As pediatricians and health system leaders, we have the privilege of caring for children during some of the most important moments in their lives. We also recognize a simple reality: We see children for minutes at a time. Educators see them for hours each day.
A pediatrician may spend 20 minutes with a child during an office visit. Teachers, school nurses, counselors, coaches, and other education professionals spend as many as eight hours per day with that same child. They witness the daily realities that shape health — whether a child is struggling with asthma, anxiety, hunger, chronic absenteeism, or the effects of trauma. Their perspective is indispensable.
If children's hospitals are serious about improving child health, we must partner with schools.
Health and education are inseparable. A child who cannot breathe because of uncontrolled asthma cannot fully participate in class. A student experiencing untreated anxiety or depression cannot focus on learning. Food insecurity, chronic illness, sleep challenges, and social needs all influence attendance, classroom engagement, and academic success. Likewise, educational attainment is one of the strongest predictors of lifelong health.
Too often, we build separate systems to address these interconnected challenges, leaving families to navigate the gaps and overlaps between them. Health systems manage medical care. Schools manage education. Both work to address social needs in partnership with community organizations. Each system has different funding streams, accountability measures, and priorities. Families may work with different organizations and care coordinators who are all attempting to support the family.
Our experience has shown there is a better way.
Effective ways to partner with schools
At Children's National Hospital and the Medical University of South Carolina (MUSC), we have independently — and now together — developed models that place schools at the center of children's health and wellness. While our approaches are tailored to our communities, they are grounded in the same belief: Schools are among the most effective places to reach children and families with meaningful health supports.
Schools already reach more than 90% of school-aged children every day. They are trusted community institutions where prevention, early intervention, and coordinated care can happen before challenges become crises. Rather than asking whether schools should play a role in health, we should ask whether health systems are doing enough to support schools in that role.
This philosophy guided the development of School-Friendly Health Systems, a national framework and learning collaborative led by Children's National that helps hospitals intentionally partner with schools to improve health, attendance, and academic outcomes. Today, more than 20 children's hospitals are participating in this growing national collaborative, sharing best practices, and accelerating implementation across the country.
At the same time, MUSC's Boeing Center for Children's Wellness has demonstrated the power of comprehensive school-based wellness initiatives across more than 300 schools, improving student wellness while contributing to reductions in absenteeism, healthier body mass index trends, and stronger educational outcomes.
These efforts reinforce the same lesson: When health systems and schools work together, children do better.
These partnerships extend far beyond school-based clinics. They include:
- Telehealth and telemental health services that increase access to care
- Data-sharing partnerships that help identify and address barriers to attendance
- Chronic disease management, behavioral health supports, and coordinated strategies that connect health care providers, educators, families, and community organizations around shared goals
Health systems can consider partnering with education systems to assume joint accountability for metrics such as kindergarten readiness, third grade reading proficiency, immunization rates, or school attendance rates.
How to succeed together
Perhaps most importantly, these partnerships begin by listening. Listening to kids about what they need. Listening to families to understand their struggles and barriers as well as their joys and successes. And listening to the other professionals who work with children and families.
Clinicians and educators bring unique expertise. While each has a deep understanding of children's daily experiences, family dynamics, and learning environments, neither perspective is sufficient on its own. When health care leaders and education leaders sit at the same table, we develop more effective solutions than either sector could achieve independently.
This collaborative spirit was evident during the recent Boeing School Wellness Symposium in Washington, D.C., hosted by Children's National and sponsored by The Boeing Company, where nearly 200 leaders representing 70 organizations came together to share innovations and strengthen partnerships advancing student wellness.
Throughout the symposium, one message emerged consistently: No school, hospital, community organization, or government agency can improve child well-being alone. It requires shared responsibility, shared accountability, and shared investment.
Children's hospitals have long embraced the responsibility of caring for all children. Today, that responsibility also means meeting children where they spend their time — not just in hospitals, but in schools and communities.
Creating School-Friendly Health Systems is not simply another program. It represents a shift in how we think about our mission. It recognizes that children's hospitals must be partners in creating environments where children can thrive physically, mentally, and academically.
The future of pediatric health care depends not only on the care we deliver inside our walls, but on the partnerships we build beyond them. Schools are not only places where children learn. They are among the most important places where children's health is built — and children's hospitals have a unique and essential role to play in that work.
By working together, health systems, schools, families, and communities can create the conditions that every child needs to learn, thrive, and reach their full potential.
