School Health Education and Services
Section Newsletter
Fall 2005

MESSAGE FROM THE CHAIR: KATRINA’S LESSONS

 
It is an unspeakable tragedy for the entire country that so many people died unnecessarily in New Orleans, so many others have been left homeless and miserable, and a rich element of our cultural heritage has been destroyed. I for one was looking forward to visiting the city again for the APHA Annual Meeting, and will always cherish my memories of the city as it was.

If there is a silver lining, it is that Hurricane Katrina reminds us of some important lessons:

· PREVENTION MATTERS. Investing in basic infrastructure and human services saves a lot of trouble and money in the long run.

· SCIENCE MATTERS. Careful study of the world around us is necessary to ameliorate harmful effects of our modern society.

· COORDINATION MATTERS. Putting one person in charge (ideally, someone who is qualified for the position) can help bring order to a plethora of resources.

· GOVERNMENT MATTERS. As President Franklin D. Roosevelt said, “Taxes, after all, are dues that we pay for the privileges of membership in an organized society.”

Perhaps the nation is starting to heed of some of these lessons. It heartens me that more and more legislators and education leaders are paying attention to another steadily rising catastrophe that will also eventually cause unnecessary misery and carry a huge price tag —- the epidemic of youth obesity. Schools, districts and states across the country are finally beginning to address the problem of easy availability of junk foods at school. Physical education is beginning to make a comeback. Sen. Harkin’s school wellness policy provision of the School Lunch Program reauthorization act has ignited a firestorm of interest and attention among national organizations.

Decades ago, I chose a career in school health education because it was obvious that the country needed a more prevention-oriented health system and schools had a key role to play in it. Although the turnaround in thinking is taking much longer than anticipated, perhaps it is finally happening. The members of SHES understand this -- we are all in education because we all working to help bring about a better future for America.

The outpouring of strong research abstracts to SHES for this year’s scientific program at the APHA Annual Meeting is another indication that school health is rising in importance. Again, the number of papers submitted hit a new high, and again the number of sessions allocated by APHA has not increased. The Program Planning Committee had to turn away many excellent abstracts. The positive result is a uniformly excellent SHES program, which can be accessed online at http://apha.confex.com/apha/133am/techprogram/program_518.htm.

I look forward to seeing everyone in Philadelphia where the torch will be passed to the incoming SHES Chair Terry Wessel.

Plan Ahead for 2006 Health Education Advocacy Summit

The next National Health Education Advocacy Summit will be held March 11-13, 2006, in Washington, D.C. Once again participants will be able to receive either basic or advanced-level advocacy training, briefings on specific legislative issues by experienced professionals from the government relations staffs of key public health organizations, and arrange and conduct visits —- either individually or in state delegations -— with Congressional representatives or other federal officials. Both the summit advocacy training and the Congressional visits enable the health education profession to speak with a collective voice on priority legislative issues of vital interest to the health education community, often at a critical point in the development of each year’s Federal budget.

Summit sponsors include:

· The School Health Education and Services (SHES) and Public Health Education and Health Promotion (PHEHP) sections of the American Public Health Association (APHA)

· American Association for Health Education (AAHE)

· American College Health Association (ACHA)

· American School Health Association (ASHA)

· Directors of Health Promotion and Education (DHPE)

· Coalition of National Health Education Organizations (CNHEO)

· Eta Sigma Gamma

· National Center for Health Education (NCHE)

· Society for Public Health Education (SOPHE)

· Society of State Directors of Health, Physical Education, and Recreation (“The Society”)

This is an excellent educational activity for students in public health programs. For more information visit <www.healtheducationadvocate.org/Summit/>.

Friends of School Health Testify Before Congress

The Friends of School Health testified before the United States House of Representatives Committee on Appropriations Subcommittee on Labor, Health, and Human Services Education and Related Agencies. You can find the oral testimony and written testimony on the Health Education Advocate Web site at: <www.healtheducationadvocate.org>.

D.C. School Nutrition Program Works to Stem the Obesity Trend

Research studies and health statistics continue to underscore the link between obesity in both children and adults and the onset of many serious and chronic health conditions, such as heart disease and diabetes. With the problem reaching what some call epidemic proportions, state and local jurisdictions have been challenged to look for cost-effective and innovative ways to introduce more nutrition and physical education into already beleaguered school systems. But in the nation’s capital, where in 2003, 16.8 percent of students were at risk of becoming overweight and 13.5 percent were already overweight, help has come through what some might consider an unlikely source: the city’s free health insurance program, D.C. Healthy Families (DCHF).

