School Health: Policy and Practice / Edition 7 available in Paperback
School Health: Policy and Practice / Edition 7
- ISBN-10:
- 1581108443
- ISBN-13:
- 9781581108446
- Pub. Date:
- 03/01/2016
- Publisher:
- American Academy of Pediatrics
- ISBN-10:
- 1581108443
- ISBN-13:
- 9781581108446
- Pub. Date:
- 03/01/2016
- Publisher:
- American Academy of Pediatrics
School Health: Policy and Practice / Edition 7
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Overview
- New content on school health in medical education, family and community involvement, staff wellness, global school health, emergency and disaster preparedness in schools, and more.
- Updates on the role of the school physician, school nurse, and guidance on school-based screening, serving populations with unique needs such as allergies and asthma, mental health and social services, and program assessment and evaluation.
Product Details
| ISBN-13: | 9781581108446 |
|---|---|
| Publisher: | American Academy of Pediatrics |
| Publication date: | 03/01/2016 |
| Edition description: | New Edition |
| Pages: | 393 |
| Product dimensions: | 6.00(w) x 8.80(h) x 0.90(d) |
About the Author
Read an Excerpt
School Health
Policy and Practice
By Rani S. Gereige, Elisa A. Zenni
American Academy of Pediatrics
Copyright © 2016 American Academy of PediatricsAll rights reserved.
ISBN: 978-1-58110-844-6
CHAPTER 1
An Overview of School Health in the United States
William Potts-Datema, MS, FASHA, FAAHE Howell Wechsler, EdD, MPH
Introduction
When asked why he robbed banks, renowned thief Willie Sutton is often credited with saying, "Because that's where the money is" Although Mr. Sutton often denied uttering the famous phrase, the urban legend remains, along with its obvious logic.
Pediatricians, educators, other professionals, and community members interested in improving health and wellness will understand this obvious logic when considering how to reach children and youth. Schools are a critical setting for health promotion and disease prevention efforts, because the vast majority of youth attend school. In the United States, schools have direct contact with more than 50 million students for at least 6 hours a day during 13 key years of their social, physical, and intellectual development. After the family home, schools are one of the primary entities responsible for the development of young people.
Establishing healthy behaviors during childhood and adolescence is easier and more effective than trying to change unhealthy behaviors during adulthood. Schools can influence students' likelihood of risk of a variety of conditions through a variety of approaches, including health education, provision of or referral to physical and mental health services, and establishment of a safe and supportive environment that provides social and emotional support to young people.
Schools have been a site for health programming in the United States since the early colonial period. In the 1890s, the focus was on protecting the school environment, whereby physicians and nurses were hired in both Boston and New York City schools to exclude potentially contagious students. In the early 1900s, the focus of school health shifted to protecting students. During this era, school health services spread and we saw the blossoming of the first schools to provide full clinical services on site, leading to multiple and new possibilities. When public education became compulsory in the mid-19 century, the strategic role that schools could play in promoting and protecting health became recognized; schools soon became the front line in the fight against infectious disease and the hub for providing a wide range of health and social services for children and families. School health in the 1950s and 1960s involved health education, immunization documentation, screenings, treatment for minor injuries, and referrals for diagnosis and treatment of certain problems; however, services did not include treatment of acute conditions. Health education and physical education have been staples of public education for well over a century. Schools and school systems have played central roles in providing health services, improving nutrition, fostering mental health promotion, and slowing the spread of disease across the nation.
In addition to students, school faculty and staff members present another important and large population that can be reached through schools. In 2008, public school systems employed more than 4.7 million people as administrators, classroom teachers, other professional staff, clerical workers, and service work- ers. School systems are often among the largest employers in cities and counties across the nation. School districts are like businesses in the private sector when it comes to employee-related expenses: they must pay for employee absenteeism, health care costs, workers' compensation, lost productivity, and disability. Reaching school faculty and staff affects not only individual staff members but also their students, families, and the community at large. Enlisting faculty and staff members in healthy school initiatives can have a powerful influence on students through modeling and supporting healthy behavior.
