The Interdependence of Health and Learning

1
The Interdependence of Health and Learning

• California Department of Education
• School Health Connections
• July 2002

2
Impact of Focus on Testing

• Testing, testing, testing
• Causes stress among teachers and administrators,
  which is not good for learning.
• Narrows the mission of education and contributes
  to teacher burnout,which is not good for
  learning.
• Causes stress in students,which is not good for
  learning.
• Holds schools accountable for only part of their
  mission.

3
Education Goals 2000

• All children will start school ready to learn.
• With proper nutrition, physical activity, and
  access to health care, children get the basics
  that support learning.
• 90 of students will graduate from high school.
• Dropout prevention, substance use prevention,
  sexuality education and integration of services
  help students stay in school.

4
Education Goals 2000

• All students will demonstrate competency in core
  subject areas.
• Though not designated a core subject in Goals
  2000, health education is fundamental. National
  and California Challenge Standards have been
  developed for health education.
• The Nations teachers will have access to
  programs to improve professional skills.
• Quality school programs provide ongoing
  professional development for staff.

5
Education Goals 2000

• Every school will be free of drug, violence and
  firearms.
• Substance use and violence prevention,
  counseling/mental health and safety programs
  indicate school is a place for healthy behavior.
• Every school will promote partnerships to improve
  parent and community involvement.
• School health councils, integrated services, and
  community wide health promotion strategies
  indicate

6

• Participation in health risk behaviors has been
  linked to negative outcomes on the following
  measures of school performance

Symons, 1997, JOSH V.67 (6)
7
Education Behaviors are Impacted by Health

• Attendance
• Drop-out rates
• Behavioral problems at school
• Degree of involvement in school activities
  (homework and extracurricular activities)

Symons, 1997, JOSH V.67 (6)
8
Education Outcomes are Impacted by Health

• Graduation rates
• Grades
• Performance on standardized tests

Symons, 1997, JOSH V.67 (6)
9
Student Attitudes are Impacted by Health

• Toward school (aspirations for postsecondary
  education)
• Feelings concerning safety on school property
• Personal attitudes (self-esteem)

Symons, 1997, JOSH V.67 (6)
10
Negative Educational Outcomes Impacted by Heatlth

• A lack of interest in school
• Behavior problems at school
• Low self-esteem
• High drop-out rate
• Truancy
• Destruction of school property

Symons, 1997, JOSH V.67 (6)
11
Testing only addresses one of the educational
goals BUT it now dominates the education process

• Focusing instructional attention on testing is
  causing neglect of other important facets of the
  educational process.
• Ironically, the neglect of those facets will
  result in lower test scores as well as failure to
  achieve our goals related to those other
  important facets.

12
Coordinated School Health
Health Education
Family Community Involvement
Physical Education
School-site Health Promotion for Staff
School Health Services
School Nutrition Services
Healthy School Environment
School Counseling Social Services
13
Physical Education

• Schools have reduced time for physical education
  and physical activity to increase instructional
  time.
• Studies show it does not improve test scores.

14
Physical Education

• Schools that offer intensive physical activity
  programs see positive effects on academic
  achievement even when time for PE is taken from
  the academic day, including
• increased concentration
• improved mathematics, reading and writing
  scores and
• reduced disruptive behaviors.
• Shepard RJ. (1997). Pediatr Exerc Sci, 9 113-126.
• Sallis JF, et al. (1999). Res Q Exerc Sport,
  70(2), 127-134.

15
Physical Activity has been Shown to Improve Brain
Function

• Controlled Studies Indicate that School Based
  Physical Activity Programs
• Increase oxygen uptake
• Improve physical performance measures
• Reduce susceptibility to stress
• Reduce disruptive behaviors
• Improve concentration and
• Improve reading, math, and writing scores.

Symons, 1997, JOSH V.67 (6)
16
School Nutrition Services

• Testing has little direct effect on nutrition
  services.
• However, stress affects diet, with those who
  dont need calories eating more and those who do
  need calories eating less.

