Wellness reports in for Cassville schools

Wednesday, July 22, 2015

Figures show where to focus presentation

Each year, the Cassville school district invites employees to participate in a free health risk assessment event to promote wellness and preventative care, and to keep insurance costs down.

The district also provides student wellness reports as required by the state.

For employees, Mercy Hospitals provides an assessment then submits a summary report to the district.

"We have a district health risk assessment and get back a summary report," said Richard Asbill, superintendent. "It does not give us specific information about individual employees. In this case, our vendor, Mercy, puts our district information in and puts us against the rubric of weight, blood pressure, tobacco users, all those types of things, and gives us a report back that says, based on current trends, this is the wellness factor of the district, or this is where you should focus on employees becoming more well."

Employees in the district were screened for blood pressure, blood sugar levels, triglycerides, total cholesterol, stress, body mass index and tobacco use.

Out of 225 participants, 51 had zero risk factors, 48 had one, 58 had two, 35 had three, 19 had four and 14 had five or more.

For tobacco use, out of 221 participants who responded, 160 had never used tobacco, 39 were previous tobacco users, 22 were total tobacco users, 16 were cigarette smokers and six were tobacco chewers.

Participants were also screened for metabolic syndrome. The Mayo Clinic describes the syndrome as a cluster of conditions including increased blood pressure, a high blood sugar level, excess body fat around the waist and abnormal cholesterol levels, that occur together, increasing the risk of heart disease, stroke and diabetes.

The summary report describes metabolic syndrome as identified by the presence of three or more of the following components: Triglycerides, greater than 149; fasting glucose, greater than 99; blood pressure: systolic, greater than 129 and diastolic, greater than 84; HDL cholesterol: males, less than 40 and females, less than 50; and obesity as measured by waist circumference: males, greater than 40 inches and females, greater than 35 inches.

According to the summary report, which screened 225 participants, 50 participants, or 22 percent of the group had three or more components for metabolic syndrome.

Based on the results of the health risk assessment, total projected cardiovascular health care costs to the district was $2,080,270.

The highest category of risk was uncontrolled hyperlipidemia at $760,760, or $5,720 per person. Hyperlipidemia refers to fats in the blood and means high lipid levels, equating with high cholesterol and high triglyceride levels. High lipid levels can increase the likelihood of atherosclerosis, or hardening of the arteries. Atherosclerosis increases risk of heart disease and stroke. Lifestyle changes like exercising and eating a healthy diet can lower lipid levels.

The lowest risk was tobacco use at a total projected cost of $127,952. Uncontrolled hypertension came in at $144,300. Uncontrolled pre-hypertension came in at $331,500.

Increased BMI came in at $204,688. Diabetes came in at $292,040. Pre-diabetes came in at $219,030.

According to Asbill, the report provides averages and insights into what the district can do to encourage overall wellness, which, in turn, helps keep medical costs and insurance premiums down. Because they are averages, based on demographics, and there are so many variables per individual regarding size, height, weight and health habits, Asbill said they are not specific or exact.

"Mercy establishes criteria for the average demographic person," he said. "If I have high blood pressure but no other traits, I'm a low risk. If I have high blood pressure, am a smoker, have diabetes and other health issues, I'm going to show up in four areas.

"We don't know who those people are. It just gives us a demographic of our district and allows us to focus on certain areas that could help us be more well. And also allows us to focus on those indicators that could raise insurance costs and help us reduce those costs. It shows where we need to focus."

Students wellness and nutrition were also measured.

"Annually, we have two student reports that are required by the state in regard to student wellness," Asbill said. "We take that information and plug it into the state system and it gives us a report back based on wellness trends."

An example Asbill used were activities school children have to perform that are timed. Students also participate in a BMI measurement.

"About a year-and-a-half ago or so, Michelle Obama changed the nutrition system through the United States Department of Agriculture (USDA)," he said. "I wholeheartedly support nutrition but the school nor the government can control the nutrition choices students make. Trying to legislate how many vegetables a child eats is frustrating.

"Understand that we as a school, cannot legislate what people eat. If a child does not want to eat beets, you can't make them eat beets. There is nothing wrong with nutritional standards, we have to provide opportunities to meet those standards in the best way we can, such as whole wheat and other options. We're only two meals a day, and not all kids eat breakfast. Even if we're providing two healthy meals students still have snacks and choices outside the school that contribute to their wellness. If they go eat a bag of chips, three candy bars and two sodas it kind of undoes what we attempt to do during the day."

The summary report showing the BMI measurements of third-, fourth- and fifth-grade students in the district from 2014-2015, the approximate period of time the nutritional changes took effect, reflects not much change, showing only slight movement up or down.

For third-graders, total percentage of students who had a normal BMI was 58 percent in 2014 and 64 percent in 2015. Total percentage of students found to be obese was 24 percent in 2014 and 20 percent in 2015.

For fourth-graders, total percentage of students found to have normal BMI was 55 percent in 2014 and 56 percent in 2015. Total percentage of students found to be obese was 27 percent in 2014, and again, 27 percent in 2014.

For fifth-graders, the percentage of students who had a normal BMI was 55 percent in 2014 and 51 percent in 2015. Total percentage found to be obese was 28 percent in 2014 and 32 percent in 2015. The percentage found to be obese was 28 percent in 2014 and 32 percent in 2015.

The percentages do not take into account differences between boys and girls, differences in body size and composition, differences in number of students measured from 2014-2015 in the same grade, which affects overall percentages, or what nutritional choices they make outside of the choices offered to them at school.

"Yes we have made mandated nutrition changes," Asbill said. "We're trying to meet those standards however students will still eat at other locations whether it be at home or restaurants and they may eat two portions or three or desserts or other unhealthy food choices. I'm all for providing students with the healthiest meals possible, but it is our priority to make sure that all of our kids have a meal. Our piece is that if a child needs food, we provide it.

Recommendations made for the district to improve over the next two years, as listed in the summary report, included moving toward a smoke and tobacco-free campus, continued improvement in the nutrition offered to the students and staff, and education in nutrition, diet, exercise and tobacco cessation available to all staff.

Since the last program assessment, the district received the following recognitions and achievements:

* The Healthy Teacher program at the high school in partnership with Mercy of Cassville/Aurora was used as a Teacher Leader program for neighboring districts.

* Nutritional guidelines have been changed to award the district with a six-cents per tray performance-based reimbursement that demonstrates compliance with the New Meal program.

* Employee Rita Beebe was selected to attend a culinary skills institute in August in Kansas City, where she will learn to better prepare tastier fruits and vegetables for students.

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