School Health Programs
School health programs and policies in the United States have resulted, in large part, from a wide variety of federal, state, and local mandates, regulations, initiatives, and funding streams. The result, in many schools, is a "patchwork" of policies and programs with differing standards, requirements, and populations to be served. The most comprehensive summary of the different federal, state, and local laws and policies that affect school health programs can be found in a 2008 supplement to the Journal of School Health titled "A CDC Review of School Laws and Policies Concerning Child and Adolescent Health" (http://onlinelibrary.wiley.com/doi/10.1111/j.17461561.2007.00272_4.x/pdf) The most comprehensive summary of current state laws and policies on school health topics can be found in the State School Health Policy Database, managed by the National Association of State Boards of Education (http://nasbe.org/healthy_schools/hs). Work in the field of school health is further complicated by the fact that the professionals who oversee the different pieces of the patchwork come from multiple disciplines: education, nursing, social work, psychology, nutrition, and school administration, each bringing specialized expertise, training, and approaches.
The Whole School, Whole Community, Whole Child Approach
The Whole School, Whole Community, Whole Child (WSCC) approach is the new standard framework that has been developed to bring order and cohesion to the patchwork that is school health. Released in 2014, the WSCC was developed through a partnership of the Centers for Disease Control and Prevention (CDC) and one of the largest education associations, ASCD, in collaboration with key leaders from the fields of health, public health, education, and school health.
The WSCC approach responds to calls from the education, public health, and school health sectors for greater alignment, integration, and collaboration between education and health to improve each child's cognitive, physical, social, and emotional development. Public health and education serve the same children, often in the same settings. The WSCC focuses on the child to align the common goals of both sectors. The approach builds on lessons learned from collaborative partnerships between education and health and evidence of connections between health and learning.
The WSCC model (see Figure 1.1) combines and builds on the ASCD's Whole Child framework and an expanded version of the Coordinated School Health approach first described by Allensworth and Kolbe in a 1987 article for the Journal of School Health. The WSCC incorporates the 5 tenets of the Whole Child model by putting the student at the center and making him or her the focal point. The inner ring represents the tenets:
* Each student enters school healthy and learns about and practices a healthy lifestyle.
* Each student learns in an environment that is physically and emotionally safe for students and adults. Each student is actively engaged in learning and is connected to the school and broader community.
* Each student has access to personalized learning and is supported by qualified, caring adults.
* Each student is challenged academically and prepared for success in college or further study and for employment and participation in a global environment.
Surrounding the child/student is a ring that stresses the need for coordination among policy, process, and practice. This ring also describes the critical role of day-to-day practices and process and the essential role of policy in sustaining a school environment that supports both health and learning.
The outer ring of the WSCC model reflects greater integration and alignment between health and education by incorporating the components of the Coordinated School Health approach and emphasizing the school as an integral part of the community. As part of the development of the WSCC model, components of the Coordinated School Health approach were expanded and modified to better reflect current evidence and practice. Definitions and descriptions were also updated and revised. These expanded and modified components include:
* health education;
* physical education and physical activity;
* nutrition environment and services;
* health services;
* counseling, psychological, and social services;
* social and emotional climate;
* physical environment;
* employee wellness;
* family engagement; and
* community involvement.
Under the WSCC approach, each of these components needs to be guided by well-qualified and appropriately prepared staff who implement policies and practices supported by the strongest scientific evidence available. However, the key contribution made by WSCC is its emphasis on bringing together leaders from each of the components into a team that works together to strategically plan, implement, and monitor school health activities.
Coordinating the many parts of school health into a systematic approach can enable schools to:
* eliminate gaps, reduce redundancies, and reinforce efforts across different initiatives and funding streams;
* build partnerships and teamwork among school health and education professionals in the school; and
* present a unified approach to potential community partners that makes it a great deal easier for schools to access community-based health and safety resources.
States and local school districts have been successful in creating greater alignment between health and education using WSCC. More information about the WSCC approach is available on the Web sites of the CDC (http:// www.cdc.gov/healthyyouth/wscc/index.htm) and ASCD (http://www.ascd. org/programs/learning-and-health/wscc-model.aspx).
Local Infrastructure
In local school districts, a coordinated approach to school health includes two critical, interconnected leadership structures:
(1) A team approach to guide programming and facilitate collaboration between the school and the community. At the district level, this group may be called a school health council, and at the school level, it is typically called a school health team. Ideally, the district school health council includes at least one representative from each of the components and school administrators, parents, students, and community representatives involved in the health and well-being of students, such as a representative from the local health department and the school districts medical consultant. School health teams generally include a site administrator, an identified school health leader, teachers and other staff representing the components, parents, students, and community representatives when appropriate. A comprehensive guide to organizing and maintaining school health councils is available from the American Cancer Society: http://www.cancer.org/acs/groups/content/ @nho/documents/document/guidetocommunityschoolhealhcou.pdf.
