Serving the needs of new immigrants, rousing teenagers from their couch potato lifestyle, and increasing community awareness of the dangers of lead paint in older houses are just some of the public health services that students have taken action on in innovative programs developed through ASCD's Health in Education Initiative.
Teachers involved in these programs—whether in urban Seattle, rural Utah, or the historic mill town of Pawtucket, R.I.—believe that exposing their students to real-world health issues will not only help them to appreciate the relevance of their current schoolwork, but also spark an interest in pursuing careers in the field of public health.
A key tool of the programs, each funded by two annual grants of $20,000 from the Robert Wood Johnson Foundation, is encouraging collaboration between public and community-based health organizations and local school districts. This collaboration is helping students in these programs learn firsthand about public health issues and careers in health care through field experiences, conversations with professionals, and internships.
Health Challenges
Like many large U.S. cities, Seattle welcomes thousands of immigrants each year. These new American residents bring with them their own ideas of health care, which may differ from standard procedures in U.S. clinics and hospitals. Families coming from Mexico, Ethiopia, Somalia, and various Asian countries—including China, Vietnam, and Cambodia—often have different health practices based on cultural, religious, or family systems of understanding health, says Robin Fleming, a registered nurse at John Hay Elementary School in Seattle.
"There are a number of factors working against immigrants. They're new, and they may not be aware of how to access health care. If they're people of color, they also face huge risks educationally, socially, and economically," Fleming says.
In two years, Fleming has worked with students and teachers in two middle schools and three high schools to develop public health education programs. Working with teachers of English as a second language, Fleming begins with a survey that gauges students' interest and understanding of public health issues.
In Seattle's Roosevelt and Ballard High Schools, Fleming directed Hispanic students working on computer literacy skills to a local Web site that highlights how health care practices and expectations vary among immigrant communities in Seattle. EthnoMed (http://www.ethnomed.org), sponsored by the University of Washington's Harborview Medical Center, profiles various ethnic groups, including the Vietnamese, Ethiopians, Mexicans, and Chinese, and explains health care practices and expectations for each culture.
"Health care providers and educators need to be sensitive to a variety of health care practices. Some cultures use concepts of hot and cold to categorize illnesses and corresponding treatments, but some mainstream practices here may not jibe with this," Fleming says. To increase the level of trust, it's best not to be judgmental, she advises, "or else they won't come back."
When a representative from Harborview Medical Center explained to Fleming's students the value of the EthnoMed site as a health care resource for students whose families are new to the United States, her students opened up and wrote articles about the immigrant perspective on dealing with the school system, police, and gangs and on accessing local health care, Fleming says. Because many students work to help support their families, some wrote persuasive essays calling for a change in the high school starting time of 7:45 a.m.
Meanwhile, in Seattle's Denny and Madison Middle Schools, Fleming and teachers helped students focus on nutrition. Students recorded diary entries of their food choices over several weeks. After categorizing their choices—including ethnic foods—according to the food pyramid groups (e.g., cereals, meat and poultry, dairy, and fats and oils), students drew their own food pyramids for display in local community centers.
Each school's program culminates with a job fair involving a dozen professionals, usually immigrants, who talk with students about careers in public health. Occupations featured at these health fairs have included health care advocates, doctors, dieticians, nutritionists, social work case managers, academics, and public health department employees. "Experts have one-on-one contact with each and every kid at the fair, which can set the stage for future internships or mentoring relationships," Fleming says.
Battling the Urge to Sit
Students and teachers at the North Cache 8–9 Center in Richmond, Utah, and Skyview High School in nearby Smithfield, located in a region of dairy farms and cheese factories, decided to confront the problem of physical inactivity among American youth. After learning from a recent Centers for Disease Control report that the percentage of overweight youth has more than doubled in the last 30 years, they decided to address the issue by implementing Planned Approach to Healthier Schools (PATHS) programs, frameworks for establishing community-based health programs.
Students at North Cache, Skyview, and two other control schools without PATHS programs took surveys, which showed that as the students got older, their physical activity decreased. The survey also indicated that many students were failing to consume healthy amounts of milk, fruit, and vegetables. With a marketing firm hired by the Utah Department of Health, participating students chose a logo and a catchy slogan, "Get Up, Get Out, Get Fit," to launch school-based campaigns to promote good nutrition and the value of physical activity. Although only 430 students from both schools directly participated in developing and carrying out the PATHS programs (as members of physical education, language arts, sociology, and biology classes), altogether 2,500 students will be exposed to their message of healthier living.
At Skyview High School, teachers of English, physical education, biology, and sociology worked together to integrate the topic of nutrition and exercise into their subject areas, whether focusing on good eating habits or persuading students to take their health seriously.
Teachers noted several side benefits of the health campaign: student leaders emerged; the self-esteem of students leading the health campaign increased; and at North Cache, principal Larry Larson challenged himself and teachers to increase their own level of physical activity by buying and using pedometers to record the number of steps they took each day. "This created enthusiasm for the program and gave faculty from different departments something in common to talk about. We hadn't anticipated this," says Monica Lounsbery, an assistant professor at University of Nevada-Las Vegas and one of the coordinators of the PATHS program.
Lounsbery and fellow researcher Julie Gast at Utah State University plan to survey students at North Cache, Skyview, and the control schools in April to see whether their nutritional habits and levels of physical activity have changed as a result of the two-year program. The PATHS program gives students authentic learning experiences across the curriculum, says Lounsbery, who believes the program's flexible structure will allow other schools to adapt it to their own local health concerns.
The Dangers of Lead Poisoning
In Pawtucket, R.I., known for its historic textile mill that launched the American Industrial Revolution, the amount of turn-of-the-century housing that contains lead paint has been an ongoing health concern. Older houses often become rental properties, and many of them are rented to immigrant families who are unaware of the danger or reluctant to sue landlords if their children become lead-poisoned. Recent news reports have highlighted the problem of lead paint in Pawtucket and many Rhode Island cities and towns, and the state attorney general is prosecuting landlords who fail to abate lead levels.
It was the growing concern of lead poisoning that incited Robert Wooler, executive director of the Rhode Island Youth Guidance Center, to use the center's Health in Education grant to further educate Pawtucket high school students about ways to prevent lead poisoning. To raise community awareness, students have already designed brochures and posters about lead poisoning in six different languages.
"It's a very visible issue and something kids can tie in to lots of avenues—legislation, social service, health"—while fitting it into their studies in chemistry, environmental science, or school-to-career programs, explains Wooler.
Four internships will allow high school students to further explore the lead problem by working at Rhode Island Housing, the Rhode Island Department of Health, and the community-based health groups Blackstone Valley Community Action Project and the Childhood Lead Action League. Using their internship experiences, the high school students will each produce a paper or presentation to explain his personal contribution to reducing the public health threat of lead.
Chemistry teacher Julie Goulet at William E. Tolman Senior High School tells her students, who will be involved in testing for lead in various Pawtucket homes, that the project will give them "real-life experiences that will be a plus for their lives beyond school."
