Category Archives: School Health
County Health Rankings & Roadmaps — Transforming Public Schools in Baltimore: Q&A with Robert English
Years of research shows that school facilities in poor condition—including faulty heating and cooling systems, poor indoor air quality, and deficient science labs—significantly reduce academic achievement and graduation rates. On the other hand, new and renovated school buildings that are equipped with modern science labs; art and music resources; and other amenities lead to improved educational outcomes. Research has also shown that when students attend high-quality schools they are more likely to be engaged in school and have higher attendance, test scores and graduation rates.
The public schools in Baltimore, Md., have the lowest graduation rates and oldest facilities in the state. A recent report described 85 percent of Baltimore’s 162 public school buildings as being in either poor or very poor condition.
While graduation rates in Baltimore public schools have increased significantly in recent years, thanks to better funding and other academic-focused efforts, Baltimoreans United in Leadership Development (BUILD) aims to further improve the graduation rate, educational outcomes, overall health and economic prosperity of Baltimore residents. The goal is to integrate the rebuilding and renovation of every city school into the district’s education reform efforts. BUILD and its partners, ACLU of Maryland and Child First, want to change state and city policies to support school construction and renovation.
BUILD is the recipient of a County Health Rankings & Roadmaps community health grant to educate and engage parents, school leaders, and leaders from other sectors such as business, the community and faith leaders about the need for updated schools to get the best education outcomes for Baltimore’s students. NewPublicHealth recently spoke with Robert English, BUILD’s lead organizer, about the group’s recent successful efforts.
>>How healthy is your county? Join the live webcast event on March 26 to celebrate the launch of the 2014 County Health Rankings and to spotlight communities taking action to build a culture of health across America.
NPH: What’s the link between improving the school infrastructure and improving the graduation rates?
English: A leading indicator of students graduating from high school is that they feel safe and challenged in their schools. We’ve talked to thousands of students and families in Baltimore City and by the time students here in Baltimore get into the 9th grade and 10th grade, they have often lost interest in high school and many of them have said that it’s because of the facilities. We didn’t have science labs in many cases or other core components of a quality education to send kids to college.
This campaign is about building the 21st century learning environments that can prepare young people not only to graduate, but to go to college. For BUILD this is not a bricks-and-mortar campaign—this is about providing the educational space where every child has an opportunity to learn, and then secondly this is about bringing people together around creating high expectations for students. We’ve continued to organize in the schools that are in year one through year three of school construction, and the constituency we are building will be here to hold our schools accountable to providing real results.
For some kids, getting ready to head back to school takes more than a new backpack and a sharpened pencil. In an effort to reduce the deaths and harassment that some Chicago kids faced on their way to and from school, the city has enhanced a program called “Safe Passage,” which trains city workers to help children get to school safely. Last year there were 600 workers in the program, and this year that number has been doubled.
“The whole city is with you, shoulder to shoulder, doing our part to make sure every child in every neighborhood is safe on the way to and from school and has academic success once they get there,” said Mayor Rahm Emanuel in a meeting with Safe Passage workers late last month.
The program currently serves 91 schools. Over the last two years crime on Safe Passage routes was down 20 percent and incidents among students were down 27 percent the schools.
Training for Safe Passage workers includes work on how to build relationships, anticipate issues before they occur and strategies for de-escalating situations. Training continues throughout the school year.
Stationing workers is actually part of a much larger strategy in Chicago for improving school safety, which has included trimming trees and removing weeds to make areas easier to see and safer; installing safe passage signs; removing graffiti; and repairing broken sidewalks and street lights. The city has also conducted community education training about the Safe Passage program. Parents along the Safe Passage routes got school specific information before the term began. See safe passage routes here.
CDC: U.S. School Districts Seeing Improvements in Multiple Health Policies
U.S. school districts are seeing continued improvements in measures related to nutritional policies, physical education and tobacco policies, according to the U.S. Centers for Disease Control and Prevention (CDC). The findings are part of the 2012 School Health Policies and Practices Study, a periodic national survey assessing school health policies and practices at the state, district, school, and classroom levels. "Schools play a critical role in the health and well-being of our youth," said CDC Director Tom Frieden, MD, MPH. "Good news for students and parents – more students have access to healthy food, better physical fitness activities through initiatives such as ‘Let’s Move,’ and campuses that are completely tobacco free."