(2) A full-time or part-time school health coordinator, who may be a physician, school nurse, teacher, counselor, or another individual with interest and training in health matters. The school health coordinator helps maintain active school health councils, facilitates health programming in the district and school, and leads efforts to obtain health-related resources from the community. The coordinator organizes the components of school health and facilitates actions to achieve a successful, coordinated system, including policies, programs, activities, and resources.
Assessing school health needs and existing school health policies and practices is a critical, early, and ongoing activity for school health councils, under the leadership of a school health coordinator. A number of tools exist to help schools assess health needs and existing health policies and practices, including the CDC's School Health Index: A Self-Assessment and Planning Tool (http:// www.cdc.gov/healthyyouth/shi) and ASCD's Healthy School Report Card (http://www.healthyschoolcommunities.org/HSRC/pages/reportca rd/ index.aspx). School health councils also can play a critical role in integrating health-related goals, objectives, language, and data into school mission statements and improvement plans that guide school management decisions.
Priority Health Issues
Another key task for school health councils is to decide which of the many different health problems that can affect the health and academic achievement of young people will be addressed by their school health policies and programs. Prioritizing is essential, because the primary mission of schools is to educate young people, and schools typically do not have the time in the school day or the resources to address a broad spectrum of health issues.
On the basis of an epidemiologic analysis, the CDC has identified 6 clusters of health risk behaviors as the highest priority health issues for schools to address. They are:
* behaviors that result in injuries, whether unintentional (eg, car crashes) or intentional (eg, homicide, suicide);
* sexual behaviors that increase risk of infection with human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs), as well as unintended pregnancy;
* alcohol and other drug use;
* tobacco use;
* physical inactivity; and
* unhealthy dietary choices.
Injuries are, by far, the leading cause of death among young people, and young people 15 to 24 years of age account for approximately half of all new cases of STDs and a growing proportion of HIV cases. Use of alcohol and other drugs is a major contributing factor to social delinquency as well as injury-related mortality and morbidity and unsafe sexual behavior. Tobacco use, physical inactivity, and unhealthy dietary choices are behaviors that are established in childhood and adolescence and contribute greatly to the chronic diseases (eg, cardiovascular disease, cancer, diabetes) that account for most of the nation's deaths and health care costs. The CDC also has urged schools to address other critical health issues, such as mental health, management of asthma and other chronic diseases, food allergies, noise-induced hearing loss, skin cancer prevention, and insufficient sleep.
The Campaign for Educational Equity at Teachers College/Columbia University, the nation's oldest college of education, has argued that low-income, urban schools should focus their attention on addressing health problems that are the most important barriers to student academic achievement. The Campaign used 3 criteria — prevalence and extent of health disparities, evidence of causal effects on educational outcomes, and feasibility of implementing proven or promising school-based programs and policies — to identify the following 7 most critical health priorities: vision; asthma; teen pregnancy; aggression and violence; physical activity; breakfast; and inattention and hyperactivity.
Support for School Health Programs
Federal Support
Federal agency support for school health programs has been limited by the role that the federal government plays in education decision making. Education is primarily a state and local responsibility in the United States, with less than 13% of the funds for elementary and secondary education coming from federal sources. Federal influence on state and local education decision making has dramatically increased in recent years with new federal education initiatives. However, these initiatives have not emphasized addressing health-related barriers to learning. Federal agency efforts to support school health programs have largely focused on collecting data, sponsoring evaluations of school-based health and safety promotion interventions, issuing evidencebased guidance on effective policies and practices, and providing funding for state and local school health programs.
Many units within federal agencies provide funding and support for research and implementation of state and local school health and safety programs. The primary unit addressing health and safety issues at the US Department of Education is the Office of Safe and Healthy Students. Within the US Department of Health and Human Services, a number of different agencies provide support for school- based health and safety promotion research and program efforts, including the Office of Adolescent Health in the Office of the Assistant Secretary for Health, the Administration for Children and Families, the CDC, the Food and Drug Administration, the Health Resources and Services Administration; the Indian Health Service, the National Institutes of Health, and the Substance Abuse and Mental Health Services Administration. Other federal agencies that provide support for school health and safety research and program efforts include the Department of Agriculture, Department of Defense, Environmental Protection Agency, Department of Justice, and Department of transportation.
(Continues...)
Excerpted from School Health by Rani S. Gereige, Elisa A. Zenni. Copyright © 2016 American Academy of Pediatrics. Excerpted by permission of American Academy of Pediatrics.
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