An existing Memorandum of Understanding between DCHF and the D.C. Public School System paved the way for the insurance program to extend its commitment from getting families insured, to promoting healthy lifestyles among the city’s youth. The goal: to develop a sustainable, replicable and culturally competent school-based health program that would positively influence students’ perceptions about nutrition and physical activity and increase the proportion of D.C. youth engaged in healthy behaviors. The program would target adolescents as the budding consumer, both increasingly independent and choice-conscious. School system professionals worked on their end to identify the most appropriate middle and junior high schools that benefit from this intervention most.

In the development phase, focus groups with seventh and eighth grade students and their parents were held to assess their existing attitudes, opinions, and beliefs about nutrition and physical activity, as well as their habits. Program planners also discovered an existing curriculum designed by the United States Department of Agriculture (USDA), specifically for adolescents, called Team Nutrition. Findings from the focus groups were used to tailor the Team Nutrition curriculum to better fit D.C. youth, and what resulted was the Fit For A Lifetime: School Nutrition Program, a social marketing approach to helping adolescents adopt healthier lifestyles.

It was important, however, that the curriculum complement the standards of learning set forth by the school system through the use of reading, mathematic, analytical, and verbal skills. A Team Nutrition educational kit and other age-appropriate and culturally specific materials were used to meet this requirement. The materials were intended to assist seventh and eighth grade students in learning to make healthy food and physical activity choices. For instructors, the program employed graduate students enrolled in local universities studying in health-related fields. Each completed a mandatory four-day training session and was responsible for lesson plan delivery, activity development, and classroom evaluation.

The initiative finally launched in March 2002, during National Nutrition Month. Now, three years later, DCHF staff are training science teachers to deliver the curriculum themselves, in their own classrooms. Currently, the initiative is in 20 schools throughout the District. DCHF has enjoyed support from many partners along the way, such as the WIC Food Stamp Nutrition Education Program and local grocery store chain, Safeway Food Stores, Inc., which have made possible numerous classroom activities, field trips and food demonstrations. Additionally, each year students compete for the Presidential Active Lifestyle Award, through the Presidents Council on Physical Fitness and Sports, and receive pedometers and award certificates/badges as incentives. To date, 4,500 seventh and eighth grade students have participated in the Fit For A Lifetime school nutrition program.

Students are assessed on their nutrition-related knowledge and behaviors and their self-reported level of physical activity prior to the intervention and afterward through the use of pre- and post-tests. Overall, year after year, participating schools have shown significant increases in scores – an average of 11 percent -- from pre- to post-test. Moreover, student awareness has continued to increase in all five assessment categories, with the highest student performance in general nutrition knowledge and self-reported physical activity levels.

Schools provide a great opportunity to enhance the future health and well-being of children. They offer continual regular contact with children and opportunities for nutrition education and promotion of physical activity both within the formal curriculum and informally through a supportive school and community environments. School-based healthy eating and physical activity programs can reach almost all children and may enhance learning and provide social benefits, enhance health during critical periods of growth and maturation, lower the risk for chronic diseases in adulthood, and help to establish healthy behaviors at an early age that will lead to life-long healthy habits.

Currently there is limited quality data on the effectiveness of obesity prevention programs, and few trials have investigated school-based primary prevention programs directed at obesity. This evaluation has shown that risk factors for obesity can be successfully aimed at and implemented in D.C. middle and junior high public schools and that change can be achieved in the school environment and in children’s knowledge base with relatively few additional resources. A broader implementation of and investment in school-based health initiatives has a high potential to reduce childhood obesity and, in the longer term, comorbid conditions and health care spending.

Note: D.C. Healthy Families is funded by the District of Columbia and the federal government, and is administered by the D.C. Department of Health, Medical Assistance Administration and Department of Human Services, Income Maintenance Administration through its outreach contractor, Houston Associates, Inc.

