Taylor Walsh on D.C.'s "Health Week" and Green Ribbon Schools: Addressing Social Determinants
Written by John Weeks
Taylor Walsh on "Health Week" in DC and the Green Ribbon Schools: Addressing Social Determinants
Summary: Integrator editorial adviser and columnist Taylor Walsh shares a hopeful U.S. Department of Education program that has everything to do with "integrative health." To be awarded as a "Green School" by the U.S. Department of Education means implementing a whole system view of health. As Walsh explains, this can mean engaging the nation's childhood obesity epidemic. While not regular Integrator fare, the story is not only interesting but raises questions about the optimal role of integrative practitioners and their related organizations in urging public health approaches, including in elementary school education, that influence the pervasive and powerful social determinants of health.
Social determinants of health
A humbling reality for any clinician is encountering the fact that therapeutic interventions account for as little as 15%-25% of the health of a population. Many extra-office determinants of health are much more significant factors. Integrator columnist and adviser Taylor Walsh reminds us of this with this exceptional column on a federal government program that recently acknowledged 78 Green Ribbon Schools. Walsh notes that the obesity epidemic in our children lurks behind this program. He shares that the three "pillars" to measure greenness are: environmental impact and energy
efficiency; healthy school environments; and environmental and sustainability
education.
Walsh celebrates these initiatives as fascinating grassroots initiatives, often engaged in some partnership with state or local governments. I am reminded of the philosophical underpinning of the National Prevention, Health Promotion and Public Health strategy imbedded in the Affordable Care Act. Promoted originally by the Samueli Institute as the Wellness Initiative for the Nation, that plan fundamentally acknowledges that our Nation's health is as much - or more - a function of energy policy, transportation policy and education policy as it is our healthcare policy. Walsh rightly gives kudos to the US Department of Education for stimulating this program and honoring these innovations.
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Health Week in DC, 2012 & the Green Ribbon Schools Program
It is a rite of spring in the
Nation's Capital: a proliferation of health-related conferences, meetings and
extravaganzas. In the first week of June
I attended three variations, always looking for evidence of integrative practice
somewhere on the agendas. The
associations are most often indirect at best, as it was at a presentation by
the Bipartisan Policy Center, whose Nutrition and
Physical Activity Initiative released its recommendations for addressing the
nation's obesity epidemic; as it was amid the cheering at the boisterous third
annual Health Datapalooza, which attracted multitudes
of technology developers and entrepreneurs seeking to make something of
the massive amounts of health data being released by federal agencies and
health institutions. Then there was the
Green Ribbon Award ceremony held by the US Department of Education.
For several years I have been
tracking brushfires around the country where local initiatives have been
re-creating a new social and civic basis for health assumptions in their
communities, even if their adherents may not describe their work in those
terms: schools, hospitals, companies, urban design, energy and sustainability
projects among them. I look for the examples in which changes have been
institutionalized, or appear to be approaching a state of permanence. As I have a bias toward the initiatives found
in K-12 schools, I was intrigued to attend the award ceremony on June 4 at which
the Department of Education awarded its first ever class of 78 Green Ribbon
schools from 29 states. Several aspects
of this initiative are worth noting:
None of these initiatives was launched as the result
of any dictum, funding or program from the Dept. of Education. They are all invariably true grass roots
endeavors, responding in recent years to what I take to be an awareness in
the collective consciousness that the health of our population and
resolution of the obesity epidemic can't wait for the national health
policy apparatus to come up with a solution.
While "green" historically centers on the physical
plant - green buildings and the grounds of properties that vie for the
coveted LEED medallions -- in the schools "green" now appears to encompass
all of the thinking and ideas that have put in place school gardens, food
and nutrition, energy and environmental projects, physical education and
in some settings stress management.
Some of the awardees include those making first stabs at a curriculum
based on these elements. (One of
the most highly regarded winners, the Willow School of Gladstone, NJ --
one of 11 independent schools to be selected - is soon to break ground for
a new building designed solely for its new nutrition and wellness
programs.)
Although the grim reality of unchecked obesity among
our youngsters looms over much of the motivation for these initiatives,
particularly in food and exercise, these green ribbon initiatives are not
overtly considered or referred to much as "health" projects. Indeed, the school nurse gets a nod here
and there, but it is obvious that the potential evolution to broader
health and wellness coaching is the most underdeveloped concept in
evidence in this program.
While 78 schools may not appear to be many within a
total K-12 school population of 130,000, the coordinators from the states
who applied their schools noted that many more are engaged in these
activities. A Pennsylvania deputy
secretary of education told me that in addition to the four PA schools
selected for the green ribbon more than 100 others applied.
The Green Ribbon School program
created three "pillars" to measure greenness: environmental impact and energy
efficiency; healthy school environments; and environmental and sustainability
education. These criteria led to a
diverse selection of programs, although the school garden has become widely
adopted for food production, composting, even sales, and nutrition education. Solar energy, using bio-diesel and waste
kitchen oils and fuel, and water collection systems were a few of the projects
that created new forms of engagement for these schools and often with the
broader community.
Most impressive about this singular
gathering of the inaugural green ribbon schools was the breadth of innovation
that is now at work across the country. These projects are in various states of formation, operations, financing
and stability, but all are earnestly taking the initiative to change the
prevailing paradigm within their communities.
U.S. Department of Educvation program
The Dept. of Education didn't
inaugurate these endeavors, but it deserves kudos for raising awareness about
them and for the broader intention that their work represents. In his remarks US Secretary of Education Arne
Duncan said the collective experience of this first class of award winners has
proven that the idea of green school "is no longer a specialty area" and that
"every school in the country is seeking what has been developed among these
schools."
Duncan also made a point of noting
the collaborations at the state and local levels that created, fostered and
supported the school programs, as well as the recent collaboration among
federal agencies to support the Green Ribbon program. These initiatives and the federal support
were undertaken without any special authorization from Congress, a fact he
suggested might be instructive to those members. "This is a program with no natural enemies,"
he said.
The department has already started
taking applications for the 2013 (which will not include any of the first
year's winners), and will soon begin a series of webinars to help other schools
prepare their applications. Program director Andrea Falken said that there was
a plan to create a yet-to-be defined clearinghouse where the progress of the
first group of awardees can be tracked.
While these fabulous initiatives
still remain a small collection of brushfires, their experiences have the
potential to evolve, perhaps even rapidly, throughout the nation's school
community. Along with other locally
oriented health programs, such as the Community Transformation Grants that are
part of the National Prevention fund, the attention to the health quality and
infrastructure of the schools could do much to influence the broader
communities in which they are located and create opportunities for local
integrative health and wellness practitioners.