Thursday, November 29, 2007

Health care should be as simple as a library card for kids

I've been mostly mute about my thoughts on health care access in this forum, as the great children's health care debate waged on this fall. But, if you have been reading between the lines (or if you've looked at my comments on other blogs), you probably know that I think that it's criminal for children (or anyone really) to go without health care in the United States. All children should have equal access to health care regardless of race, gender, religious or political affiliation and socioeconomic status. Simply put, I think that gaining access to health care should be as simple as getting a library card.
Unfortunately this is not the case in America.
When reporting on high school sports injuries, I was horrified to learn that Caleb Bailey, a teenage boy living in Commerce, was forced to weight more than six months to receive an operation on his torn meniscus because he no longer qualified for Peachcare.
“You feel trapped as a parent,” Don Bailey said. “You want to take care of your kids, but sometimes you have to weigh it all out. If you don’t have insurance, you are always praying that nothing does happen.”
The number of kids in Caleb’s position is rapidly increasing, said Brian Robinson, chairman of the secondary school committee for the National Athletic Trainers’ Association (NATA). His part of Illinois is relatively upper middle class, but “you would be amazed at the number of kids without health insurance,” he said.
On the other side of the country, Wes Wirkkala deals with the same perpetual sense of worry that the Bailey parents encounter each day. Despite bringing in annual salary of approximately $70,000, the Wirkkalas can't afford health care coverage for their children.
So I leave you with one final question. Regardless of what side of the political fence you sit on, shouldn't all children have access to health care?

Tuck your kids in early tonight (and every night)!

My Thanksgiving bulge got me thinking again about obesity, so I thought since about a third of U.S. children are overweight or obese, it might be a good idea to re-examine childhood obesity.

As the holiday season looms before us, I thought parents should know that a recent study suggests that tucking your kids in early and letting them sleep late may reduce the risk of obesity. Children between the ages of 9 and 12 who got less than nine hours of sleep were at more likely to be obese regardless of other factors such as socioeconomic status, reported the study which appeared earlier this month in the journal Pediatrics. Lead researcher and pediatrician Julie Lumeng suggest that young children receive between 10 and 12 hours of sleep each night.

In addition to getting those zzzz's, children need to consume a healthy diet and participate in regular physical activity. Back in September, Jennifer Burnell, a nutrition education and fitness specialist with the Athens Regional Medical Center, reminded parents to nix the clean-your-plate rule and to help children make healthy food and lifestyle choices. We Can!, a national program designed to assist elementary-aged children in keeping off extra pounds, echoes Burnell's thoughts. In addition to providing children with commonsense steps to reduce weight, the program relies on parents to help kids make good decisions about diet and exercise. So, in addition to tucking your kids in early this holiday season, why don't you guys jog over to the park and have fun, instead of watching Tv and eating that extra brownie?

Friday, November 16, 2007

A Taste of New Orleans

Without detouring the more than 15 blocks to the lower ninth ward, I could have easily left the city with the impression that New Orleans is back to normal more than two years after Hurricane Katrina wreaked havoc on the city.

An eight-hour van ride with two special representatives of Women of the Storm, a group of influential women from New Orleans dedicated to educating the public about the plight of Katrina survivors, opened my eyes to the third-world like conditions that persist in parts of the city. Amidst piles of rubble and crumbling homes, countless individuals endure the daily struggle of rebuilding their storm-ravaged lives.

Only hours into the experience, I felt a sense of depression that I couldn’t shake. Imagine how residents of the ninth ward must feel each day.

In the wake of Katrina, Dr. Julie Gerberding, the director of the federal Center of Disease Control and Prevention, said that the storm’s greatest health challenge would be in the mental health resources. Her words still ring true today.

In the first four months after the storm, suicide rates rose to more than 300 percent above pre-Katrina levels, according to coroner’s office statistics.

In the last two years, approximately 80 percent of Cecile Tebo’s mental health calls have come from suicidal individuals, many of whom did not have a previous history of mental illness before the storm. A licensed clinical social worker that assists police officers on mental health calls, Tebo, has witnessed the number of severely depressed adolescents surge in the last nine months. Data collected by the New Orleans School System during the 2006-07 school year supports Tebo’s observations citing that 45 percent of students displayed symptoms in need of mental health care.

