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Institute for Advanced Journalism Studies

Cuban children absorb the last lessons of the day


Cuban School Officials Put Premium On Health Of Students

By Nikole Hannah-Jones
Institute for Advanced Journalism Studies

HAVANA - Three years ago, doctors, dentists and health specialists converged on Principal Alina Verdi’s school. For two weeks, they went class by class examining every student at the Pedro Domingo Murillo primary school. They checked teeth and vision, hearing and weight, cognitive ability and overall health.

The doctors found some of Verdi’s students were overweight. Some needed glasses or had unaddressed speech problems. Two students were diagnosed with high blood pressure. Those who had dental problems were sent to the dentist; those with health problems to a doctor. The overweight students were given an extra exercise program at school and their parents received counseling on diet and nutrition.

What happened at Verdi’s school was part of a national effort by the Cuban government, which gave comprehensive health exams to every primary and secondary student in the nation.

It was a massive undertaking for the Third World nation and used immense resources and time. But for a country that considers education a point of pride and a national necessity, the reasoning behind it was simple: Sick children struggle to achieve.

Cuba already offers no-cost universal health care to all of its 11 million citizens – and guarantees health in its Constitution – yet government officials say education is so important that just offering students free health care isn’t enough. The government must ensure they reap its benefits.

“They wanted to know the real health state of all the children,” Verdi said. “It is important because not all parents get the same care for their children. Some (children) need to go to the dentist. Sometimes it is the teacher who realizes the child needs glasses. And if a child can’t see, he can’t read well or write well.”

Many American studies have shown a link between poor health and academic performance. Yet, 7.8 million American children went uninsured last year, according to the U.S. Census Bureau. And African-American children are more likely to be uninsured than white children – meaning they are more likely to go to school sick. They also are more likely to miss school due to illness and have academic problems associated with poor health.
Poor health also could contribute to the racial academic-achievement gap in the United States, where just 14 percent of black fourth-graders are proficient in national reading assessments compared with 43 percent of white students, the 2008 Educational Testing Service reports. By 8th-grade, there’s a 30-point gap in math scores between black and white students.

By the time they reach 12th-grade, black students in the U.S. are four years behind their white peers in English, math and science and  post an average SAT score 200 points lower than white students, according to The Education Trust, a Washington, D.C.-based public policy group.

About 73.2 percent of American students graduate from high school, according to a study released in September by the National Center for Education Statistics. In contrast, the Cuban government puts its graduation rate at nearly 98 percent.

One study by Columbia University economics professor and poverty expert, Janet Currie, released in 2005, says health disparities among upper-income and lower-income American students and black and white American students could account for as much as 25 percent of the racial achievement gap. Others show direct causal affects between hunger, earaches, untreated asthma and other illnesses and academic performance.

A report released this year by the state of Washington showed that healthier students are likely to do better academically. The report concluded that healthy students learn better and are more successful in school and that students with more health risks are less likely to graduate from high school on time or attend college. The study also found that fewer than 10 percent of students with no health-risk factors have no academic problems while at least two-thirds of students with several health risks had learning problems.
The U.S. government links health and academic performance. One example deals with dental care. According to the Centers for Disease Control, poor children have almost 12 times as many restricted-activity days because of dental problems than do children of higher-income homes, with untreated dental disease leading to eating, speaking and learning problems. Chronic pain from dental disease can affect children’s cognitive abilities and behavior. Untreated tooth decay is more common among poor children overall, and black children specifically.

Many American schools, which see first-hand the results of children who can’t get medical care for their illnesses, have pushed for school-based health centers. But those centers are costly, and many districts cannot afford them. Thanks to the expansion of both federal and some state programs for children, the number of uninsured children shrunk by 800,000 in 2008 to the lowest level since 1987. Still, millions of American children cannot afford to go to the doctor when sick.

A dental clinic sits right on Verdi’s school compound and all students receive a dental check-up in school during their first year.

Cuba has one dentist for every 1,000 people and one doctor for every 151 residents. Family doctors are located in every neighborhood and 499 polyclinics are spread throughout the island.

At the Vedado Polyclinic, a bustling mid-level medical facility in the Vedado neighborhood, dozens of mothers with children in their laps wait for a doctor’s care. No one asks them for an insurance card. No one must prove their ability to pay before they are treated.

Jose De Jesus Portilla Garcia, a professor of surgery who works for the Cuban Public Health Ministry, said family doctors visit the homes of every one in their neighborhood three times a year. It is an investment, he said, that Cuba must make in its future.

“We are poor but we have human resources,” Portilla Garcia said.

Back at the school, Verdi recounts a story that would be highly unusual in the United States.

A student returned from recess panting and saying he couldn’t breathe and had pains in his chest. The school called the boy’s mother but didn’t wait for her to pick the boy up. The school took him the short distance to the neighborhood clinic and he was already receiving treatment before his mother arrived.

For Cuba, health care and the academic success of its populace are intrinsically linked.

“We view health the same as education,” said Verdi. “Everyone has access to schools and health care.”

Index of Black-White Achievement Gap Stories