When the Trump administration released its Make Our Children Healthy Again Strategy last week, we looked closely for recognition of what every parent and teacher knows: children cannot be healthy if their schools are not healthy. Unfortunately, despite our request to meet with MAHA leadership and our recommendation to focus on school environmental health, the final strategy released by the Trump administration misses the mark.
The MAHA strategy: a missed opportunity to improve school environmental health
Pediatricians, health providers, and public health advocates like Healthy Schools Network understand there is a crisis in children’s health.
- 40 percent of all school age children have existing chronic health conditions;
- Schools are more densely occupied than nursing homes;
- The American Society of Civil Engineers has repeatedly assigned school facilities a grade of “D,” citing massive deferred maintenance;
- Most schools built before 1980 still contain asbestos, lead, and PCBs, while mold, flooding, extreme heat, and other hazards harm health and routinely disrupt learning;
- Poor indoor air quality is one of the leading causes of absenteeism, and puts children’s health and learning at risk.
MAHA children’s strategy emphasizes four drivers of childhood chronic disease—poor diet, chemical exposure, lack of physical activity and chronic stress, and overmedicalization—all of which intersect with school life. Children spend more waking hours in school buildings than in any other setting except their homes.
The meals they eat, the air they breathe, the water they drink, the stress they carry, and the exposures they face every day inside classrooms have direct impacts on health and learning outcomes.
To omit schools and childcare facilities from the core of the strategy is to miss the most universal, bipartisan, and actionable setting for prevention.
How to bring school environmental health into the MAHA strategy
Fortunately, the strategy is open to interpretation in many areas. It includes provisions that advocates can—and must—leverage to improve school environmental health. We must sustain and build on the positives and promote a real agenda for making children healthy:
Public Awareness Campaigns
The strategy’s “Make American Schools Healthy Again” campaign is envisioned as a platform for nutrition and physical activity. While these are important objectives, the campaign should be expanded to address environmental health.
HS Network’s recommendation: Elevate school environmental health in communications. Every public campaign launched under MAHA should include communication and tools for improving school indoor air, environmental quality, drinking water safety, and chemical management in schools, while addressing hazards such as radon, mold, and toxic cleaners.
EPA’s Data Tools and CHPAC
The strategy’s expansion of EPA’s report America’s Children and the Environment, which provides indicators on children’s environmental health, should include school-specific facility indicators. In addition, the strategy’s charge to EPA’s Children’s Health Protection Advisory Committee provides an opportunity for outside experts to elevate school environmental health within EPA and across the government.
HS Network’s recommendation: Expand indicators to include schools, and elevate CHPAC.
- EPA’s expansion of indicators must include ventilation, drinking water testing, and integrated pest management, along with safer disinfectants, green procurement of materials and supplies, and remediation with timelines. Data drives accountability.
- CHPAC should be fully funded and directed to deliver recommendations on school environmental health and a roadmap for updating and funding EPA’s IAQ Tools for Schools, as well as other priority federal actions.
Water Quality and Air Quality Research
The strategy’s call for review of contaminants in drinking water and of air quality impacts on children’s health should encompass measurable interventions in schools.
HS Network’s recommendation: Expand federal reviews to include schools and consider interventions, such as safe fountains, bottle fillers, and filters, along with improved classroom ventilation and filtration.
Nutrition and Early Childhood Programs
USDA and HHS commitments to implement new dietary guidelines in school meals, Head Start, and childcare settings create an opportunity to link good food to safe environments. Children cannot thrive on healthy meals if they are drinking unsafe water or breathing polluted air.
HS Network’s recommendation: As part of their commitments to implement new dietary guidelines in school meals, Head Start, and childcare settings, USDA and HHS should emphasize the importance of healthy and safe air and water as well as good food.
Medicaid and CHIP Quality Measures
The MAHA strategy calls for improvements in children’s health programs and specifically highlights the need to strengthen Medicaid and CHIP quality measures, noting that current measures do not adequately capture children’s health outcomes
HS Network’s Recommendation: Environmental interventions—such as fixing ventilation, improving indoor air quality, and reducing asthma triggers—should be explicitly recognized as interventions that count toward managing asthma and absenteeism. Integrating these interventions into Medicaid/CHIP quality measures would align program accountability with real-world determinants of children’s health.
Community Transformation Funding
The MAHA strategy frames community transformation as a way to invest in local demonstration projects that tackle root causes of poor health.
HS Network’s recommendation: Establish a pilot program for healthy school districts under the MAHA’s community transformation model to demonstrate and measure the success of approaches for achieving healthier air, safer water, reduced exposures, and improved attendance.
The Challenge Ahead for Healthy Schools
Our bottom line: No strategy for children’s health can succeed without addressing the health of the places where children spend their days.
Schools must be recognized as central to prevention, equity, and resilience. The MAHA strategy opens doors—but we must walk through them together, bringing school environmental health to the front of the national agenda. See the Coalition for Healthier Schools comprehensive policy statement which guides our advocacy work.
Call to Action
Healthy Schools Network needs your help now. We will continue to provide you with timely updates on federal policies impacting school health. Working with allies and elected officials, we will continue to fight for children’s health in schools and to provide opportunities to make your voice heard.
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