Building School Health Connections to Improve Health and Academic Outcomes

October 24, 2022

Children’s National Hospital has proudly served the early childhood and K-12 school systems for more than two decades. We currently…

The CHAI Adopts a Land Acknowledgement Statement  

A land acknowledgement statement, also known as Indigenous land acknowledgement, are formal statements used to spread awareness and understanding of the longstanding history of the Indigenous population genocide that occurred on the land that we reside on. They can be verbal or visual: signage, short theater presentations or simple spoken-word greetings before large events such as conferences.  

“When we talk about land, land is part of who we are. It’s a mixture of our blood, our past, our current, and our future. We carry our ancestors in us, and they’re around us. As you all do.” Mary Lyons (Leech Lake Band of Ojibwe) 

Land acknowledgements do not exist in a past tense, or historical context: colonialism is a current ongoing process, and we need to build our mindfulness of our present participation. It is also worth noting that acknowledging the land is Indigenous protocol.  

Why are land acknowledgement statements necessary? 

Land Acknowledgement Statements became popular in countries like Australia, New Zealand and Canada. These countries started these statements for various reasons, for example in 2008, Canada launched a Truth and Reconciliation Commission that included 94 recommended calls to action created by First Nation people to address the historical harm done to their communities.  

Photo by Aaron Burden on Unsplash

Land acknowledgements started in the United States’ from within the arts community due to the direct call to action from the North Dakota Pipeline protests starting in 2016. The US Department of Arts and Culture launched a social media campaign called #HonorNativeLand and provided a resource on Indigenous People’s Day 2017 (October 11): ‘Honor Native Land: A Guide and Call to Acknowledgment.’ Soon after, higher education institutes started providing statements. The first university to provide an official land acknowledgement statement was in 2018 by Northwestern University (NU) read at commencement, printed in programs, and published online. Due to the growing popularity of these statements on college campuses and the spark of the Black Lives Matter movement, this demanded that organizations take a look at their practices and traditions.  

These statements and movements led to the historic name change of the NFL Washington Football Team. Why is that important? It may seem like a small change, but the term “redskin” is considered a slur by Native American activists and has been used since the 18th century. This slang was used by the first colonists settlers and utilized to label Native Americans (or known as “Indians” during that time) as lower than white people. Some historians say that the term “redskin” could be reference to when Native Americans were scalped when they were hunted for bounty in the 1800s. Since the 1960s, activists have tried to encourage the NFL to change the mascot and name of the Washington team. Land acknowledgements and civil rights movements help to bring awareness and hold large corporations like the NFL accountable.   

How to Use Statements 

Email Signatures 

In order to spark awareness, you can have a simple statement at the end of your emails such as this one: 

“In the spirit of healing, I acknowledge and honor the Piscataway and Nacotchtank Tribes, and all of the original Indigenous peoples of the land upon which Children’s National Hospital stands. / Whose land are you on?” 

The link provided shows the historical territories of Native American tribes throughout the United States. Links like this can be provided or another education link regarding land acknowledgements.  

Formal Statements 

In the spirit of healing, CHAI has created a land acknowledgement statement. Children’s National Hospital has not established an official statement yet, but we encourage you all to spread awareness. You may utilize this statement for your own needs during appropriate times before large gatherings or in need of reflection regarding racial equity topics. If you do choose to use this statement, please reach out to Lin Chun-Seeley at to ensure you are using the statement appropriately.  

Our Example: CHAI Land Acknowledgement Statement  

The Child Health Advocacy Institute at Children’s National Hospital acknowledges that Washington, DC is the traditional territory of the Nacotchtank/Anacostan and Piscataway people. This land acknowledgement is read to recognize and honor the Indigenous peoples and the genocide, forceful removal and displacement of their elders whose lands and territories were stolen from them. We acknowledge their legacy and find inspiration in their great stewardship of the region for generations. 

The CHAI recognizes and celebrates the resilience, strength, and enduring presence of Indigenous people in Washington, DC and in all communities around the world. We have a shared responsibility to acknowledge the history and legacy of colonialism in our history as a community, as a nation, and as an institution. We commit to supporting the Indigenous members of our community as we educate ourselves on Indigenous histories, cultures, and issues. 

