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Circling the Dome

READY to Build on the 3 R’s

The notion that children suffering from chronic conditions, like asthma or diabetes, are more likely to miss school and lag behind academically is hardly new. But there is now strong evidence showing just how health problems in childhood can also thwart lifelong success well beyond the classroom—an achievement gap that can be driven even wider by higher rates of chronic illness in low-income communities.

That’s why Johns Hopkins Children’s Center pediatricians and the Norman and Ruth Rales Foundation, headquartered in Washington, D.C., are joining forces with local educators to create what they say will be the most comprehensive, fully integrated school-based health program in the country, designed to ensure that Baltimore City students from economically disadvantaged areas achieve their full academic potential.

The $5 million initiative—named the Ruth and Norman Rales Center for the Integration of Health and Education, headquartered at the Johns Hopkins Children’s Center—will offer a wraparound, fully integrated model of health and education.

The center’s signature program, called READY—Rales Educational and Health ADvancement of Youth—soft-launched last August in two Baltimore KIPP (Knowledge Is Power Program) schools, which serve 1,500 elementary and middle school students, of whom 83 percent come from low-income backgrounds.

Under the program, KIPP students have access to a full-time clinic for acute and primary health care and a range of wellness services. The READY program is staffed by a pediatrician, nurse practitioner, nurse, dental hygienist, wellness coordinator and parent engagement coordinator. By contrast, only 45 percent of public schools in the United States have full-time nurses, and 30 percent of schools share a nurse with another school.

The impact and cost-effectiveness of the READY model will be assessed in five years to determine whether the approach has bolstered conditions that could narrow the achievement gap. Specifically, researchers will measure whether it has contributed to a healthier school climate, successfully reduced absenteeism, minimized asthma flare-ups, reduced obesity, curbed risky behaviors, and boosted well-child visits and immunization rates.

“We’re doing this with the intention that it will become a replicable and scalable model that could change population health,” says Rales Center co-director Sara Johnson, associate professor of pediatrics.