Good medicine

How do you fight chronic absenteeism? Put a nurse in every school.

Almost a fifth of Memphis students are considered chronically absent from school, and too often it’s because of an asthma attack, a toothache or an undiagnosed psychological condition.

Community leaders grappling with the city’s high rate of absenteeism frequently have cited challenges rooted in poverty — from students who struggle to get a ride to school to embarrassment over dirty uniforms. Now they’re zeroing in on a deeper related problem: chronic health conditions.

Last year, a staggering 44,000 Memphis students reported suffering from a chronic health condition, contributing to 18 percent of students missing at least 18 days of class in Shelby County Schools or the state-run Achievement School District.

“It’s clear that having a nurse at every school could greatly reduce the number of students who miss school for preventable health reasons,” said Lora Jobe, executive director of PeopleFirst Partnership, a coalition of business, government, academic and civic leaders. “The health concerns we’re talking about disproportionately affect impoverished children and children of color. In Memphis, addressing this should be a top priority.”

Community leaders came together Wednesday at the University of Memphis for a summit on how health disparities are causing youngsters to miss school. The gathering follows last month’s launch of an attendance campaign by Shelby County Schools, providing supports for 10 schools with the most-absent students.

Students in Memphis are mostly people of color and from low-income families, both groups with higher-than-average rates of asthma and untreated dental cavities.

Last year, in fact, Memphis was named the nation’s worst city to live with asthma, a chronic lung condition that leads to episodes of wheezing, coughing and shortness of breath, among other symptoms.

Panelists talk about chronic absenteeism and health at a summit spearheaded by PeopleFirst Partnership.
PHOTO: Caroline Bauman
Panelists talk about chronic absenteeism and health at a summit spearheaded by PeopleFirst Partnership.

The summit was attended by doctors, dentists, nurses and mental health professionals, as well as education and nonprofit leaders. Discussions gravitated frequently to the importance of having a full-time nurse in each school, not only to treat students but also to educate their families about how to manage medical conditions that might keep their kids home from school.

Tennessee law requires only one nurse for every 3,000 students, and budget cuts have made it impossible for Shelby County Schools to keep a nurse in every school building. Instead, nurses rotate across the district, usually giving each school one day of medical staffing a week.

That’s not enough, said Angela Hargrave, the district’s director of attendance and discipline.

“Parents aren’t comfortable that their children will be properly cared for at school,” Hargrave said. “People at schools aren’t comfortable with that responsibility. We’re not medical professionals. Our front office staff isn’t trained for that.”

A full-time school nurse can provide the medical care or information that makes the difference in coming to school or staying home, said Cindy Hogg, director of health services at Le Bonheur Community Health.

“A nurse in the school building is often the only care provider many children in low-income areas in Memphis see for years,” Hogg said. “Of course, nurses should send students home when they are sick. But so often students are missing way more school than they should because no one in the health world is communicating with them or their parents.”

Jobe pledged that PeopleFirst Partnership, which organized the summit, will lobby local and state officials to enact and fund a policy that lower the school nurse-to-student ratio.

“I hope this time next year, when we see Tennessee require a nurse in every school, you will be able to say, ‘I was in the room when this started,’” Jobe told the group.

catching some zzzzs

One Colorado district moving toward later high school start times — maybe — while another shelves the idea

PHOTO: Chellseyy, Creative Commons

Of the two large Colorado school districts that were actively exploring later high school start times for the 2017-18 school year, one is moving ahead and one has dropped the idea for now.

The 55,000-student Cherry Creek district — the state’s fourth largest — continues to consider proposed start- and end-time changes at all school levels. While the district is still collecting community feedback, the current proposal would set elementary school start times at 7:55 a.m., middle school start times at 8:50 a.m. and high school start times at 8:15 a.m.

Currently, Cherry Creek elementary schools start about 9 a.m., middle schools start about 8 a.m. and high schools start about 7 am. A recommendation will go before the Cherry Creek school board this spring.

Meanwhile, the 31,000-student Boulder Valley school district won’t change school start times next year because of the complexity of managing school bus schedules and the prospect of higher transportation costs, district spokesman Briggs Gamblin wrote via email.

