Among the many, uh, charms of being involved with the public school machine in Pennsylvania is the requirement that every child in certain grades (K through fourth now, expanding each year by adding a grade until every grade is included) has a BMI measurement, which is sent home to parents along with lots of helpful advice about what to do should one's child's BMI be deemed not quite right. This program, called the PA Growth Screening Program, is a joint effort of the Pennsylvania Departments of Health and Education.

At first blush, this sounds no different than other screenings a child might receive in school (remember visiting the nurse's office for that annual scoliosis finger-down-the-back check?). And, indeed, that's exactly how the program is being marketed - no different than, say, a vision or hearing assessment or other useful tool for parents to use in evaluating their child's health.

From my perspective, this is a far cry from a vision or hearing evaluation. A very far cry.

The program literature includes boilerplate letters to parents, administrators and staff outlining the procedures and what will happen after the BMI measurements have been obtained. While the literature includes areas where school nurses may detail the ways in which the school and district are endeavoring to create healthier environments for kids - and, indeed, offers suggestions to nurses of ideas they might pursue in this regard - the program itself is not designed to offer solutions. So it's entirely possible that parents may recieve a letter that reads something along the lines of "Hey, your kids' BMI is XX. Good luck with that!"

So we have this measurement sent to parents, with the explanation that false readings are possible and that it should be discussed with the family physician and included alongside are all the ways that the school district is going to help keep/get the child healthy/-ier (one hopes, but maybe/maybe not on this point). The thing is, if I actually have a physician (assumed by the literature), why do I need this? If I am already required to submit a physical form filled out for each child by that same physician as a requirement of enrollment, what is this duplicative screening meaning to accomplish?

I also wonder the point of such a screening in an environment where children recieve 15 minutes a day per lunch (as is the case at my neighborhood elementary school), a 10 minute recess if they're lucky, and gym class once every six days. If the message of the Growth Screening Program is to encourage healthy eating and activity, isn't that diluted somewhat by the day-to-day message kids receive while actually at school? On the one hand, parents may learn that their son or daughter is over-/underweight but why bother to tell them what they likely already know when they have no control over a schedule that teaches those same children to either shove their food down their throats as quickly as possible just to finish or that they couldn't possibly finish so why bother eating when you can just go to the library and get something done?

I'm also troubled by the program's lack of attention to common root causes of both under- and overweight. Among the suggestions that school nurses ask the local YMCA what programs might be available for overweight kids and find sports programs to recommend there is no attention paid to helping families who need assistance in obtaining affordable healthy food, finding living situations that include kitchen facilities in which to cook and store said healthy food, or providing support for families when kids themselves are responsible for preparing their own meals because mom and dad are working long hours or otherwise aren't home (by whether by choice or necessity). Not to mention all the other issues that go into a family's food environment - maybe mom will only eat yogurt and lettuce or dad feels that a meal without meat is like a day without sunshine, etc. Or the prevailing model of the upwardly mobile, achievement-oriented family in which everyone is off accomplishing and no one is eating so much as a single meal together in any given week. Or that the very schools that are being required to conduct the screenings offer sports programs - hey! healthy activity! - that require kids to be away from their own family tables four or five nights a week. Or that even if we fixed all of what I see as our society's really weird attitudes toward food, we still won't teach people how to cook. (Insert your own neurosis here.)

(ETA: On the drive to pick the Boy up from school just after posting this I realized that today is the school's Market Day pick up. Market Day products are sold as a PTA fundraiser and the order/pick-up cycle runs monthly. Among the plain frozen veggies on offer are frozen french toast sticks, tacquitos, cheesesteak "kits" and bagel pizzas. And this month moms - there's that mom being responsible for feeding people thing again - were encouraged to by as many pies as possible since the company offered an extra $1 per pie profit to the school. Not all that compatible with a BMI obsession, you say? Yeah, I say, too.)

At the end of the day, this feels to me like just another message from someone with grant money to spend that parents aren't doing their job right. It's an easy position to take, after all, since all you have to do is declare that someone's son or daughter isn't healthy and, gee, they'd really better do something about it, when you aren't tasked with or even interested in offering concrete assistance or solutions. At least a vision or hearing test comes with some way to deal with the problem.

I don't see an opt-out for parents who do not wish their children to participate in the Growth Screening Program. So I plan on one of my own - an unopened letter, filed directly in the compost heap.