Twenty-nine American states fail to require adequate health screenings for children entering school, according to a latest report by Columbia University Mailman School of Public Health professor Dr. Irwin Redlener. The paper, entitled “Missed Opportunities,” examined school health screening laws in all 50 states and Washington, DC, for seven specific health conditions found to significantly impede a child’s ability to learn in school. The seven conditions—known as Health Barriers to Learning (HBLs)—are vision problems, hearing difficulties, asthma, dental pain, hunger, lead exposure, and behavioral/mental health issues. The study findings are published online in PLOS One.

Researchers assigned a letter grade to each state and DC, based on the requirements and frequency of screenings written into state law for the seven HBLs. Almost 60% of states earned either a “D” or an “F.” More than 41 million children live in these states.

For the states that earned "F's" researchers were unable to find any screening requirements upon school entry for vision, hearing, or dental pain. In the state of South Carolina, for example, researchers could not identify any requirements for students to receive basic screenings for these conditions even once throughout their K-12 academic careers.

Other low-performing states required limited or infrequent HBL screenings upon school entry. For instance, the state of Utah only requires vision screening once in a student’s K-12 academic career, and does not require screening for any of the other health barriers, as far as researchers could identify.

Only Washington, DC, earned an “A,” as it requires annual screenings for six of the seven barriers, while just six states earned “B’s.” Twelve million children live in these highest-performing states/territories.

“This report shows that a large majority of American states are failing children,” said Redlener, MD, Mailman School professor of health policy and management and co-founder and President Emeritus of Children’s Health Fund. “It’s unacceptable to expect students to learn when they cannot see the chalkboard or hear what the teacher says. Governors, state legislators, and education commissioners in the 29 states that earned “D’s” or “F’s” must do better to help the children of their states reach their true potentials.”

Struggles in school often originate in early childhood, and unrecognized or undermanaged health conditions are among the many possible causes. Many state governments are missing prime opportunities to help children succeed by neglecting to require adequate health screenings for students. With this report, Redlener and colleagues urge public officials to level the playing field for children so that a child in South Carolina is given the same opportunities to succeed as a child in Washington, DC.