Changes are still possible for the 2018-19 school year if the district can find a way to keep transportation costs at their current levels, he wrote.

The push for later high school start times has gained steam nationally with increasing evidence that when school schedules match with teen sleep rhythms, students are healthier, more focused, attend school more regularly and do better academically. In the last two years, both the American Academy of Pediatrics and the Centers for Disease Control and Prevention have come out in favor of start times of 8:30 a.m. or after.

In districts that have considered changing high school start times or actually changed them, the logistics of bus schedules and after-school sports are typically the biggest hurdles.

In Colorado, some smaller districts, including the Montezuma-Cortez district in southwest Colorado and the Harrison district in Colorado Springs, have pushed start times to 8:30 a.m. or after for some or all secondary schools.

But large districts have been slower to join the club. Denver Public Schools, the state’s largest school district, briefly explored later start times for some high schools a couple years ago, but the effort did not lead to any changes.

In the Boulder Valley district, a task force spent the 2015-16 school year researching later high school start times, with one of the group’s leaders saying last August she hoped the district could move forward with changes in 2017-18.

In Cherry Creek, where changes to school start and end times have also been under consideration over the last year, a November survey on the topic drew 25,000 responses.

Seventy-three percent of respondents said they wanted high school start times to align more closely to the American Academy of Pediatrics recommendation. When respondents were asked to pick between six high school schedule scenarios, the 8 a.m.-3:30 p.m. scenario was most popular — garnering more than 7,000 votes.

No thanks

Diet Nope: Colorado’s large districts still keeping diet soda out of high schools

After a state rule change last fall that allowed Colorado high schools to sell diet soda after a seven-year ban, many of the state’s big school districts have decided to stay soda-free.

Officials in six of Colorado’s 10 largest districts — Denver, Douglas County, Cherry Creek, Boulder Valley, Poudre and Colorado Springs 11 — say there are no plans to allow diet soda sales.

In some cases, such as Boulder, the district’s existing wellness policy already bans the soft drinks. In others, such as Poudre, the superintendent’s cabinet made the decision in the fall. In Denver, the district’s Health Advisory Council has recommended a continued prohibition of diet soda, but the school board hasn’t voted on the recommendation yet.

“We really commend the districts that are strengthening their own policies to continue to disallow diet soda,” said Sarah Kurz, vice president of policy and communications for the advocacy group LiveWell Colorado.

Three of the 10 largest districts — Aurora, Jeffco and Adams 12 — haven’t decided yet whether to bring back diet soda. Adams 12 officials say they’re gathering feedback from the district’s health advisory committee, 42 school wellness committees and all building principals. When that process is complete, any proposed changes will go through a policy-making process that ends with a recommendation to the superintendent.

Jeffco administrators say they’ll also collect data and public input before deciding whether to update the district’s wellness policy to ban diet soda. Aurora officials said there’s no timeline for a decision.

The St. Vrain district was the only one that declined to provide information about its diet soda plans.

“At this time, St. Vrain Valley Schools has no comment regarding this topic,” spokesman Matthew Wiggins wrote via email.

The diet soda issue popped up last summer shortly after new federal rules came out governing certain types of school food. Under those rules, diet soda can be sold to high-schoolers from vending machines and school stores. Colorado’s stricter rules — in place since 2009 — ban all types of soda in schools.

But officials at the state education department who brought the proposed rule change to the State Board of Education said the change would better align state and federal rules and reduce schools’ regulatory burden. Regular soda is still banned in schools because it exceeds maximum calorie limits under both sets of rules.

In August, and again in September, the State Board of Education voted 4-3 along party lines to change Colorado’s “Healthy Beverage Policy” and allow diet soda in high schools. Republican members in favor of the rule change said the seven-year ban hadn’t cut obesity and that it’s the job of parents not schools to ensure kids make healthy choices.

A coalition of health groups, including LiveWell Colorado, lamented the decision, arguing that diet soda has no nutritional value, harms teeth and diverts students from drinking healthier beverages like water.

Kurz said with the recent change in the state board’s composition — Democrats now hold a majority — it’s possible a vote now would go in favor of a diet soda ban. Still, with lots of big education issues looming, she doesn’t expect the board to take up the issue again.