1. Children’s Well-Being: What It Is and How to Achieve It
EDU 153 Granberry Spring 2015
4/17/2017
Chapter 1
Children’s Well-Being: What It Is and How to Achieve It
©2015 Cengage Learning.

2. EDU 153 Granberry Spring 2015
4/17/2017
Preventive Health
The preventive health concept emphasizes the importance of assuming responsibility for one’s personal well-being.
On a personal level—preventive health practices include following a nutritious diet, participating in physical activity, keeping immunizations current, wearing seat belts, avoiding substance abuse, etc.

3. EDU 153 Granberry Spring 2015
4/17/2017
Preventive Health
On a social level—citizens have a collective responsibility to support policies and practices that promote the health of all individuals, such as establishing food safety standards, water fluoridation, regulating air pollution and pesticide use, and advocating for child safety legislation.
Photo: © Cengage Learning

4. National Preventive Health Initiatives
EDU 153 Granberry Spring 2015
4/17/2017
National Preventive Health Initiatives
National health initiatives and programs that support and promote children’s well-being:
Healthy People 2020
National Children’s Agenda
Children’s Health Insurance Program (CHIP)
Logo: © healthypeople.gov

5. EDU 153 Granberry Spring 2015
4/17/2017
Healthy People 2020
Healthy People provides science-based, 10-year national
objectives for improving the health of all Americans.
For 3 decades, Healthy People has established benchmarks and monitored progress over time in order to:
Encourage collaborations across communities and sectors.
Empower individuals toward making informed health decisions.
Measure the impact of prevention activities.
Healthy People 2020 continues in this tradition with the launch on December 2, 2010 of its ambitious, yet achievable, 10-year agenda for improving the Nation’s health. Healthy People 2020 is the result of a multiyear process that reflects input from a diverse group of individuals and organizations

6. Mission Healthy People 2020 strives to:
EDU 153 Granberry Spring 2015
4/17/2017
Mission
Healthy People 2020 strives to:
Identify nationwide health improvement priorities.
Increase public awareness and understanding of the determinants of health, disease, and disability and the opportunities for progress.
Provide measurable objectives and goals that are applicable at the national, State, and local levels.
Engage multiple sectors to take actions to strengthen policies and improve practices that are driven by the best available evidence and knowledge.
Identify critical research, evaluation, and data collection needs.

7. EDU 153 Granberry Spring 2015
4/17/2017
Goals
Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Achieve health equity, eliminate disparities, and improve the health of all groups.
Create social and physical environments that promote good health for all.
Promote quality of life, healthy development, and healthy behaviors across all life stages

8. EDU 153 Granberry Spring 2015
4/17/2017
CHIP
The Children’s Health Insurance Program (CHIP) provides health coverage to nearly 8 million children in families with incomes too high to qualify for Medicaid, but can’t afford private coverage.
Signed into law in 1997, CHIP provides federal matching funds to states to provide this coverage.
Like Medicaid, CHIP is administered by the states, but is jointly funded by the federal government and states. The Federal matching rate for state CHIP programs is typically about 15 percentage points higher than the Medicaid matching rate for that state (i.e. a State with a 50% Medicaid FMAP has an “enhanced” CHIP matching rate of 65%). Every state administers its own CHIP program with broad guidance from CMS