Among the key findings:
- The percentage of school districts that allowed soft drink companies to advertise soft drinks on school grounds decreased from 46.6 percent in 2006 to 33.5 percent in 2012.
- Between 2006 and 2012, the percentage of districts that required schools to prohibit junk food in vending machines increased from 29.8 percent to 43.4 percent.
- The percentage of school districts that required elementary schools to teach physical education increased from 82.6 percent in 2000 to 93.6 percent in 2012.
- The percentage of districts with policies that prohibited all tobacco use during any school-related activity increased from 46.7 percent in 2000 to 67.5 percent in 2012.
Read more on school health.
Poor Oral Health Linked to Increased Risk for Oral HPV Infection
Poor oral health is associated with increased risk of the oral human papillomavirus (HPV) infection responsible for as many as 80 percent of oropharyngeal cancers, according to a new study in the journal Cancer Prevention Research. Researchers found that people who reported poor oral health had a 56 percent higher prevalence oral HPV, people with gum disease had a 51 percent higher prevalence and people with dental problems had a 28 percent higher prevalence. “The good news is, this risk factor is modifiable—by maintaining good oral hygiene and good oral health, one can prevent HPV infection and subsequent HPV-related cancers.” said Thanh Cong Bui, MD, postdoctoral research fellow at the University of Texas School of Public Health. Other factors also increased the risk, such as being male, smoking tobacco or using marijuana. Read more on cancer.
Study: Hospital Pediatric Readmission Rates Not an Effective Measure of Quality of Care
Hospital readmission rates for children are not necessarily an effective measurement of the quality of care, according to a new study in the journal Pediatrics. "As a national way of assessing and tracking hospital quality, pediatric readmissions and revisits, at least for specific diagnoses, are not useful to families trying to find a good hospital, nor to the hospitals trying to improve their pediatric care," study author Naomi Bardach, MD, an assistant professor of pediatrics at the University of California, San Francisco, Benioff Children's Hospital. "Measuring and reporting them publicly would waste limited hospital and health care resources." After analyzing 30- and 60-day readmission rates for seven common pediatric conditions, researchers found that at 30 days readmission for mood disorders was most common, at 7.6 percent, followed by 6.1 percent for epilepsy and 6 percent for dehydration. Readmission rates for asthma, pneumonia, appendicitis and skin infections were all below 5 percent. Bardach said the low rates leave “little space for a hospital to be identified as having better performance.” Further study could improve the way readmission rates are utilized to assess the quality of pediatric care. Read more on pediatrics.
Jane Brody is the Personal Health columnist for The New York Times. She joined the newspaper in 1965 as a specialist in medicine and biology after receiving degrees in biochemistry and writing for multiple college newspapers, as well as for the Minneapolis Tribune. With her column she has seen and reported on almost 50 years in the evolution of personal and community health.
NewPublicHealth recently spoke with Brody about her take on the state of community health—and what we can all do to improve it.
NewPublicHealth: Over the years, what efforts have you seen that you think have been most effective at improving community health?
Jane Brody: Well, I think one of the most exciting things that’s happened in New York City, and possibly in other cities as well, is getting better food to people who live in food deserts. For example, collecting food that would otherwise be wasted and bringing it to communities where people get free food that is healthy, fresh, and they even have demonstrations of recipes. In fact, I got one of my favorite recipes—it’s a green bean frittata—from one of their demonstrations that I attended just to see how it all worked out.
We’ve also, as you’ve no doubt heard, been putting in all of these bike lanes and we now have introduced the Bike Share Program, which is not inexpensive, but it does at least give more people an opportunity to get off their butts and get out of their cars and maybe even not even use public transportation in some cases, but to get some exercise to and from work, which is wonderful. I remember during one of the transit strikes that we had in New York City, I rode my bicycle from Brooklyn to Times Square where I work, over the bridges and stuff, and it was just wonderful because I got my exercise in at the same time as I got to work and I didn’t have to spend an extra hour exercising. There have been improvements. We have, of course, public pools that are only open in the summer, but in summer is better than no public pools and nobody has to pay anything for a public pool, which is really great.
