Health and education: Two intersecting beats

By Holly Hacker

Cover education long enough and you’re likely to write about physical education classes or sex education, school nurses or school lunches.

Almost everywhere on the education beat, from the state policy level to inside classrooms, health issues abound.

“It’s inherently interesting. It’s like education – everyone has a stake in it,” said Staci Hupp, who frequently covers health-related issues as an education reporter at the Des Moines Register.

Consider some of the many ways in which health and education intersect:

• Childhood obesity is a serious problem that schools are expected to tackle, from requiring more physical activity during the school day, to serving more nutritious meals in the cafeteria, to banning soda and candy from campus vending machines.
• Parents, teachers and lawmakers in some communities still debate what (and how much) to teach in sex education classes.
• Millions of children (14 percent of all children in public schools) come to school with physical, mental or emotional disabilities that teachers and health professionals must address.
• Alcohol and drug abuse among young people remains a concern, and schools and colleges are expected to help prevent it.
• Recent cases of H1N1 flu have affected schools and colleges – they’ve had to temporarily close and try to prevent spread of the illness. And because of excessive student absences, some campuses worry they’ll be hit financially.

Finding story ideas

As with any beat, health-related story ideas come from keeping your eyes and ears open and from developing good sources.

Kimberly Melton, an education reporter at The Oregonian, has written extensively about special education and mental health issues in schools. She checks in periodically with special education directors and teachers, but she gets most of her tips from parents of children with disabilities.

“They are frequently a very vocal and emotional group here,” Melton said. She also found out about a parent advisory group for special education, so she’ll check in with those members.

Melton said she also tries to look at new studies, research reports and other materials that relate to health and education. Sometimes they give her ideas of questions to ask in the school district she covers.

Other stories surface when you least expect them.

Jeffrey Weiss, who covers education for The Dallas Morning News, was sitting through a routine school board meeting when something on the consent agenda caught his attention: approval of a new, updated video for “health education,” which he figured was code for sex education. That turned into a feature in which Weiss wrote:

Is there a more delicate task in the public school curriculum than choosing a film that teaches about human reproduction?

It’s hard enough to negotiate through the minefields of morality and science. But if the film shows a boy with a mullet, a girl in overalls, and graphics that might have been state of the art 30 years ago, the teacher has to deal with snickers from the so-sophisticated seventh graders of 2009.

The story also hit a serious point: While the new film probably wouldn’t provoke ridicule like the old one, it was just as squeamish in ignoring topics like contraception, sexual orientation, AIDS and sexually transmitted diseases.

Hupp, who reported in Dallas before moving to Des Moines, picked up on a health trend while observing an elementary school for another story. The teacher finished a math lesson and then had students stand up, stretch and do jumping jacks for 10 minutes – right there in the classroom. So Hupp wrote about creative and questionable ways that schools try to squeeze in physical activity, as required by state law, without sacrificing academics.

Reporters can look for other disconnects between policies as they’re drafted vs. how they play out in schools. Another idea from Hupp: Some schools have banned or limited junk food from campus. Do those efforts really work, or do students just get their fill of fat, salt and sugar from off-campus sources?

Challenges

Education reporters grapple with complex school budgets and funding formulas. They find it hard to get certain information because of student privacy laws. Of course, health issues come with their own particular challenges.

Take those privacy laws. While the Family Educational Rights and Privacy Act (FERPA) protects many student records, so the Health Insurance Portability and Accountability Act (HIPAA) blocks access to certain medical information.

Hupp said a colleague at the Des Moines Register asked the state health department for a list of school districts with high absentee rates due to H1N1 flu. The state denied the request, citing medical privacy. But the reporter took the request to the state attorney general’s office, which issued an opinion that the information was in fact public.

It can also be difficult to encourage sources to talk about sensitive health-related topics, as Melton discovered when writing about a sexual assault that happened in a special education classroom.

“I found that the biggest challenge was understanding the nature of the program and getting people comfortable enough to talk to me,” Melton said. “Those kinds of challenges can be overcome by doing some periodic reporting and interviews over the course of the year so people don't feel like we're only around for the big news.“

At times education reporters also need to become instant mini-experts on health topics such as autism or alcohol abuse.

“You need to get smart about whatever health issue you hit,” Weiss said. Ask around and read up, he advised, and don't make Wikipedia your primary source. And while educators will understand the education-related ramifications of an issue, you’ll want to turn to a health expert to understand the medical side.

Getting some medical expertise can also guard against writing overly alarmist stories (Swine Flu:  We’re All Going to Die!). “The only way to set the tone is to get as smart about the issue as you can,” Weiss said. “On a breaking deadline, you can lean on someone whose judgment you trust. But for any story lasting more than a day, you need to climb the learning curve as fast as possible.”

Issues to watch

So what health stories should education reporters watch for?

Many states have serious budget shortfalls. Education reporters can examine what that means for mandates on school nurses, physical education or nutrition.

Take health clinics that have opened in schools. They’ve come under fire in tough economic times, Melton said. Is the cost for these clinics worth the service they provide?

Iowa law requires school districts to have registered nurses – but Hupp discovered that with tight budgets and a nursing shortage, many districts applied for waivers. Others met the letter if not the spirit of the law by hiring nurses for only a few hours of work.

“Sometimes the best intentions aren’t carried out,” Hupp said. “In these little schools, secretaries were treating kids or calling for help. The requirement was a big stretch for them.”

Melton said she’s seen nursing shortages in some Oregon schools, too. She wonders about the implications for low-income families who otherwise wouldn’t seek medical care.

Meanwhile, some states and school systems have banned fatty snacks and sodas from vending machines, or a la carte items (like French fries) from cafeterias. But, as Hupp noted, those items are often cash cows for schools – so will nutrition or fiscal health prevail?

Here are some other ideas and issues to watch:

• Social pressures that lead to anorexia, bulimia and other eating disorders among high school students.
• Children with disabilities who move from residential treatment facilities to more traditional schooling. Are they receiving the services they need?
• How honest is too honest with kids? From Melton: “Some teachers have been disciplined for making jokes or telling stories and even doing puppetry to discuss sex, condoms and reproductive organs. In trying to get kids to talk about this very real issue, is there a line that teachers shouldn't cross?”
• Food safety in schools. USA Today recently reported on salmonella-tainted beef that slipped into the National School Lunch Program.
• Drug and alcohol abuse – How does your local college handle drug and alcohol violations? Some colleges have “medical amnesty” policies that don’t penalize young people who seek medical help because of excessive drinking.
• How many children in your community have no health insurance? How does this affect their ability to learn, and are schools able to do anything to help?
• Continuing effects of H1N1 in schools. Several newspapers have reported on schools no longer giving awards for perfect attendance, so sick kids and their germs stay home. Weiss recently wrote about Texas school districts worried that extra absences from swine flu could cost them millions of dollars, because schools receive state money based on how many kids show up each day.
• Vaccinations and immunizations. Some states are requiring young girls to be vaccinated against human papillomavirus (HPV), which causes cervical cancer and genital warts. But some parents worry that vaccinating kids could encourage sexual promiscuity.
• Sports injuries in school. Cheerleading is the leading cause of catastrophic injury among young women. Football players risk devastating problems by playing with concussions. Another risk to football players: heat stroke from twice-a-day summer practice.

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Holly Hacker is an education reporter at The Dallas Morning News. She’s covered education for most of her journalism career, including at the St. Louis Post-Dispatch and Ventura County (Calif.) Star. She has a master’s degree from the Missouri School of Journalism and a bachelor’s degree in political science from Stanford University.