Schools and Health Our Nation's Investment (1997) / Chapter Skim
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1 Introduction
1 Introduction
Pages 16-32
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From page 16... ...
, teen pregnancy, and depression; students' lack of access to reliable health information and health care; changing family structures; and increasing poverty. Traditional approaches to school health programs may no longer be sufficient to deal with these complex issues.
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From page 17... ...
CSHPs may be promising not only for improving health and educational outcomes for students but also for reducing overall health care costs by emphasizing prevention, adoption of health-enhancing behaviors, and early identification of health problems and by providing easy access to care. The Committee on Comprehensive School Health Programs in Grades K through 12 (K-12)
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From page 18... ...
The Importance of Education Concern about students' academic performance and our national competitiveness has led to a national education reform movement and volun 2The following poverty rates existed in 1992: children under age 18, 21.9 percent; adults 18-64, 11.7 percent; adults 65 and older, 12.9 percent (National Research Council, 1995~. 3For example, the infant mortality rate for U.S.
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Among its directives, the National Education Goals call for (National Education Goals Panel, 1994) the following: 1.
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Although the difference between current school completion rates and the National Education Goal does not appear to be great, the graduation rate is significantly lower in many inner city and rural areas. Furthermore, the Bureau of the Census has projected that the population of academically at-risk children will continue to grow.
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The CDC's Youth Risk Behavior Survey found that 30.5 percent of high school students smoke cigarettes, only 15.4 percent eat five or more servings of fruits and vegetables per day, and only 34.3 percent attend physical education class daily. The major causes of chronic disease and death among adults cancer, heart disease, injury, stroke, and liver and lung disease are influenced by health behaviors and lifestyles established during childhood and youth (U.S.
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To improve the health of all age groups, the U.S. Public Health Service, in partnership with practitioners and private organizations, developed the Healthy People 2000 initiative, a set of nearly 300 national health promotion and disease prevention objectives to be achieved by the year 2000 (U.S.
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Even the youngest kindergartners arrive at school with backgrounds that will have a profound influence on their school experience; some are at a physical and mental disadvantage even before entering school, due to their mother's lack of prenatal care and to inadequate care and nurturing after birth. A report of the Carnegie Task Force on Meeting the Needs of Young Children found that there are three major "protective factors" that help a child to achieve positive outcomes: perinatal factors such as full-term birth and normal birthweight, dependable caregivers whose childbearing practices are positive and appropriate, and community support.
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The new social morbidities, which are expressed as negative behaviors, also have a disproportionate impact on poor students. While school health programs attempt to address many of the social and environmental factors that influence human behavior, biomedical factors can also profoundly influence behavior and thus the effectiveness of school programs.
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From page 25... ...
In those schools that have 70 percent or more of students receiving free or reduced-cost lunches, the proportion of schools reporting unsatisfactory environmental factors greatly exceeds those schools with less than 20 percent of students receiving such lunches. In the highest-poverty schools, 19.1 percent report unsatisfactory lighting compared to 14.3 percent of schools with lower numbers of students in poverty; 22.6 percent report inadequate indoor air quality compared to 15.8 percent of low-poverty schools; 32.8 percent report unsatisfactory acoustics compared to 24.1 percent of low-poverty schools; and 30 percent report unsatisfactory physical security compared to 19.4 percent of low-poverty schools (GAO, 1995)
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According to 1990 census figures, only 14 percent of children live in such "traditional" families with fathers who work year-round and mothers who stay home, and only 3 percent of children living in two-parent families have a grandparent in the home. In many families, parents are increasingly making the decision, often driven by economics, to have both parents work outside the home (Gordon, 1995~; 15 percent of children live in two-parent families in which both parents work full-time, and another 24 percent live in two-parent families in which the father works full-time and the mother works parttime.
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report that between 1979 and 1986, 1.26 million children lost health insurance coverage because of reductions in their parents' employer-based plans. The largest decline occurred in conventional two-parent, single wage earner families, in which coverage of children decreased by 11.7 percent between 1977 and 1987 (Solloway and Budetti, 1995~.
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From page 28... ...
Even those adolescents with insurance and family doctors do not seek help from health care professionals for problems of greatest importance for their high-risk behaviors. In fact, doctors themselves do not feel qualified to discuss most adolescent health behaviors only 38 percent feel they have adequate training in alcohol and drug abuse, and a mere 11 percent feel qualified to discuss depression with a youth (Beringer, 1990~.
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of comprehensive school health programs and their components? What are the data gaps and possible ways of filling them?
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1990. Providing medical services through school-based health programs.
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Washington, D.C.: American Medical Association and the National Association of State Boards of Education. National Education Goals Panel.
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1991. Healthy People 2000: National Health Promotion and Disease Prevention Objectives.
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