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School Nurses, Disparities and Helping our Students Learn

Recently, NASN’s Weekly Digest focused on equity and health disparities. Disparities and equity is more than just cultural sensitivity, it is more than social determinants (although both of these are often interrelated; health equity is ensuring the highest level of health for all).

Not long ago, I attended two meetings that helped me better understand the role school nurses have related to health disparities and equity. One meeting was at the Urban Institute regarding the use of housing data to better understand issues related to poverty (including health) and evaluate programs addressing them; the other was a Scholars Forum, funded by the Robert Wood Johnson Foundation, addressing health disparities. These two meetings were great examples of how disparities are more than just about health-they are about different opportunities for education, housing, and finance.

. . . disparities are more than just about health

So why is this important to school nursing? School nurses are often the bridge in their communities between education and health. When school nurses address health issues we often find that housing, employment and other determinants are strong factors in the health of the student. When I was a school nurse, I remember accompanying a school employee on a home visit because of concerns we had for one of our students. We arrived to find that the student and his family did not have heat, and the mom had just come home with a newborn baby. The father worked long hours to make ends meet. We assessed the situation and realized the family was truly doing the best they knew-but as school health persons we could provide them with information on additional resources and programs to prevent further health complications. We could also share their story with policy makers to show where gaps exist. In this example, we could not fully address health until we addressed the social determinants. School nurses see when our students may not be receiving quality healthcare and where disparities exist.

School nurses are often the bridge in their communities between education and health.

For example, evidence exists that asthma is not just a health concern, but a disparity concern, especially for groups at risk. This is particularly true for children who are twice as likely to be hospitalized for asthma as adults. We already know that asthma is one of the leading causes of absenteeism in schools. To address students’ asthma we must look at existing social factors and disparities in treatment. As advocates for our students, school nurses address health disparities to ensure a child is healthy and in school. As we share our stories and use the data we collect (this is one of the reasons we are emphasizing the Uniform Dataset), school nurses make a difference for our students and their families.

As other professions address disparity, school nurses can again serve as the link between various worlds (health, education, housing, community development, sociologists, criminal justice, and others). We must be at the table however, or they may not realize the valuable contribution we can provide. School nurses must be part of the team to ensure our students are safe, healthy, ready to learn, and have the equal opportunity to do so.

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