What Role Should the School Play in Public Health?

There’s a neat article in the November 9th edition of The Chronicle Review that looks at how public health initiatives have changed in the last century. Written by Philip Alcabes, a professor at City University of New York, it’s a well-written examination of how the role of the public health professional has evolved from the smallpox and polio era of 1920 to the concerns over MRSA and avian flu today.

If you believe that common schools are for the propagation of the common good, and that having a healthy community and society is part of the common good, then it follows that schools have a place in helping to promote public health. My question to you is, what should that role be?

In my school we have a part time nurse, who works for a total of 20 hours a week. She’s mainly charged with giving hearing and vision screenings, as well as handling any outbreaks of lice that come along. Beyond that she functions as a sort of dispensary, giving out prescribed drugs like Ritalin and ice packs to the kids who scrape their elbows. I suspect that this is the model in most schools. Our PE teachers are charged with the health part of the puzzle, including promoting active lifestyles and showing the kids how exercise can be fun and healthy. In the classroom we do those units on nutrition and the body that are mandated by the state.

Yet it’s inarguable that we’re only providing the basics, just as it’s also inarguable that there are schools where the basics aren’t enough. When you consider situations like the obesity epidemic, the numbers on sexually transmitted diseases, or dental health, something in the system is screwy. Two thoughts, here:

1. At what point, if ever, do you demand parental responsibility? Does anyone have the right to suggest, “Ma’am, your son is too fat,” or, “You really need to get that kid to a dentist”? With lice we’ve mandated proof of eradication before the child comes back to school, because of the risk to other children—should that standard ever be applied because of a risk to the child themselves?
   
2. There’s an interesting economic argument to be had here as well. It takes taxpayer money to make anything happen in a school; is that a wise use of the monies available, or just another instance of wasteful spending? Are we slapping the invisible hand of capitalism if the school takes on roles that can be served by private companies (i.e., dentists?).

I’ve been doing some reading on community schools, those schools that have a full-time nurse and invite health professionals into the building to work with the kids right there in the schoolhouse. It feels like there’s a lot of potential there to positively impact the lives of kids—it could fall under the broad heading of “early intervention”—if only for the want and the will.

What’s the state of health education in your school?