New administration must put children's health and education first
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While the budgeting and administrative oversight of child health and education remain separate on every level of government, there is a growing body of evidence that says we can no longer look at our children’s health, education, or well-being as independent silos.

This past Tuesday, Children’s Health Fund, the organization we lead, released a report entitled “The Prevalence and Educational Consequences of Health Barriers to Learning in Underserved Children: A Review of the Literature” which outlines the evidence base of how health issues can negatively impact a child’s ability to learn.

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The report offers recommendations on how we can ensure that there are viable pathways out of poverty that begin with an understanding of how health and educational success are inexorably linked. 

To do this, maximizing the educational experience and success of every child in America must be a priority of the next administration and a critical national goal. If the nation is to remain economically stable, prosperous, innovative, and influential internationally over the coming decades, it is essential that children are healthy and well-educated, graduate from high school on time, and perform at their full potential.

Poor educational attainment has its roots in early childhood, with many children not adequately prepared to read at grade level in the early elementary years. There are many reasons for less than optimal academic performance, but too often among these reasons are health conditions that have been unrecognized or under-managed. 

These conditions, referred to in our report as “Health Barriers to Learning” (HBLs), include the following: uncontrolled asthma, uncorrected vision problems, unaddressed hearing loss, dental problems, persistent hunger, certain untreated mental health and behavioral problems, and effects of lead exposure. Left untreated or under-managed, HBLs can adversely affect children’s ability to see, hear and pay attention in the classroom, their ability and motivation to learn, their attendance, their academic performance, and even their chances of graduating from high school. These particular HBLs have been identified due to their prevalence, evidence of their link to learning, and availability of effective screening and treatment approaches.

The prevalence of Health Barriers to Learning is higher in children of color or in poverty, and these same children bear more burden of disease — largely due to their poor access to healthcare services. In the report, Children’s Health Fund puts forward a series of recommendations to increase the identification, management, and treatment of HBLs for all children, with a focus on those living in poverty.

First and foremost, in the healthcare sector we believe that all children should have an affordable, accessible medical home. Clinicians should prioritize annual, age-appropriate systematic screening and management of the HBLs and communicate with parents and schools about the results of the HBL screenings, ensuring that parents and caregivers know why addressing HBLs is critical to academic success, and what they can do to manage HBLs.

In the education sector, school systems should train teachers and other school personnel to recognize potential HBLs in their students and what they can do to ensure such conditions are diagnosed and managed. This will require annual screenings for HBLs, either through school-based programs, or in collaboration with children’s primary care providers. But it’s not enough to just screen, schools must work with healthcare providers to ensure that once identified, HBLs are treated and managed.

Family service agencies also need to play a role. Court and family service agencies should receive appropriate training on the relevance of HBLs to children in their care and ensure HBLs are appropriately addressed in their decision-making and care plans.

Finally, the most important partner in the health, education and welfare of any child are their parents and caretakers. Using a social marketing approach, public awareness campaigns and aligned messaging from the health, education, and welfare sectors are needed to engage and empower parents to become informed advocates for their children. Parents must demand and proactively request annual screening of their children for HBLs and ensure communication between their child’s clinical team and school on any HBLs.

With a new administration looking for innovative ideas, maybe it’s time to look at how to effectively integrate our nation’s strategy for ensuring the health, education and well-being of our children. Consolidating administration, resources and systems to support services for screening, treatment, and mitigation of HBLs is a good place to start.

Irwin Redlener, MD is president and co-founder of Children’s Health Fund and professor of pediatrics and health policy and management at Columbia University.

Dennis Walto is executive director of Children's Health Fund, a US non-profit organization that provides health care to America's most vulnerable children.  He has been at the front lines of poverty eradication and humanitarian relief in the United States and around the world for the past 25 years.

 


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