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Report identifies 7 health barriers to learning :

January 17, 2017

Common health issues may hinder children’s ability to thrive in school and tend to disproportionately impact minority and low-income children, according to a new report.

Authors from the Children’s Health Fund are calling on physicians, educators, service agencies, families and policymakers to collaborate in order to mitigate the effects of these health barriers to learning (HBLs).

“We don’t think any one sector alone can solve this problem,” said Children’s Health Fund Chief Medical Officer & Senior Vice President Delaney Gracy, M.D., M.P.H., FAAP, a member of the AAP Council on Community Pediatrics. “Part of the solution is all the sectors and all the groups working together and understanding each other and sharing messaging and training that ultimately makes sure kids get what they need.”

The non-profit Children’s Health Fund, co-founded by Irwin Redlener, M.D., FAAP, works to bring health care to underserved children. The group’s report Health Barriers to Learning: The Prevalence and Educational Consequences in Disadvantaged Children was published Tuesday at

The report identifies seven health issues that are fairly common, easy to screen for and manageable, but are barriers to learning if left untreated. It highlights asthma, vision problems, hearing loss, dental problems, persistent hunger, mental health and behavioral problems, and effects of lead exposure.

“Left untreated or undermanaged, HBLs can adversely affect children’s ability to see, hear and pay attention in the classroom, their ability and motivation to learn, their attendance, their academic performance, and even their chances of graduating from high school,” according to the report.

For instance, nearly 10% of children have asthma and those children missed 13.8 million days of school in 2013, authors found. About 56% of 6- to 8-year-olds experience dental caries and if untreated, they too will miss school and struggle to pay attention when they do attend.

HBLs disproportionately affect minority and low-income children, according to the report. Children in the 3 million households who don’t have enough food may experience behavior and cognitive impairments. In the case of dental caries, 32% of 6- to 9-year-old black children go untreated compared to the national average for that age group of 22%.

One of the underlying factors that can exacerbate HBLs is adverse childhood experiences (ACEs) such as abuse or exposure to a caregiver’s mental illness, substance abuse or criminal behavior. Roughly 48% of U.S. children have experienced an ACE, including 60% of black children and 67% of children in poverty, according to the report. However, the authors found only about one-third of pediatricians regularly ask families about ACEs.

Children’s Health Fund provides recommendations for health care workers, educators, family service agencies, parents and policymakers and calls on them to work together. The organization also would like minimum standards for screening and school forms and is reviewing each state’s requirements as well as experimenting with different models of reaching children.

Pediatricians can do their part by prioritizing annual, age-appropriate screening and improving communication with schools and parents.

“We want to make sure that pediatricians prioritized these seven things as age appropriate to make sure kids aren’t sitting in class with these barriers to their educational success,” Dr. Gracy said. “Because (for) most of them, it’s a matter of screening and appropriately managing to lift that barrier for the child.”

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