Category Archives: Healthy Schools
The New York Times recently reported on the deaths of two pedestrians killed by bicyclists in the city’s storied Central Park. New York City has recently ramped up efforts to reduce pedestrian deaths—with a focus on car crashes—but anecdotal and police reports in the city find that the growing number of walkers, skaters, cyclists, pedibikers and other people heeding advice to get out and move is resulting in more injuries and deaths. Other cities have also reported increases in accidents linked to increases in physical activity. NewPublicHealth recently reported on efforts launched this year by the U.S. Department of Transportation to prevent and reduce pedestrian injuries.
Several conferences this year—including the annual meetings of the American Public Health Association, the Transportation Research Board and New Partners for Smart Growth—will have sessions looking at pedestrian safety in the wake of communities creating new opportunities for residents to get exercise outdoors. And Sunday Streets, a growing program across the country, shuts down main city streets to give walkers free reign, often with a booth set up by departments of public health or safety on staying safe when sharing the roads.
Read the full story from the New York Times.
Frontline, the Public Broadcasting Service documentary series, has a unique football stats blog, Concussion Watch, which is now in its third year. The blog tallies—game by game—the number of National Football League (NFL) players sidelined by a possible concussion and how soon they return to play.
Based on tracking for the last two years, the blog predicts that 150 players will suffer concussions during the current season, which in many cases could lead to lifetime debilitating problems. This is despite new playing rules and ever-evolving helmets.
The impact of concussions on the players’ heath and lives is startling. Based on Concussion Watch data, 306 players have suffered a combined 323 concussions over the past two seasons. In half of the cases where a concussion occurs, players return to the field without having missed a single game. According to the blog, although there’s no standard recovery time for a diagnosed concussion, guidelines developed by the American Academy of Neurology and endorsed by the NFL Players Association indicate that athletes are at the greatest risk for repeat injury in the first 10 days after a concussion. And the more head injuries a person suffers, the more likely they may be to develop complications later on.
In fact, the NFL is due a decision by mid-October from thousands of league retirees on whether they will accept a proposed settlement in a class-action concussion case brought by more than 4,500 former players. Papers filed in the case show that the NFL expects more than thirty percent of all retired players to develop some form of long-term cognitive problem—such as Alzheimer’s disease or dementia—in their lifetime as a result of head injuries suffered during games. During the preseason and the first week of official play, 15 players suffered head injuries and 12 have already returned to their positions.
Harold W. “Bill” Kohl, PhD, a professor of epidemiology at the University of Texas School of Public Health is in the midst of a three-year appointment to the President’s Council on Fitness, Sports & Nutrition (PCFSN) Science Board. Kohl’s role is to provide recommendations in the areas of program development and evaluation, which is critical to the Council’s mission to engage, educate and empower all Americans across to adopt a healthy lifestyle that includes regular physical activity and good nutrition. During his time at the School of Public Health, Kohl has been researching effective uses of social networking to create demand for healthy lifestyles among youth and working with organizations to promote disease prevention, physical activity and exercise as a health priority.
NewPublicHealth recently spoke with Kohl about the work of the President’s Council.
NewPublicHealth: Is the current mission of the President’s Council different than it was in the past?
Bill Kohl: There has been a shift. The President’s Council started in the 1950s as the result of a small study that suggested that American kids are not as fit as kids in Eastern bloc countries—Russia, primarily. The President’s Council started under President Eisenhower and then President Kennedy’s administrating sought to increase kids’ fitness by doing fitness testing in schools and promoting physical activity and physical education.
That wound its way through the ‘60s and ‘70s. Then in the ‘80s there was a much bigger rush to health-related physical fitness rather than skill-related fitness activities—things that you can actually change and that are related to health outcomes compared to fitness skills you might be born with, such as the ability to run a 50-yard dash.
Then, most recently, the Council has included nutrition in his mission and been renamed.
NPH: How does your background inform your new role?
Kohl: As chair of the science board, my job is to make sure that the President’s Council has the most up-to-date science that’s relevant to its mission and advancing initiatives that are evidence-based.
While more than 30 million children receive free or reduced-cost meals through the U.S. Department of Agriculture’s (USDA) National School Lunch Program during the school year, only about 3 million of those kids sign on for summer meals through the USDA’s Summer Food Service Program, according to agency statistics. While not all 30 million need the summer meals—many are enrolled in summer programs that offer food or have parents that are able to take responsibility for providing meals—USDA and hunger experts know that millions are going hungry each summer, impacting their day-to-day lives, the learning gains of the previous year and learning readiness for the next grade.
“Most of the reason eligible kids aren’t getting meals in the summer is simply because parents don’t know about them,” said Audrey Rowe, head of the USDA’s Food and Nutrition Service, which runs the meal programs.
Last year, USDA made increasing the number of kids getting summer meals (sites typically serve one meal and a snack or two meals) a top priority, according to a the report Summer Doesn’t Take a Vacation, published by the Food Research and Action Center (FRAC), a Washington, D.C.-based nonprofit aimed at ending child hunger. According to the report, the summer of 2013 marked the first major increase in the number of low-income children eating sponsored summer meals in 10 years, and the program grew last year to serve nearly three million children, an increase of 161,000 children or 5.7 percent from 2012. This represents the largest percentage increase since 2003.
