Student health a low priority

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Rasheema's gym class

Jason Reblando

Rasheema's gym class

At 8:40 a.m. on a mid-January morning, 10-year-old Rasheema Fox dashes up the front stairwell at Cameron Elementary School. With five minutes left before the bell, she doesn’t need to run. But the athletic 5th-grader is fueled with an energy she can barely contain. For the next six and a half hours, however, contain it she must.

Like most Chicago elementary schools, Cameron dropped recess long ago in favor of a shorter lunch period and shorter school day. Classes run from 8:45 a.m. until 2:30 p.m., and Rasheema stays until 3:30 for after-school reading or math, as her test scores are somewhat below average. She gets only a 20-minute break for lunch.

And physical education class is only a weekly event. A state law mandates daily gym classes. But the state doesn’t enforce it, and some cash-strapped districts like Chicago ignore it, opting instead to provide more time for academics.

But neglecting physical activity undermines the drive for higher student achievement, according to a recent review of the research by Action for Healthy Kids, which partners with 40 national organizations and government agencies. “There is a very strong link between nutrition, physical activity and academic achievement,” insists Executive Director Alicia Moag-Stahlberg.

School administrators may assume that kids get enough exercise after school. But a week spent with Rasheema and her classmates in the Humboldt Park school reveals that many do not.

Rasheema, for one, fills most afternoons with homework, television or video games—and not because she prefers to be inactive.

Rasheema longs to move. You can see it in a sudden sprint down the sidewalk, in a twirl down the school hallway and in her powerful front flip. If Cameron’s girl’s basketball team hadn’t folded, she would have signed up. If Cameron still ran intramural sports, she’d stay late and play. When friends linger outdoors on winter afternoons, strolling the blocks south of Division Street or tossing slushy snowballs, she joins them. But those afternoons are few.

Rasheema’s sedentary days and a junk food habit are nudging her in a dangerous direction.

America’s childhood obesity epidemic has been widely publicized. But the obesity rate for children in Rasheema’s neighborhood is almost four times the national average, according to a recent study by Sinai Health System. Forty-seven percent of Humboldt Park children aged 2 to 12 are overweight, the study found. Other low-income minority Chicago neighborhoods showed similar rates.

Poor nutrition compounds the exercise problems. Rasheema relies on Cameron for two-thirds of her weekday meals. Although school breakfasts and lunches meet federal dietary guidelines, they are still heavy on salt and sugar and low on whole grains. She and her classmates usually find the cooked vegetables in their packaged lunches inedible, and few consume enough vegetables at home to make up the deficit, a class survey showed.

Poor nutrition and inactivity increase the risk that children stay home sick and fall behind in school, Action for Healthy Kids found.

It would be unfair to blame schools for the obesity epidemic, says Dr. Matt Longjohn, executive director of the Consortium to Lower Obesity in Chicago Children. More than 20 percent of Chicago kids are already overweight when they enter kindergarten, according to a recent Consortium study.

But schools need to be part of the solution, he says, adding that that it is in their best interests to do so. “It is clear that physical activity does improve academic performance.”

A week with a typical Chicago 5th-grader and her classmates points to where the district succeeds and where it falls short.

Gym classes few or none

Rasheema likes the gymnastics unit that her teacher, Dennis Peters, scheduled for three weeks in January. But it doesn’t give her much exercise.

And it’s the only physical activity that some of her classmates will get during the school week.

The Tuesday morning class officially lasts 35 minutes, but with time for equipment set-up, safety instructions and a quick debriefing afterwards, the kids spend only 20 minutes on gymnastics, much of it waiting in line.

Gym teachers in Chicago are not given a curriculum, only vague learning goals from the state like: Acquire movement skills and understand concepts needed to engage in health-enhancing physical activity.

Except for a few districtwide workshops each year and a smattering of special programs—a golf program for 50 schools, a nutrition and fitness program for 30—teachers are mostly left to their own devices.

This morning Peters, a middle-aged man in a baseball cap, makes due with one mat, a springboard and some vintage gymnastics equipment that he thinks might be original to Cameron’s 100-year-old building.

During the first eight minutes, the girls take turns bouncing on the springboard and tumbling onto a thick mat while Peters spots them. Some girls trot lazily to the springboard and somersault with a flop.

Rasheema takes her six paces at a run and flips easily with no hands and a broad smile. But she gets only four turns.

Then it’s time for the boys to tumble, and the girls cross over to the two pieces of equipment that fold out of the wall on chains and pulleys. One is a varnished wooden ladder that leans into the wall.

There isn’t much to do on the ladder. When it’s her turn, Rasheema climbs up its underside a few rungs and drops to the floor.

