Chronic Stress Takes a Lasting Toll on Students and Educational Success

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Terri Wright
Terri Wright Terri D. Wright is the director of the newly established Center for School, Health & Education Division of Public Health Policy and Practice at the American Public Health Association. She will provide leadership to the strategic development and integration of public health in school-based health care and education. She recently retired from the W. K. Kellogg Foundation in Battle Creek, MI where she served for 12 years as a program director for health policy. In that capacity Terri developed and reviewed the Foundation’s health programming priorities and initiatives, evaluated and recommended proposals for funding, and administered projects and initiatives. She also assisted in public policy analysis and related policy program development, as well as provided leadership to the Foundation’s school-based health care policy program. Previously, Terri was maternal and child health director and bureau chief for Child and Family Services at the Michigan Department of Community Health in Lansing, Michigan. In that role, she managed policy, programs and resources with the goal of reducing preventable maternal, infant, and child morbidity and mortality through policy and programming. She received her bachelor’s degree in community and school health, as well as her New York State certification in secondary school education from the City University of New York and her master’s of public health degree in health planning and administration from the University of Michigan in Ann Arbor. She is currently a doctoral student in public health at the University of Michigan. Terri takes an active leadership role in several professional associations and community organizations including the American Public Health Association and the Institute of Medicine’s Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities.

“How do they not know that you are hungry and you didn’t eat yesterday?”

“They say don’t bring weapons, but … I walk to school … and, like, I don’t feel safe.”

“My whole life is stressful. I ran away from home … There’s not enough food and everything for everybody to be there. One winter we had no heat. We had no electricity. We had no water. It was bad.”

These quotes from students at a Detroit high school provide an inside glimpse at a significant barrier to education—one that is too often overlooked in the quest to improve graduation rates.

Basic needs such as food, shelter, and a stable and safe environment are not a reality for many of our students. Poverty deals extraordinary obstacles to them on a daily basis.

Together, these obstacles contribute to the social determinants, the conditions in our environment that directly affect our health and quality of life. As Health.gov explains: “The conditions in which we live explain in part why some Americans are healthier than others and why Americans more generally are not as healthy as they could be.”

For disadvantaged students, those factors shape not only health, but also their educational success. No matter how strong we make our educational system, it can be difficult or impossible for many students to concentrate on science and math when they are dealing with issues such as violence, unstable homes, and hunger. Routinely showing up for school and ultimately graduating can be an insurmountable expectation when even getting there is, quite literally, a matter of life and death. Dealing with these challenges can create intense daily and cumulative stress, which adds another layer of interference to students’ ability to succeed in school.

As we continue to underscore the connection between educational success and student health, the Center for School, Health and Education (CSHE) at the American Public Health Association is focusing on chronic stress as a critical barrier to graduation. Recently, we hosted age- and gender-specific discussion groups with ninth- through twelfth-grade students at the Detroit high school mentioned above to understand how they experience and manage the stressors that put them at risk for dropping out. What we uncovered echoes the issue of stress among many of the nation’s most vulnerable teens, as reported in the latest Stress in America survey by the American Psychological Association. The report shows that 37 percent of teen girls and 23 percent of teen boys have felt depressed or sad in the last month. The findings from our students parallel those from the report.

In addition, we learned that the stress that affects many of the students emanates from feeling unsafe and fearful in their schools and communities, neglected, threatened by crumbling buildings in their neighborhoods that enable crime, disconnected from school, and subjected to school violence such as bullying, fighting, and theft. Faced with these conditions, students often isolate themselves, become frustrated and aggressive, turn to violent behavior emanating from their fear or anger, and disengage from school.

It has never been more clear: stress impacts learning and educational success.

As we work with students and schools to explore chronic stress and how to mitigate it, we turn to school-based health centers (SBHCs). The staff members in these centers are often the first to see signs of stress across the student body, have a unique perspective on what’s causing it, and can work with students, teachers, and administrators to moderate it. For example, they might engage students in youth-led initiatives to address neighborhood conditions that affect them, facilitating resources from community agencies, hosting community town halls, or arranging meetings with local legislators so that the “stories” of the students are heard. They might implement school-wide stress management programs available to all students in every grade. Or they might strategize with school staff and administrators to enhance school climate, increase school safety, and ensure that discipline measures do not curtail attendance and learning.

School-based health centers are also proven frontline resources for individual students who may need help, including mental and behavioral health services. A 2011 report by the Connecticut Association of School-Based Health Centers revealed that African American and Latino males feel that SBHCs are more accessible than other community agencies, and that they are more comfortable sharing their experiences in these settings. As a result, they tend to use SBHC-provided mental health services at a higher rate than those students who do not have an SBHC in their school. SBHCs can build on this success.

In short, SBHCs have tremendous potential to help students address the source of their stress and to help them manage it. Thus, SBHCs are a critical resource to ensure student health and educational success. While we continue to reform the education system in this country, we must make sure that the connection between chronic stress, health, and education is acknowledged, valued, and addressed by all. We must also ensure the sustainability of SBHCs for the same reason.

Please think about how you can help relieve students’ stress through your work, and explore opportunities for school-based healthcare in your community.

I invite you to comment below or on our Facebook page. How have you seen stress impact students in your community? How do you or others help them cope? Where do you see opportunities to improve educational success by supporting students’ health and wellness?

And if you would like more information on the American Psychological Association report, click here.

The Connecticut Association of School-Based Health Centers report.

For our children’s sake, thank you.

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