Additional Resources:

CDC Reports and Guidelines for Overweight and Obesity
http://www.cdc.gov/health/obesity.htm

Dietary Guidelines for Americans
http://www.health.gov/dietaryguidelines

5-A-DAY for Better Health
National Cancer Institute
http://dccps.nci.nih.gov/5aday/

Healthy People 2010 Initiative
http://www.health.gov/healthypeople

Nutrition.gov
http://www.nutrition.gov

Physical Activity and Health: A Report of the Surgeon General
http://www.cdc.gov/nccdphp/sgr/sgr.htm

President’s Council on Physical Fitness and Sports
http://www.fitness.gov

Promoting Better Health for Young People Through Physical Activity and Sports
http://www.cdc.gov/nccdphp/dash/presphysactrpt/index.htm

Team Nutrition
USDA Food and Nutrition Service
Child Nutrition Division
http://www.fns.usda.gov/cnd

Resources to Help Cope with Natural and Other Disasters

 
The American Academy of Pediatrics has a number of resources to assist parents and professional address issues related to natural disaster. These resources can be found at:


http://www.aap.org/new/disasterresources.htm

The Center for Health and Health Care in Schools

 
SAMHSA Sets Crisis Hotline for Persons Affected by Hurricane

Profound sadness, grief, and anger are normal reactions that many people may be experiencing in the wake of hurricane Katrina, and the U.S. Department of Health and Human Services wants people in crisis to know they can call a hotline and speak to a trained counselor in one of the local crisis centers across the country. The network, run by the Substance Abuse and Mental Health Services Administration (SAMHSA), involves more than 110 certified crisis centers where people who are in emotional distress or suicidal can call at any time from anywhere in the nation, to talk to a worker about their problems and to receive immediate referral to local “resources and expertise,” according to SAMHSA. The number for the toll-free hotline is 1-800-273-TALK, or (800) 273-8255.

Study Finds Most Schools Offer 'Competitive' Foods


Asked by Congress to come up with some hard data on the extent to which schools are offering students the opportunity to buy and eat foods not on the federal school lunch and breakfast menus, the Government Accountability Office (GAO) said this week that in the 2003-2004 school year, nine out of 10 U.S. schools sold competitive foods, ranging from nutritious items like fruit and milk to less nutritious items such as sodas and candy. High schools and middle schools were more likely than elementary schools to make competitive foods available, on a la carte lines in the cafeteria or in vending machines. Though school district officials commonly set overall policies for competitive food sales, decisions about specific sales were usually left to school food authority directors and principals. And those sales generated substantial revenues for schools, according to the GAO study - as much as $125,000 per school for some high schools. To compile its data, the GAO visited six school districts in California, Connecticut, Mississippi, Missouri, and South Caroline. The report, GAO-05-563, is available online at <www.gao.gov/new.items/d05563.pdf>.

Bills Would Require Schools to Minimize Use of Pesticides

Saying “Children have the right to learn in a healthy atmosphere,” Sen. Frank Lautenberg, D-N.J., and Rep. Rush Holt, D-N.J., are reintroducing bills that failed to pass in the last session of Congress, calling for schools to implement integrated pest management systems, minimize the use of pesticides, and inform parents and employees when they plan to use pesticides in schools. Senator Lautenberg cited a study reported in the July 2005 issue of the Journal of the American Medical Association that found pesticide exposure at school caused acute illness in school employees and students. He noted that safe alternatives to the use of dangerous pesticides exist and said his bill would “emphasize these safe alternatives.” The Senate bill, S. 1619, School Environment Protection Act of 2005, introduced Sept. 7, can be read and tracked on <http://thomas.loc.gov>.

Effects of Childhood Exposure to Second-hand Smoke

A new study has found that early-life exposure to second-hand smoke can cause life-long respiratory problems. In a paper published online in the journal Thorax, researchers at the National Institute of Environmental Health Sciences in the National Institutes of Health, the University of Minnesota, and the National University of Singapore reported that individuals who had lived with smokers in childhood had more respiratory problems later in life, including chronic coughs. More than 45 percent of the 35,000 non-smoking study participants had fathers who smoked, and 19 percent had mothers who smoked. “This research adds to a growing body of evidence that exposure to second-hand smoke early in life has health consequences that can last a lifetime,” said NIEHS Director David Schwartz, MD. “In addition to finding ways to reduce the exposure of children to tobacco smoke and other environmental pollutants, we also need to look for ways to reduce the disease burden.” The study also found that a diet high in fruit and soy fiber seemed to protect adults against some of the negative health effects often associated with early tobacco exposure. A fuller account of the study is available at <www.nih.gov/news/pr/aug2005/niehs-30.htm>.