Pa. Screening Schoolchildren for Obesity
Sep 14 3:36 PM US/Eastern
By MARTHA RAFFAELE
As they wait for their children's first report cards to come home this year, elementary-school parents across Pennsylvania also can expect to get a separate report on a key indicator of their children's health.
For the first time, the state Health Department is requiring school nurses to compute students' body-mass index _ or height-to-weight ratio _ during annual growth screenings of children in kindergarten through fourth grade.
Parents will get letters about the results that will encourage them to share the information with their family doctors. The letters will explain whether the BMI is above, below, or within the normal range for the child's age and gender.
"Schools have screened students for height and weight for about 50 years," Health Department spokesman Richard McGarvey said. "They're simply taking what they've already been screening for and calculating the BMI."
The measurement will be required for students up to eighth grade next year, and for all students in the 2007-08 school year.
Pennsylvania joins four other states that already collect BMI data during student growth screenings, according to the Centers for Disease Control and Prevention: Arkansas, California, Florida and Missouri.
About 35 percent of Pennsylvania's children are overweight or at risk of becoming overweight, according to a state Health Department study of more than 25,000 students' health records during the 2001-02 school year.
A pilot test of Pennsylvania's BMI reporting requirement in the fall of 2003, which involved 4,390 students at 10 schools, produced similar results.
"When you have a kindergartner who weighs 80 pounds, that's concerning," said Nancy Alleman, a nurse at one of the test schools, Sylvan Heights Science Charter School in Harrisburg.
But Dr. Reginald Washington, a Denver pediatrician who co-chairs an obesity task force for the American Academy of Pediatrics, said the recommended doctor visit is a simplistic solution.
"If you're a general practitioner, you see patients probably every 10 minutes. It takes about an hour of counseling and evaluation to even begin to do something about obesity," Washington said. "To say, 'Here's a piece of paper and the world will be right,' is foolish."
A districtwide BMI-notification program that the East Penn School District in Emmaus instituted in 2001-02 got off to a rocky start, partly because parents weren't informed ahead of time, said parent Lisa Lechmanik.
School officials also didn't consider that in some cases, muscle contributed to a high body-mass index, she added.
"They have athletes that are training year-round, and some of the premier athletes were getting these letters," including two of Lechmanik's children, who have since graduated, she said.
The furor died down after the district made several changes, including giving parents the option of not getting the letters, she said.
Schools should be prepared to help children address weight problems by educating them about proper nutrition and providing adequate exercise time, among other things, said Ivy Silver, founder of A Chance to Heal, a Rydal-based advocacy group for people with eating disorders.
"They should develop programs so kids who are possibly at risk have the wherewithal to better manage and take care of themselves," Silver said.
Beth Trapani, spokeswoman for Pennsylvania Advocates for Nutrition and Activity, a nonprofit group that is helping the department publicize the BMI screening, said remedies need not be complicated.
"We're talking about simple, easy changes that can make a big difference _ switching to skim or lowfat milk, eating more fruits and vegetables," Trapani said.
I think this is a terrible mistake. This will destroy whatever shred of self esteem these overweight kids have. I can not think of a better way to help children develop eating disorders. I think parents can see their child has a weight problems without the school "grading" them on their body fat content.