She moves next to a horizontal, elevated wooden ladder: Kids are supposed to hang from it and travel across, swinging from rung to rung by hand.

But Rasheema is tall for her age—when she swings, her toes drag on the floor. Halfway across, she abandons the activity as pointless. Before time is up, she gets in a couple more quick climbs on the leaning ladder and a brief clamber across a metal trellis near the door. That’s gym class for the week.

Last year, Cameron had two gym classes a week, but it cut one this year to avoid cramming two classes into a gym barely large enough for one.

Instead, it traded a gym teacher for a second librarian, a move the board’s staffing formula permits.

Illinois is the only state in the nation that mandates daily physical education, earning it much admiration from national health experts. But a third of Illinois districts secured a waiver from the requirement, a recent study found. (Chicago’s 1997 waiver allowed it to drop gym in the 11th and 12th grades.) And at least another 20 percent of schools “don’t have waivers [but] are acting as if they do,” says David Thomas, an exercise science professor at Illinois State University in Normal, who conducted the study.

That’s the case in Chicago elementary schools, which the district requires to offer gym only once a week, although some offer up to three, according to Patricia Faire, the district’s physical education manager.

For several reasons, Cameron’s program has an edge over some:

One, Cameron has a gym. Some CPS elementary schools make due with a smaller “multipurpose” room, says Faire.

Two, Cameron has a gym teacher. A gym teacher shortage in the district has left some elementary schools with no gym class at all, Faire reports. Chicago’s 1997 waiver cost some gym teachers their jobs, and local colleges have been graduating fewer physical education majors, she explains.

Three, Cameron is one of a handful of CPS schools to benefit from a $400,000 grant Faire won from the U.S. Department of Education. The grant paid to train gym teachers at 28 elementary schools in a curriculum called SPARK (Sports Play and Active Recreation for Kids) that emphasizes fitness over sports-related skills. The initiative gave Cameron’s Peters new equipment—$10,000 worth—and a new mind-set, he says. Last year, six kids might have practiced jump shots while the rest watched and waited. Now the goal is fitness, so he tries to keep everybody active, he says. “Just practicing, even if the form is bad, is better than waiting behind a cone.”

Faire is hoping to secure funding to spread the curriculum to a third of CPS elementary schools by fall of 2005. But schools will still need to supply their own equipment, she says.

However, the lack of equipment is one of the reasons kids used to stand around waiting, says Peters. Before the grant, three volleyballs, three soccer balls and an old parachute with holes in it were among his sparse supplies. “Everything was 30 to 40 years old here.”

Few after-school options

A pig-tailed girl pumps her dirt bike up a ramp and executes a whirling dismount. Landing solidly, she careens through the urban landscape, charging up staircases and down train tracks, slicing across the top of brick walls. Two feet away, Rasheema sits slouched at the foot of her sister’s bed, clutching the control panel to her GameCube, orchestrating the action with her thumbs.

Like many of her classmates, Rasheema falls short of the 60 minutes of daily physical activity recommended for kids by the National Association for Sport and Physical Education. Even children who are not overweight can develop diabetes and high blood pressure if they are not active, according to Charlene Burgeson, the association’s executive director.

Rasheema knows she needs more exercise. Her gym teacher said so. But temperatures hovering near freezing this week keep most kids indoors, and Rasheema doesn’t like to play outside alone.

So over the course of the week, her activity comes mostly in spurts—a 10-minute snowball fight with her little cousin on Tuesday, 15 minutes of chasing and play-fights before the school doors open on Thursday and on Saturday, a short walk to the nail shop with her friend, Bria, and an indoor game of tag.

Wednesday is her only truly active day. The weather turns balmy, the snow to slush, and Rasheema spends two hours roaming the blocks south of Division, mostly with Bria, outrunning boys with snowballs and stopping at Bria’s for video games. In two hours, she covers about three miles.

Like most elementary schools, Cameron offers competitive after-school sports. But team sports serve only a tiny fraction of its 1,120 students. In the fall, Rasheema was one of 20 girls who went out for volleyball; 24 boys joined the basketball team, and 24 played flag football. This winter, Cameron offered only one sport, basketball for boys and for girls. Rasheema planned to join but changed her mind when only one other girl signed up.

Cameron used to offer an intramural sports program that Chief Executive Officer Arne Duncan launched in 2002. Last year, about 100 5th- to 8th-graders turned out for volleyball, soccer, basketball or open gym at the school or a nearby park, says Jerry Strickland, Cameron’s athletic director.

