Q&A with Dr. Dora Hughes, Senior Policy Advisor to the Secretary of Health and Human Services

April 28, 2010

RD and Dora at WH summit
Founding Director Rochelle Davis with Dr. Dora Hughes, Senior Policy Advisor to the Secretary of Health and
Human Services, at the White House summit on childhood obesity

Earlier this month, HSC Founding Executive Director Rochelle Davis participated in a a White House meeting hosted by the Interagency Taskforce to Prevent
Childhood Obesity. Also in attendance was Dr. Dora Hughes, Senior Policy Advisor
to the Secretary of Health and
Human Services, whom
HSC has been honored to work with in the past. (In 2008, Hughes toured a healthy, high-performing school with HSC.) 

In May 2009, we had the opportunity to interview Hughes about her role, her vision for schools and the importance of promoting a healthy, active lifestyle. Much has happened since then — including the launch of Let's Move and the formation of the Interagency Taskforce to Prevent
Childhood Obesity — but her thoughtful remarks continue to provide relevant insight into the important role schools can play in our nation's wellness efforts. Below is our Q&A with Dr. Dora Hughes from May 2009.

What role can schools play in the prevention aspect of health care?

Starting at the top with President Obama, there is tremendous support for expanding and promoting prevention, particularly in community settings, which we define as prevention activities that occur outside traditional healthcare locations. Community settings include schools, work sites, homes, and other locations. We have a number of quite promising program models for providing effective preventive care in the community. The goal now is to expand and accelerate implementation and evaluation of these models on a larger scale, and to engage all of the agencies throughout Department of Health and Human Services (HHS) and beyond. 

What is your vision for schools?

We all understand that schools must be a priority, in part because of the number of hours that children spend in schools for academic work and for extracurricular activities. We see a number of leverage points that can be used to improve student health: increasing physical activity, including recess but also physical education and other types of activity, and improving diets through school breakfast and lunch programs. These leverage points also include a number of enhancements such as green changes that can create healthier environments, which are both the right thing to do for children’s health and also the smart thing to do for the environment. 

There is a lot of thinking going on right now, within HHS and across departments such as the U.S Department of Agriculture and the Department of Education. With regard to the Child Nutrition Act reauthorization, for example, there is a lot of thinking about what role healthy school food initiatives can play in promoting prevention and enhancing school performance. We’re seeing a commitment to the issue across departments and leadership from the White House. The full support of the President, energy and excitement across departments and broad awareness and support from public stakeholder groups creates an environment where we as a nation will be able to move forward with expanding access to promising programs for children’s health promotion. 

I do believe there is a growing awareness in the general public about the need for prevention and an understanding of how to implement prevention in schools, including through physical activity, healthy foods, and green environments. It’s starting to galvanize the attention and awareness of the general public. It is bringing different stakeholders to the table – elected officials as well as public health officials, private sector leaders, parents, providers and of course teachers and school administrators. This collaboration is helping amplify the message and will help to make prevention initiatives more successful than if they were championed by only one group. 

Several major reports have come out in the past three to five years, so there’s increased knowledge about what works and what evidence gaps still exist. We’ve seen large and small foundations putting resources towards this work, which is helping to leverage federal investment of attention and resources in this area. 

We’re reaching a pivotal point in time where we’re able to point to the evidence base and at the same time engage willing and active partners. 

From the perspective of preventive care, what characteristics do you see in an ideal school?

That’s a difficult question, because there are so many factors that contribute to a healthy environment. I’d say that in addition to the food, physical activity and the green aspects of a school, you can’t overstate the importance of the human resources. Leadership from principals, commitment by teachers, efforts by the food service professionals to serve healthier choices are all critical. Healthy schools empower students, inspiring them to be leaders in their own right. Healthy schools address not only children’s physical health, not just their clinical health, but also their social functioning and development. We have to work to improve the human environment as well as the physical environment to create a healthy school environment. It’s not just a matter of financing, although that is important, but also a matter of leadership. 

Parental involvement is particularly critical. With all of the challenges on a school’s plate, an active parent base can be very motivating and inspiring – when you see parents care about these issues, it elevates the importance of the issues and helps increase the odds of success for wellness activities.

In November 2008, you joined Healthy Schools Campaign on a tour of some Chicago schools that have made wellness and environmental health a priority. What stood out to you on that tour? 

What really stood out was the commitment from teachers and the administrative staff to making health and green practices a top priority. We saw people definitely thinking outside the box in terms of integrating physical activity into the school day, improving the nutrition of school meals, and making green practices of the school into learning opportunities for children. This points to making sure that at the federal level, we encourage innovation and invention, making sure that ideas that begin at the local school level can bubble up to become part of solutions at the federal policy level. 

 What role do school nurses play in preventative health care in schools? 

School nurses have played a critical role in expanding access to care. They’re also able to elevate the message of prevention and wellness, which is invaluable. I don’t think the importance of school nurses could be overstated.