Strong evidence supports the existence of Health Barriers to Learning (HBLs)—health conditions that when untreated or unmanaged can interfere with a child’s ability to learn and succeed in school. These HBLs include vision and hearing deficits, uncontrolled asthma, mental and behavioral problems, dental pain, persistent hunger, and the effects of lead exposure. However, 19% of US children aged 6 to 11 did not receive their annual checkup in the past year. School requirements for health screenings can help identify children with HBLs. This study explores which states require health screening for children in elementary school, and the extent to which the 7 HBLs are included.MethodsInvestigators reviewed websites of state departments of health and education, and legislation for all 50 states and DC. For states with mandated screenings and a required form, investigators applied structured analysis to assess HBL inclusion.ResultsNo state mandated that schools require screening for all 7 HBLs. Less than half (49%) required comprehensive school health examinations and only 12 states plus DC required a specific form. Of these, 12 of the forms required documentation of vision screening, 11 of hearing screening, and 12 of dental screening. Ten forms asked about asthma and 9 required documentation of lead testing. Seven asked about general well-being, emotional problems, or mental health. None addressed hunger. When including states without comprehensive school health examination requirements, the most commonly required HBL screenings were for vision (80% of states; includes DC), hearing (75% of states; includes DC) and dental (24% of state; includes DC).ConclusionThe lack of state mandated requirements for regular student health screening represents a missed opportunity to identify children with HBLs. Without state mandates, accompanying comprehensive forms, and protocols, children continue to be at risk of untreated health conditions that can undermine their success in school.

To contribute to the ongoing discourse about successful programming supporting intermediate behavioral and mental health needs of vulnerable communities affected by disaster, this article presents the Children’s Health Fund (CHF) Sandy Recovery and Resiliency Program as a descriptive case study for a multifaceted, community-based approach to building resiliency, coping, and socioemotional skills in an underserved community in New York City that was affected by Superstorm Sandy. The case study involves retrospective review and analysis of qualitative and quantitative data that were collected as part of routine care and program implementation. From the analysis emerged a program consisting of 3 components: (1) delivery of workshops and community events to decrease stigma and build community-wide resilience, (2) delivery of workshops for students and educators in the local school to increase coping skills as well as referrals to clinical mental health care, and (3) provision of mental health care via a mobile mental health clinic. As a result, we found that following periods of excessive trauma, children and families require a broad-based approach to mental health support. Additionally, the use of the mobile clinic abated most common access barriers and served as a proxy of the concern of the organization for the community. (Disaster Med Public Health Preparedness. 2018;page 1 of 5)