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First the bad news: Nearly 28 percent of Tennessee’s adults and 20 percent of Tennessee’s children ages 10 to 17 are obese, according to an August report by Trust for America’s Health. That’s the nation’s fifth-highest rate for adults and fourth-highest rate for kids.

The good news is that the Tennessee Department of Education’s Office of Coordinated School Health announced in August $12.3 million in grants to local school systems to help combat the widening girth of Tennessee schoolchildren.

“We are the only state in the entire nation that has this coordinated, comprehensive school-health law,” explained Connie Givens, the office’s director, who has a bachelor’s degree in health education and a master’s in education. She is a former school nurse and former director of health services for the Hawkins County School District. “Our mission is to work with schools and to provide an approach for them where health and academics merge. We know that healthy kids learn better. So our project is to set in motion the infrastructure that will create a healthy teaching and learning environment.” Healthier students, she added, “are less likely to be absent from school and less likely to drop out.”

Tennessee’s initiative is unique in the country, the result of legislation passed in 1999 and funded for the first time with $1 million in 2000. For six years, 10 school systems participated as pilot programs to prove the model’s effectiveness, and prove it they did. Givens said that after state lawmakers studied the evaluations and heard testimony from participants, they “decided that this was a model that they wanted to expand for every (school system) in Tennessee. Now Tennessee is leading the nation.”

Tennessee’s program mirrors a model developed by the federal Centers for Disease Control and Prevention. The model partners schools with families and community members such as healthcare providers and businesses, and the goal is a focus on health awareness, physical activity and counseling for nutrition and health, both physical and behavioral.

When announcing the $12.3 million in grants, Gov. Phil Bredesen said, “I am pleased to see these local school systems embrace a greater role in protecting the physical, mental and emotional health of Tennessee’s students. Education and health are a natural partnership given the amount of time children spend in school.” Givens credited Bredesen with recognizing the program’s value, saying, “Governor Bredesen is known as being a good businessman, and he sees the impact that prevention can have on Tennessee’s economy. … In the future, we’ll have a healthier workforce.”

The Office of Coordinated School Health (CSH) received a total of $14.9 million, and some of the money not used for grants funds Givens’ position, an administrative position for the office and a statewide physical-education specialist to help school systems meet the mandated 90 minutes of weekly activity per student. The amount of grant funds available to each district is not based on number of pupils but is instead based on that district’s Basic Education Plan funding. Tennessee’s Basic Education Plan is designed to ensure fair and adequate funding no matter the size of a district. The grants make possible, at the minimum, one CSH coordinator for each school district, and perhaps an assistant as well, plus professional development opportunities. The program has eight components facilitated by each system’s coordinator:

1. Comprehensive health education — physical, mental, emotional and social.

2. Health services provided or supervised by school nurses that include assessments and coordination with community healthcare professionals.

3. A healthy school environment.

4. Nutrition services to ensure access to nutritional, affordable and appealing meals.

5. Physical education and activity.

6. School counseling.

7. Health promotion for school staff.

8. Student, family and community involvement.

Givens said healthcare providers have a unique opportunity to become involved in their local school system’s CSH program. Loudon County, for example, enjoys the participation of Dr. Elizabeth Friend, a pediatrician who served on the county’s School Health Advisory Council. Dr. Celia Harrison, an emergency room physician, volunteers at Philadelphia Elementary School. “In Tipton and Hardin counties, pediatricians volunteer to do screenings or health education,” she added. Washington County, one of the original 10 pilot programs, has forged a valuable relationship with Mountain State Health Alliance.

Givens said that it is the hope of the program that state funding will increase as the local initiatives bear fruit. “We hope to show the legislature some good data and some good results, and we hope the amount might be raised. When you look at the big scheme of things, that’s not a whole lot of money. We are talking about trying to curb the trend for childhood obesity,” she said.

The state also is using the CSH initiative to help spread the word about CoverKids, Tennessee’s program to provide comprehensive health insurance to uninsured children 18 and under, Givens said.



October 2007

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