Health Screening Information
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Body Mass Index
Body mass index (BMI) is measure of body fat based on height and weight. BMI has been shown to be a reliable indicator of total body fat, which is related to the risk of disease and death. The score is valid for males and females, however, it does have some limitations. The limitations are:
- It may overestimate body fat in athletes and others who have a muscular build.
- It may underestimate body fat in people who have lost muscle mass.
BMI scores are rated as follows:
- < 18.5 indicates your child may be underweight
- 18.5 24.9 indicates a healthy weight range
- 25 26 indicates your child is slightly overweight
- 27 29 indicates your child is mildly obese
- > 30 indicates severe obesity
For people who are considered obese (BMI greater than or equal to 30) or those who are overweight (BMI of 25 to 29.9) and have two or more risk factors, the guidelines recommend weight loss. Risk factors include:
- Physical inactivity
- Cigarette smoking
- High blood sugar
- High blood pressure
- High LDL cholesterol
- Low HDL cholesterol
Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing diseases associated with obesity. For those who have less than two risk factors it may be important to maintain your weight rather than loosing weight.
Body Mass Index Percentile
Body mass index percentile is used to also determine a childs health. The percentile ratings indicate that a child is:
- overweight if they have a BMI over the 95th percentile for their age
- at risk of becoming overweight if they have a BMI between the 85th and 95th percentile for their age
- underweight if they have a BMI under the 5th percentile for their age
A child has a healthy BMI if it is between the 5th and 85th percentile.
High Blood Pressure in Children
Children can have high blood pressure. The American Heart Association recommends that all children over the age of 3 have yearly blood pressure measurements. Children who are overweight usually have higher blood pressure than those who arent overweight. A prescribed diet and regular physical activity may lower blood pressure in overweight children. Early detection of high blood pressure will improve health care of children and may prevent complications later in life. Some children inherit the tendency for high blood pressure from one or both parents who have high blood pressure. This tendency is more frequent in families of African Americans than among Caucasians.
Exercise and Physical Activity in Children
Increased physical activity has been associated with an increased life expectancy and decreased risk of cardiovascular disease. Physical activity has physical, psychological, and social benefits. For example, physical activity has been shown to help with:
- Controlling weight
- Reducing blood pressure
- Raising HDL (good) cholesterol
- Reducing the risk of diabetes and some kinds of cancer
- Improving psychological well-being, including gaining more self confidence and higher self esteem
The American Heart Association recommends that children and adolescents participate in at least 60 minutes of moderate to vigorous physical activity every day. Physical activity can be increased simply by reducing sedentary time such as watching television, playing computer video games, or talking on the phone. Physical activity should be fun and parents should try to good role models for active lifestyles and provide children with opportunities for increased physical activity. All children, even less coordinated ones, need to be physcially active.
Overweight and Obese Children
Obese children are more likely to become obese adults. Successfully preventing or treating obesity in childhood may reduce the risk of adult obesity and in turn reduce the risk of heart disease and other diseases.
Reaching and maintaining an appropriate body weight is important. Thats why recommendations focus on small but permanent changes in eating instead of short term changes that cant be sustained. For example:
- Reducing dietary fat is the easiest change. Children 2 years and older should be encouraged to eat at least 5 servings of fruits and vegetables daily.
- Becoming more active is also widely recommended.
- Careful attention to eating too many calories is also useful.
The main emphasis in treating most obese children should be to prevent weight gain above whats appropriate for expected increases in the childs height. For many children this may mean limited or no weight gain while they grow taller instead of actually loosing weight. The body mass index, or BMI, is a formula that assesses weight relative to height. It is a useful, indirect measure of body composition.
Vision Screening
The School Health Act requires that each child of school age be given a vision test annually by a school nurse. In testing vision, eye doctors employ a time-honored reference to measure visual acuity. The Snellen chart or the Titmus Vision Tester, with progressively smaller letters, has become almost universal. "20/20" means that the person being tested can see the same letters on the chart, viewed from 20 feet, as a theoretically normal eye can see from 20 feet. "20/80" means the eye sees at 20 feet what a normal eye sees at 80 feet.
In kindergarten through Grade 3, the standard of failure for near vision or far vision is inability to read 3 out of 5 or 4 out of 7 symbols on the 20/40 line with either eye. In Grades 4-12, the standard of failure is inability to read the same number of symbols on the 20/30 line with either eye. A child who fails the visual acuity test should have a professional eye examination by an eye doctor.
School health services are designed to include a variety of functions which assist in maintaining and improving student health. The pervasive purpose of school health services is the attainment of optimum health for all children. To that end health screening each year includes vision testing, hearing testing, height and weight screening, and the determination of BMI.
Hearing Screening
The major goal of hearing screening is to locate children with hearing impairments. Results of hearing screening programs have shown that from 5% -10% of the school population do not pass the hearing test. The majority of these children are in need of medical treatment. Such treatment may result in restoration of hearing and prevention of permanent hearing impairment. Listening and talking are so much a part of us that we very seldom consider the implications of not being able to hear. The most serious effect of a hearing loss is the interference with communications between people. In a child some of the consequences may be:
- Interference with normal speech and language development
- Development of abnormal social growth and behavior
- Interference with education
Each year all students in kindergarten, and grades 1,2,3,7,and 11 are given a hearing screening test. Parents and guardians of students who fail the test are notified by mail so that follow up with a professional can be accomplished.
Students can only excel in school when their health needs are met. This information is just a glimpse of what school health services are all about. We must all work together to keep our children healthy.
Tips for Healthier Living Try to Increase Your Activity!
Ten Ideas to Get Active
Kids
- Take your dog for a walk.
- Play a game of kickball.
- Join a sports team.
- Go to the park with a friend and a parent.
- Help with yard work.
- Play tag with kids in your neighborhood.
- Ride your bike to school.
- Walk to the store.
- See how many jumping jacks you can do.
- Race a friend to the end of the block.
Adults
- Use a push mower to cut the lawn.
- Go for a walk in a park.
- Take the stairs instead of an elevator.
- Bike to work, to run errands, or to visit friends.
- Clean out the garage or the attic.
- Walk with a friend over the lunch hour.
- Volunteer to become a coach or referee.
- Sign up for a group exercise class.
- Join a softball league.
- Park at the farthest end of the lot.