School Health Programs Get Mixed Review
Tobacco use down but physical education needs work, says CDC
WEDNESDAY, Sept. 19, 2001 (HealthDayNews) -- The nation's education system has earned mixed marks in a new report card of school health issues released today by the Centers for Disease Control and Prevention.
Educators and public health officials say schools, along with the home and the community, present an excellent opportunity to educate children about sound health habits. But as the latest report shows, the extent to which they fulfill this potential varies widely, with recent gains in areas like tobacco control and violence prevention but leaving much room for improvement in health awareness, physical education and nutrition.
"We hope that health and education officials and school health professionals will use [the report] as a 'road map' to understanding the nature of school health programs nationwide," says Dr. James S. Marks, director of the CDC's National Center for Chronic Disease Prevention and Health Promotion, in a statement today. "The success of this assessment will really be determined by how much it stimulates improvement in school health policies and programs around the country."
The School Health Policies and Programs Study 2000 examined eight aspects of school health, including health and physical education, mental health and social services, nutrition, school policies and environment, faculty and staff health promotion and family and community involvement in student health. A write-up of the study appears in this month's issue of the Journal of School Health.
Susan Wooley, executive director of the American School Health Association, says the latest findings "provide direction for areas that need improvement and attention" at both the state and local level. School-based programs help children reduce risky or unhealthy behaviors, Wooley says, such as tobacco use, violence, drug and alcohol consumption and dangerous sexual activity.
The report shows that schools made progress in removing tobacco from their campuses during the last decade. Between 1994 and 2000 the share of tobacco-free schools jumped from 36 percent to 64 percent, and the number that now teach tobacco prevention rose from 83 percent to 92 percent.
Officials also expressed pleasure in the number of schools that offer violence prevention programs to students -- 73 percent up from 58 percent in 1994 -- a trend motivated in part by recent mass killings at several schools across the country.
But schools need remedial work in providing health education, particularly to older students whom officials say need it most.
Eighty percent of states, and an even greater proportion of school districts, require schools to teach health education. But the number of schools that make health ed compulsory drops markedly as students get older and by 12th grade, the report shows, only 2 percent of schools have mandatory health education.
"As they need more health education, we're actually providing less," says Laura Kann, a CDC researcher who helped prepare the report. "The same can be said for physical education."
The study shows that roughly 50 percent of schools make physical education mandatory for children in grades 1 through 5, while 25 percent require it for eighth graders and only 5 percent require it for high school seniors.
Only 8 percent of elementary schools, 6.4 percent of middle and junior high schools, and 5.8 percent of senior high schools offer daily physical education classes -- or the equivalent in weekly exercise -- year round for everyone.
And while students may be less exposed to cigarettes these days, they're more likely to have access to fatty, salty and sugary snacks between classes. More than four in 10 elementary schools, three-quarter of middle- and junior-high schools, and 98 percent of senior high schools have either vending machines or canteens that sell predominately junk food. Nearly 63 percent of milk that schools order for students is whole or 2 percent, considered high fat.
"Those sources of foods could be a real opportunity to provide students with healthy choices," Kann says. "We would like to see more of that."
Avoiding "empty" calories is particularly important given the recent surge in childhood obesity, Kann says. In 1999, 13 percent of children ages 6 to 11 were overweight, compared with 11 percent in the period from 1994 to 1998, the CDC says. Among adolescents the figure rose from 11 percent in the mid-1990s to 14 percent in 1999, according to the agency.
When it comes to health services, schools don't fare especially well, either. Nurses are the primary source of care on campus, yet only 53 percent of schools met the recommended nurse to student ratio of 1-to-750, the report says.
Nichole Bobo, education coordinator at the National Association of School Nurses in Castle Rock, Colo., says her group conducted a survey last year that found that 28 percent of its members reported being the only nurse for more than 1,000 students.
"The bottom line is funding," says Bobo. "Even if it's mandated [to have more nurses], it's not always budgeted" at the district or school level, she says. At the same time, Bobo says school nurses are being asked to deliver increasingly specialized care as mainstream schools take on disabled students.
Bobo says studies are now underway to explore how the availability of school nurses affects student health and learning.
On a brighter note, while school mental health and social services are rarely specified by state or local policies, many schools provide them. Close to two-thirds of schools have student assistance programs and more than three-quarters offer crisis intervention, counseling or help finding a counselor, stress management services or related programs, the report found.
What To Do
An estimated 53 million American children attend 117,500 elementary and secondary schools each day.
For more on the report, visit the Centers for Disease Control and Prevention.