17
School Nutrition Services

• Poor diet, high in sugar, inadequate breakfast
  and snack food availability may all contribute to
  poor concentration.
• Resources are diverted to other programs, which
  motivates schools to raise money by the sale of
  non-nutritious foods, including exclusive soft
  drink contracts.

18
School Nutrition Services

• Schools that incorporate school breakfast
  programs in their food service see increases in
  academic test scores and daily attendance and
  class participation.
• Powell CA, et al. (1998). Am J Clin Nutrition,
  68(4), 873-879.
• Murphy JM, et al. (1998). Arch Pediatr Adolesc
  Med, 152(9), 899-907.
• Meyers AF, et al. (1989). Am J Dis Child,
  143(10), 1234-1239.
• Symons CW, et al. (1997). J Sch Health, 67(6),
  220-227.

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Healthy Kids Survey Links Nutrition and API Scores
20
Opinions of Parents of Adolescents About School
Health Education

• 84 said that health education is either more
  important than or as important as other subjects
  taught in school.
• 74 said schools should spend more time or the
  same amount of time teaching health education as
  they do for other subjects taught in school.

http//www.mcrel.org/standards/articles/survey/
21
Health Education

• Studies show that health education is linked to
  improved academic achievement.

22
Health Education

• Five years after a substance abuse curriculum,
  participants had higher overall academic
  achievement scores on the Comprehensive Test of
  Basic Skills than their national peers.
• (Elias et al Am. Jl. Of Orthopsychiatry 61,no.3
  (1991)
• After participating in a life-skills class, 259
  high risk youth in grades 9-12, showed increased
  grade point averages (GPA) across all classes
  while the GPAs of non-participants stayed
  essentially the same.
• (Eggert et al, Am. Jl. Health Promotion
  8(3)202-15, 1994)

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Use of Tobacco, Alcohol, and Other Drugs has been
Linked to

• Poorer relationships with parents
• Lower grades
• Increased absenteeism
• More frequent depression
• More frequent risk-taking behaviors
• Stifled creativity and ambition

Symons, 1997, JOSH V.67 (6)
24
Students who use Drugs Display Similar Attributes
to School Dropouts, Including

• Less commitment and attachment to conventional
  values and institutions of family and school
• Lowered sense of well-being

Symons, 1997, JOSH V.67 (6)
25
Drug Use is a Threat to School Climate Through

• Erosion of self-discipline
• Decreased motivation toward academic success
• Increased risk for injury, violence, sexual
  behavior, and legal problems

Symons, 1997, JOSH V.67 (6)
26
Studies Confirm that School-Age Childbearing is
associated with

• Significantly reduced academic achievement
• Higher drop-out rates
• Decreased participation in school activities
• Lower grades
• Ongoing sexual risks

Symons, 1997, JOSH V.67 (6)
27
School Counseling and Social Services
School-based mental health services, with the
involvement and support of families and
educators, improve educational outcomes by
addressing behavioral and emotional issues and
other barriers to learning. Youth receiving
mental health services have experienced decreases
in course failures, absences, and disciplinary
referrals, and improved grade point
averages. Jennings J, et al. (2000). J School
Health, 70(5), 201-205. Nabors L, Reynolds M.
(2000). Child Serv Soc Pol Res Pract, 3, 175-189.
Nabors L, Prodente M. (August, 2000). Poster
presented at the annual meeting of the American
Psychological Association, Washington, DC.
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School Health Services

• School-based (or linked) health services reduce
  absenteeism by providing on-site care for
  problems.
• School-based providers detect numerous emotional
  problems early and institute needed care.

29
Staff Health Promotion

• The greatest challenge facing public education
  today is not API testing.
• It is recruiting, training and retaining
  excellent teachers and administrators.
• The University of California projects a shortfall
  of 65,000 teachers in California by 2010.

