Reimagining Schools as a Place for Improving the Health of Chicago's Children

Project: Reimagining Schools

Reimagining Schools is an interdisciplinary team of clinicians, school health leaders, and innovators in Chicago, Illinois.

Wicked Problem

Child health inequities are pervasive in Black and Latin communities across Chicago. The school environment represents an important venue for providing resources and programs to optimize children’s health and wellness. Despite this, approximately half of US schools do not have a full-time school nurse, contrary to national recommendations. In Chicago, the large and diverse Chicago Public School (CPS) district employs 300 staff nurses and contracts with about 250 “agency” nurses for over 361,000 students in 640 schools across 800 buildings. The result is that each CPS nurse is assigned to 3-5 schools and is present at each school less than one day per week. This insufficient school nursing ratio and the structural problem of funding for school nursing are important barriers to chronic illness care.

Asthma is the most common chronic childhood condition and has been linked to poor academic and health outcomes. Among the one in 12 affected children in the US, over half had an exacerbation in the past year, resulting in 13.4 million missed school days, 1 million emergency department (ED) visits, and 140,000 hospitalizations annually.

Approach

Our approach is to reimagine schools as a place for health and wellness by integrating community health workers (CHWs) in schools. To address the wicked problem of asthma disparities, in the context of significant school nurse shortages, our team will create an innovative and scalable model that integrates CHWs in school settings. While our long-term vision is to apply the school-based CHW model to support children broadly, we will first integrate CHWs into the schools by focusing on asthma care. In this way, we will develop, test, and refine this care model to optimize its feasibility for use deployed to address a high prevalence and high morbidity chronic condition among children.