To reach those increases, the USDA worked with organizations including FRAC, Feeding America, Share Our Strength, the YMCA and other national, state and local stakeholders to target states with high rates of poverty, food insecurity and low participation rates in summer food programs. Efforts ran from high-level conversations with state governors—some of whom had known nothing about summer meal programs—to dozens of webinars to teach officials and private partners the nuts and bolts of running the programs. For example, sites are eligible in communities where more than half the area children receive subsidized school meals.
More than half of youths in the United States have access to parks or playground areas; recreation centers; boys’ and girls’ clubs; and walking paths or sidewalks in their neighborhoods, according to a new report from the U.S. Centers for Disease Control and Prevention (CDC), State Indicator Report on Physical Activity, 2014.
While that information might conjure up images of newly built, dedicated playgrounds, the reality is different...and less expensive. Thousands of communities have created physical activity opportunities by developing shared use agreements with schools to allow the use of facilities after school hours and on weekends.
In 2011, for example, the nonprofit Partners for Active Living (PAL), in Spartanburg, S.C., met with the city’s Parks and Recreation Department and learned that while the city did have access to defunct school facilities, it had no shared use agreements that would let PAL use school facilities for exercise. With help from a board member (who was also a member of the city council) and online resources for shared use agreements, PAL was able to move the concept forward by showing that:
- Under South Carolina law, school districts and third parties would be protected under the recreational user statute.
- The South Carolina Tort Claims Act imposes the same liabilities and protections both during and after the school day.
- The school district may be liable for negligent supervision of a student only if a duty is executed in a grossly negligent manner.
After about a year of discussions with parents, activists, policymakers, school officials and others, agreements were worked out in 2012 for school soccer fields, basketball courts, trails, playgrounds and football fields to remain open to the community on weekends and from 9 a.m. to 6 p.m. on non-school days and after school until 6 p.m. on school days, with supervision by the Parks and Recreation Department to deal with damage, vandalism and other concerns. The agreement is automatically renewed every five years unless amended. To promote the continued usage of school playgrounds, the department will offer regularly scheduled programming at each site and PAL will be tracking usage.
“College is certainly a different experience today than it was in my day,” said an audience participant at a panel discussion late last week on campus health initiatives at the Partnership for a Healthier America summit in Washington, D.C. The partnership is a nonprofit that includes health leaders working on childhood obesity issues.
The college health panel, moderated by former U.S. Health and Human Services Secretary Donna Shalala, who is the president of the University of Miami and co-chair of the Bipartisan Policy Center’s Nutrition and Physical Activity Initiative, included Lynn R. Goldman, dean of the George Washington School of Public Health and Health Services; Beverly Daniel Tatum, president of Spelman College, a historically Black college in Atlanta; and Michael Goldstein, Associate Vice-Provost for the Healthy Campus Initiative, at the University of California, Los Angeles (UCLA).
A driving force behind health and wellness improvement initiatives on campus—including bike and walking paths, more staircases and smoking bans—is the opportunity to help students make changes that will last their lifetimes.
- At Spelman several years ago, Tatum canceled the schools’ competitive sports program—which was benefitting less than 5 percent of the 2,000-person student body—and replaced it with a “wellness revolution.” The campus-wide programs include “Body Fat Tuesday” weekly checks, new exercise equipment and a “PE for life” initiative that includes integrating such things as lunges and squats for students waiting for tennis courts to encourage greater physical activity.
- Changes at UCLA include a new restaurant, the Bruin Plate. Entrees—none more than 400 calories each—include root-vegetable tagine; a red-quinoa-and-sweet-potato burger with pineapple salsa; and chicken with dates, polenta and spinach. Side dishes have no more than 200 calories each and there are no French fries, traditional desserts, cured meats or heavily processed foods. The restaurant serves only calorie-free sodas and house-made infused waters with flavors such as pineapple-mango-hibiscus, vanilla-peach and butternut squash. Desserts have been overhauled and include seasonal fruit with balsamic sauces and lower-calorie quick breads.
- Changes on the George Washington University campus, which is just blocks from the White House, include indoor and outdoor bike racks, four bike rental stations, widened pathways and changes at the Food Court to include many healthier options. Goldman says that since the school is in the middle of the city, rather than a closed campus, many of the changes were also aimed at benefitting the community residents.
“A lot has changed since campuses were filled with cigarette smoke and offered just a single dining hall with a set menu,” said Shalala. “We have a captive audience, and campuses are good places to learn healthy habits.” Recent changes at the University of Miami include more visible staircases and signage pointing to the stairs; widened walkways for walking and biking; bike repair stations; outdoor fitness equipment; and farmer’s markets.
Recommended Reading: As 2014 Begins, the Stanford Football Team is an Exercise Model for the Rest of Us
As the new year begins, the United States is awash in millions of people resolved to go to the gym, run many miles every day, blow the dust off the treadmill in the basement and park yards away from the office front door. But a recent article in The New York Times on the exercise regimen of the Stanford University football team finds that slow and steady, rather than extreme, may be the effective approach toward injury-reduced, successful exercise.
