Too many kids with asthma, food allergies lack school emergency plans

Schools without health plans are unprepared to handle life-threatening emergencies

CHICAGO --- Only one in four students with asthma and half of children with food allergies have emergency health management plans in place at school, leaving schools inadequately prepared to manage daily needs and handle medical emergencies related to often life-threatening medical conditions, reports a new Northwestern Medicine study in partnership with Chicago Public Schools (CPS).

"Given the amount of time kids spend in school, it's critical for school staff, clinicians and parents to make sure there's a health management plan in place for students with health conditions," said Northwestern Medicine pediatrician Ruchi Gupta, M.D., lead author of the study. "Not having a health management plan leaves students without a vital safety net during the school day. With kids now returning to school, this is the time to get it done."

Gupta is an associate professor of pediatrics at Northwestern University Feinberg School of Medicine and a physician at Ann & Robert H. Lurie Children's Hospital of Chicago.

In order for schools to be well prepared to handle these medical conditions, including daily control of students' health and emergencies, school personnel need to have a health management plan from the child's clinician on file. Chronic medical conditions affect up to 25 percent of children in the U.S. with asthma and food allergies being among the most common.

A health management plan specifies special requirements for the child during school if medications are needed, and what to do in case of an emergency.

The study was published in the journal Pediatrics Sept. 8.

Through a partnership between Northwestern's Center for Community Health and the CPS Office of Student Health and Wellness, the study focused on understanding the district's chronic disease reporting and management process in order to better serve the health care needs of CPS students with conditions such as asthma and food allergies.

"CPS and Northwestern have worked together to develop promotional tools to increase the identification and verification of students with chronic conditions based on the findings of our collaborative research," said Stephanie A. Whyte, M.D., study coauthor and chief health officer of CPS. "All students with chronic health conditions should have a plan that supports their health and safety while in school, because healthy students are better learners."

Northwestern scientists looked at the database of CPS, the third largest U.S. school district, to identify students with asthma and food allergies.

The study found only one in four students with asthma and half of students with a food allergy had a school health management plan. CPS students were less likely to have a plan in place if they were a racial/ethnic minority and if they were low income, measured by whether they qualified for a free or reduced-price lunch. This critical study brings to light the underutilization of school health management plans district wide and underscores the fact that the most underserved students are left particularly vulnerable.

Many students also had more than one chronic condition. Of asthmatic students, 9.3 percent had a food allergy; of food allergic students, 40.1 percent had asthma. Students with both conditions were more likely to have a management plan on file.

"This is definitely a national problem in schools around the country," Gupta said. "We think the situation in Chicago schools is representative of schools everywhere. It's critical for all students with any chronic condition to have a health management plan in place at school."

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Other Northwestern investigators include Victoria Rivkina and Bridget Smith, and other CPS project team members include Lilliana DeSantiago-Cardenas and Blair Harvey-Gintoft.

This study was funded by Mylan Specialty, LP and Northwestern's Alliance for Research in Chicagoland Communities.