Question of the Week
February 7, 2005

If you received a health grade last semester, it probably had more to do with your performance in class called "Health," than it did with your actual medical state of being. Depending on where you live, there are those who are trying to change all that:

"Van dePutte [a state senator from San Antonio] is proposing a state law requiring schools to weigh students, compute their body mass index, and send that information
home on their report cards. ... Some parents in Texas are outraged. 'They don't need to tell us that to realize your kid is overweight,' says parent Rosa Medellian. Dr.
Stephanie Setliff, who treats kids with eating disorders at the Children's Medical Center in Dallas, also believes the proposal is a bad idea. 'We know that eating disorders like anorexia nervosa and bulimia nervosa can be triggered by one comment made from a peer or a coach,' says Setliff. The state's largest teacher group also opposes the bill, saying teachers should just teach. 'The school has a place to provide nutritional food and nutritional information in health class, but they're not doctors,' says Eric Allen with the Association of Texas Professional Educators."

Obesity is a problem.

"The percent of children and teens who are overweight also continues to increase. Among children and teens ages 6-19, 15 percent (almost 9 million) are overweight according to the 1999-2000 data ... In addition, the data shows that another 15 percent of children and teens ages 6 to 19 are considered at risk of becoming overweight. ... Although children have fewer weight-related health problems than adults, overweight children are at high risk of becoming overweight adolescents and adults. Overweight people of all ages are at risk for a number of health problems including heart disease, diabetes, high blood pressure, stroke and some forms of cancer. Obesity can weaken physical health and well-being, and can shorten life expectancy."

But obesity is not the only problem, and there are those with valid concerns.

"It is estimated that 8 million Americans have an eating disorder -- seven million women and one million men
* One in 200 American women suffers from anorexia
* Two to three in 100 American women suffers from bulimia
* Nearly half of all Americans personally know someone with an eating disorder (Note: One in five Americans suffers from mental illnesses.)
* An estimated 10 - 15% of people with anorexia or bulimia are males
Mortality Rates
* Eating disorders have the highest mortality rate of any mental illness
* A study by the National Association of Anorexia Nervosa and Associated Disorders reported that 5 - 10% of anorexics die within 10 years after contracting the disease; 18 - 20% of anorexics will be dead after 20 years and only 30 - 40% ever fully recover
* The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 - 24 years old.
* 20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems"

While other schools have not sent this information home on report cards, a precedent has been set. There are concerns on both sides of the issue. So why have some schools decided to conduct BMI assessments?

"Reasons to perform BMI assessments of Arkansas school students
* Body Mass Index (BMI) screening is recommended by the American Academy of Pediatrics for all children and adolescents
* Many parents do not understand the risks of childhood obesity
* Parents want and deserve to be informed if their children are at risk for developing health problems
* Many children do not make regular visits to the doctor, and when they do, most doctors do not routinely check BMI
* Screening for vision and hearing problems are currently conducted in schools. BMI assessment is a screening tool to determine if children are overweight, underweight or at risk for becoming over / underweight
* Parents of overweight children who are overweight, underweight or at risk will be encouraged to seek counseling from their doctor, school nurse, or other healthcare provider
* Preventing and / or treating childhood obesity is more effective than treating obesity in adults
* Plans are being developed to perform BMI assessments and deliver reports in a way that will be private, confidential and accurate"

Schools know that they cannot tackle health issues alone. They are trying to get information to parents, so that parents can connect with students -- and help the students connect with a health care provider.

"A coordinated school health program (CSHP) model consists of eight interactive components. Schools by themselves cannot, and should not be expected to, address the nation's most serious health and social problems. Families, health care workers, the media, religious organizations, community organizations that serve youth, and young people themselves also must be systematically involved. However, schools could provide a critical facility in which many agencies might work together to maintain the well-being of young people."

Schools have been involved with health screenings for decades: hearing, vision, even head lice (to name a few). The information is then sent to the parents -- who are expected to take appropriate action.

Questions of the Week:
How are BMI screenings and reports different from the other health screenings that schools are currently conducting? How are they similar? What roles should schools play in addressing health issues? Why should schools play certain roles, and avoid others? What roles should they avoid? How can schools work with parents, and others in the community, to best address the health issues facing students?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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