Tessa Richards: Schools and health—could do better

Tessa Richards
To what extent are we sabotaging the future health and wellbeing of our children through ignorance, neglect, and misguided policy? And what can we do to redress this? Discuss.

Discuss? The education and public health experts participating in an international cross-sector meeting convened by the Salzburg Global Seminar in Klingenthal, near Strasbourg last week, scarcely drew breath. But there was a lot to talk about.  Improving the life trajectories of children, particularly disadvantaged ones, through changes in policy and practice across the spectrum of child development and education is a challenging task.

Topics discussed ranged from early detection and management of children with autism ( US data suggests it effects 1 in 70 boys and Sweden is to start screening for it at the age of 2), to bullying in schools, social exclusion, teenage pregnancy, and sexual health, but the obesity epidemic dominated. Among the raft of policies being introduced the meeting was told about an initiative in Georgia in the US, which is seeking to engage, inform, and enlist the public’s help in tackling the problem.

It’s been kick started by putting up posters of fat children with arresting captions. These include “Being fat takes the fun out of being a kid,” and “It’s hard to be little girl when you are not.” Key figures outside the health sector are also pushing for regulatory change, including the Mayor of New York, Michael Bloomberg, whose plans for a “soda” tax have been both welcomed and criticised. Not to be outdone, Boris Johnson, Mayor of London has just used his column in the Telegraph to herald new strategies to “release children from the captivity of fatness.”

If only it were that easy. Jacky Chambers, a public health physician in Birmingham, said that over 70% of children in the UK are failing to meet national guidelines for recommended physical activity and it correlates strongly with socio economic status. By the age of 7 [as the Jesuits knew*] unhealthy behaviours are evident and the watershed for interventions to counter them is around 13 years. To hit home the point, she said that contrary to NICE guidelines, hundreds of obese teenagers with type 2 diabetes in her region were having gastric bands inserted; it was seen as the only way of dealing with their obesity.

Sympathy for the excessive demands put on teachers’ time gave way to the consensus that they must explicitly acknowledge their responsibility for the physical and mental wellbeing of their pupils as well as their academic achievement. Teacher pupil relationships and school ethos may be as influential as parenting styles in the development of young children’s resilience and emotional quotient, it was argued.

Light relief to high falutin discourse was enlivened with bursts of enthusiasm for quick fixes to promote healthy child development. Top of the list was the recommendation, a la Marie Antoinette, to “take them camping.”

Another, pushed forcibly by Marianne Olsen, a Swedish health care manager, was for schools to mandate 1-2 hours of exercise a day, and provide healthy meals and education about nutrition. Evidence from “health promoting” schools programmes has shown that this not only pays health dividends, but also boosts educational attainment, she said. No further evidence was needed.

But in the worst recession for decades with ministers focusing on knee jerk responses to poor academic standards while cutting back services, including the provision of youth schemes and extra-curricular activities, will anyone listen?

One way of making them, suggested Wessel van Rensburg, a social media technology consultant, is to harness the power of the new media. Everyone from political activists to fashion houses recognise the power of the social media to propagate messages and create communities and networks whose collective view can spur public campaigns. Health professionals and educationalists need to think outside the usual boxes if they are to succeed in their quest to change the behaviour of young people and sway political mindsets.

*“Give me a child until he is 7 and I will answer for the man,” a maxim attributed to the Jesuits.

Tessa Richards is analysis editor, BMJ.