Dr. Kevin Fang of Children’s Hospital Los Angeles spoke about healthcare inequities at The L.A. Trust Learning Collaborative.
The word of the day was “hopeful” as L.A. Unified representatives, Wellness Center operators and staff from The L.A. Trust prepared for school re-openings at the fourth pandemic-period Wellness Network Learning Collaborative, March 10 on Zoom.
Maryjane Puffer, executive director of The Los Angeles Trust for Children’s Health, conducted a roll call of representatives from the 17 LAUSD Wellness Centers, noting The L.A. Trust has been hosting the collaboratives for more than a decade.
Health equals success
Guest speaker Dr. Kevin Fang addressed healthcare inequities, saying, “Zip Codes are better determinants of health outcomes than genetic codes.” Children of parents without a high school diploma are more likely to live in an environment with health barriers, Fang said, noting the direct correlation between education and life expectancy, income and smoking.
Fang said chronic absenteeism was a strong predictor of poor academic achievement. COVID-19 has exacerbated an already high chronic absenteeism rate among California public schools, he said, noting it has risen 89%. Proven solutions include school nurses and other forms of school-based health, physical education and individual education plans. Fang suggested ways to increase collaboration between schools and the medical community, including ACES (adverse childhood experiences) training for pediatricians and Wellness Center clinicians and in-class visits by doctors and medical students.
Fang is an attending physician and an assistant program director for the Pediatric Residency Program at CHLA. The former high school biology teacher is also Fellowship Director for the General Academic Pediatrics Fellowship in Health Equity and assistant clinical professor of pediatrics at USC’s Keck School of Medicine.
Victor Luna, organization facilitator for LAUSD Student Health and Human Services, provided a 2020 report card for the Wellness Network.
Visits to the Wellness Centers were down dramatically due the pandemic and facility closures. Visits varied widely — some clinics never closed and some remained closed for most of the year. Organization Facilitator Gloria Velasquez observed that 2020 was not a good year to determine trend lines in the network.
The two-hour collaborative concluded with a group discussion among the clinicians, educators, Student Advisory Board Adult Allies and The L.A. Trust staff. Topics included telehealth, getting students to make and keep medical appointments, and sexual and reproductive health services.
Appointments for STI prevention and birth control have been most impacted by the pandemic. Without outreach and the confidential setting of the school Wellness Center, students may be reluctant to reach out or use telehealth from home. LAUSD Organization Facilitator Ana Griffin said Wellness Centers and students were countering this through outreach campaigns. “We emphasize to students (who have sexual health questions) that the Wellness Center is a no-judgment zone.”