Health Assessments are conducted in schools to identify conditions or health problems that affect the students’ ability to learn, and take part in educational programs. Information obtained from such assessments is then used to improve the quality of life of the students, which in turn improves their ability to learn and take part in their respective educational programs (Weber & Kelley, 2009). This paper is an assessment of Sherwood Elementary School. The assessment is done through three data collection methods: secondary data collection, observation, and an interview with a school nurse. The last section is the diagnosis of the school’s health problem.
Sherwood Elementary School Dimensions
This school enrolls students from pre-kindergarten to 8th grade. 2012 -2013 data shows that Sherwood elementary school’s largest demographic is black. This is 96.7% of the student population. There are other races which are; Hispanics, whites, Asians, Native Americans and others. This group is composed of 3.3% of the student population. The second largest demographic is the Hispanics which is 2% of the student population. Still as of 2012-2013, the number of students enrolled in the school was 301. From this number, 15.6% were special education students, and 97% were low income students (Chicago Public Schools, 2013). According to the Local School Directory (2013) and USA School Info (2013), however, the total number of students enrolled as at 2013 is 408 and 386 respectively. USA School Info’s data shows that the male population is slightly higher than the female population. That is, 200 (51.8%) and 186 females (48.2%) (2013). Local School Directory’s data shows that the school has 204 males and 204 females (50% each). The Local School Directory (2013) and USA School Info (2013), also have different statistics about racial groups attending Sherwood elementary school. According to USA School Info, races are divided into Hispanic, black and other races (which are two or three). The black constitute 96% of the total student population, the Hispanic constitutes 2%, and other races also constitute 2% of the total population (2013). Local School Directory’s statistics shows that there are only blacks and Hispanics as at 2013. The black constitute 99%, while Hispanics constitute 1% of the total student population (2013).
Secondary Data Collection
Based on the above information, it is important to focus on health problems affecting low income groups in Chicago, as well as those associated with black people, and Hispanics. One of the major health problems affecting Hispanics and black children in Chicago is obesity. This is as revealed by the Chicago public-health department report. Lowest rates are observed in Asian and white communities. During the 2010-2011 school years, 42% of black students, and 44% of Hispanics were obese. This is in contrast to 3% and 9% Asian and White students found to be obese respectively. Schneider also indicates that obesity is related to income. Obesity decreases with increase in income (2013). This means that low income students are most likely to have obesity. The statistics shown above indicates that 97% of Sherwood Elementary School’s total students are of low income. This shows the high likelihood of occurrence of obesity, or high likelihood of its existence as the main health problem. Obesity is a primary problem with other associated problems such as drug use, homicide, housing and drop-outs (Schneider, 2013). The Children’s Defense Fund (2012) also notes that obesity is prevalent among black children with 1 in 4, of children aged 6 to 17 being obese. The black children are also at higher risk of being overweight. Black teenage girls of 12-19 years are at 40% risk of being overweight. Being obese is one health problem, but there are other health problems associated with obesity. Children with obesity are at high risk of getting bone and joint problems, psychological and social problems (such as poor self esteem and stigmatization), cardiovascular disease, and sleep apnea.
Asthma is also a prevalent disease among black people at all income levels. There is 20% more likelihood for Black children to be diagnosed with asthma, than White children. They also have similar percentage likelihood to have an attack in the earlier year. Nationwide statistical analysis shows that 8% of White children have been reported to have asthma, 7.8% of Latino children, 19.2% of Puerto Rican children, and 12.7% of black children. Black children also have a higher rate of hospitalizations, and emergency room visits due to asthma attacks compared to White children. They are 3.5 times likely to be hospitalized and have an emergency room visit. They are also at a higher risk of dying from asthma than White children. Reports also indicate that Latino and Black children are more likely to be diagnosed with diabetes type II (Children’s Defense Fund, 2012).
Data Collected through Observation
I went to Sherwood Elementary School to assess school environment and the students, to find out areas of weaknesses in the health care service provision in the school, and diseases that may affect the students. I walked in all the classrooms and observed one major problem; obesity. There is no classroom that had no obese student. Most of the classrooms had more than two obese students. I also found out one of the Nurse’s duties. Some of them that were important to note are: providing care to diabetic patients, administering medication to students, providing traditional care such as attending to students who become ill and any injuries, providing advisory and counseling services to parents and teachers on extra care requirements for some students, and working with specific groups of asthmatic, diabetic, and anemic students among other groups, to ensure the well being of the students. The school is a pre-kindergarten through 8th grade. I noted that there are a number of health issues; included are cases of cerebral palsy, asthma, sickle cell anemia, and diabetes.
Data Collected through Interview (Interviewed is one of the Sherwood Elementary School Nurses)
Interview questions and respective responses (responses are edited, but main points included):
- Tell me about the Sherwood Elementary school
This is a well-managed school with good health care structures. There are disease prevention and health promotion activities that are put in place to ensure good quality of life for the students. There are also school health programs that ensure good management of common diseases within the school. A good number of the children here have asthma and the school has ensured there are certain provisions that the parents and guardians have to follow to ensure the students’ safety.
- What are the main health problems in the School?
