1. Opinions of U.S. Adults About School Health Programs
81% of parents of children in K-12 want their kids to receive daily physical education1
74% of parents of adolescents said schools should spend more time or the same amount of time teaching health education as they do teaching other subjects2
1. Survey by Opinion Research Corp. based on interviews with a nationally representative sample of 1,017 adults, February 2000 (margin of error = +6%)
2. Gallup Organization for the American Cancer Society, national telephone survey of 1,003 parents of adolescents enrolled in U.S. public schools, 1993

2. Overview A Missing Link in School Reform
A Coordinated Approach to School Health
The Need for Coordinated School Health in Tennessee
The Future of Our Nation

3. Coordinated School Health: The Components
Health Education
Physical Education
Family and Community Involvement
Health Services
Health
Promotion
for Staff
Nutrition
Services
Healthy and Safe School Environment
Counseling, Psychological, and Social Services

4. Coordinated School Health: The Process
School health coordinators and councils/teams, with the active support of school administrators, provide leadership to enable school districts and schools to:
foster collaboration across CSH components and between the school and the community
integrate health-related goals and objectives into school improvement plans 4

5. Coordinated School Health: The Process
Priorities determined through a systematic assessment and planning process that
Is evidence-based and data- driven
Includes extensive input from the school community
use assessment to develop, implement, and monitor plans for improvement

6. A Coordinated Approach Addresses Many Critical Health Issues Affecting Students, Including:
Asthma and other chronic health conditions
Mental health
Immunizations
Infectious diseases
Oral health
Emergency preparedness
Physical activity, nutrition, and obesity
Tobacco use
Sexual health, including pregnancy, HIV, and other STD
Safety and violence
Alcohol and other drug use

7. Benefits of Coordinated School Health
Increased effectiveness of each component
Synergy from collective effort
Greater focus on the Whole Child
Reduced duplication and fragmentation
Links with community resources
Greater likelihood of sustainability

8. Overview A Missing Link in School Reform
A Coordinated Approach to School Health
The Need for Coordinated School Health in Tennessee
The Future of Our Nation

9. Tennessee Youth Risk Behavior Survey, 2009
Number of students in a high school class of 30 who:
Attempted suicide1 (7%)
Used marijuana2 (20%)
Smoked cigarettes2 (21%)
Had been in a physical fight1 (32%)
Had at least one drink of alcohol2 (34%)
Had ever had sexual intercourse (53%)
Did not get enough physical activity3 (76%)
Did not eat enough fruits and vegetables3 (82%) 2 6 6 10 10 16 23 25
1 - During the past 12 months; 2 – During the past 30 days; 3 – During the past week
Source: Youth Risk Behavior Survey

10. Birth Rates Among Girls 15–19, 2009
Lowest: 16
TN: 51
Highest: 64
Birth rate/1,000 girls 15–19
US rate: 39
Europe: 4 (lowest)–24 (highest)
Source: National Vital Statistics System, National Center for Health Statistics, CDC

11. Teen Pregnancy Rates in U.S. and 5 European Nations, 1970 and 2006
39%
80%
68%
82%
81%
80%

12. % of Secondary Schools That…
School Health Profiles 2010 Results: Median Among 47 States vs. Tennessee
% of Secondary Schools That…
Median, 47 States
Tennessee
Had a school health council, committee, or team
58%
75%
Used the CDC School Health Index to assess health policies, activities, and programs
34%
72%
Did not sell junk food or sugar sweetened beverages
38%
61%
CDC, School Health Profiles

13. % of Secondary Schools That…
School Health Profiles 2010 Results: Median Among 47 States vs. Tennessee
% of Secondary Schools That…
Median, 47 States
Tennessee
Required students to take >2 health education courses
52%
31%
Taught all 14 essential nutrition education topics
66%
62%
Prohibited all tobacco use at all times in all locations
57%
45%
CDC, School Health Profiles

14. Overview A Missing Link in School Reform
A Coordinated Approach to School Health
The Need for Coordinated School Health in Tennessee
The Future of Our Nation

15. A Survey of >400 Employers
# 1 factor that will have the largest impact on the workplace over the next five years:
#1 emerging content area in terms of its importance for future graduates entering the U.S. workforce in the next five years:
Rising Health Care Costs
Making Appropriate Choices Concerning Health and Wellness (76% of employer respondents rated it as “most critical”)

16. Estimated Financial Costs of Our Failure to Sufficiently Address Youth Health Problems
Among year olds in 2000:
Total lifetime costs of injuries: $79.8 billion1
Costs of new cases of STDs: $6.5 billion2
Average annual costs associated with a child born to a teen mother in 2004: $9.1 billion3
Total costs for treating asthma in 2006: $8 billion4
1 - Finkelstein EA et al. The Incidence and Economic Burden of Injuries in the United States. 2006
2 - Chesson HW et al. Perspectives on Sexual and Reproductive Health 2004; 36(1):11-19
3 - The National Campaign to Prevent Teen Pregnancy. By the Numbers: The Public Costs of Teen Childbearing
4 - AHRQ. Statistical Brief # 242. April 2009

17. Economic Costs Associated with Obesity are High
Direct health care costs of obesity and overweight:
1998: $74 billion
2008: $147 billion
½ of costs publicly financed by Medicare or Medicaid
Obesity accounts for 9.1% of annual medical spending
Note that the $147 Billion for 2008 is estimated based on 2006 data.
Obesity is defined as BMI > 30
Finkelstein EA, et al. Annual medical spending attributable to obesity: payer and service-specific estimates. Health Affairs. 2009;28(4)

18. Weight Issues Plague the Military
The Department of Defense estimates as many as 1/3 of military-age youth are ineligible for service because of their weight.2
In 2007, approximately 15,000 military recruits failed the entrance physical exam because of weight/body fat limits; this was the most common reason for medical disqualification among applicants for active duty enlisted service.3-4
Note: AMSARA is the Accession Medical Standards Analysis & Research Activity Annual Report: Attrition & Morbidity Data for FY 2008 Accessions
1. Mission Readiness press release , Feb 9, Hsu et al. J Adolesc Health AMSARA Annual Report 2008.
4. Reading, Willing , and Unable to Serve, 2010.

19. Obesity: A National Security Threat
“Obesity rates threaten the overall health of
America and the future strength of our military.
We must act, as we did after World War II, to
ensure that our children can one day defend our
country, if need be.”
-Retired U.S. Army Gens. John M. Shalikashvili and Hugh Shelton
Source: The Washington Post, April 30, 2010

20. Obesity: A National Security Threat
“We urge Congress to:
Get the junk food and high-calorie beverages out of our schools.
Upgrade the quality of meals served in schools.
Develop research-based strategies, implemented through our schools, to help parents and children adopt healthy habits.”
-Retired U.S. Army Gens. John M. Shalikashvili and Hugh Shelton
Source: The Washington Post, April 30, 2010

22. Howell Wechsler, EdD, MPH
Promoting Health and Academic Achievement Through Coordinated School Health
Howell Wechsler, EdD, MPH
Director, Division of Adolescent and School Health
Tennessee School Boards Association Annual Convention
Nashville, TN, November 14, 2011
National Center for Chronic Disease Prevention and Health Promotion
Division of Adolescent and School Health