Go Back to Basics, Go Back to Schools

Jan 23, 2015, 9:00 AM, Posted by Katherine Vickery

If we want to create a Culture of Health in America, a 2015 priority must be to focus on ways to break down the barriers that separate us and keep us from being as effective and efficient as possible. Currently, health care systems, education, housing, and public health work in siloes; they are funded in siloes, and workers are trained in siloes. Yet, people’s concerns and lives are not siloed and a community health culture/system cannot be either.  One of the places to begin coordinated cultural change is in schools.

Schools are a smart choice to target because nearly 98 percent of school-age children, in their formative years, attend school and schools provide access to families and neighborhood communities. The Department of Education’s Full-Service Community Schools Program and Whole School, Whole Child, Whole Community Initiative reminds us that, in order for children to be educated, they need to be healthy and there must be a connection between school and community.

There are many school health initiatives in place, such as healthy food choices, physical fitness, healthy policies, school health services, community support, and after-school programs. The potential is there—but so are the siloes. But when schools are appropriately staffed with school nurses, the nurses help break down the siloes; that is because school nurses are extensions of health care, education, and public health and thus can provide or coordinate efforts to ensure a holistic, resource efficient, healthy school community.

School nurses serve as an extension of the health care system because they work with health care providers and regularly assist students and their families in self-managing their health conditions. School nurses are also an extension of public health system because they are the eyes and ears of daily activities of the community. Every day, school nurses observe how health behaviors, social determinants (including community/neighborhood environments), and health policies affect the health of students and their families. School nurses address these concerns. They also collect rich and important data that, when aggregated, can help schools and communities identify health trends, concerns and successful interventions at a very local level.

School nurses also serve as the gateway for improved access to care, by working in conjunction with school-based/linked clinics, federally qualified health clinics (FQHCs), and other physical and mental health care providers to ensure all children have access to needed treatment.

In addition, school nurses serve in a pivotal role for the entire school community by having the skills, knowledge, and ability to promote healthy environments and by reaching out to those who are at risk for health problems (including mental health conditions that are often masked by physical symptoms).

In short, school nurses help bridge the gap between school, communities, and health systems while also ensuring students ready and able to learn.

I witnessed this first hand when I was a school nurse. I worked with health care providers, students, and families to address individual health conditions such as diabetes, asthma, and seizure disorders. I also taught or coordinated education and health promotion activities in the school that addressed community needs. For example, I once taught sixth to eighth graders, who were often the caretakers in the home, about the importance of refrigeration of foods because of a concern identified by a community worker. We also arranged events to take place in the school to promote community well-being. These events related to literacy, housing, or other broader health needs.

School nurses bridge a gap not just in providing care and coordinating activities, but also breaking down funding siloes. Traditionally, school nurses have been employed by education. However, health care systems, public health, and community organizations are beginning to employ school nurses, which also helps break down traditional funding siloes and expands accessible resources while improving student/family health.

Targeting schools by having appropriate school nurse staffing to address the needs of the school community is an important priority for 2015 in the campaign to build a Culture of Health in America. A school nurse-led coordinated health focus will ensure students not only learn early healthy habits and are ready to learn other subjects, but it also will help provide an environment to work with families and the larger community, coordinating efforts and increasing the focus on building a Culture of Health.

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.