Departments: Health
Take a Shot at Getting Immigrant Students Vaccinated

Approximately 5 million school-aged children from more than 100 different countries entered U.S. public schools during the past decade. Rena Large of the NEA Health Information Network looks at the risks these children--and their U.S.-born counter-parts--face if all students aren't properly immunized.

Do children who've immigrated to the United States have special health concerns?
According to the American Academy of Pediatrics, immigrant children and their families may have numerous health risks or conditions that are undiagnosed. Some may not have been immunized adequately. And in the case of international adoptees, they may arrive here without adults who can provide information about their medical history.

Immigrant elementary school children suffer from twice as much tooth decay in primary teeth as their U.S. counterparts.

Then do immigrant children pose a health risk for their classmates and school staff?
No. These children are more likely to have such diseases as Hepatitis B, parasitic diseases, and salmonella, which pose negligible risk to others, says Dr. Mark Sawyer of the University of California, San Diego, a specialist in pediatric infectious diseases.

Tuberculosis is a common concern in immigrating populations, but young children are generally not felt to be contagious.

In fact, when it comes to worrying about who can catch what from whom, the concern should run in the opposite direction: Immigrant children, who are less likely to be properly immunized, can contract diseases and conditions that they come into contact with upon entering the United States.

So it's the immigrant children themselves who are at risk?
Yes. These children can run into contact with American-born students who haven't been immunized. Both groups would risk contracting diseases that they could easily be vaccinated against.

Why aren't all children vaccinated and immunized?
For one, many working families, American-born and not, can't afford health insurance for their children.

Another reason is that many immigrant families fear that if they access services that provide them with free immunizations and other health care, they jeopardize their immigrant status.

Third, language and cultural barriers prevent some immigrant families from getting access to the regular health care they need, including immunizations.

Is there any good news?
Yes. State Child Health Insurance Programs are now available to provide free or low-cost health insurance for children in working families. These programs can provide regular doctor's exams, prescriptions, vaccinations and immunizations, and other urgent child health care needs.

Each state's eligibility requirements and enrollment process are different. Families interested in accessing these programs should contact their state's program office (see Resources).

Those families who fear they would jeopardize their immigrant status if they enroll in a public health program should know that, thanks to changes in welfare law, immigrant families that are applying to become lawful permanent residents can now be granted access to health care benefits such as State Child Health Insurance Programs, Medicaid, and free or low-cost medical care at clinics and health care centers. And using these programs will not change a family's immigrant status.

What role can schools and educators play?
Schools play a large part in providing students' families with information--how to access health insurance for children, why immunizations and vaccinations are important, and why younger children are especially at risk.

Schools also can help identify cultural, racial, ethnic, religious, and other commonly held values in their student populations and partner with community organizations to link their students and families with needed health services.

What should educators do if they fear a student's health puts them or others at risk?
All school employees should operate under the assumption that any student or staff member--and not just immigrant students--could have a communicable disease or condition, whether it's head lice, HIV, or chicken pox. Follow the Occupational Safety and Health Administration's universal precautions (on the Web at www.osha.gov/) to reduce the risk of transmission in school settings.

Educators shouldn't make assumptions about student health that can promote stereotypes and stigmas. Beyond the hurt and damage that such hearsay can cause to the student, what is said to others about a student's health or speculated health condition could violate a student's privacy and expose an educator to criminal penalties and civil lawsuits.

The Family Educational Rights and Privacy Act of 1974 (also known as the Buckley Amendment) places certain privacy restrictions on student records maintained by schools that receive federal funds, including the written permission from parents to share any information about student health with anyone other than designated school officials.

Schools should have written policies and procedures that govern record-keeping and identify proper school officials with whom you can share your student health concerns.

Resources

• To find important safety information on vaccines and immunizations, visit the National Immunization Program Web site at www.cdc.gov/nip/ or call the Immunization Hotline at 800/232-2522 (English) or 800/232-0233 (Spanish). A free Fax information service is also available by calling 888/CDC-FAXX and following the recorded instructions.

• To learn more about your state's free and low-cost health insurance program for children under the age of 18 who are members of working families, visit the Web at www.insurekidsnow.gov/ or call 877/KIDS-NOW.

• To obtain your copy of the American Academy of Pediatrics' policy statement "Health Care for Children of Immigrant Families," visit their Web site at www.aap.org/policy/970702.html.

Stress Management: Getting Stronger, Handling the Load

"For a lot of ESP, the biggest source of stress is not feeling appreciated," says Virginia Bailer, lunchroom manager at Section Elementary in Jackson County, Alabama.

