As local educational agencies continue to grapple with more issues linked to student health, it is critical that health professionals weigh in on the conversations school boards have as they shape and adopt policy, according to an Oct. 23 article published in JAMA Pediatrics.
Co-author Charles G. Prober — founding executive director of the Stanford Center for Health Education and professor of Pediatrics, Microbiology and Immunology at Stanford University — noted that the COVID-19 pandemic dropped school boards into the middle of having to implement policies from the Centers for Disease Control and Prevention and state governments, often without adequate health-related guidance.
Despite the significant role LEAs play in shaping public health, the perspectives of health professionals are often underrepresented in these settings, Prober said.
“At nearly every meeting, school boards must contend with resolutions and policies that shape several critical social determinants of health (SDOH),” he wrote. “Irrespective of whether they choose to run for elected office themselves, health professionals can contribute to education policy changes through numerous approaches, such as attending board meetings, informing health promotion efforts at schools and liaising directly with local families.”
How education policy shapes student health
School board decisions have the potential to broadly impact student health across many domains. For example, boards interpreting and implementing federal guidelines for cafeteria nutrition can influence obesity rates, while investments in air filters, air conditioning systems and protection from excessive sun exposure can mitigate other issues.
Decisions to hire school-based health professionals, foster partnerships with county health offices or support comprehensive school-based health services that span preventative, acute and emergency care are obvious ways in which boards can influence the health of students, the article notes. But curriculum-related decisions such as shaping physical education practices and allowing accurate sexual health curriculum can also have short- and long-term impacts, as can the adoption of resolutions advancing school safety by seeking to prevent bullying, harassment, discrimination and other forms of violence.
“Ultimately, board knowledge and support for these services may facilitate improved access to preventative care for youth, including mental health care, immunization, and sexual health care,” Prober said. “Pediatricians, mental health professionals and epidemiologists in particular may offer relevant insights to school boards as they grapple with health care delivery and SDOH challenges. Moreover, school boards would benefit from expertise in translating frequently updated research guidance to actionable insights.”
Recommendations
Prober acknowledges that clinicians may be wary of engaging in “such contentious political arenas,” but calls on them to take these opportunities to provide evidence and best practices and get involved in other ways too.
Involvement may include something as simple as engaging in discussions with policymakers, to establishing rotations for pediatric residents or fellows “through school-based health clinics during which learners may be asked to attend a school board meeting to understand how they can better collaborate with local policymakers.”
Healthcare professionals should consider reaching out to board members and attending meetings, but school boards can take steps on their end to seek out the expertise of local health professionals too, Prober noted. School boards may “hardwire” advisory roles for health care professionals to take on tasks like reviewing proposed initiatives. Boards can pass provisions mandating that these roles be filled by those with specific experience, he continued.
“A productive relationship begins with clinicians investing time to understand the board’s workings and practicing active listening such that they may better aid in matters affecting health. Longitudinally, pediatricians should be at the forefront of advocating for equitable education and social policies ensuring equitable opportunity for young people,” Prober and his co-authors concluded. “Ultimately, while not a panacea, taking these steps may improve the translation of evidence from the bench to the bedside, to the school board room, and toward health-promoting policies for all students.”