9. EDU 153 Granberry Spring 2015
4/17/2017
CHIP
In the fall of 1998, North Carolina implemented its State Children Health Insurance Program, North Carolina Health Choice for Children (NCHC).
This stand-alone, fee-for-service program quickly enrolled large numbers of children and has been considered one of the State Children Health Insurance Program success stories.
The NCHC has been successful in improving access to health care for low-income children. Parents reported that the program helped make health services financially accessible to their children, enabling them to get needed physician's care, eyeglasses, or prescription drugs. A significantly higher percentage of children received care in the private sector, increasing from 62% to 75% for well-child care visits and 67% to 78% for acute care. The percentage of children with unmet medical needs dropped significantly from 20% to just 2% after enrollment in NCHC. The improvement in access to care is much more striking for the older age groups and for children who were uninsured prior to NCHC enrollment (rather than those who graduated from Medicaid into the program). Despite these gains, there are still substantial numbers of children who are not receiving age-appropriate well-child care.
MEDICAID IS the single largest health insurer for children in this country. The program, which is jointly supported by the federal and state governments, covered 21 million of the poorest children in 1998—more than 25% of the nation's children.1 While Medicaid is available for the poorest children, many families with incomes just above the Medicaid guidelines have been unable to afford private insurance.2 Between 1989 and 1996, the percentage of children with private health insurance coverage decreased from 73.6% to 66.3%.3 During this same time, the percentage of children with Medicaid coverage increased from 15.7% to 21.8%. Although the percentage of children on Medicaid increased, it did not completely make up for the loss in private health insurance coverage, leading to an increase in the percentage of children who were uninsured from 13.3% in 1989 to 14.8% in 1996.
Uninsured children have been shown to have less access to care and use fewer health care services These children are less likely to be treated for injuries (including serious injuries such as broken bones) and are less likely to get care for common childhood illnesses, such as pharyngitis, ear infections, or asthma.11 If left untreated, these illnesses can lead to more serious conditions and use of more expensive health care services such as hospitalization for uncontrolled asthma.
To address growing concerns about uninsured children, Congress enacted the State Children Health Insurance Program (SCHIP) in Congress appropriated approximately $40 billion over 10 years in federal block grant funds to assist states in developing or expanding state-level health insurance programs for uninsured children whose family income was too high to qualify for Medicaid but still too low to purchase private insurance.13 The SCHIPs were created with the expectation that more low-income children would have health insurance coverage and, consequently, improved access to care. Flexibility was allowed in how states designed their programs to meet this goal. Fifteen states have used the SCHIP funds to expand their Medicaid programs; 16 created stand-alone state-designed SCHIPs; and 19 created programs combining different public insurance models.14
In the fall of 1998, the state of North Carolina implemented its SCHIP, North Carolina Health Choice for Children (NCHC).15 Under this program, uninsured children in families with incomes above the Medicaid threshold but at or below 200% of the federal poverty level (FPL) qualify for coverage. North Carolina Health Choice for Children is a stand-alone, fee-for-service, state-designed SCHIP that is administered jointly by the NC Division of Medical Assistance (the Medicaid agency), and the NC Teachers and State Employees' Comprehensive Major Medical Plan. At the time of this study, children were required to be uninsured for at least 2 months before they were eligible for enrollment in NCHC, unless they had just graduated from Medicaid or had lost private insurance coverage because of a change in parental employment or discontinuance of insurance by the employer

10. National Preventive Health Initiatives
EDU 153 Granberry Spring 2015
4/17/2017
National Preventive Health Initiatives
Healthy Child Care America
National Health and Safety Performance Standards for Child Care
No Child Left Behind
Coordinated School Health Program (CSHP)
National Children’s Study
Let’s Move!
Can you think of others?
Photo Source: letsmove.gov
NCLB support State and local efforts to keep our schools safe and drug-free, while at the same time ensuring that students-particularly those who have been victims of violent crimes on school grounds-are not trapped in persistently dangerous schools. As proposed in No Child Left Behind, States must allow students who attend a persistently dangerous school, or who are victims of violent crime at school, to transfer to a safe school. States also must report school safety statistics to the public on a school-by-school basis, and LEAs must use Federal Safe and Drug-Free Schools and Communities funding to implement drug and violence prevention programs of demonstrated effectiveness
Coordinated School Health (CSH) is an effective system designed to connect health (physical, emotional and social) with education. This coordinated approach improves students' health and their capacity to learn through the support of families, communities and schools working together. The Office of Coordinated School Health works with many partners to address school health priorities.
The Coordinated School Health (CSH) model is a method of connecting health and learning that consists of eight inter-related components. This approach constitutes a systems change by improving students' health and their capacity to learn through personal responsibility, and the support of families, communities and school.
By definition all Coordinated School Health components work together to improve the lives of students and their families
NCS aims to track factors affecting the health of 100,000 children from before birth to age 21,
Letsmov.gov

11. Healthy Child Care America
EDU 153 Granberry Spring 2015
4/17/2017
Healthy Child Care America
GOALS:
To promote the healthy development and school readiness of children in early education and child care by strengthening partnerships between health and child care professionals.
To provide information and support necessary to strengthen children’s access to health services.
To promote the cognitive, social and physical development of children in early education and child care.
To provide technical assistance regarding health and safety for health professionals and the early childhood community.
To enhance the quality of early education and child care with health and safety resources.
To support the needs of health professionals interested in promoting healthy and safe early education and child care programs.
The Healthy Child Care America (HCCA) program is coordinated by the American Academy of Pediatrics (AAP), Early Education and Child Care Initiatives (the Section on Early Education and Child Care) , and is partly funded by the Office of Child Care (OCC), Administration for Children and Families (ACF), and the Maternal and Child Health Bureau, HRSA, US Department of Health & Human Services.

