Written by Jamie Baxley
North Carolina requires first-time public school children and students who immigrate from another state to undergo a health exam within 30 days of enrolling. Those who do not want to risk a suspension that could cause them to fall behind academically.
Economically distressed, rural areas like Duplin County are at increased risk because many residents lack health insurance and there is a shortage of health care providers. More than a quarter of children in the county live in poverty, according to the 2022 Health Needs Survey.
Duplin County has about 49,000 residents, a quarter of whom are under 18, and only four pediatricians. Some surrounding counties have even fewer providers.
For the past three years, East Carolina University medical students have provided free health exams to hundreds of Duplin schoolchildren. The initiative is part of Healthy Living in School and Beyond, an initiative the university launched in 2016 with funding from the U.S. Department of Health and Human Services.
Originally a telehealth program, Healthier Lives expanded to offer in-person health exams after the university converted a Wi-Fi-enabled transit bus into a mobile clinic in 2020. The bus now regularly visits the K-12 campus in Duplin, Jones. and Sampson County.
Lauren Nuridin, a third-year physician candidate in the ECU Brody School of Medicine, gave an overview of the program at the Rural Health Symposium in Greenville last month. She said her school health screenings were “successful in addressing the barriers to care faced by children in rural areas.”
Nuriddin said these barriers include “mistrust of medicine,” immigration status and limited access to transportation. She said many parents cannot take their children to health care providers because they cannot afford to take time off from work.
“All children have the right to education and no child should be deprived of this right for reasons beyond their control, such as not having a school health check,” Nuriddin said. The classmate added, “We know that suspension has a negative impact on children.” We are committed to doing something about it. ”
Effect of suspension
Nuriddin said drug withdrawal can cause some “research-proven long-term negative side effects,” especially in older children. She said they may not be able to graduate on time and may have difficulty finding “living wage employment” after graduation.
A 2021 study by the Institute of American Studies found that out-of-school suspensions “have a consistent negative impact on society.” […] Delivering long-term educational outcomes for students. ” The study was based on 10 years of out-of-school suspension data for middle school and high school students in New York City.
Another study published in 2022 by the nonprofit Learning Policy Institute found that students who are suspended from school are “less likely to earn a high school or college degree.” The study said an analysis of national data showed that out-of-school suspensions are “disproportionately applied to Black students, Native American students, and students with disabilities.”
Similar disparities were found in North Carolina. A 2020 report by the North Carolina Institute of Medicine found that Black students are more likely to receive suspensions than white students.
“Children of color are disproportionately punished in the education system through mechanisms such as short-term suspensions,” the report's authors wrote. “These penalties hinder academic performance and open gateways that can eventually lead to involvement in the justice system.
“Lower educational attainment and incarceration both reduce employment opportunities and earning potential, and have long-term negative effects on health and well-being.”
Nuriddin said bus health screenings currently make up a small percentage of healthy living program encounters with students, but that percentage is increasing. He hopes the service will contribute to the institute's goal of reducing the state's short-term suspension rate by 2030.
See the impact
Nuriddin and his fellow medical students have helped more than 300 schoolchildren avoid suspension since ECU began offering mobile health screenings.
The initiative saved her parents an estimated 330,000 miles worth of travel, she said. She also had “increased student teaching time where she would have had to miss school” to attend doctor's appointments.
Kristen Hall, chief officer of district effectiveness and student support services for Duplin County Schools, called the program “a valuable service.”
“Not only do our students enjoy the unique experience of being assessed on ECU's athletic bus, but our school system has greatly benefited from this service,” Hall said in an email to NC Health News. I wrote it in “The seamless integration of the mobile health assessment bus will contribute to the overall efficiency and effectiveness of the school system and ensure access to health and medical services for all enrolled students.”
Nuriddin said bus health checks not only help schoolchildren, but also “benefits students at all levels.”
“For public school students, we will reduce school closures by completing required health exams.” [results in] My academic engagement and grades have improved,” she said. “For medical students, providing school-based outreach opportunities within the curriculum enhances learning and engagement.”
Nuriddin described his time in the program as a career-affirming experience. She said she feels “blessed” to have the opportunity to make a difference in children's lives.
“The direct experience I had with children at school was invaluable and gave me an opportunity to think about the impact I could have as a future physician beyond the walls of my clinic,” she said. Told.
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