HLTH 5473 Module 1 School Community Health Assessment Example

Needs and Assets Around a Rural Middle School: A Community Health Assessment Focused on Adolescent Prediabetes and Type 2 Diabetes Risk

Student Name

American College of Education

HLTH5473: School-Community Health Partnerships

Module 1 Assignment

Instructor Name

October 5, 2026

Introduction

Schools see the health of their communities every day, in the students who arrive hungry, the ones who get winded on the stairs and the growing number referred by pediatricians for high blood sugar. This paper assesses the community around a composite rural middle school of about 620 students in grades 6 through 8, located in a Southern town of 7,000 people that serves as the center of a largely agricultural county. The school's nurse has raised concern about adolescent prediabetes and type 2 diabetes, conditions once considered adult diseases. The assessment examines the health needs related to that concern and, equally, the assets the community has to address them. It is the first step toward a school-community partnership that later modules will develop.

The National Picture

Type 2 diabetes in young people has been rising. Using data from the SEARCH for Diabetes in Youth study, Lawrence et al. (2021) reported that the estimated prevalence of type 2 diabetes among U.S. youths aged 10 to 19 increased from 0.34 per 1,000 in 2001 to 0.46 per 1,000 in 2009 and continued to rise through 2017, with the highest rates among Black, Hispanic and American Indian youth. Prediabetes, in which blood sugar is elevated but below the diabetes threshold, is far more common. Andes et al. (2020), analyzing national survey data from 2005 to 2016, found that 18.0% of adolescents aged 12 to 18 had prediabetes, with higher prevalence among boys and among adolescents with obesity. Youth-onset type 2 diabetes tends to progress quickly and brings early complications, so prevention in adolescence has lasting value.

Local Data

Local indicators suggest the county carries more than its share of risk. County health rankings data show adult diabetes prevalence and adult obesity above state and national averages, a large share of residents with limited access to healthy food and fewer primary care providers per resident than urban counties. At the school, 78% of students are eligible for subsidized meals. The school nurse's records from the past three years show a rise in students referred by their pediatricians or the local clinic with elevated blood sugar or acanthosis nigricans, a skin sign of insulin resistance, from a handful to 23 students last year. The school's physical education records show that fewer than half of students met aerobic fitness standards on the annual assessment. A student survey conducted by the health teacher found that most students drank sugary drinks daily and that fewer than one in four reported 60 minutes of physical activity on most days.

The Food and Activity Environment

The environment helps explain these numbers. The town has one full-service grocery store, located on the highway at the edge of town, and three dollar stores and several gas station markets that sell mainly packaged foods and sugary drinks. Many families live more than a mile from the grocery store without reliable transportation. Fast food restaurants cluster near the school. On the activity side, the town has a park with ball fields used mainly for organized leagues, a walking trail along an old rail line that is poorly lit, no public pool and few sidewalks outside the town center. Many students ride buses for 45 minutes or more each way, which shortens the time available for after-school activity. Story et al. (2009) described how school food and physical activity environments and policies shape children's eating and activity, noting that schools can influence nutrition and activity through meal standards, competitive food rules, physical education and access to facilities; in this community, the school environment matters all the more because the surrounding environment offers few healthy options.

What Community Members Say

Interviews and listening sessions add perspectives that data cannot. Parents described long work hours, often at a poultry processing plant or in agriculture, and limited money for fresh food. Several said that diabetes runs in their families and that they worried about their children but did not know what to do. Students said they would be more active if there were safe places and things to do after school, and many said they liked cooking shows and would like to learn to cook. Pastors at two churches described health ministries that already hold blood pressure checks and would welcome more programs. The clinic's nurse practitioner noted that families often come in only when problems are severe and that follow-up for prediabetes is difficult because of distance and cost. These voices point toward both the barriers and the motivations that a partnership must address.

Community Assets

Listing problems alone overlooks what a community can already do. Kretzmann and McKnight (1993) argued that communities are built from the inside out, by identifying and mobilizing the capacities of individuals, associations and institutions rather than starting from a map of needs. Applying that approach reveals substantial assets. Individuals include parents who garden, retired teachers, a local chef who runs a catering business and coaches who are trusted by students. Associations include churches with health ministries, a 4-H program, a youth football league and a volunteer fire department. Institutions include the school itself, with a cafeteria, gym and land for a garden; the county extension office, which offers nutrition education through its federally funded program for low-income families; the federally qualified health center clinic; the public library; and the town's parks department. The walking trail and park are physical assets that could be improved. These assets suggest that the community has many partners who could contribute.

Gaps in the Assessment

Every assessment has gaps, and naming them guides what to learn next. County data are several years old and cover all ages, so they only approximate conditions for adolescents. The school nurse's referral count depends on which families see a clinician and which clinicians screen for elevated blood sugar, so the true number of students with prediabetes is likely higher than recorded. The student survey relied on self-report and did not reach students who were absent on survey day. Listening sessions drew mostly parents who were already engaged with the school, while parents working night shifts and families who speak Spanish at home, a growing share of the town's population since the poultry plant expanded, were underrepresented. The assessment also lacks information on how students' families use the food assistance programs available to them. To fill these gaps, the partnership will hold a Spanish-language listening session at the Catholic parish, add questions to next year's student survey and ask the clinic for de-identified counts of adolescents screened and diagnosed. Treating the assessment as a living document keeps the partnership honest about what it knows.

Priorities

Bringing needs and assets together suggests three priorities. The first is increasing students' daily physical activity, through before- and after-school opportunities and safer places to walk and play, using the school's gym, the park and the trail. The second is improving access to and skills with healthy food, through school meals, a garden and cooking education, building on the extension office, the local chef and churches. The third is connecting students with elevated risk and their families to care and support, through the school nurse and the clinic. Each priority draws on existing assets, is supported by community interest and addresses factors that research links to prediabetes and type 2 diabetes in youth. Module 2 will identify and analyze the partners needed to act on them.

References

Andes, L. J., Cheng, Y. J., Rolka, D. B., Gregg, E. W., & Imperatore, G. (2020). Prevalence of prediabetes among adolescents and young adults in the United States, 2005-2016. JAMA Pediatrics, 174(2), e194498. https://doi.org/10.1001/jamapediatrics.2019.4498

Kretzmann, J. P., & McKnight, J. L. (1993). Building communities from the inside out: A path toward finding and mobilizing a community's assets. ACTA Publications.

Lawrence, J. M., Divers, J., Isom, S., Saydah, S., Imperatore, G., Pihoker, C., Marcovina, S. M., Mayer-Davis, E. J., Hamman, R. F., Dolan, L., Dabelea, D., Pettitt, D. J., & Liese, A. D. (2021). Trends in prevalence of type 1 and type 2 diabetes in children and adolescents in the US, 2001-2017. JAMA, 326(8), 717-727. https://doi.org/10.1001/jama.2021.11165

Story, M., Nanney, M. S., & Schwartz, M. B. (2009). Schools and obesity prevention: Creating school environments and policies to promote healthy eating and physical activity. The Milbank Quarterly, 87(1), 71-100. https://doi.org/10.1111/j.1468-0009.2009.00548.x