A community needs assessment of a Chinese-American community in New York City several years ago found multiple barriers to physical activity for children and teens including parents unable to supervise kids at play because of long work hours, unsafe neighborhoods, limited knowledge or access to existing programs, financial hardship, inadequate support for physical activity in schools, limited time due to competing priorities such as academics, and too much time in front of video games, computer screens and television. To increase exercise time and options and help to reduce obesity rates among Chinese-American youth, public health professionals from the Charles B. Wang Community Health Center sought out funding from the New York State Department of Health and Mental Hygiene to create the Chinatown JUMP (Joining Urban Partners for More Physical Activity) program.
>>Read more on New York's Health Improvement Plan, which sets out a plan for similar community health assessments and cross-sectoral collaborations in response to these findings.
Chinatown JUMP currently works with eight afterschool programs to incorporate daily physical activity into the curriculum of these academic programs, blending activity with learning. Program goals include:
- Promote healthier and fit children by educating them and their families about the correlation between exercise and staying healthy.
- Increase staff capacity to support students’ healthier lifestyle through training and technical assistance.
- Establish an afterschool culture that supports physical activity as well as academic achievement.
The program works hard to incorporate parents’ support and involvement as well. Participating students in iMove receive a community resource guide with information about free and low-cost recreational centers and public spaces in the neighborhood to share with their parents. Parents are also invited to workshops on the importance of physical activity and healthy eating habits.
NewPublicHealth recently spoke with Susan Yee, Associate Director of Programs at the Charles B. Wang Community Health Center, about Chinatown JUMP.
NewPublicHealth: What is the Chinatown JUMP program and what do you think sets it apart from other programs with similar goals?
Susan Yee: Chinatown JUMP’s goal is to try to improve opportunities for more physical activity in the Manhattan Chinatown area in order to create sustainable changes within the community.
Howard County has been the healthiest in Maryland since the Country Health Rankings launched in 2010. NewPublicHealth recently spoke with the county’s executive, Ken Ulman, about how the Rankings have helped drive further progress in improving the health of Howard County. Health initiatives introduced by Howard County have included a program that certifies schools as “Healthy Schools,” if they meet criteria in several areas including nutrition and physical activity, and a smoking ban in all county parks.
NewPublicHealth: Howard County has been consistently been ranked the healthiest county in Maryland. What key factors do you credit for that?
Ken Ulman: We start with some advantages. We have the blessings of a highly educated population that cares deeply about their community and have good jobs, and many, though not all, have [adequate financial] resources and access to care. We also have the advantage of having a nonprofit, the Horizon Foundation, based in Howard County that is dedicated to improving the health and wellbeing of people living and working in our county.
So it’s a combination of policy initiatives coupled with a public that really wants to make progress in these areas.
NPH: Have the County Health Rankings helped drive any of your public health and prevention initiatives?
Every two weeks the Agency for Health Care Research and Quality (AHRQ) releases an Innovations Exchange newsletter in order to share innovative health practices from around the country that can be adapted by other communities. The Innovations Exchange supports the Agency's mission to improve the quality of health care and reduce disparities.
The current issue focuses on school-based programs for youth at risk. According to AHRQ, many adolescents—particularly those in minority and low-income communities—lack access to health information, preventive care, and clinical services, leaving them at risk for untreated physical and mental health issues. School-based health care delivery, according to AHRQ, can improve access to care and address the needs of this vulnerable population.
The featured innovations for at risk youth include:
- A school-based program to reduce type 2 diabetes risk factors for children and young adults;
- An inner city school district's reproductive health services model;
- A school-based health center that improved access to mental health services, particularly for minorities.
The newsletter also features quality tools that schools can use to support HIV and STD prevention programs in schools and to facilitate school-based preventive, mental health, nutrition, and oral health services.
>>Read the latest issue of the AHRQ Innovations Exchange.
Shortly after the shooting of 20 children and six adults in Newtown, Ct., a large group of Hollywood stars released a video asking viewers to “demand a plan” on action to be taken to prevent future mass shootings. Since then several videos have popped up on YouTube that show almost all of the actors in the video wielding weapons in films and television shows.
Another video also demands a plan on gun violence, with a compelling set of spokespeople. This one stars and was developed with minority teens in California and produced by the California Endowment, a private health foundation. At last check, the teens’ video had gotten close to 750,000 hits on YouTube.
NewPublicHealth spoke with Barbara Raymond, director of youth opportunity at the California Endowment about how the video came to be and what the next steps are for taking action on gun violence.
