Promoting a Promoting a

Coordinated Approach for the Health Coordinated Approach for the Health

and Well-Being of Children and Youthand Well-Being of Children and Youth

Carolyn Fisher, Ed.D., CHES

Elizabeth Haller, M.Ed.

Division of Adolescent and School Health

National Association of County and City Health Officials

August 18, 2005

Six Key Health Risk Behaviors Six Key Health Risk Behaviors for Young Peoplefor Young People

• Behaviors that may result in unintentional injuries

and violence

• Sexual risk behaviors

• Alcohol and other drug use

• Tobacco use

• Unhealthy dietary behaviors

• Inadequate physical activityoverweight

Trends in Leading Causes of DeathTrends in Leading Causes of DeathRates per 100,000 10 to 19 Year OldsRates per 100,000 10 to 19 Year Olds

1981—20011981—2001

0

2

4

6

8

10

12

14

16

1981

1983

1985

1987

1989

1991

1993

1995

1997

1999

2001

Motor VehicleHomicideSuicide

Sexual Risk Behavior and Pregnancy Sexual Risk Behavior and Pregnancy Trends Among YouthTrends Among Youth

Pregnancy

80

Condom use among sexually active students46

Ever sex

54

0

20

40

60

80

100

1991 1993 1995 1997 1999 2001

Per

cen

t

15-17 year-old females High school students

54

2003

0

10

20

30

40

50

60

70

80

Rat

e

63

47

Percentage of High School Students Who Reported Percentage of High School Students Who Reported Current Alcohol, Marijuana, and Cocaine Use,* 1991 – Current Alcohol, Marijuana, and Cocaine Use,* 1991 –

20032003

* Drank ≥ 1 drinks of alcohol on 1 of the 30 days preceding the survey1 Significant linear decrease and quadratic effect, p < .05

* Used marijuana 1 times during the 30 days preceding the survey1 Significant linear increase and quadratic effect, p < .05

National Youth Risk Behavior Surveys, 1991 - 2003

51 505152

4845147

2224

272625

1815

4443322

0

20

40

60

1991 1993 1995 1997 1999 2001 2003

Pe

rce

nt

* Used cocaine 1 times during the 30 days preceding the survey1 Significant linear increase and quadratic effect, p < .05

Cocaine

Marijuana

Alcohol

Percentage of High School StudentsPercentage of High School StudentsWho Reported Current Cigarette Use*Who Reported Current Cigarette Use*

2831

35 36 35

29

22

0

10

20

30

40

50

1991 1993 1995 1997 1999 2001 2003

Pe

rce

nt

*Smoked cigarettes on > 1 of the 30 days preceding the survey.Significant linear increase, p < .01; significant quadratic change, p < .001.National Youth Risk Behavior Survey, 1991-2003.

Percentage of U.S. Children and Percentage of U.S. Children and Adolescents Who Were OverweightAdolescents Who Were Overweight**

* >95th percentile for BMI by age and sex based on 2000 CDC BMI-for-age growth charts**Data from 1963-65 for children 6-11 years of age and from 1966-70 for adolescents 12-17 years of ageSource: National Center for Health Statistics

Ages 12-19

Ages 6-11

54

1616

0

2

4

6

8

10

12

14

16

18

1963-70**

1971-74 1976-80 1988-94 1999-2002

Relationship Between Relationship Between Health and EducationHealth and Education

“No educational tool is more essential than good health.” Council of Chief State School Officers

“Health and success in school are interrelated. Schools cannot achieve their primary mission of education if students and staff are not healthy and fit physically, mentally, and socially.”National Association of State Boards of Education

www.thesociety.org/pdf/connections.pdf

Components of a Coordinated School Health Program

Components of a Coordinated School Health Program

Physical Education

Health Education

Health Services

NutritionServices

Counseling, Psychological

and Social Services

Healthy School Environment

HealthPromotionfor Staff

Family and Community Involvement

Characteristics of a Quality Characteristics of a Quality Coordinated School Health Program (1)Coordinated School Health Program (1)• Secures administrative support and commitment

• Establishes a School Health Council

• Identifies a school health coordinator

• Develops an annual plan

• Uses multiple strategies

• Addresses priority health-enhancing and health-risk behaviors

• Involves youth

• Provides professional development for staff

Roles of School Health CoordinatorRoles of School Health Coordinator

• Integrate school health council priorities into overall program

• Facilitate development and implementation of effective policies and programs

• Facilitate communication among components

• Build collaboration between school and community

• Secure resources

• Coordinate evaluation and maintain accountability

Resources for School Health Councils Resources for School Health Councils and Coordinatorsand Coordinators

www2.edc.org/MakingHealthAcademic

Coordinated School Health Program ResourcesCoordinated School Health Program Resources

CDC Promising Practices in Chronic Disease CDC Promising Practices in Chronic Disease Prevention and Control for State AgenciesPrevention and Control for State Agencies

Building a Healthier Future through School Health ProgramsPriority Actions

– Monitoring– Infrastructure– Partnerships– Policies– Technical assistance– Health communication– Professional development– Evaluation

www.cdc.gov/healthyyouth/publications/promisingpractices.htm

VERB VERB Opportunities Opportunities

for Schoolsfor Schools

• Materials on Web

• Promotions

• Contests

• VERB Online for tweens

www.cdc.gov/youthcampaign

http://www.cdc.gov/nccdphp/dnpa/kidswalk/

KidsWalk-to-School KidsWalk-to-School

Youth Risk Behavior Survey 20052005

School Health Profiles

School Health Policies and Programs Study 20062006

CDC Data SourcesCDC Data Sources

20062006

• Co-facilitated by CDC/DASH and HRSA/MCHB/OAH

• Key partners include:

– Professional membership associations

– University-based grantees

– State Adolescent Health Coordinator Network

National Initiative to Improve National Initiative to Improve Adolescent HealthAdolescent Health

Uses CSHP approach to address:

• Physical activity

• Nutrition

• Tobacco-use prevention

• Safety

• Asthma (summer 2005)

Model Policies Address:

•Physical activity

•Nutrition

•Tobacco use

•Skin cancer prevention

•Asthma

•School Health Services

•Healthy Environments

To be added Injury and violence prevention; Sexual risk behaviors

www.nasbe.org

School Nutrition Improvement StrategiesSchool Nutrition Improvement Strategies

• Establish nutrition standards• Influence food and beverage

contracts • Make more healthful foods and

beverages available • Adopt marketing techniques to

promote healthful choices• Limit student access to competitive

foods• Use fundraising activities and

rewards that support student health

Curriculum Analysis Tools Curriculum Analysis Tools Health Education and Physical EducationHealth Education and Physical Education

Staff Health Promotion ResourcesStaff Health Promotion Resources

www.cdc.gov/healthyyouth

Promoting a Promoting a

Coordinated Approach for the Health Coordinated Approach for the Health

and Well-Being of Children and Youthand Well-Being of Children and Youth

Carolyn Fisher, Ed.D., CHES

Elizabeth Haller, M.Ed.

Division of Adolescent and School Health

National Association of County and City Health Officials

August 18, 2005