In the spirit of reconciliation, healing, and collaboration, please join us in a moment of reflection to acknowledge the injustices of our past and present as we work to dismantle the ongoing legacy of colonialism. Land acknowledgement is only one small part of supporting Indigenous communities. We hope our land acknowledgement statement will inspire others to stand with us in solidarity with Native nations.  


Header photo by Stephanie Valencia on Unsplash

Language Matters: Incorporating an Equity Lens in Your Communication 

Have you ever used words like ‘vulnerable,’ ‘disadvantaged’ and ‘underserved’ to describe the people you serve? In education and health, we learn to use these words to describe people who live in under-resourced communities. These words have pejorative undertones that are demeaning, belittling and discriminating.  

 The term underserved connotates a group of people who are “waiting to be handed something on a silver platter and that all of their challenges relate to services when in fact their challenges reflect a lack of resources – of which services is only one.”1 The term is also “part of a suite of commonly-used, vague words and expressions” and does not adequately describe the structural forces that limit the resources for particular populations.2 In fact, their challenges reflect a lack of resources or under-resourced, which includes leadership, physical assets, and power.   

 I began to understand the use of my own language after participating in a webinar led by Jerry Hawkins from Dallas Truth, Racial Health & Transformation. I learned why language matters and how to stop racist and discriminatory narratives. 3  

Photo by Sunbeam Photography on Unsplash

 The use of appropriate language is critical to building bridges in our community. Over the last year with the Child Health Advocacy Institute at Children’s National, we have trained over 300 employees on how to incorporate an equity lens in their communication. We encourage inclusive language to avoid perpetuating negative biases and instead embrace diversity and inclusivity to promote equity and strengths in our society. We remind our colleagues that this is a continuous learning process and share the quote from a collaborative organization called SumOfUs: 4  

 “Reclaiming power from racist systems takes a willingness to come to the conversation with curiosity and openness and a willingness to get it wrong without letting that stop us from continuing to try to understand and do better.”  

 Below are a few ways you can incorporate inclusive language in your writing and when speaking to colleagues, patients and families.  

PEOPLE-FIRST LANGUAGE places the person at the center rather than the problem. Focusing on the individual rather than the condition minimalizes generalizations and stereotypes. Using the terms “a person with” or “person experiencing” a specific condition.  

Rather than saying…

  • Disadvantaged children
  • Disabled people
  • The homeless
  • Autistic children

Instead say…

  • Children experiencing health care disadvantages
  • People with disabilities
  • Families experiencing homelessness
  • Children diagnosed with Autism Spectrum Disorder

EMPOWERING LANGUAGEseeks to frame issues with an agency lens, rather than depicting people living in poverty as helpless. The use of empowering language portrays affected people as the agents in their own story.    

Rather than saying…

  • Resources for at-risk children
  • Underserved population
  • Vulnerable or disadvantaged
  • Poor/poorest
  • Our work transforms lives and families

Instead say…

  • Resources to reduce risk factors for children
  • Under-resourced population
  • People experienced barriers
  • People with income below the poverty line
  • Our work provides support to individuals to transform their lives and families

STRENGTH-BASED LANGUAGEdraws on a person’s strengths rather than deficits. The use of strength-based language focuses on a person’s contributions and aspirations as opposed to the challenges they face.    

Rather than saying…

  • Victims of bullying
  • Children suffering from cancer
  • Minimize risk
  • Comorbidities

Instead say…

  • Survivors of bullying
  • Children living with cancer
  • Maximize growth
  • Co-existing conditions


1. Burke NS. How to Fix a Broken Tongue. Accessed February 22, 2021.  

2. Katz AS, Hardy B, Firestone M, Lofters A, Morton-Ninomiya ME. Vagueness, power and public health: use of ‘vulnerable’ in public health literature. Crit Public Health. 2019 Aug; 30(5): 601-611.  

3. Hawkins J. Dallas Truth, Racial Healing & Transformation, Language Matters: Storytelling for Racial Justice. Accessed March 8, 2021.  

