Students’ Physical and Mental Health Declined During the Pandemic. Could a New Telehealth Initiative Help?

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Hope that school might return to normal in the fall is quickly dimming as new COVID-19 variants threaten to pummel communities throughout the country and COVID hospitalization rates increase.

Many districts are dusting off COVID-19 safety and cleaning protocols and shoring up remote learning options. All signs point to record teacher and staff departures at schools across the country. Pandemic era shortages continue to plague school districts, affecting everything from the availability of nutritious food for school lunches to basic classroom supplies. And that’s to say nothing of the impact of high inflation and record-high gas prices on schools. Meanwhile, school and district leaders continue to try to regain ground against so-called “learning loss” that occurred during the pandemic, investing in tutoring programs and summer school options.

Faced with these daunting realities, it’s understandable that school and district leaders might put deep investment in students’ physical and mental health on the back burner.

But that would be a mistake.

Children’s Health Is Crucial to Closing the Achievement Gap

Student wellbeing—including physical and mental health—is deeply intertwined with learning outcomes. In short, healthy children learn better than children who are suffering from health-related problems. That’s the big takeaway from decades of research and emerging findings on the impact of the COVID-19 pandemic on student outcomes.

Researchers have shown that mental health risks—including aggression, depression, and suicidal behaviors—are often present for students experiencing struggles in school. On the other hand, researchers have found a positive correlation between physical exercise and particular types of cognitive skills, particularly executive function. Executive function includes many of the core skills needed for learning: memory, attention, planning, and the ability to manage multiple tasks.

Even short amounts of physical activity have been shown to improve students’ cognition. In one study, researchers asked children to complete cognitive tasks after either watching television or engaging in physical activity for 30 minutes. The children who participated in exercise significantly outperformed those who watched television. In another study, researchers administered academic achievement tests after children walked on a treadmill at a moderate pace. Children who walked on the treadmill performed better on the achievement tests than those who rested prior to testing.

There’s a key equity dimension of this research. Health challenges disproportionately affect children in low-income communities, particularly children of color in urban areas, resulting in a widening achievement gap. Children in low-income communities are more likely to experience pollution, food insecurity, housing insecurity, and stress, among other factors affecting physical and mental health, which, in turn, affect learning.

The pandemic has only exacerbated these challenges. More than 200,000 children have lost a parent or caregiver to COVID-19, affecting Black and Hispanic children at nearly twice the rate of white children. Researchers have documented declines in children’s mental health during remote learning and social distancing. Just a few months into the pandemic, one in three parents reported that their child was experiencing harm to their mental or emotional health. One study found that during the pandemic, adolescents showed more signs of anxiety and depression and a decrease in life satisfaction.

Researchers have also found substantially decreased physical activity among children during the pandemic, with socioeconomically disadvantaged children faring especially poorly. Many experts have raised concerns that these disparities could lead to increased risk of diabetes, obesity, and other adverse health outcomes for children in the long-term. In turn, such health challenges could significantly affect students’ learning—especially among students from low-income communities—further widening an achievement gap that has become more pronounced during the COVID-19 pandemic.

What can schools do about these health challenges?

Research has shown that school investments in physical education and mental health services can play a role in improving student learning outcomes. And during the COVID-19 pandemic, many schools have stepped up or extended existing programs to provide food and social services to students and families. But with few trained counselors, nurses, or other professionals, and with so many other demands on educators’ time and energy, it’s hard for many schools and districts to help address students’ mental and physical health at scale.

Instead, statewide initiatives offer an opportunity to leverage pandemic-era learnings in order to offer health services at scale. One such model is the Mississippi Department of Education’s (MDE) partnership with the University of Mississippi Medical Center (UMMC) to provide telehealth services to K-12 students. The partnership officially launched earlier this year, with clinical implementation beginning in July.

Leveraging Investments in Tech for Better Health

The $17.6 million telehealth delivery system grant is funded by the MDE out of the state’s COVID-19 relief funds. The program will draw on UMMC personnel to provide telehealth services to K-12 schools in Mississippi across the following areas: remote urgent care, remote behavioral health, dental health education, and lifestyle coaching of students at risk for developing diabetes.

UMMC will conduct needs assessments with schools and districts, and set up and maintain the program locally, training school nurses and other staff on how to use the system. UMMC staff will convene local stakeholders to identify goals and metrics to evaluate locally and will continue to monitor progress for the duration of the grant. The program will initially be available in four districts, but telehealth services will expand to all districts throughout the state by July 2023.

The goal of the program? To use preventative services to improve health outcomes of Mississippi’s students, in order to improve learning.

Carey Wright, the recently retired Mississippi state superintendent of education, explained the goals of the partnership this way: “Healthy students learn better. … This program can potentially reduce absenteeism, help parents and guardians get quicker access to services for a child and even save lives.”

The MDE leverages the technological capacity that the MDE has built through its Mississippi Connects program. That initiative provides computing devices to students and teachers throughout the state, and offers the infrastructure to support use of these devices, including professional development, software, curricula, broadband, and other resources. These devices and services are critical for students accessing telehealth services.

The telehealth partnership also leverages the expertise of UMMC’s professionals in delivering telehealth services. UMMC’s Center for Telehealth has more than 200 sites in 73 of the state’s 82 counties and has expanded its telehealth capacity during the pandemic.

That reach and expertise has been particularly important for serving the state’s most vulnerable populations, according to Dr. Saurabh Chandra, chief telehealth officer at UMMC’s Center for Telehealth. “Telehealth has provided means to increase access and delivery of care, especially in the rural and underserved communities,” Chandra says.

It’s too soon to say how effective the partnership will be. But the MDE’s telehealth partnership with UMMC has the promise to address health disparities that have become more pronounced during the pandemic, and that threaten students’ learning. It’s a model that other states would be wise to monitor.

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