But this year, the After School Matters program required schools to enter data on participating schools into a computer, intending to save them paperwork. Hearing about the system at a district meeting, Strickland thought it sounded too time-consuming. Nobody at Cameron wanted to do it, he says, so the program was cancelled.

Cameron might not have had its intramural program renewed, anyway. Funding from the After-School All-Stars non-profit group declined this year, forcing CPS to drop participating schools from 75 to 61, says Elizabeth Swanson, CPS director of after-school programs.

School day a forced march

Like most Chicago elementary schools, Cameron’s schedule allows for only a 20-minute lunch, leaving little or no time for recess. Cameron has none. Rasheema’s teacher, Marianne Cabrera, thinks the lack of physical activity leaves the kids restless. “They have all this energy, and they don’t have a way to work it out.”

A first-year teacher with a progressive teaching style, Cabrera tries to work movement into her lessons. One afternoon, for instance, she has them stand and stretch their arms into obtuse, right and acute angles.

Cabrera’s engaging lessons and businesslike manner usually keep her students focused. But as the week wears on, she says, that focus erodes.

That was evident the second week of January.

Monday is peaceful. Even after lunch, with the classroom temperature hovering near 80 degrees, students quietly sketch congruent triangles onto plastic transparencies. Tuesday is almost as good. But by 1:40 p.m., the room is restless with whispering and wandering. Wednesday, attention trails off late morning; only a handful stay focused through the silent reading period. Thursday, the wandering escalates.

Friday, a substitute teacher fills in for Cabrera, and the class gets some exercise chasing each other around their desk clusters, racing into the coat closet and sneaking out a door in the coat closet to dash down the hallway.

Thirty years ago, a 45-minute lunch that included recess was the standard in Chicago, says Margaret Harrigan, a retired principal and sub-district superintendent. But gradually schools shifted to a 20-minute lunch to avoid the hassle of supervising recess and to give teachers a shorter school day, she says. “Principals loved it: ‘It’s going to make my day so much easier.’ And teachers said, ‘Wow, I have more personal time now.'”

Cameron Principal Floricita Valignota says that in 30 years, she’s never heard of a CPS school with a 45-minute lunch and didn’t know it was an option for her school.

Some schools recently revived recess, and principals say that it has lengthened kids’ attention spans. Without recess, kids got antsy in the afternoons, says Principal Joseph Kallas of Peterson Elementary in North Park. “We had to do something brainless immediately after lunch. Now they come in, they’ve run themselves out. They’re ready to learn again.”

Junk food a silent killer

Friday morning at about 8:30, Rasheema detours off the sidewalk along Division Street into Nickel Liquor, a dingy convenience store a half block south of Cameron. For years, the principal has begged the owner not to sell junk food to her students before school. She wrote a letter. She even spoke with the owner in person, flanked by members of her local school council.

A store employee estimates that 50 to 100 kids visit the store each morning, and Flamin’ Hot Cheetos are their top pick, he says. Rasheema grabs two bags for 25 cents each. Out on the corner, she joins three other girls, one with a Reese’s Cup and a Twix Bar, the other two with three bags of the Flamin’ Hot Cheetos apiece.

While Rasheema and her friends are not fat, their junk food habits may put them at risk for nutritional deficiencies and for weight problems later in life, according to David Grotto, spokesperson for the American Dietetic Association.

For some kids, junk food occasionally replaces a school lunch or breakfast. (Last evening Rasheema skipped dinner after two bags of Cheetos, some candy, an ice cream sandwich and a jelly donut.) Usually it’s just a snack. Mid-morning, Rasheema sneaks into the coat closet to polish off her chips.

To promote healthier eating in school, the Board of Education passed a policy in June 2004 that replaced the junk food in school vending machines with healthier snacks like fruit juice and granola bars. Cameron never installed a vending machine for students and doesn’t intend to, says Assistant Principal Patricia Bowman. “Kids don’t need more snacks.”

CPS has made some effort to educate elementary kids about nutrition. In the spring of 2001, the district piloted a health education program at 90 elementary schools, including Cameron. Called The Great Body Shop, it covers not only nutrition but also safety, disease prevention, mental health and substance abuse. It was selected by a task force of 15 health agencies and organizations.

Funding for the $2.2 million pilot came from a tobacco lawsuit settlement with the State of Illinois. The program barely got off the ground at Cameron.

One teacher leader went to the district training and distributed curriculum manuals to the staff.

Rasheema’s 2nd-grade teacher says she couldn’t find the time to teach it. Her 3rd-grade teacher was in her first year on the job. She saw the binder sitting in her room but never attempted it. When Rasheema was in 4th grade, Cameron officially made the program optional.

Rasheema’s current teacher, also in her first year of teaching, says she has never heard of The Great Body Shop.

