent years the trend has reversed in many states including California. State laws to encourage changed eating habits appear to be paying off:
Many organizations work to improve child nutrition. In California, ChildrenNow is a good resource for understanding the issues.
Budget cuts have had a severe impact on the ability of schools to hire nurses. School nurses — if you have them — take care of a lot more than cuts and scrapes. They administer medications and vaccines, provide health counseling, support school wellness programs, and make health referrals.
The Robert Wood Johnson Foundation warns that the lack of nurses weakens school health services and puts children at risk. In every school, some children suffer from life-threatening conditions and diseases such as diabetes, seizures, asthma, bleeding disorders, and severe allergies. Medical advances have rendered many of these conditions treatable or manageable, but they do not manage or treat themselves.
California lags the nation in school nurses. According to KidsData.org, in California there were 2,784 children per school nurse in 2014. The National Association of School Nurses recommends a ratio of 750:1 for well children and 225:1 for student populations with special needs. And children with acute health care needs may require even more help to remain in school. School Health Services for Children With Special Health Care Needs in California, a report from PACE, points out the challenges facing our children and our schools, such as this eye-opener: "In the absence of nurses, a range of school personnel are being called on to provide health services, such as administering medication, treating life-threatening allergic reactions, performing gastrostomy tube feeding, injecting insulin, suctioning tracheotomies, and providing urinary catheterization."
Vaccinations are a cornerstone of public health policy in California, which as of 2016 requires vaccinations for all students with very few exceptions. Prior to 2016, the law had allowed families to cite personal beliefs to opt out of vaccinations, leading to falling rates of immunity and increased risk of outbreaks. Certain exemptions are still allowed for a home-based private school or an independent study program with no classroom-based instruction. The California Department of Health provides a web site aptly titled Shots for School that enables you to check the immunization rate at your school.
Even though California mandates physical education (P.E.) for virtually every child virtually every day, there is a growing recognition that children do not get the daily physical activity they need.
According to the Centers for Disease Control and Prevention, physical inactivity is consistently linked to poor grades and lowered educational attainment. Among the campaigns to address this are ShapeUP SF and Team California For Healthy Kids. The Centers for Disease Control provides school health guidelines to promote healthy eating and physical activity.
Most people agree that schools need to teach sex ed. But they don't necessarily agree about what sex education should include, what the goals of sex ed programs should be, and whether specific programs can achieve those goals.
In 2015 the California legislature updated its policies for sex education and HIV/STD prevention. In doing so it significantly clarified what schools are obligated to teach. The California Healthy Youth Act requires public schools to provide all students in grades 7-12 with age-appropriate sexual health education that is "comprehensive and medically accurate."
For more about the effectiveness of sex education have a look at the Ed100 blog post on the subject.
Health issues go far beyond a school nurse, healthy meals and physical activity. They include indoor air quality, lead abatement, asthma management and sun safety measures at school. Some have campaigned to get children to sleep more, based on evidence that children learn poorly when they are fatigued. (The simplest “pro-sleep” intervention is to start school later in the morning). The California State PTA provides resources for parents on healthy schools and healthy lifestyles.
In order to increase overall family health and wellness, some communities use school sites to provide low-cost health services such as immunization and toddler wellness checks. (The most celebrated example is the Harlem Children’s Zone in New York). In the early 1990s, California created a Healthy Start program to provide seed money for these types of partnerships. In a few communities those efforts have been sustained without state funding. More recently, Oakland has started a new effort, working in partnership with Kaiser, a major provider of health services in the area.
All school districts that participate in the National School Lunch Program are now required to have a school wellness policy. These cover goals for nutrition as well as physical activity and other school-based activities that promote student wellness.
If you are trying to boost wellness in your school, this policy can be a place to start. Work with your PTA and principal to create parent information nights about wellness activities and additional needs at your school. For nutrition, think school snacks, classroom parties, snacks brought by parents, or foods given as incentives. Schools also must allow community input in the development, implementation, review, and update of the local wellness policy.
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