30
Staff Health Promotion

• Many teachers are disheartened by the increasing
  demands placed upon them, the lack of public
  support, the long hours and poor wages, and the
  diminishing opportunities to see how their
  teaching makes a difference in the lives of
  students.
• Reducing education to just test preparation may
  break the camels back.

31
Staff Health Promotion

• Staff health promotion programs
• Send a supportive message to teachers.
• Improve morale, absenteeism, and future health
  and well being.
• A healthy staff does a better job of teaching,
  creates a better working and learning
  environment, and sets a good example for students.

32
Essential Functions of a Healthy School
Environment

• Minimizes distractions
• Minimizes physical, psychological and social
  hazards
• Creates a climate for students and teachers to do
  their best work
• Expects that all students can succeed
• Implements supportive policies

(Health is Academic, 1998)
33
Indoor Air Quality (IAQ) and Schools

• 5.5 million children in the US suffer from asthma
  (up 160 in 20 years in children under 5).
• Asthma is the leading cause of school absenteeism
  due to chronic illness.
• IAQ is a key factor in asthma exacerbations and
  half the nations schools have poor IAQ.

34
Environmental Protection Agency and IAQ

• EPAs response
• Indoor Air Quality Tools for Schools (1999)
• Institute of Medicine study, Clearing the Air
  (2000)
• IAQ Practices in Schools Survey (voluntary, 2001)
• By 2005, 15 of public and private schools will
  implement sound IAQ practices

http//www.epa.gov/iaq/schools/index.html
35
A Healthy School Environment Sets the Stage for
Other Seven Components

• Tobacco-free policies reinforce health education.
• Tasty, healthy food choices reinforce physical
  education and health education.
• Counseling, psychological social services can
  help identify and resolve conflicts and reduce
  violence at school.

(Health Is Academic, 1998)
36
Family and Community Involvement

• Schools that collaborate with students
  families, local businesses, community
  organizations, and health services see improved
  classroom behavior, increased PTA membership, and
  improved family functioning.
• McDonald L Sayger T. (1998). Drugs Society,
  12, 61-85.

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Family and Community Involvement

• School districts that collaborate with social
  service providers across other districts,
  counties, and cities strengthen social structures
  for students and their families and observe
  improved scholastic performance.
• The combined academic, health, and social
  programs began to show positive achievement gains
  by the third year of the project.
• Mitchell M. (2000). Public Health Reports, 115,
  222-7.

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Six Preventable Health Risks

• Tobacco use
• Abuse of alcohol and other drugs
• Sexual behaviors that increase risk for HIV, STDs
  and pregnancy
• Behaviors that risk intentional and unintentional
  injuries
• Physical inactivity
• 6. Poor eating habits

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Lets take a look at a single risk factor over
time. Data from the National Behavioral Risk
Surveillance System reported in the Journal of
American Medical Association 1999 28216
OBESITY
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Prevalence of Obesity Among U.S. Adults
BRFSS, 1999
Source
Mokdad
AH, et al.
J Am
Med

Assoc
199928216.
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Obesity Trends Among U.S. AdultsBRFSS, 2000
(BMI ? 30, or 30 lbs overweight for 54
person)
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Healthy Schools/Healthy Communities
Healthy Children
School Performance
Increased Social Capital
Healthy Communities
The relationship between schooling and health
outcomes is one of the strongest generalizations
to emerge from empirical research in the U.S.
Nagya R. (2000). Applied Economics, 32, 815-822
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Conclusions

• Hold schools accountable for their entire mission
  of education and the promotion of successful
  child development.
• Coordinated school health programming is a
  fundamental piece of this larger mission.
• Even if we must narrowly focus on test results,
  the scores will be better if we incorporate
  coordinated school health into our education
  system.

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California School Health Coordinator Leadership
InstituteThese slides can be downloaded
fromhttp//www.cde.ca.gov/cyfsbranch/lsp/health/
Links.htm

• Some slides courtesy of
• Alan W. Cross, MD
• Director, Center for Health Promotion and Disease
  Prevention
• University of North Carolina at Chapel Hill