In Michigan, around one million school-aged children take part in hearing and vision screenings each year. Approximately 88,000 of them need help and are referred for further hearing and vision services. These services are vital to children’s overall health as well as to their academic and social success. 

Early detection and treatment can prevent vision and hearing problems, delayed speech and language skills, and learning difficulties in school as well as help children to avoid negative feelings about themselves and difficulty making friends and relating to others. As public health services, these screenings are free and accessible to insured and uninsured children at their local health departments.

One of those local health departments, District Health Department #10 (DHD #10) serves ten counties: Crawford, Misaukee, Wexford, Manistee, Lake, Oceana, Mason, Mescosta, Kalkasa and Newaygo. In 2023, DHD#10 screened 1,654 preschoolers and 5,684 school-aged children for hearing problems as well as 1,737 preschoolers and 6,397 school-aged children for vision problems.

Yours, Mine and Ours — Public Health spoke with DHD#10 health officer Kevin Hughes about vision and hearing screening for children, why it’s significant, and what the health department is doing to continue these services.
Kevin Hughes.
Q: Why is it so important to provide children with hearing and vision screening?

A: From an educational standpoint, they need to be able to hear what the teacher is saying as well as need to be able to see the blackboard and what's going on. There may be instances where the child may notice that they have vision related problems. So, they might sit up front but not want to say anything, because they're hesitant to have to wear glasses or something like that. So, if we can correct these things, I think it helps with their education as well as their health.

Q: At what ages are Michigan children screened for hearing and vision?

A: It’s important to mention that these screenings are free to preschool and school-aged children. For our vision screening, we will screen children initially between the ages of three and five, and then we will go back and screen those children again at grades one, three, five, seven, and nine. Generally, those screenings are done in the schools or during the school year and we'll have our staff, which are three techs trained by the state, cover our 10 counties. For hearing, it's the same people that will conduct the screening. The kids initially, again, between three to five years of age and then kindergarten, and then grades two and four.

Approximately 88,000 Michigan children are referred for further hearing and vision services after screenings each year.
Q: What happens when a screening detects a vision or hearing deficiency?

A: If any of our state-trained technicians find abnormalities or questions that come up as a result of doing the screening, we will make referrals to the appropriate individuals in our jurisdiction, whether it be a primary care provider or an optometrist, whichever is necessary to refer that child to. We are just providing an initial screening. Then, if there are things that we find, it gets referred to the appropriate provider.  

Q: Vision and hearing screenings are provided at no cost to preschool and school-aged children. Where is the funding coming from?

A: Because this is one of the eight core mandated services, the state provides part of the funding. The public health code dictates that those core services are essential local public health services. Funding for those comes from the state as well as from local sources. Each of our counties contributes money towards the operation of the health department. And it's through those two amounts that we provide those eight core services. We have an annual allotment of dollars that we get for the hearing and the vision program. While hearing and vision is referred to as one of the essential local public health services, funding for those two programs does not come from the Michigan Department of Health and Human Services (MDHHS) any longer. It actually comes from the Michigan Department of Education (MDE). 

Q: Is there enough funding for all the children in the state to be screened?

A: Because hearing and vision screening are a core public health service, this is a minimum program requirement that we are required to meet as a department. So regardless of whether the funding is there or not, we have to provide the service and find a way to fund it. The hearing and vision program has not seen an increase in funding since 1999. I can assure you costs are not what they were back then. So, we have to find other dollars or utilize other local funds to continue to provide that service. If there's not an increase in state funding, we internally find those dollars to be able to provide the services.

Q: 25 years without an increase in funds is a long time. What’s being done to advocate for additional funding?

A: The Michigan Association of Local Public Health (MALPH) is advocating for more funds to cover for an inflationary increase. Inflation rates from 1999 to today have had a $3.5 million increase. So, what we're asking is that $3.5 million be added to the current hearing and vision line. Overall, the total that's dedicated for hearing and vision statewide is $5.1 million, so we're asking for that to increase to $8.6 million.

Q: How would additional funding benefit DHD#10?

A: The biggest benefit for DHD#10 is that it would allow us to cover more of our expenses with state dollars, and it would free up some of our local dollars that we could redirect towards other programming areas in our budget allowing us to continue to give people these mandated health services in our jurisdiction.

“Health care is a right, not a privilege.” It is significant that these services stay available for Michigan children and families because it ensures that everyone is supported by a system that allows them to live a healthy and safe life. The additional funding will keep these services available for children and their own children down the line. But without the funds to cover inflation costs, underfunding of health services occurs, lessening the accessibility of these rightful services to vulnerable families and communities.   

Monique Bedford is an aspiring journalist, currently freelancing for Issue Media Group publications. She graduated from Oakland University in fall of 2022 with a bachelor's degree in journalism and a minor in Spanish. Monique has experience in solutions journalism, media design, and hosting a radio show. When she's not writing, you can always find her studying different cultures and languages, reading her favorite newspaper, The New York Times, and spending quality time with her friends and family.

Photos by Anthony Shkraba, Chi N. Ba, and Gustavo Fring via Pexels.com.

The Yours, Mine, and Ours — Public Health series highlights how our state's public health agencies keep us healthy, safe, and informed about issues impacting physical and mental health in our communities, homes, workplaces, and schools. The series is made possible with funding from the Michigan Association for Local Public Health.