THIS STORY HAS BEEN FORMATTED FOR EASY PRINTING

Flu derails obesity initiative in schools

By Stephen Smith
Globe Staff / August 27, 2009

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A state campaign to reduce childhood obesity will get off to a slower start than planned because school nurses and public health authorities are consumed with preparations for the flu season.

Last spring, state officials ordered public schools to begin weighing and measuring students so that they could calculate the children’s body mass index, widely known by the acronym BMI, a measurement used to determine whether someone is overweight.

The initiative was a response to the expanding waistlines of the state’s children: Nearly one-third of high school and middle school students weigh too much, according to state surveys.

The state’s public health commissioner, John Auerbach, said in an interview that he still expects 80 school districts, with about half of the state’s public school students, to conduct the screening before the 2009-2010 academic year ends but that he no longer anticipates widespread screening before the winter holidays.

Instead, he said, nurses will devote the first months of the school year to tracking and responding to the arrival of seasonal flu and an expected resurgence of swine flu, known scientifically as H1N1.

“He’s right; BMI screenings will be eclipsed by H1N1,’’ said Kathy Hassey, immediate past president of the Massachusetts School Nurse Organization. “Flu surveillance is going to be issue number one for nurses.’’

It is another sign that the rush to draft battle plans for the flu season is consuming considerable time and resources at public health agencies across the nation.

“Postponing BMI screening to be sensitive to the demands of H1N1 doesn’t mean that this is any less of a priority for us,’’ Auerbach said. “But there are only so many hours in the day, so we’re saying, ‘Let’s postpone the BMI for a bit.’ ’’

That decision reflects internal pressures at Auerbach’s agency as well. Some of the same specialists who are essential to the launch of the childhood obesity initiative have been immersed in flu preparations. As a result, materials the Department of Public Health had expected to have ready for the fitness campaign have yet to be completed.

The health agency and school nurses are focused instead on issues such as whether flu vaccinations should be dispensed in schools. Already, Auerbach said, about 100 districts are exploring the feasibility of providing immunizations during and after classes.

Last week, more than 300 school and public health nurses convened in Marlborough to discuss the threat presented by the upcoming flu season and the role schools are likely to play in blunting its impact.

Since first appearing in the United States, the H1N1 virus has proven to be a particular threat to children and young adults, with 5- to 24-year-olds the most likely to be infected, according to research by the US Centers for Disease Control and Prevention. That is why schools have emerged as a potential venue for distributing some of the 9 million doses of vaccine against seasonal and swine flu that are expected to flood into Massachusetts during the next several months.

But long before the arrival of swine flu, schools had been identified as a prime place to address another scourge of childhood: excess weight.

As part of Governor Deval Patrick’s initiative to improve the fitness of adults and children, health regulators decided to implement a body mass index screening program modeled on the first-in-the-nation campaign in Arkansas. The screenings are scheduled to begin in certain districts, including Boston, this academic year. All public schools are expected to begin conducting them by the end of the 2010-2011 academic year.

The screenings will be performed on students in grades 1, 4, 7, and 10, unless parents request that their child be excluded. A report will then be sent to families with guidance on how to interpret the information and where to turn for assistance.

But the state health agency is still drafting that advice, assisted by pediatricians who have also been overwhelmed with demands related to swine flu.

Stephen Smith can be reached at stsmith@globe.com.

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