4. Thomas H, Hirsch A. A Progressive’s Style Guide. Accessed March 8, 2021.  


Header photo by Kat Stokes on Unsplash

HB 2019: Stocking Albuterol in Virginia Schools

The world has spent the last few years grappling with a virus that, at its most acute, denies its host the ability to breathe. Sometimes lost in the sheer scope of the death and destruction wrought by SARS CoV-O-V2 is the terrifying struggle for air faced by those afflicted. There is something uniquely awful about the denial of that which sustains us, and more terrible when we imagine what a child must feel when faced with it. Sadly, such is the case with asthma, which is among the most common chronic diseases to affect children. Managing asthma has two primary components: controlling the disease and ensuring access to rescue medication in the event of an attack. In this year’s General Assembly session, lawmakers tackled the latter of these components with a bill to mandate that all public schools keep undesignated albuterol on-site.  

Child advocates know that 80% of the factors that affect a patient’s health occur outside the care of a doctor. Environmental factors such as where they live, their household’s economic status, the quality of their school, etc. weigh heavily on a child’s opportunities for success. These factors manifest in a number of ways, but the prevalence of asthma offers a glimpse into the equity gap in public health. Asthma disproportionally affects the African American and Hispanic communities not because there is any sort of genetic predisposition to the disease, but because decades of structural inequity have contributed to factors that exacerbate the respiratory condition. Through no fault of their own, children who live near or below the poverty line are far more likely to be exposed to mold, smoke, poor air quality, along with other triggers.  

Addressing those underlying inequities is a long-haul cause; there is not a ready-made solution to unwinding deep-rooted structural inequity in housing policy, though such a solution should be a priority of policy makers. Lack of long-term answers should not prevent us from pursuing acute solutions, however. A small step, but a meaningful one, was contemplated by House Bill 2019 (HB 2019). 

Patroned by Delegate Delores McQuinn (D-Richmond), HB 2019 would require all Pre-K through 12th grade public schools in Virginia to maintain a stock of undesignated (or blanket prescribed) albuterol) on site. Let’s say that a student forgets to pack their rescue inhaler. Let’s say that this child attends school in a building that is more than 40 years old and learns in a dusty classroom. Let’s say that child has an asthma attack and reaches into their backpack only to find their rescue inhaler absent, what then? In the most favorable outcome, mom or dad is able to rush home and grab the inhaler and get it to the school before the asthma attack has gotten out of control. Even here, however, it is painful to imagine the trauma the child experiences during the time that elapses before their ability to breathe is restored.  

It is worth noting that uncontrolled asthma is the leading cause of absenteeism in school aged children. Given the unprecedented potential for learning loss over the last year, addressing that adjacent issue takes on even greater importance. Thus, HB 2019. 

Photo by Peter Idowu on Unsplash

The bill in question builds on legislation from last year and taken in total provides for a standing order to be written by the head of a local health department, gives immunity to school personnel who would administer the medicine, requires schools to stock albuterol, inhalers, and spacers, and provides funds to alleviate the financial burden on school systems for their initial investment.  

This policy is not without complication, however. Schools play an instrumental role in a child’s development, and those who dedicate themselves to the profession of teaching are heroes in their own right, but they have expressed concerns over the scope of their job responsibilities when it comes to the administration of medicine. These are valid concerns, and they were vociferously expressed during the debates over the fate of HB 2019.  

Progress is rarely a straight line. It sometimes demands compromise and it sometimes requires stubbornness and determination. Advocates for the bill opted for the latter, though with a tinge of the former, and ultimatelyultimately, they were successful in the passage of HB 2019. Legislating often involves placing the pros and cons on opposing sides of a scale and making a decision. Often that decision is not easy, and even more often the hardest part of the decision is opting for progress over the status quo. In this case, lawmakers (or, a majority of lawmakers in each chamber of the General Assembly) elected to support the measure and in so doing take a small step toward reducing uncontrolled asthma in children.  

Make no mistake, HB 2019 is not going to solve the pernicious inequity in health outcomes derived from other policy areas like housing and education funding. Further, the COVID-19 pandemic has affected populations differently because of underlying issues that it has exacerbated, not created. Policy makers who do not see these deep inequities are either ignorant of them (a charitable conjecture), or they simply do not prioritize their alleviation. It is the job of child health advocates to ensure that these disparities are not ignored. It is imperative that they be seen for what they are, addressed head on, and resolved so as to ensure every child has the same opportunity for success.  


Header Photo by Santi Verdi on Unsplash