12. In What Ways Are Health, Safety, and Nutrition Interrelated?
EDU 153 Granberry Spring 2015
4/17/2017
In What Ways Are Health, Safety, and Nutrition Interrelated?
Although each component is important by itself, all three must be considered collectively.
Each component influences the state and quality of the others.
health + safety + nutrition = well-being

13. EDU 153 Granberry Spring 2015
4/17/2017
What Is Health?
Health is a state of physical, social, economic, emotional, cultural, and spiritual well-being.
How might these qualities affect each other and also influence an individual’s health?
Photo: © Cengage Learning

14. EDU 153 Granberry Spring 2015
4/17/2017
What Is Health?
Health is determined by the dynamic interaction of genetics and environmental factors.
The quality of a person’s health is always changing.
In what ways can teachers promote children’s health?
Photo: © Cengage Learning

15. EDU 153 Granberry Spring 2015
4/17/2017
Children’s Safety
The term safety refers to the behaviors and practices that reduce the risk of unintentional injury.
Why must teachers always be aware of children’s safety issues?
Unintentional injuries cause the
majority of childhood deaths.
Prevention is every adults’
responsibility.
Photo: © Cengage Learning

16. EDU 153 Granberry Spring 2015
4/17/2017
Children’s Nutrition
Food provides nutrients that are essential for growth, energy, protection from illness and disease, and continuous tissue repair.
Food insecurity and unhealthy dietary practices can lead to malnutrition and/or obesity.
Children’s behavior is also affected by the quality of their diet.
Photo Source: letsmove.gov

17. Children’s Growth & Development
EDU 153 Granberry Spring 2015
4/17/2017
Children’s Growth & Development
The term growth refers to the numerous physical changes, such as eruption of teeth, increased height, weight gain, and improved visual acuity that occur as a child matures.
Growth results from the interaction of genetic potential and environmental factors.
Photo: © Cengage Learning

18. Children’s Growth & Development
EDU 153 Granberry Spring 2015
4/17/2017
Children’s Growth & Development
The term development describes changes that occur in the complexity of children’s cognitive, social-emotional, motor, and language abilities.
Development involves an interactive process of maturation and opportunity (to experience and practice).

19. Children’s Brain Development
EDU 153 Granberry Spring 2015
4/17/2017
Children’s Brain Development
An infant’s brain is wired and ready to learn at birth
Maternal practices during pregnancy influence the brain’s structural development
A majority of a child’s brain development occurs by age 5 yrs.
What are “windows of opportunity”?
What is plasticity?
Photo: © Cengage Learning
maternal practices (e.g., diet, sleep, prenatal care, physical activity, weight gain, smoking, alcohol or drug use, stress) prior to and during this period
Windows of opportunity sensitive periods, or “windows of opportunity,” during which neural connections in certain regions of the brain form more readily than they will later on. For example, vision and hearing connections peak between 2 and 4 months, whereas those governing emotional regulation begin to form months later. Sensory and learning pathways established during these sensitive periods are critical to the normal development of more advanced skills ( Twardosz, 2012). For example, the visual system must be fully developed and functional before children are able to read or to play softball. An infant raised in a darkened room with few visual opportunities (e.g., mobiles, pictures, toys) will not form the network connections in the brain's sensory region that are conducive to the same quality of learning.
plasticity the brain's ability to organize and reorganize neural pathways.
Video

20. Children’s Oral Health
EDU 153 Granberry Spring 2015
4/17/2017
Children’s Oral Health
What purpose do teeth serve?
Chewing
Maintaining space for permanent teeth
Helping to shape the jaw
Speech
What practices are important for promoting children’s oral health?

21. Children’s Social-Emotional Competence
EDU 153 Granberry Spring 2015
4/17/2017
Children’s Social-Emotional Competence
Social-emotional competence refers to the way a child thinks, feels, and acts on a daily basis.
It affects how a child handles stress, communicates, and makes decisions.
It ultimately influences a child’s self-concept and self-esteem.
Photo: © Cengage Learning

22. Children’s Mental Health
EDU 153 Granberry Spring 2015
4/17/2017
Children’s Mental Health
One in 5 children/adolescents have a mental health disorder.
One in 10 have a serious emotional disturbance that disrupts daily functioning.
When early problems are not treated, they can contribute to school failure, family conflict, drug abuse, violence, depression, and suicide.

