Washington, D.C. -- The Center for Health and Health Care in Schools (CHHCS) opened its doors this month to study strategies for delivering both health promotion and health care services to youth in schools.
Inspired by research on the root causes of disease and premature death in this country, and on children’s unmet health care needs, CHHCS will explore how best to organize and fund two types of school-based health programs: those to help students learn how to maintain good health, and those that provide health care services to catch physical and emotional problems before they advance.
Studies indicate that the leading killers of school-aged children are behavior choices, not disease. Motor vehicle accidents and other unintentional injuries, homicide, and suicide, are responsible for over 70 percent of all deaths to 10-19-year-olds. And, the leading killers of adults – heart disease, cancer, and stroke – are enormously influenced by tobacco use, diet, and physical inactivity. These behavior choices are formed during the school-aged years.
Moreover, when it comes to getting check-ups and following up on health problems, 10-19 year-olds are the least likely of all age groups to use health care. Dental and mental health care now top the list of children’s unmet needs. More than half of all children ages 6-8 suffer from tooth decay and over 20 percent of 9 – 17 year-olds (8 million children) has a diagnosable mental or addictive disorder a high proportion of these children go untreated.
“Outside of the home, schools offer the single most important place in the lives of our children. It makes sense to teach them healthy behaviors where they learn other essentials, and it’s logical to place health care services where young people can most conveniently find them,” said Michael McGinnis, M.D., senior vice president at The Robert Wood Johnson Foundation and former Assistant Surgeon General responsible for disease prevention and health promotion.
CHHCS is based at The George Washington University and is jointly sponsored by the School of Public Health and Health Services and the Graduate School of Education and Human Development. The center is headed by Julia Graham Lear, Ph.D. For 20 years, Dr. Lear has been a leader in the field of school health services, and a pioneer in developing school-based health centers.
“The nation spends over $2 billion to provide school nurses, primary care and mental health counseling in schools,” Lear noted. “Yet we do very little to measure whether the volume of services is adequate or if they are meeting the community’s needs. Nor do we plan how school nurses, guidance counselors, psychologists, health educators, and primary care providers in each community can avoid duplicating efforts and work in a way that best serves the students. CHHCS will study how all of these programs and services can be most efficiently financed and organized.”
In a major first initiative, CHHCS will direct a Robert Wood Johnson Foundation grant to fund qualifying school-based health centers to test how they can best provide dental and mental health care to students. Two recent reports from the Surgeon General note that school can be an ideal place to offer these services.
Other CHHCS research priorities include:
- How Medicaid and the State Children’s Health Insurance Program can help support school-based health promotion and primary care
- Best practices for coordinating school-based health promotion and primary care services with the overall health care delivery system
- How mandated health services for disabled children can mesh with other school-based health programs and the larger health care system.
CHHCS will use its comprehensive Web site to inform government policymakers, leaders in schools and health care institutions, and the public.
“Young people need repeated exposure to messages and skills about healthy living before wanted behaviors can take root,” said McGinnis. “And, when providers are stationed at schools, kids are more likely to seek health care because they get a chance to build a relationship with these professionals. To make a difference with kids it really helps to be part of their world. We need the research base to make optimal use of health programs in schools. CHHCS is filling a critical gap.”