Despite the abundance of mental health issues, Tebo remains horrified by the dearth of mental health resources in New Orleans. “The healthcare system for people with mental illness has reverted back to the dark ages here,” she said. Currently, just less than half of the approximately 350 pre-Katrina public and private psychiatric beds in New Orleans are available to the public, according to Kevin Stephens, the director of the New Orleans Health Department.

Despite the clouds of gloom, rays of sunlight are beginning to shine through in the area’s fragmented mental health system. This week, a total of $523,000 in grant monies was awarded to six local organizations to treat children’s mental health problems, and the state launched a workforce initiative to recruit medical professionals to the area this summer. Still, much work is needed to repair the fragile state of mental health in New Orleans.

Since returning home, I have struggled to put into words the images that haunt my thoughts. No words can adequately express the sorrows and struggles of these survivors. I am grateful for all of the things in my life that I have long taken forgranted and want only to do something more to help the people of New Orleans.

As you gather around the table this Thanksgiving, I encourage you to consider walking a mile in the footsteps of a Katrina survivor living in the lower ninth ward. How would you feel if you didn’t know where your next meal was coming from? Count your blessings this holiday season and consider lending a helping hand in the rebuilding effort.

Friday, November 9, 2007

Heading back to New Orleans

In August 2005, I was balancing a full-time gig at the Athens Magazine with a full load of master's classes at Grady College. After an evening split-level newspaper design class, I journeyed home to Jefferson and crawled onto my couch to watch a few minutes of CNN (for what had become my Tuesday and Thursday night routine). I had heard bits of a story about Hurricane Katrina making landfall during my Tuesday morning commute. It sounded as if New Orleans had dodged a bullet, but I was curious to see what was going on. As a lay on the couch in exhaustion, CNN delivered quite a different assessment: New Orleans was quickly becoming a city under water. Over the next week, I was glued to the television as clip after clip revealed the disaster that was unfolding in the Gulf.

Each moment that I watched, flashbacks of a whirlwind visit to New Orleans during the 2003 Sugar Bowl flooded my mind. Before the game, my husband and I took in as much of the city's charm as we could. We visited the French Quarter, hopped on the trolley and even sampled a beignet or two. These images stayed with me over the next two weeks as I became increasingly horrified by the government's mismanagement of the disaster. Photographs of children crying before the Armageddon-like backdrop haunted me. New Orleans stayed in my thoughts daily.

But, like so many others, as the days turned into weeks and months, Hurricane Katrina slipped off my radar. My focus turned back to juggling: school and work, work and school. I hate how so many Americans, like myself, have let Katrina survivors become a distant memory only briefly considered during anniversaries of the event.

On Saturday, I will head back to New Orleans for the first time since 2003. When I think back about Katrina, my heart still hurts for the people of New Orleans and the Gulf Coast. While I pack, I'm left wondering: what will I encounter in New Orleans and how can I make a difference?

Thursday, November 1, 2007

More school nurses please!!

I've been thinking about school nurses for awhile. A month or so ago, I told you about young Adella's visit to the school nurse in Barrow County. Because of translation issues the spanish-speaking kindergartner couldn't gain access to her cold medication.

Several weeks later I considered the role of the school nurse when I covered the increasing rates of hypertension in youth (doctors fear obesity's silent sidekick hypertension will continue to rise as our children's waistlines continue to bulge). While gathering information for the article, I was shocked and disheartened to learn that because of legal liability issues Athens Clarke-County school nurses could only check a child's blood pressure with a doctor's note.

Like I said, over the last two months, I've considered the precarious role of the school nurse. After reading an article in the NY Times this week, I'm still thinking about them (I'm reminded of the Willie Nelson song "Always on my Mind" right about now).

School nurses are inundated with visits from child after child every day. They have to determine if a child's illness is legit or an attempt to play hooky. In certain cases, like the latter example mentioned above, they can't fulfill a parent's request for a blood pressure check for fear of legal liability. In addition, some school nurses are forced to cover more than one school in a school system. (In Athens-Clarke County school nurses cover several schools each day). Simply put, school nurses are overwhelmed.

