Youth health and safety

The current core contradiction in the field of adolescent health and safety in my country has never been the lack of relevant norms and protection policies, but that the existing rules are generally divorced from the real life scenarios of adolescents during the implementation process, and fail to take into account the balance of the three dimensions of physical health, mental health, and social adaptability.

Last week, I followed the district disease control school health screening team to visit three junior high schools. When I met Xiaoyu, who was in the second year of junior high school, he was hiding from his mother with his head lowered: after wearing OK glasses for a year, the reading still increased by 150 degrees. His mother kept talking about it all the way on the road, saying that he hid in bed every day and watched short videos, and didn't listen no matter how many times he said it. I took Xiaoyu to ask alone and found out that the LED lights used for evening self-study in his class were found to have excessive flicker last year and have not been replaced. He could not see clearly the formulas on the blackboard while sitting in the third row, so he had to borrow a classmate's notes after class to copy them. ； The school is afraid of accidents when students run and jump during recess. They don't even allow students to stay in the corridor, let alone go to the playground for activities. During the 10-minute recess, they lie on the table and watch short videos to pass the time. Isn't the temperature rising quickly?

I've talked to many school administrators about this, and they all feel bitter. A vice-principal of a primary school told me that last year, a student broke his bones while playing catch during recess. The parents filed a lawsuit with the Education Bureau, and not only did they pay more than 80,000 yuan, but the school's qualifications for evaluation for the whole year were cancelled, and the class teacher's performance was also deducted in half. “Do you think I dare to let them run away? Who can afford it if something goes wrong? ”This idea of ​​"no accidents is the greatest political achievement" is now common in many schools: potentially risky equipment such as horizontal bars and ladders have been dismantled, long-distance running events in basketball games and sports games have been cut off, and some schools even require students to stay in their seats except to collect water and use the toilet during recess.

The cognitive differences on the parents' side are actually even greater. Some parents still think that "health and safety means no illness, no injuries, and good grades." I have seen a mother who has enrolled her sixth-grade child in nine extracurricular classes. Even how many times the child drinks water and how many times he goes to the toilet is listed in the timetable. The child's physical examination revealed scoliosis and mild anxiety. She also asked me, "Can I take some medicine to supplement it, so as not to delay the Mathematical Olympiad competition next month?"” ； There are also parents who go to the other extreme and completely let go of their children's social and online activities. They only notice later when their children are bullied at school or defrauded of their lucky money by online fraud.

From the perspective of public health practitioners, we often say that health is the trinity of "physiology-psychology-society", but when it comes to implementation, everyone is still used to dismantling these three things. For example, current campus health screenings are very strict in checking physiological indicators such as vision, weight, and scoliosis, but most psychological screenings only require children to fill in a questionnaire. If children with depression and anxiety tendencies are actually screened out, many schools are afraid of taking responsibility and do not dare to notify parents. They do not have supporting psychological intervention resources, and in the end they just pretend they have not seen them. Last year we took on the case of a sophomore girl in high school. Because she was called fat by her classmates, she secretly took diet pills for half a year and did not get her period for three months. The parents initially thought it was because of the stress of studying, but they did not send her to the doctor until the child fainted in the classroom. This is a typical psychological problem that eventually turned into physical harm.

The solutions currently being tried in various places are completely two ways. In the past two years, many schools in Shanghai began to promote "recession relaxation" and specifically bought campus sports accident insurance for students. As long as there is no malicious play, minor abrasions and sprains will be covered by the insurance without the responsibility of teachers and schools. Data from one semester of the pilot show that the myopia rate of students has dropped by 0.18 percentage points month-on-month, and the average score of the anxiety scale has also dropped by nearly 10 points. The effect is indeed visible. But there are also many voices of opposition. People in the education system said, "If something serious like a fracture or concussion occurs, parents will still make trouble even if the insurance pays out. In the end, it will be the school that is unlucky." Some places are trying a "youth participation system" that allows students to be their own health and safety supervisors, checking whether the lights in the classroom are bright enough, whether the food in the cafeteria has gone cold, and arranging their own anti-bullying and anti-internet fraud melodrama. Many teachers say that it is much more effective than us talking under the national flag every day, but some people say that this is just a formality. What professional health standards do children know?

To be honest, after working on youth health intervention for so many years, I have never felt that there is any perfect solution that is universally applicable. When I met Xiaoyu again last week, he raised his arms to show off to me, saying that the school had finally put back the horizontal bar that had been removed for half a year. He could now pull 12 after school. His mother also communicated with the teacher and moved him to the second row. He also promised that he could play with his mobile phone for 20 minutes after finishing his homework every day, so he no longer had to hide under the quilt to watch. Look, how can there be so many complicated truths? It is nothing more than solving the small problems that are stuck in the children's real life one by one. Only then can the matter of health and safety be truly implemented.