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Dearth of School Nurses Impacts Health and Education in Rural Mississippi

In my latest piece for The Hechinger Report and The Greenwood Commonwealth, I take a look at the role of school nurses in rural Mississippi, where many students lack access to doctors or health clinics and rely on school nurses for medical care.

More than 12,300 students across Mississippi attend school each day in a district with no nurse, often because the school district cannot afford one. Schools in Mississippi have only been fully funded twice since 1997, which means many districts are struggling to pay for supplies and teachers. Statewide, there is only one school nurse available per 1,138 students, even though The National Association of School Nurses recommends 1 nurse per 750 students in most schools, and one nurse per 125 students in a population with "complex health care needs," like asthma and diabetes, which are both common in Mississippi.

Nationwide, rural children are more prone to health ailments and conditions like asthma than their peers. In some cases, aspects of rural life may continue to cause health issues. A recent study of children in Ohio found that rural kids suffer from more health ailments than their urban peers due partly to an increase in child poverty, which often means kids experience food insecurity. One school nurse in Mississippi told me that she sees an increase in asthma and allergy flare-ups on days when crop-burning or crop-dusting is occurring nearby.

In the rural Mississippi school districts that I spoke to that do not have a school nurse, administrators said that students are more likely to miss school for a minor health issue that could easily be addressed by a school nurse. In absence of a nurse, various staff members have taken on tasks like administering health screenings and asthma treatments. Samaria Stevenson, a nurse in the Greenwood school system, also emphasized the fact that, especially in rural towns, nurses can be a trusted source of health advice for parents and when school nurses are not present, parents may not otherwise hear that advice.

Medical schools across the nation have tried to increase the amount of doctors and nurses in rural areas by offering scholarships, allowing graduates to bypass residency programs, or providing rural-specific training. In Mississippi, some nonprofits have stepped in to help. In Clarksdale, the Aaron E. Henry Community Health Services Center sends nurse practitioners to nearby schools on a regular basis to conduct exams and write prescriptions if needed. The Delta Health Alliance, a nonprofit in Indianola, Miss., has started a home visitation program aimed at teaching parents how to parent, which includes a health education component.

Karen Matthews, president and chief executive officer of the Delta Health Alliance, said that the program has helped to improve health outcomes. Ultimately, she said, a school nurse still serves as a critical step in preventative healthcare, which improves educational outcomes for children.

"Children at times don't get diagnosed with things that could help them with their education," Matthews said. That includes vision, hearing, and learning disabilities, all of which "really need to be diagnosed early." School nurses, Matthews added, "help catch some of these problems before they get really bad."

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