The NY Times article confirmed an earlier hypothesis: we need more school nurses. For schools that say, "we can't afford them." I'm reminded of a rather astute comment from Brian Robinson, the secondary school committee chair for the National Athletic Trainers’ Association. Though he was discussing certified athletic trainers the comment applies here. Here's a quick paraphrase, most schools hide behind the fact that they can’t afford an additional health care provider (i.e. certified athletic trainer or school nurse), but they don't make it a priority. Fact is schools can't afford not to.

Thursday, October 25, 2007

No-pain, no-gain culture of sport trickles down to youth

After a routine tennis practice early in May, I wandered home and rested on the couch. Later that night, I noticed a nagging pain in my lower back. I took a couple of Advil and ignored it. In two days, I was back out on the courts again...but every time I hit my backhand a sharp pain shot through my leg and back. Still, I played through the pain, after all it was a USTA match--I couldn't let my team down. The next day I could barely walk. I took Sunday off but came back for more on Monday. I couldn't miss my tennis drills. During Tuesday's singles match, I had to retire because of pain. When I visited the doctor in intense pain, he said that I aggravated my piriformis and should take a month off. I lasted two weeks.
Last month, I watched my stepsister Alex in her first basketball scrimmage of the season. Fearlessly, Alex stepped in the lane, drawing a charge. She went down with a thud, knocking her head against the court. More than a minute later, she slowly pulled herself up off the ground, rubbing the back of her head. In the absence of a certified athletic trainer, Alex wandered back to the sideline as the final seconds of the first half dwindled away. In the second half, Alex was back in full action as if nothing had happened. After the game, Alex complained of a headache and her parents watched for symptoms of concussion. When I spoke to her later, she admitted that she probably shouldn't have played the second half. "I just hated not to," she said. "I'm tough."
Both of these stories illustrate the influence of sports no-pain, no-gain culture. From an early age, children learn to sacrifice their bodies, to play through pain and to be tough in sports. After all, "there's no crying in baseball" (or any sport for that matter). We learn these cues from every aspect of our culture, even from our parents.
In June, HBO Real Sports with Bryant Gumbel aired a provocative piece on "boomeritis." According to the sources in the piece, American baby boomers, unwilling to kick their daily sports habit, are pushing their bodies to the edge. Instead of slowing down, these weekend warriors with overuse sports injuries fill doctor offices and hospitals looking for an easy cure--a quick pill. What the weekend warriors fail to consider is the message that they are sending to their children and grandchildren.
We need to look in the mirror and consider if we are sacrificing our health for the love of the game?

Thursday, October 18, 2007

Concussions are brutal reality in high school sport

Since 1997, more than 50 teens have been killed after sustaining head injury in sport (see graphic from NY Times). Concussions, 'the silent sports injury,' are a stark reality in high school sports. A recent series of studies out of Ohio State University and Nationwide Children's Hospital revealed that girls are more than twice as likely to sustain concussions in sport than boys (see NY Times article). Although football still causes the highest rate of concussions (with 47 per 100,000 incidents of participation), girls soccer is next in line (with 36 per 100,000).

Interesting stuff, I know. So should we ban kids from playing sports, you may be asking yourself? Of course not. Dr. Dawn Comstock, a co-author of the study, points out that the benefits of participating in sport far outweigh the dangers. But, we should be aware of the risks of playing sport. (Believe it or not, this research out of Ohio State is the first sustained epidemiological study on high school sports injury. It will allow the general public to learn about injury patterns in sport and most importantly prevention techniques).

These particular findings do raise several questions: why are girls more likely to sustain concussions than boys? And, why are they held out of competition for longer than boys? Researchers noted that several factors may be at play here: 1. perhaps there are physiological differences 2. perhaps it's because girls were less protective head gear in sports 3. perhaps girls are more likely to report concussions or 4. perhaps coaches, parents, trainers, etc., are more likely to listen when a girl reports symptoms of a concussion.

According to CDC guidelines, an athlete diagnosed with a concussion should sit out at least a week before resuming play. According to the study, boys sit out approximately three days while girls sit out for a week or more. Why aren't boys held out for the appropriate amount of time? I dare say culture might be a factor here. Whatever the reason, it's a problem to stick an athlete back in competition before he or she is ready.