September 11 2019

Three cheers for Governor Gavin Newsom this week in signing two bills to assure a greater level of well-being for children.

First, and of greater strategic relevance to our Building Healthy Communities work over the years, the Governor and legislature acted to remove “willful defiance” in K thru 8 school settings as a justifiable cause for suspending a child out of school.  Our grantee partners across the state have been fighting for years to strengthen social-emotional health and wellness in the school setting, by expanding mental health and counseling supports, and introducing “restorative justice” practices where kids who misbehave are held accountable for their actions – but kept within the school setting.

As a pediatrician, the worst thing you can do to a child who is exhibiting troubling behavior is to suspend the child out of school, which sends a message to a troubled youngster that “you’re not wanted here,” and wastes a potential opportunity to get to the root cause of the child’s behavior.  The scientific research on adverse childhood experiences tells us that a child who is acting out may, for example, be psychologically or sexually abused, or is witnessing violence in the home, or may have just experienced the incarceration of a family member.  Further, the research tells us that each time a student is suspended out of school the risk is raised of dropping out of school entirely and becoming part of the juvenile justice system. Let’s work in partnership with school districts and teachers to assure they have the resources and training to address these kids’ needs and do our best to keep them in school.

The second reason to cheer – and I understand how controversial this issue is – is the Governor signing the bill to crack down on fraudulent vaccine exemptions, and I appreciate his courage to do so.  Whatever the level of noisemaking and allegations about childhood vaccines on social media, it is fundamentally clear that the science continues to weigh decisively on the side of universal vaccine programs in children.

On a more personal and experiential level, I witnessed the public health devastation on this question in 1990-91.  At that time, I served as a physician in the Philadelphia Department of Public Health and was on point in managing a horrific outbreak of measles at that time.  We saw more than 1,000 cases of measles citywide, and nine childhood deaths.  A major contributing factor: a fundamentalist church called Faith Tabernacle operated a school with hundreds of students, none of whom were vaccinated because their parents refused vaccinations and medical care.  We estimated that a few hundred cases of measles occurred in the school, and six children ultimately died (if you google “Faith Tabernacle measles outbreak”, the stories will come up).

In any case, it was a nightmarish moment for me in my public health career, and the pain of witnessing completely avoidable child deaths and illness is something that haunts me even to this day.

(I also want to be clear that our foundation is prohibited from lobbying on active legislation, so we had to sit on the sidelines as these two issues played out.)

Not an easy call for our Governor given the passionate views on childhood vaccines, but from a public health and science standpoint – the right call was made.

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