Allecia Alexander, director of coordinated school health for the district, says that many schools have found it difficult to fit the program into their schedules. And the district could afford to replace materials at only 95 schools this year and update training at 49 last spring, she adds.

However, another initiative did make an impression on Rasheema and some of her classmates. Dieticians at the University of Illinois at Chicago trained community nutrition educators to lead workshops at 20 schools in Chicago, including Cameron in 2002-03 and 2003-04.

The educators visited classrooms weekly for months, armed with visual aids, like a five-pound blob of fat. Rasheema’s classmate Xavier Morales says the fat blob convinced him to give up junk food. “It looked nasty. People die because of how fat you are,” he explains.

But the non-profit that sent educators to Cameron folded.

Rasheema remembers hearing that junk food is bad for you, but she doesn’t recall how much is too much. So she came up with her own theory. It’s OK to eat up to 10 servings a day, as long as you don’t eat them all at once. Another girl in her class figures that up to 20 servings a day is OK, “as long as you exercise.”

“Holy Moly,” says Grotto of the American Dietetic Association. “That’s a classic example of an inverse pyramid way of eating.” The U.S. Department of Agriculture puts foods with sugar and oils at the top of its food pyramid, meaning they are an occasional indulgence rather than the base of one’s diet.

The danger in junk food isn’t only the extra calories; it’s the loss of healthier options.

“You’re replacing foods that would be rich in vitamins and minerals and plant chemicals that are shown in research to fight many of the diseases that are plaguing children now, such as adult onset diabetes, high cholesterol and heart disease.”

School meals a problem

During the school week, Rasheema eats two-thirds of her meals in Cameron’s cafeteria. Many breakfasts and lunches are heavy on salt and sugar. All are low on whole grains.

On a Monday morning at 8:25, Rasheema sits at one of the long cafeteria tables, a plastic-wrapped breakfast sandwich resting before her on a styrofoam tray. She unwraps the sandwich: a white English muffin soaked with processed cheese, encasing a slice of turkey ham and a spongy, heavily salted egg disk. If she ate it, it would sock her with a third of the USDA’s maximum daily allowance for sodium. But Rasheema eats only the ham, with her fingers, in strips spread with strawberry jam.

Meals served through the federal school lunch program must meet USDA requirements for vitamins, minerals, protein, fats and calories.

Sugar and salt are not regulated, and whole grains are not required. That may soon change, as the USDA released new guidelines in January that federal lunch providers will probably need to meet within the next year or so, according to the School Nutrition Association in Alexandria, Va.

But schools need to take a larger role in allowing students a choice of meals and assisting with quality control, says Sue Susanke, director of logistics in the CPS food service bureau.

Cameron’s lunches and breakfasts are delivered prepackaged from Preferred Meal Systems, which serves 190 elementary schools that don’t have kitchens or whose kitchens, like Cameron’s, are too small or under-equipped to prepare meals on site. Other school food services prepare meals on site. All menus are analyzed with USDA software and approved by Susanke’s office.

Preferred Meal Systems offers two meal choices per day; some providers offer up to four. But elementary schools typically allow only one choice per day because they have only 20 minutes for lunch, and more choices would slow the lunch line, Susanke explains.

But at schools that do offer more choices, kids tend to eat more, she says.

During the week, Rasheema skips a number of meals because she doesn’t like the food—the breakfast sandwich on Monday, a bowl of cheesy grits and a salty ham and cheese sandwich on Tuesday and a salty slice of pizza on Friday. Kids also avoid some slightly bitter mixed vegetables and some unseasoned green beans that had a yellowish cast.

Susanke says that she personally samples every new Preferred Meal entree at least several times.

Her office also sends inspectors to see that menus are followed, portion sizes correct and meals attractively presented. But with only 12 field staff to cover 634 schools, Susanke says she needs help spotting problems.

School staff or parents can call her direct at (773) 553-2833 or a hotline at (800) 422-1145.

“Especially if there’s a trend: If every time the sub sandwich is served, they see most of that is going in the garbage, then that should raise a red flag.”

Schools aren’t going to give health the attention it deserves without a bigger push from central office, insists Brenda Bannor, a health and education consultant with Millenia Consulting, who formerly ran two CPS school-based health centers. What the district needs is a health initiative on par with its ambitious math and reading initiatives, she explains.

“If you’re not mentally well, physically well—if you’re tired, if you’re hungry—you’re not going to be able to grasp all of the things that are going on in the classroom,” she says. “Kids need to be well to do well.”

To contact Elizabeth Duffrin, call (312) 673-3879 or send an e-mail to duffrin@catalyst-chicago.org.