An A+ for adolescent health.

• Author: Koprowicz, Connie
• Position: Includes related article on risky behavior among adolescents

Who would have dreamed that schools would have to have formal violence prevention programs? And yet most of them do, along with many reforms that recognize the connection between good health and good school performance.

Would you like to live through adolescence again? Pose this question to a group of adults, and it's likely they will agree that, although at times being a teenager was fun, the good times were often overshadowed by the difficulties of becoming an adult. No one yearns for the pressure we felt to smoke, have sex or conform to the ideal body image. No one misses the stress of family break-ups, threats of violence at school or the struggle for academic success amidst personal turmoil.

Today's adults shouldn't forget those battles of adolescence. The stakes are too high. In their December 1998 Spotlight News, the Educational Development Center Inc. (EDC) reported that 25 percent of children suffer social, emotional and health problems that could affect their school performance. Numbers like these put us face-to-face with the relationship between a child's health and his or her educational success. This realization has led to school reforms that address adolescent health issues as well as academics.

'HEALTHY KIDS MAKE BETTER LEARNERS'

Nora Howley, acting project director of the Council of Chief State School Officers' School Health Project, says, "One of the things we stress is that healthy kids make better learners. Continuing that logic, better students make for better communities. So health issues can't be separated from a school's academic mission."

In many ways, adolescence serves as a testing ground for adulthood. And that's a test that many educators, health care professionals and policymakers would like to see more young people pass. The new approach is to address health issues - ranging from sex education to nutrition to drug use prevention - in a comprehensive manner. At the center of this movement lies the school site, which is used as the link between the student and the many health agencies involved in adolescent care.

Government has used schools to address children's health concerns for decades. School lunch programs began during World War I. Policymakers added school breakfast programs in the '60s and '70s. When the public became aware of the wide-ranging effects of teen pregnancy, school-based health clinics were added to the mix. And when the clinics did not reduce the incidence of teen pregnancy, as developers had hoped, professionals saw the need to address more than the physical aspects of the problem.

"The clinics did good things," says Diane Allensworth, chief of program development at the Division of Adolescent and School Health, Centers for Disease Control (CDC), "but they didn't reduce the pregnancy rate. That's when folks realized that it's not enough to have health care, but that we needed social services and juvenile justice and vocational education. That was the advent of full-service schools."

Add to this the Institute for Educational Leadership's 21st Century Schools project, which focuses on parental involvement, youth development and academic success. "That initiative," explains Aliensworth, "allows for so many things: a comprehensive approach for using the school site with an end focus of improving academics."

To advance the development of such an approach, the CDC has identified eight main components of coordinated, comprehensive school health programs. These include health services, psychological services, health education and more. Creating the ideal structure within any educational system requires an extraordinary effort by state government and the many agencies involved. To this end, the CDC has given grants to 15 states to assist the development of an infrastructure that would support such a task. Some of the largest and the smallest states - from California to Rhode Island - are using the federal seed money to take this approach to teen health care.

AVOIDING THE CONTROVERSIAL ISSUES

Bad habits identified by the CDC as preventable are very often established in childhood. They include tobacco use; poor eating patterns; abuse of alcohol or other drugs; violence; physical inactivity; and sexual activities that result in HIV infection, other sexually transmitted diseases (STDs) or unintended pregnancy.

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