Facts about youth health and people's livelihood

The core breakthrough point in the practical affairs of adolescent health and people's livelihood has never been to produce good-looking physical examination data reports, but to embed full-dimensional support for physical health, mental health, and social adaptability into every daily scene of children from school to school, and avoid the formalism of sports-based promotion and assessment-based implementation. This is also an implementation idea that is in line with the WHO's three-dimensional definition of adolescent health.

Last week, I followed colleagues from the chronic disease department at the district CDC to do quarterly health monitoring at a public junior high school in the district. As soon as I entered the third grade class, I felt dizzy. There were 42 children in the four rows, 31 of them wearing glasses. A boy in the last row rolled up his sleeves to show me the calluses on his palms. He said that he had been practicing for three weeks in a row for the pull-ups for the physical test next month. Now he is shaking a little when holding a pen and writing homework. The head teacher sighed beside him and said that during the psychological screening just last month, there were 12 early-warned children in the whole grade. The school only has one full-time psychological teacher, and the counseling schedule has been postponed until three months later.

In fact, no matter whether it is the health care system or the education system, there is no disagreement on the issue of improving the health of adolescents. However, the two groups of people have quite different ideas on how to improve the health of adolescents. Most of the thinking of the competent authorities is "quantification first". After all, people's livelihood needs to be reconciled. The myopia rate should be reduced by a few percentage points, the obesity rate should be controlled within a certain limit, and the student's physical health compliance rate. These figures are clear and included in the school's performance appraisal. If you continue to work hard, you will always see results. But most of the front-line principals and school doctors don’t buy this account. In order to achieve the goal of reducing the myopia rate, some places previously required students to go home every day to shoot a 20-minute video of eye exercises and ask parents to check in. The children originally finished their homework at 10 o’clock, but they had to do it more, and instead lost 20 minutes of sleep time. This is purely putting the cart before the horse.

I worked on a pilot project in another street in our district last year, and their approach was a bit unconventional - they did not set any rigid prevalence assessment indicators for schools, and implemented three things first: First, pediatricians and orthopedic surgeons from community hospitals were stationed at schools two afternoons a week. In addition to dealing with daily bumps, they also checked children for scoliosis, provided nutritional guidance, and worked with the school's psychological teacher to provide group counseling.； The second is to impose a mandatory requirement on all schools to return 10 minutes to children during recess. They are not allowed to leave the classroom in the name of maintaining order. The corners of the corridors are even covered with soft bags to prevent children from running, jumping and falling. ； The third is to dismantle the physical test items into daily physical education classes, not to do surprise training before exams, but to intersperse them with fun in daily life, such as turning pull-ups into "pole climbing competitions" and turning endurance running into "orienteering check-in". This pilot has been running for 8 months. Not to mention, the hard indicators are also good: the myopia rate has dropped by 1.2 percentage points month-on-month, the obesity rate has dropped by 0.8 percentage points, and more interestingly, the school sick leave rate has dropped by almost 20%, and the positive rate of early warning retests of psychological screening has dropped by 28%.

Of course, some people say that this pilot is too "ideal". After all, not every region has enough health personnel to send to schools, and not every school has the space to modify soft bags and engage in orienteering. I was talking to a friend in Jiangsu and Zhejiang who works on youth health projects, and their solution is quite clever: sign cooperation agreements with local medical universities and normal universities, and find junior and senior students majoring in preventive medicine and applied psychology to be on-site volunteers. The school provides free lunches and internship certificates, and the labor cost is directly reduced by 70%. ； In some places, pocket parks in the community have been transformed into "youth sports corners". After school, volunteers will take the children to play Frisbee and badminton without taking up school space.

I met a little boy in the first grade of junior high school at the sports corner last month. He was nicknamed by his classmates because he was overweight. He hid in the toilet and cried during physical education class. Later, he learned hip-hop from volunteers and lost 14 pounds after practicing for half a year. Now he is the captain of the sports corner and invites his classmates to play together every day after school. His mother said that in order to help him lose weight, she signed up for a weight loss camp worth more than 20,000 yuan. She spent a lot of money and rebounded quickly. Unexpectedly, he lost weight just by playing with his classmates every day, and his personality became much more cheerful.

In fact, the health of teenagers is difficult to say and easy to say. It cannot be achieved overnight by spending hundreds of millions and launching a few big projects, nor can it be done by just staring at a few physical examination numbers. After all, the core of people's livelihood is "people". You have to really think from the child's perspective: Does he have time to bask in the sun for 10 minutes every day? Is there any place to say that you have been wronged? Will you be laughed at in gym class because you can't keep up? Is the lunch you eat heavy on oil and salt? These seemingly trivial things, when put together, can really help children's livelihood.