NewPublicHealth: How did this video come to be?
Barbara Raymond: The Endowment looks at health very broadly, including things that happen in our schools and happen in our neighborhoods. We started work a couple of years ago in 14 communities across California, and through the process we’ve worked with over 20,000 residents and they came back so strongly saying safety and my own health prevention are our number one issues. And they drilled down further to issues including school safety and school climate and the epidemic of suspensions and extreme school discipline policies.
We have been able to engage a whole set of young people and they have really identified these issues as well. It’s especially the young people saying that working on these issues is urgent, including violence in the community and on the streets of our neighborhoods, fixing issues in our schools and what the kids call the school-to-prison pipeline. These issues have just come up so strongly so when the Newtown tragedy happened, young people wanted to say something and react to that.
As staff, we talked about how the tragedy would open up a whole public conversation around mental health and school safety practices and staff members suggested we reach out to the kids with the video idea.
NPH: How were the kids involved in the development of the video?
Yes, today is Wednesday. But as a new year dawns and New Year's resolutions kick in (learning Zumba and building yoga into our weekly schedule are high on the list for NewPublicHealth staffers) let's call today an honorary Monday—a day to embrace a new plan for health. The Monday Campaigns are here to help.
With the slogan "The day all health breaks loose," Monday Campaigns are a public health initiative of the Columbia University Mailman School of Public Health, the Johns Hopkins Bloomberg School of Public Health and the Lerner Center for Public Health Promotion at Syracuse University. The goal is to help prevent chronic disease by offering a weekly prompt that can support people in starting and sustaining healthy behaviors.
Research at Johns Hopkins found that a week is a critical unit of time in planning lives and Monday has special significance as the beginning of the week. People view Monday as a day for a fresh start and a chance to set healthy intentions for the next 6 days. They’re more likely to start diets, exercise regimes, quit smoking and schedule doctor’s appointments on Monday than any other day. And, according to the Hopkins researchers, they’re looking for help in setting and carrying out their healthy intentions for the week.
The campaigns have grown to include government and non-profit organizations, businesses, media outlets and communities. The three schools provide research, case studies, health-related content, marketing concepts and programs ready for individuals, communities and public health departments. Specific campaigns include:
- Meatless Monday
- Quit & Stay Quit Monday
- Kids Cook Monday
- Move It Monday
- Man Up Monday
- Caregiver Monday
The 2013 campaigns began last Monday, with a weekly series that offers tips for 2013. First up: set some long and short term goals:
A long-term goal can be something to work towards, like getting 2 ½ hours of activity each week or eating 5 servings of produce each day. Short-term goals are the smaller actions you take to build up to your objective.
>>Weigh in: Which Monday campaigns will your community try this year?
A study released this fall in the American Journal of Public Health looks at a critical evidence-based teen pregnancy prevention program led by the United Way of Greater Milwaukee. The United Way catalyzed critical partnerships between schools, community organizations and the Milwaukee Health Department to focus on the goal of reducing teen pregnancies.
In 2008, United Way of Greater Milwaukee, together with its partners, made a public commitment to reduce teen births among 15- to 17-year-olds by 46 percent by 2015. In October 2011, the City of Milwaukee and United Way announced the fourth consecutive yearly drop in the teen birth rate, by 13.5 percent, to its lowest level in decades. The current trend indicates that the partners are on track to reach their goal of 30 births per 1,000 (a 46 percent drop) by 2015.
Initiatives to support these goals include:
- Significant investments in programs through the Healthy Girls project that helps young people understand the consequences of teen pregnancy while also teaching them the skills needed to cope with social pressure to engage in sexual activity.
- A collaboration with the Medical College of Wisconsin and Children's Hospital of Wisconsin residents to develop content for a youth-focused, website, Baby Can Wait, with medically accurate and age-appropriate content on preventing pregnancy and promoting healthy relationships.
- United Way worked with Milwaukee Public Schools and other community leaders to revise human growth and development curriculum. Community members were given an opportunity to review the materials and make suggestions about content, and teachers received training in the new curriculum.
NewPublicHealth caught up with Nicole Angresano, Vice President at United Way of Greater Milwaukee, to get her take on the program’s successes and what other communities can learn from them.
NewPublicHealth: What is different about this effort to focus on teen pregnancy for your community?