This is a school with students from pre-kindergarten up to 8th grade. Prevalent health problems are such as asthma, obesity, flu, minor headaches, scrapes, and bumps which are not so complicated to manage. Obesity is however, a challenge. Occasionally, there are chronic illnesses such as diabetes. There are also emotional and mental health problems that the school deals with, although these are rare.
- Which population do you think is the most at-risk for health problems in the school?
The largest population in the school is composed of black children. Most cases dealt with and observed are, therefore, from the black community. Occasionally there would be Hispanics and others especially in cases of minor health problems such as headaches and the rest. Most common is asthma, and maybe a case of obesity, all of which are associated with black people. Cases of Asthma are therefore very high among black students.
- Why do you feel these health problems are most prevalent in this community?
Records show that black children have higher rates of asthma attacks compared to other races. They are the ones who are most likely to have the disease and are at high risk of getting it. It could be genetic or related to living conditions and environment, but what is clear is the prevalence of asthma among black children. Asthma is triggered by various factors, such as allergies, climatic conditions and even smoke. It is expected that in low income environments, such factors, except for climatic conditions, are at increased levels. This could explain the higher rate and likelihood of attacks among black children. Diabetes could be associated to obesity, eating habits and still, low income status.
- How can the school health nurses assist in protecting, preventing, reducing, or eliminating these health problems?
There are a lot of things that can be done. The nurse should just be focused, and identify health problems and appropriate management strategies. There should be, for example, good and early assessments, good planning and establishment of preventive measures, good management of the illnesses and conditions, and sufficient funding for health services.
Problems and Risks Identified: The following are various health problems identified. Obesity, asthma, sickle cell anemia, health problems associated with obesity (bone and joint problems, psychological and social problems, cardiovascular disease, and sleep apnea), diabetes, cerebral palsy, flu, minor headaches, scrapes, bumps, and emotional and mental health problems.
One School Problem or Risk that is of Greatest Concern (and should be a priority): There are two problems that are of main concern; asthma and obesity. Asthma is a common disease among black people, and various reports show that black children are likely to have asthma, are at high risk of asthma attacks, and are also at high risk to die from asthma than White children. It is also a prevalent disease among Latino children. In the school, it is also a prevalent problem. This qualifies it as a major health risk in the school. Obesity is another problem. Most of the students in the school (97%) are of low income status. Obesity is directly related to low income so that decreased income is associated with increased obesity. A good number of students were observed to have obesity. Additionally, black children and Hispanics are at high risk of being obese or overweight. Increased likelihood of the highest number of students in the school to get obesity, and proof of the existence of high number of obese students, places this health problem a priority. Asthma is well managed, but obesity is a current problem in the United States. Obesity is additionally associated with several other health problems (Schneider, 2013; Children’s Defense Fund, 2012).
The School Factors of the Priority: Black children form more than 97% of the student population. This is followed by the Hispanic population which could be 1-2%. These two groups are both at high risk of being overweight, and have the highest percentage or number of obese children.
Obesity as a Health indicator of Healthy People 2020
Obesity is one of the health problems that will be eradicated or is focused to be eliminated by Healthy People 2020. Undernutrition and weight status, the aim is to ensure reduced chronic disease risk and health promotion through maintenance of healthy body weights, and consumption of healthful diets. As described above, obesity is associated with various chronic diseases. By managing the cause, such diseases are prevented. The objectives of Nutrition and Weight Status are a reflection of the benefits of healthy body weight and eating a healthful diet. The objectives give emphasis to individual behaviors, and environments and policies that support healthful eating habits, and maintenance of weight, as the main areas to focus on in changing weight and diet. These individual behaviors, environments and policies should be in settings such as health care organizations, schools, communities and worksites. Healthy People 2020 has identified schools as an important setting in which quality health culture can be achieved. Sherwood Elementary School being one of them should assess the detailed objectives nutrition and weight status, to ensure Healthy People 2020 objectives, set for the institution are achieved. Main objective areas focus on: healthier food access, weight status, health care and worksite settings, food insecurity, Iron deficiency, and food and nutrient consumption (Healthy People 2020, 2013).
- Chicago Public Schools (CPS). (2013). Jesse Sherwood Elementary School. Retrieved May 30, 2013, from http://www.cps.edu/Schools/Pages/school.aspx?id=610173
- Children’s Defense Fund. (2012). Racial & ethnic disparities. Retrieved May 30, 2013, from http://www.childrensdefense.org/policy-priorities/childrens-health/racial-ethnic- disparities/
- Healthy People 2020. (2013). Nutrition and weight status. Retrieved May 30, 2013, from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=29
- Local School Directory. (2013). Sherwood Elementary School. Retrieved May 30, 2013, from http://www.localschooldirectory.com/public-school/25600/IL
- Schneider, E. (2013). Obesity weighs heavily on Chicago Hispanic, Black students one in four school children In Chicago public schools are obese. Medill Reports. Retrieved May 30, 2013, from http://news.medill.northwestern.edu/chicago/news.aspx?id=220256
- USA School Info. (2013). Sherwood Elementary School in Chicago, Illinois. Retrieved May 30, 2013, from http://www.usaschoolinfo.com/school/sherwood-elementary-school-chicago-illinois.28779/enrollment
- Weber, J. R., & Kelley, J. H. (2009). Health assessment in nursing (4th ed.). New York, NY: Lippincott Williams & Wilkins.