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Children’s Health Indicators

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Childhood Obesity Rates

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Childhood Obesity Rates

Nearly one in three children in America are overweight or obese, while only one-third of high school students get the recommended levels of physical activity. Obesity in children and teens may lead to:• Heart disease

• Type 2 diabetes

• Asthma

Schools that are safe and easy for children to reach on foot or by bicycle can help students:• Reach the recommended goal of 60 minutes of physical activity

every day

• Arrive at school energized & ready to learn

• Leave the car behind & reduce dependence on fossil fuels

• Take an active role in their well-being3

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Walking & Biking to School

Source: National Household Travel Survey Brief (January 2008).5

Student Distance from Schools

Source: National Household Travel Survey Brief (January 2008).6

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8

Percentage of Secondary Schools that ImplementedSchool-based Asthma Management Activities

47 States, 2008

Activity Range % Median %Had adopted a policy stating that students are permitted to carry and self-administer asthma medications

46.3% to 88.6% 76.5%

Had a full-time registered nurse who provided health services to students 3.8% to 99.1% 40.2%

Had an asthma action plan for all students with known asthma 27.0% to 77.3% 46.1%

Tried to increase student knowledge on asthma awareness as part of a required course 25.8% to 76.4% 47.0%

Lead health education teacher received staff development on asthma awareness 8.8% to 48.8% 17.3%

Source: CDC (http://www.cdc.gov/HealthyYouth/asthma/). 8

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An average of one out of every 10 school-age child has asthma. Asthma is a leading cause of school absenteeism. Each year, 10.5 million school days are missed due to asthma.

In addition to medical treatment, asthma can be controlled by managing environmental triggers in schools including:

•Pest

•Mold and moisture

•Chemical exposures

•Dust mites

•School bus diesel exhaust

Childhood Asthma

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10

Indicator ND1

Percentage of children ages 5 to 17 years reported to have attention-deficit/hyperactivity disorder, by gender

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 20080%

2%

4%

6%

8%

10%

12%

14%

All children

Boys

SOURCE: U.S. EPA. America's Children and the Environment. www.epa.gov/envirohealth/children

Girls

DATA: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey

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Children’s Exposures are Different

Mea

n In

take

mg/

day-

kg

Source: U.S. EPA. Child-Specific Exposures Factor Handbook 2008.

Children Eat More Food – Different Varieties

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12

Children’s Exposures are Different

137 11980

5327 26 24 17 13 12

238 285

173

129

75 62 6545 34 32

0

50

100

150

200

250

300

350

400

450

Ing

es

tio

n R

ate

mL

/da

y-k

g

Age

Children's Drinking Water Ingestion Rates

95th percentile

Mean

Adult Default:29 mL/day-kg

U.S. EPA. Child-Specific Exposures Factor Handbook 2008.12

13 Source: NRC (National Research Council). Green Schools: Attributes for Health and Learning (2006).

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Healthy School Environments

While no two schools are identical, the following are broad categories of environmental health issues that all schools need to address to ensure that school environments are healthy and promote high achievement by students and staff:

• Implement Clean Smart Practices;

• Maintain Dry Facilities;

• Properly Manage Chemicals and Contaminants;

• Maintain Good Indoor Air Quality; and

• Implement an Integrated Pest Management Program

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Academic Achievement

In addition to costs and energy savings, the benefits of establishing clean, green and healthy school environments include:

Healthy Students & Increased Academic Performance

Improved health and decreased absenteeism of both students and teachers

Positive impact on the students' ability to perform mental tasks requiring concentration (e.g., addition, multiplication, and sentence comprehension)

Higher scores on standardized tests

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Academic Achievement

Source: Shaughnessy et al. (2005).

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Energy Star Resources

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Energy Efficiency

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Marion County Schools2010-2011 Energy Savings

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Cost Savings

Small investments made towards making classrooms more conducive to learning through lighting, climate control, ventilation, and acoustic upgrades can yield even greater cost savings. The benefits of building green, healthy, and sustainable schools include:

• Cost Savings

Decreased school spending in areas such as electricity, gas, water, and facility maintenance

– Energy Star buildings typically save 35% or more as compared to average similar buildings

– Energy star leaders are saving between 10-60% on their energy use district wide

Helps schools avoid costly cleanups and remediation that result from chemical spills or mold and mildew damage

– Individual school districts have incurred costs from $200,000 to $13 million for remediating mold and mildew damage19

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Best Practices

Many measures, such as establishing protocols and best practices for school facility managers and occupants, can be implemented with little to no upfront costs, yet, can significantly improve the environmental health of students and staff. For example,

•Increasing ventilation rates to meet ASHRAE standards can improve student performance and reduce the transmission of airborne infections

•Modest changes in room temperature (e.g., 77ºF to 68ºF) can have a positive impact on the students' ability to perform mental tasks requiring concentration

•Existing schools can become greener by targeting energy efficiency in school operations and maintenance, reducing energy bills by 5% to 20%

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EPA Guidance

EPA has been mandated to issue two sets of voluntary guidelines to help states, tribes and territories address school environmental health issues.