While Stanford lost its Rose Bowl game against Michigan State yesterday, the team’s players have ended the season ahead of many of their competitors in injuries avoided and games missed. What’s different at Stanford is a training regimen by Conditioning Coach Sean Turley, which focuses on each player’s abilities and the muscles and strength they need most to prevent injuries, as well as get their own jobs done on the football field.
The Times reports that from 2006, the year before Turley arrived at Stanford, through last season, the number of games missed because of injury dropped by 87 percent. In 2012, only two players required season-ending or postseason surgical repair, and this year only one did. “For the subtle art of injury prevention, the [Stanford football players] stretch and stretch and stretch. They stretch before and after lifts and before and after practice. They stretch for fun.”
And think again if you think that’s just a regimen needed for elite football players. “These are things that you do for Grandma and Grandpa,” says a Stanford yoga instructor who helps train the team.
>>Bonus Link: Read a U.S. Food and Drug Administration update reminding consumers that, despite advertising they may have seen, dietary supplements cannot prevent concussions.
The normally hectic pre-Thanksgiving travel day could be more frenzied than usual this year because of predicted storms in the west that could move east—and storms are often a precursor to flight delays. So why not use the extra time to get a jump start on 2014 resolutions?
Mindful that air passengers are captive audiences, many airports have added fitness options ranging from trail markers to let you know how far you’ve walked on the airport’s walking trail (Baltimore Washington International) to a yoga room (San Francisco International and Dallas Fort Worth) and even a full fitness center with workout clothes for rent (Toronto Pearson).
Airport Hotel Gyms
While most airports don’t yet have a gym right on the premises, a growing number of airports have hotels with attached gyms in one of the terminals, including Chicago O’Hare and Orlando International. (The hotels are located outside of the security areas, so if you’re planning a workout, build in the time you need to shower, dress and clear security before boarding your flight.) Passes to the airport gyms are typically under $20 per person. Check your airport’s website for hotels onsite, and then check the hotel to find out rates and rules for short term use. And remember to wear your sneakers to the airport so you’re sure you have them for the workout.
Airport Walking Trails
In addition to the walking trail at Baltimore Washington International, a growing number of airports have marked walking trails. Keep that in mind when you pack your carryon, as there aren’t usually storage facilities for luggage once you pass security, though for $39-50 you can get a day pass at many airline clubs where you can find a quiet corner, snacks and a place to store you hand luggage while you walk the indoor trail. Ask at the airport information desk where the trail begins, or check the American Heart Association walking path website or phone app, and put in “airport” for the search engine section marked “type of path.”
Citric acid-based drinks have been linked to devastating tooth erosion, especially in Central Appalachia where the drinks are widely consumed by people of all ages. The issue was selected for a five-minute “Critical Opportunities” presentation that garnered more votes than any other issue in the session at the most recent Public Health Law Conference. This year, the issue has moved to a general session on the main day of the Public Health Law Research (PHLR) Annual Meeting, as an emerging issue in public health law. Priscilla Harris, JD, an associate professor with the Appalachian School of Law in Grundy, Va., will present “Finding Legal Interventions to Impact Purchase and Consumption of Sugar-Sweetened Beverages and Citric Acid Drinks: Trying to undo the damage of the Dew.”
According to the American Dental Association, 65 percent of West Virginia's children ages three through seven suffer from tooth decay—and near-constant sipping of Mountain Dew and other citric acid-based drinks plays a role. Harris, together with Dana Singer, JD, a program developer and researcher at the Mid-Ohio Valley Health Department and Mary Beth Shea, a dental hygienist with the health department, spoke at an information session to the Mid-Ohio Valley Board of Health a few weeks ago to present the research they have worked on to show the damaging health effects of the beverages for the people of the region. NewPublicHealth spoke with the three public health professionals just before the PHLR annual meeting began.
NewPublicHealth: What research are you working on to look at the impact of citric acid on tooth health?
Priscilla Norwood Harris: We conducted surveys to determine purchase and consumption patterns for sugar-sweetened beverages and citric acid drinks. We also interviewed and sent surveys to dentists in Central Appalachia about their perceptions of oral health problems in the region. We also went to five clinics that offer medical, dental and vision care to low-income people, and asked patients about these drinks. In addition, have almost 2,000 surveys of students in grades K through 12. We have also reviewed journal articles, many from Europe, that examine the issue of dental erosion. While it’s under the radar here in America, the studies we’ve reviewed are making the connection between dental erosion and the citric acid in drinks.
A lot of the attention in the U.S. has been focused on the sugar in these drinks and their contribution to obesity as well as the sugar with regard to oral health and cavities. Unfortunately, the acids in these drinks and the connection to dental erosion have been almost ignored. “Mountain Dew Mouth,” a term used in Central Appalachia for severely damaged teeth, involves the acids in these drinks, which can take away the tooth’s enamel.
Mary Beth Shea: From a dental health professionals’ perspective, we see a high number of adults who have said they didn’t have a clue that the beverages they’re consuming are causing the damage in their mouth and they haven’t had money for dental care.