Individual nurses like Pam Dice followed up. Nobody knows how many others did the same. They were not asked to contact parents to see if they had questions.
Every year, lawmakers wrestle with the state's mushrooming high chronic disease bills. They have been warned that those costs will double between 2008 and 2018 if the state does not find a way to reduce the number of people developing diabetes
But in 13 years of CARDIAC, no state or regional agency has systematically followed up on thousands of children identified as at risk, as a way of lowering the state's diabetes numbers.
"We should be following up in some way on the CARDIAC results," said Delegate Don Perdue, chairman of the House Health and Human Services Committee. It's a chance to save children and their families a lot of expense, he said, and "probably would have saved the state millions of dollars in the future.
"We've been warned that our health care expenses could at least double if we don't lower the percent of people who have chronic disease," said Perdue, a Democrat and a Wayne County pharmacist. "Once the alarm bell has rung, the house is on fire, and you need to be putting it out. But we are not good at prevention."
The state-funded CARDIAC program is finishing its 13th year in the schools. This spring, CARDIAC will send the schools new lists of children who have early warning signs of chronic disease. No systematic response is planned.
"It's a lot harder to organize a follow-up than it might sound," said Joe Barker, director of state Office of Community Health Systems. "Whose responsibility would it be? Therein lies the problem."
"School nurses would like to follow up on those children, but they are already overwhelmed with kids who are already diagnosed with asthma, seizure disorders and insulin-dependent diabetes and behavior disorders," said Becky King, coordinator in the state Office of Healthy Schools.
Nurses are also responsible for dealing with STDs, pregnant teenagers, kids on drugs, and kids with HIV, she said. To do more, she said, nurses need more troops.
Can local health departments help? Only three have full-time directors, Barker said. The rest are tiny, independent entities, so no central body can order them to "do this, across the state."
Melanie Purkey, director of the state Office of Healthy Schools, said that, with limited personnel, the school system is trying to improve the health of all children instead of following up on specific at-risk children.
The schools have managed to get soda pop and junk food out of vending machines, she said. The Department has launched statewide efforts to improve school lunches and increase physical activity. "Those things will help all children," she said.
"We feel specific children should be treated in their medical homes," she said. All kindergartners now must have physical exams before they enter kindergarten, as a means of requiring parents to establish a "medical home" for the children.
The Bureau of Public Health also does not have resources to organize a statewide contact-the-parents effort, Barker said. The state Diabetes Prevention Program has only three staffers to cover the whole state.
"No one agency is equipped to follow up on these kids," Barker said. "Obviously, somebody should, but everyone's pretty overwhelmed, understaffed, and under-resourced."
Reach Kate Long at (304) 348-1798 or katel...@wvgazette.com.
"The Shape We're In" is produced through a Dennis A. Hunt Fellowship for Health Journalism, administered by the Annenberg School for Communication and Journalism at the University of Southern California.