1. Siting Guidelines(Scheduled to be finalized Fall 2011) – Guidance to help school districts and community members in evaluating environmental factors to make the best possible school siting/location decisions

2. School Environmental Health Program Guidelines (Will post for public comment late 2011 and finalized Spring 2012) – Guidance to help states, tribes, and territories establish and sustain K-12 school environmental health programs to support school districts and schools in creating healthy learning environments

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Educational Facility Managers

All children deserve a safe and healthy environment in which to learn and grow. CEFPI members can help by:

•Continuing to create green, healthy and sustainable school facilities that address environmental health issue and promote student achievement.

•Encouraging sustainability through flexible smart growth approaches that support schools as the centers of communities.

•Providing feedback and comments on how EPA can help implement the School Environmental Health guidelines and the Siting Guidelines.

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Contact

Peter Grevatt, Ph.D.Director, Office of Children's Health ProtectionU.S. EPA1200 Pennsylvania Ave., NWMail Code 1107-TWashington, DC 20460phone: 202-564-8954; email: grevatt.peter@epa.gov

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References

Akinbami L. The State of Childhood Asthma, United States, 1980-2005. Advance Data from Vital and Health Statistics. In: Statistics NCfH, ed. Hyattsville, MD2006.

Buchanan, B. Sick Building, Sick Students: Poor air quality and other environmental irritants can lead to health concerns for your students and staff. American School Board Journal, June 2007.

EPA. IAQ Tools for Schools Program. April 12, 2010. http://www.epa.gov/iaq/schools/student_performance/index.html (accessed May 12, 2011).

Let’s Move. http://www.letsmove.gov/ (accessed September 14, 2011).

Ohlund L, Ericsson, K. Elementary school achievement and absence due to illness. Journal of Genetic Psychology. 1994;155:409-421.

Kuhlman, R. Helping Johnny Walk to School: Policy Recommendations for Removing Barriers to Community-Centered Schools. (n.d.).

National Center for Safe Routes to School. http://www.saferoutesinfo.org/(accessed September 14, 2011).

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References

NCEF (National Clearinghouse for Education Facilities). Green Schools as High Performance Learning Facilities. Washington D.C.: National Institute of Building Sciences; 2010:16.

NRC (National Research Council). Green Schools: Attributes for Health and Learning. Washington D.C.: The National Academies;2006.

Sahakian N, Choe, K., White, S., Jones, R. NIOSH Health Hazard Evaluation Report: Hilton Head Elementary School, Hilton Head Island, South Carolina. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health 2003.

Scheel C, Rosing, W., Farone, A. Possible sources of sick building syndrome in a Tennessee middle school. Archives of Environmental Health: An International Journal. 2001;56(5):413-417.

Shaughnessy R, Haverinen-Shaughnessy, U., Nevalainen, A., Moschandreas, D. A preliminary study on the association between ventilation rates in classrooms and student performance. Indoor Air. 2006;16(6):465-468.

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References

Thomas G, Clark Burton, N., Mueller, C., Page, E. Health Hazard Evaluation Report: Comparison of Mold Exposures, Work-related Symptoms, and Visual Contrast Sensitivity between Employees at a Severely Water-damaged School and Employees at a School without Significant Water Damage, New Orleans, LA. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health 2010.

U.S. EPA (U.S. Environmental Protection Agency). Indoor Air Quality Tools for Schools Program: Benefits of Improving Air Quality in the School Environment 2003.

U.S. DOE (Department of Energy). Federal Energy Management Program Operations and Maintenance Best Practices Guide, Release 3.0. In: Energy OoEEaR, ed2010.

Velez and Broward County Grand Jury. Interim Report of the 2002 Fall Term Grand Jury on School Board Construction2002.

Wargocki, Pawel, and David P. Wyon. "The Effects of Moderately Raised Classroom Temperatures and Classroom Ventilation Rate on the Performance of Schoolwork by Children." HVAC&R Research 13(2), 2007: 193-220.