Wednesday, October 10, 2012

More Nurses and Improved Educational Outcomes

(Image from Flickr, from Elgin County Archives)

The single biggest influence on students’ educational achievement is their socioeconomic backgrounds. While good teachers can help some students overcome the challenges they face and they can make the curriculum more exciting and engaging for the majority of their students, they cannot make all students succeed academically.

There are numerous reasons why lower income children do more poorly in school than their affluent peers. Lower income parents tend to read less to their young children and use less complex vocabulary, for example, which contributes to an academic achievement gap even before children have entered kindergarten. Lower income parents are less able to provide enriching extracurricular activities on weekends and during the summer, like camp, summer school, arts and music classes, and travel. They are less able to hire tutors or purchase supplemental learning materials. Many are working so hard to put food on their children’s table, often at multiple jobs, or at night, that they simply aren’t available to assist with homework or meet with teachers.

Poor children also have a higher rate of health conditions that can undermine their academic success. For example, they are more likely to be born prematurely or with low birth weight and to suffer from malnutrition or anemia, any one of which can lead to cognitive impairment or learning disabilities. They are also more likely to be homeless or suffer housing insecurity and have untreated chronic diseases or excessive absences, any one of which can undermine stability and consistency of educational programs and social relationships. They are more likely to suffer stress from financial uncertainty at home or from the violence in their neighborhoods, which can lead to overproduction of the stress hormone cortisol, which can impair memory and cognitive function. They are also more like to be exposed to excessive levels of cortisol in utero, which can affect their physical health and cognitive development.

While ending poverty and closing the wealth gap might seem intractable, many of the problems associated with poverty that threaten children’s ability to succeed academically can be significantly reduced by placing health clinics staffed by qualified registered nurses in every school.

As many as 18% of school children have chronic health conditions, according to the Wall Street Journal, including attention disorders, diabetes, epilepsy and asthma. 33% of students are now obese or overweight and many of them have specialized physical and mental health problems associated with their weight.

Nurses can treat mild injuries and disease symptoms, as well as administer medications to chronically ill students, thus helping to keep more students in class. They can help screen for vision and hearing problems, thus improving children’s ability to access academic lessons and resources. They can do health outreach to help reduce obesity, smoking, sexually transmitted diseases and unwanted pregnancies and to reduce transmission of infectious diseases, all of which should also serve to keep more children in school.

Sadly, the trend over the past two decades has been just the opposite. According to the National Association of School Nurses, only 45% of public schools currently have fulltime nurses, while 25% of schools have no nurses at all. The state of Michigan has only one nurse for every 4,411 students. Vermont, in contrast, has one nurse for every 396 students.

In addition to eliminating nurses entirely, many districts are replacing registered nurses with licensed practical nurses and vocational nurses, who are less expensive, but also less qualified. Linda Davis-Alldritt, president of the school nurses association, said this is like replacing credentialed teachers with teacher’s aids, according to the WSJ.

The number of children needing medical attention at school is not trivial. The National Association of School Nurses says that 24% of American school age children have vision deficiencies, 13% are on prescription drugs, 6% are out more than 11 school days due to injury or illness, 10% have asthma, 5% have seizure disorders, 5% have food allergies, 5% have hearing deficiencies and 5% have ADHD.

Many of these children come to school, but cannot concentrate or focus for extended periods because of pain or discomfort. Many don’t come to school at all because they are too sick or uncomfortable.

There is also a strong connection between absences and academic success. In a study of Baltimore school children, high school drop-outs averaged 27.6 absences per year, while graduates averaged only 11.8. Therefore, anything that can be done to reduce infections and alleviate symptoms, such as increasing health services at schools, should help increase the amount of time kids spend in class and improve their chances of graduating on time.

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