Fifteen school districts across Southeastern Massachusetts will be among the first 80 trailblazers to roll out a new state-mandated screening program this fall aimed at addressing the soaring rate of obesity among children and adolescents.
The state Public Health Council unanimously approved a regulation last week to require school systems to do a body-mass screening of students at certain grade levels, and send the information to parents, along with tips on how to provide their youngsters with healthier lifestyle choices so they may attain and keep a healthy weight. The initiative will be phased in over the next two school years.
State health officials estimate that nearly one-third of adolescents weigh too much, which can result in various health problems. In the pilot program districts this fall, students in first, fourth, seventh, and 10th grades will have height and weight measurements taken. Based on that data, school nurses will calculate a body mass index score, which is a percentile number that indicates the appropriateness of one’s weight.
Children who score in the higher percentiles could be deemed overweight, while those in the lower percentiles could be considered underweight, and that information will be forwarded to their parents or guardian. The state has promised to provide districts with material to accompany the body mass index score, so parents will get direction on proper nutrition and resources to help with weight management.
South of Boston, the districts in the pilot program are Braintree, Bridgewater-Raynham, Brockton, Canton, Mansfield, Marshfield, Middleborough, Plymouth, Quincy, Randolph, Scituate, Stoughton, Walpole, West Bridgewater, and Weymouth.
School nurses, on the whole, are excited about the new requirement, believing it is high time obesity in young people is addressed.
"We’re facing a very scary situation," said Marge Rossi, nurse leader for the Scituate School District. "Over the last 10 years, it’s been sobering to look at how the rate of obesity has grown. We’re seeing diseases like Type 2 diabetes, coronary-artery disease, and even kidney stones, in children. These are adult diseases we never saw before in children."
Rossi anticipates at least some negative reaction from parents initially. "People may think it’s like Big Brother, but nurses have been collecting this same data for years," she said. "We just never had the vehicle to communicate it to parents."
Pat Harrison, the nurse leader for the Mansfield School District, also supports the regulation. Her district has received past state grants to track students’ body mass index, but parents had never been forwarded the information. It’s time to take the next step, she said.
"I think it’s important that the message is out, and now that it’s mandated, we can provide parents with nutritional information and outreach sources," Harrison said. "I don’t know that parents are going to like it, and it will certainly raise some questions, but obesity is out of control."
Marjorie McEttrick-Maloney, Plymouth’s nurse leader, said her district has received a state health services grant the last eight years, using part of it to create an electronic record. "You enter the height and weight, and it calculates the body mass index score," she said.
Last year, Plymouth school nurses screened students in prekindergarten through eighth grade, as well as Grade 10, using funding from the state health grant. It was the first time letters on the results were sent to parents.
In the letter, McEttrick-Maloney warned parents the body mass index score is only one part of a student’s overall growth assessment. "In some cases, a higher BMI percentile may be due to an increase in lean muscle mass such as in an athletic individual," she wrote, adding that it is important to look at the child’s body type, family history, and body mass percentile over time.
"Of the 7,000 students screened, we sent home about 1,200 letters," McEttrick-Maloney said. Letters were sent to parents of children whose body mass index score placed them in the 85th percentile or higher or the 4th percentile or lower.
The letters resulted in only five calls from parents. "We had three that said thank you, and two that were very unhappy," McEttrick-Maloney said.
Gordon Luciano, chairman of the Bridgewater-Raynham Regional School Committee, said his panel expects to be briefed at its April 29 meeting on how the district’s nurses will implement the body mass index program. He said he wants to learn more about the initiative.
"I believe there will be a concern as to the level of detail the study would go into – whether it will single students out or affect self-esteem," Luciano said. "The whole detail of the program needs to be spelled out."
Carol Burns, a clinical dietician at Jordan Hospital who has been working with Plymouth school administrators on the district’s food program, said she has mixed feelings about the state’s new requirement to keep weight score cards on students.
"Clearly, any message that helps a parent to get the family to eat a little better and get exercise has value," Burns said. "I’m always amazed at the poor nutritional skills people have."
She said school budgets have lowered the amount of physical education the students get at school. And many students live relatively sedentary lives. But she still has some concern about the negative impact a body mass index report could have.
"We’ve been seeing eating disorders show up so much younger now," she said. "You don’t want a parent tipping a child who thinks she’s heavy into an eating disorder."
McEttrick-Maloney said she believes the information that accompanies the body mass index score will be critical in keeping reaction from parents positive and constructive.
"It’s all in the message," she said. "This is not a weight loss initiative. Its focus is on a healthier diet."
Christine Legere can be reached at firstname.lastname@example.org.