23. Signs of Mental Health Problems
EDU 153 Granberry Spring 2015
4/17/2017
Signs of Mental Health Problems
Uncontrollable anger
Prolonged feelings of hopelessness or sadness
Extreme fearfulness or anxiousness
Difficulty concentrating or remaining focused
Persistent nightmares
Eating disorders
Violent or aggressive behaviors (e.g., setting fires, killing animals, hurting others)

24. Promoting Children’s Social-Emotional Competence
EDU 153 Granberry Spring 2015
4/17/2017
Promoting Children’s Social-Emotional Competence
Be a positive role model.
Create environments that are supportive, responsive, and respectful.
Teach children effective social, communication, and problem-solving skills.
Recognize signs of emotional problems and refer children early.

25. Children and Bullying Why do some children bully others?
EDU 153 Granberry Spring 2015
4/17/2017
Children and Bullying
Why do some children bully others?
What groups of children are more likely to be victimized?
What is cyber bullying and what can families do to protect children?
Photo: © Cengage Learning

26. EDU 153 Granberry Spring 2015
4/17/2017
Building Resiliency
Teachers can help children become more resilient by:
Fostering supportive, nurturing environments and positive parenting skills.
Promoting effective social, communication, and problem-solving skills.
Modeling appropriate behaviors.
Offering praise and encouragement.
Respecting children and avoiding biased or judgmental treatment.
Photo: © Cengage Learning

27. EDU 153 Granberry Spring 2015
4/17/2017
Case Study
Jose, 7 years old, and his mother live alone in a one-bedroom apartment close to his school. Most afternoons Jose walks home alone, lets himself into their apartment, and watches television until his mother comes home from work. His favorite after-school snack consists of potato chips and a soda or fruit drink. For dinner, Jose's mother usually brings something home from a local fast food restaurant because she is “too tired to cook.” She knows this isn't good for either one of them. Jose's mother is currently being treated for high blood pressure, and the pediatrician has expressed concern about Jose's continued weight gain. However, Jose's mother doesn't see how she can change anything given her work schedule and limited income
Jose, 7 years old, and his mother live alone in a one-bedroom apartment close to his school. Most afternoons Jose walks home alone, lets himself into their apartment, and watches television until his mother comes home from work. His favorite after-school snack consists of potato chips and a soda or fruit drink. For dinner, Jose's mother usually brings something home from a local fast food restaurant because she is “too tired to cook.” She knows this isn't good for either one of them. Jose's mother is currently being treated for high blood pressure, and the pediatrician has expressed concern about Jose's continued weight gain. However, Jose's mother doesn't see how she can change anything given her work schedule and limited income.
How would you describe Jose's short-and long-term health potential?
What concerns would you have about Jose's safety?
What potential health problems is Jose likely to develop if his current behaviors do not change?
What environmental risk factors may be contributing to the family's health problems?
If you were working with this family, what suggestions would you have for improving their health?

28. EDU 153 Granberry Spring 2015
4/17/2017
Case Study Questions
How would you describe Jose's short-and long-term health potential?
What concerns would you have about Jose's safety?
What potential health problems is Jose likely to develop if his current behaviors do not change?
What environmental risk factors may be contributing to the family's health problems?
If you were working with this family, what suggestions would you have for improving their health?
ANSWERS TO CASE STUDY
On a short-term basis, Jose’s health is being challenged by a sedentary lifestyle, boredom, stress, and fear associ­ated with staying home alone. His long-term outlook is also poor due to inactivity, a diet high in fat and salt, and potential weight gain.
Jose is at some risk because he arrives home and stays alone for several hours each day.
Jose faces a high risk of developing a number of chronic diseases, including obesity, cardiovascular heart disease, high blood pressure, diabetes, and certain forms of cancer.
The environmental risks that may be contributing to Jose’s health include a lack of opportunities for physical activity and unhealthy dietary choices (fast foods).
Jose’s mother needs assistance in locating child care so that he is not left at home alone. Jose’s mother also needs nutritional guidance and help in learning how to prepare healthier meals. Jose must be encouraged to begin participating in some form of active play or ex­ercise each day. It is also important that Jose’s home environment is safe and that he has opportunities to socialize with other children.