"A large number of people discount what we do," says Bailer, who has organized stress management workshops for support personnel in Alabama. "Lots of ESP feel as though they're at the bottom of the totem pole but working harder than anyone else."

Feeling unappreciated. Kids shouting on the bus. Reams of paperwork. Rushing students to the cafeteria.

Educators encounter a number of stress triggers every day.

To counter that, Philip Bowser (above), a district psychologist in Roseburg, Oregon, has conducted stress management workshops for bus drivers, helping them to "get stronger and handle the load."

That involves developing strong links throughout your life, such as:

• Eat moderately and exercise regularly, especially if you have anger and frustration to work off.

• Avoid "self-medicating" with alcohol.

• If you have a chronic condition, such as hypertension, diabetes, or tobacco addiction, follow a physician's instructions to the letter.

"You know you're stressed if you find yourself thinking, 'I don't have time for all that!'" Bowser points out.

His workshops also involve guided relaxation steps.

"Most people hold their muscles more tightly than necessary, which is both uncomfortable and a waste of energy reserves," says Bowser.

"Make a fist and notice how muscle tension has a tendency to travel from the point of origin to other muscle groups," he says. "For example, some people will also clench their jaw."

By alternately tensing and relaxing various muscle groups, one can begin to discriminate smaller and smaller amounts of tension. With a little practice--Bowser recommends having someone talk you through the procedure the first time--you can recognize tension in the early stages and let it go quickly.

Another relaxation technique:_slow, deep breathing from the diaphragm.

"Put aside all worries and pay attention to your breathing," says Bowser. "Air coming in through your nose tends to be cool, dry, and makes a higher pitched sound. Air leaving through your mouth tends to be warm, moist, and makes a lower pitched sound.

"Visualize all your tension and worries being carried away by each exhalation. Start with two to three minutes and gradually work up to 15 to 20 minutes."

If stress is prolonged or excessive, a person should seek professional help. And all educators need to pay attention to their stress levels.

"When you're stressed, you do things like snap at the kids,"_says Bailer. "And kindness to the kids is the most important part of our jobs."

Easy Steps

1. Prioritize! Make sure the most important tasks get done, and then give up worrying about the rest.

2. Use your Association to make your voice heard. If you have input into working conditions and the decision-making process, you'll feel less stressed, even if the end result is far from ideal.

3. Celebrate your successes, no matter how small.

4. Interview for another job. Even if you don't switch, your current job will seem less stressful once you realize that you're not stuck.

5. Plan your life to take into account the stress load placed on you by work and family life.

6. Buy yourself flowers--they're cheaper than psychotherapy!

--Philip Bowser

Quick Tip

By Joan Deguire North

"Need a trick to help your body snap out of a stress attack?"

"Find a quiet place, sit down with a notepad, and write the answers to this question: 'What is the worst thing that could happen over this event?' You will usually see that your current situation is not the catastrophe you originally imagined.

"Then make a list of all the contributions you make at work or at home. This will help remind you of your value and give you the assurance that you can handle your problems."

Joan Deguire North is dean of the College of Professional Studies and a professor of education at the University of Wisconsin-Stevens Point. She's taught courses in stress management, but she's also taken her share of aspirin products over her 33-year career.

From the NEA Health Information Network

Anti-Drug Education
The National Youth Anti-Drug Media Campaign provides an online drug education resource with assorted classroom activities and reference tools geared toward educators with students between the ages of 11 and 14. The site also provides educators with insight into students' own thoughts and concerns on drug use. Visit www.teachersguide.org or call the National Clearinghouse for Alcohol and Drug Information at 800/788-2800 for additional anti-drug resources.

Program Planners
The "Community ToolBox: Resources for Local Health Program Planners," found on the Web at http://ctb.lsi.ukans.edu/, provides user-friendly "how-to" tools that explain how to accomplish the different tasks necessary for developing community health care programs. Sections online cover such topics as leadership, strategic planning, community assessment, advocacy, grant writing, and evaluation.

Cancer Education
NEA Health Information Network's Vivian Roy Bowser Cancer Education Fund provides small grants to state and local NEA affiliates to support small cancer education programs whose aim is to benefit school employees. For more information, call 800/718-8387 or visit www.neahin.org/breast-cervical/vrb.html.

Workplace Health
Visit the Occupational Safety and Health Administration (OSHA) Web site for an extensive and comprehensive library of occupational health information (www.osha.gov/). The new OSHA Worker's Page (www.osha.gov/as/opa/worker/index.html) provides information regarding your rights and obligations, as well as information about your employer's rights and obligations. And it will even let you file a report online. For local assistance, check your telephone directory for OSHA regional or state offices under the government listings.