Over three decades of keeping kids healthy and in school

Every March, the nation celebrates National Women’s History Month to honor and celebrate the undeniable contributions women have made throughout time. Look for the stories of other exceptional women at the bottom of this report.

The June 7, 1995 edition of the Post and Courier included a letter to the editor titled “Special Doctor.” A family from Hilton Head Island wrote that their daughter had been in and out of MUSC since March of that year, traveling to Charleston and back each time. But the reason they wrote in was to share the family’s feelings about “one very unique physician at MUSC” who they’d had “the good fortune to meet.” This doctor pulled up a rocking chair to talk to their daughter “as if she has all day.” She delivered flowers from her own garden one day and doughnuts the next. It’s clear from this letter that Janice Key M.D., made this patient and her family feel special. But that’s actually what makes Key special – she works to make sure every child can live a happy and healthy life.

Key moved to Charleston from North Carolina in 1991 to become MUSC’s first adolescent medicine specialist. Charles Darby M.D., then-chairman of the Department of Pediatrics, immediately tasked her with starting the adolescent medicine program at the University. “He’s really the kind of person who was supportive of any idea that I had,” Key said. “He didn’t tell me what to do. He would help me figure out how to get it done, which is amazing to have that kind of boss.”

But just two years after embarking on that project, she received a call from Lee Galliard, the principal of nearby Burke High School. Since most of the student body didn’t have health insurance, Galliard proposed a school-based health center in the high school. “They would defer treatment of an illness, miss days of school and then use the emergency room rather than preventative care,” Key said.

Luckily, Key had helped to start a school-based center in North Carolina, so she had the experience to start one at Burke. This one would be different, though, as it was the first time MUSC set up a clinic that was not in one of their own buildings. A year later, they received the funding to remodel some space in the school, transforming it into the first school-based health center in South Carolina.

But Burke High School was just the first of many school-based health centers. Under the guidance of MUSC’s James McElligott, M.D., and Kathryn King, M.D., the program expanded to schools in the Charleston area and throughout the state of South Carolina. Currently, Claire MacGeorge, M.D., serves as the medical director, and there are over 100 schools across the state with access to school-based telehealth.

 

“This is important because it helps reach kids equitably,” Key said. “If there’s a barrier of transportation or due to parents working, we can overcome that and can reach these kids.” The program is clearly working, too. Key reports that kids at schools that have a school-based health center use emergency rooms 50% less than those who don’t have such a center.

But Key wasn’t content to stop there. She noticed that students needed more than just clinical care. Her desire was for them not just to avoid illness but to lead healthy lives incorporating habits that would support them beyond their school years. So she compiled guidance from the Centers for Disease Control and Prevention and National Academy of Medicine and brought it into local schools. “We called it the Lean Team and started leading bridge walks,” she said. “Doctors wanted to be involved, so we changed its name to Docs Adopt School Health Initiative.”

As she learned more about the challenges facing schools, she realized that the schools wanted to encourage healthy living among their students but lacked the resources to do it. With that in mind, Key together with the Boeing Center for Children’s Wellness (BCCW), an MUSC program that she leads, developed the School Wellness Checklist. The list provides guidance for schools on topics such as nutrition, physical activity and staff wellness. “I’m careful to have a lot of things on there that are free for schools, that don’t have a big budget, that address health equity,” Key said.

The most recent impact report from the BCCW shows the value of the checklist. Children at these schools were at least 12% less likely to be categorized as overweight or obese, and every four years of school participation is associated with a 0.5% increase in the attendance rate and a 0.77% decrease in the suspension/expulsion rate. Even more impressive is that these outcomes were similar regardless of the type of school or resource level of the school community. 

Of course, Key is excited about these outcomes and is proud of what she and her team have accomplished. But at the end of the day, she’s still focused on helping one child at a time. She still visits the health center at Burke every week to see patients, just like she did back when she started the first center.

“I just followed the community,” Key said. “I didn't have this as a goal. It's not a research project. We analyze ourselves constantly, but it's not like we went to the school and said we want to do this research project. So it's really the community, following along the need, and carefully making it work each step of the way.”