Healthy Kids. Better Learners. (HKBL)

What if every child living in poverty had access to free health care in their own school community?

Photo of Amy Lottes
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Founding Story: Share a story about a key experience or spark that helps the network understand why this project got started or a story about how you became inspired about the potential for this project to succeed.

As with most of The Little Bit Foundation's programs, "Healthy Kids. Better Learners." began with a conversation with a school nurse and principal. They spoke of students missing so much school because of health issues. Issues that are not addressed due to lack of transportation or access to health care providers. This becomes a barrier to children receiving an education. It is our mission to break down those barriers, so Little Bit sought to bring health care to children in their own school community.

Which categories describe you? (the answer will not be public)

  • Black or African American (for example: African American, Jamaican, Haitian, Nigerian, Ethiopian, Somalian)


Location: Where is your organization headquartered? [State]

  • Missouri

Location: Where is your organization headquartered? [City]

St. Louis City and North County

Location: Where is your project primarily creating impact? [State]

  • Missouri

Location: Where is your project primarily creating impact? [City]

St. Louis City and North County

Problem: What problem is this project trying to address?

St. Louis has significant amounts of segregation, forcing African American families to live in certain areas separate from predominantly white neighborhoods. Consequently, health and educational outcomes for African American students have had detrimental effects on their success and well-being as they progress towards adulthood. Health care use and access in these areas tends to be more limited, thus health risks are more prevalent and can impact the abilities of children to healthily progress towards academic success and overall well-being. In 2013 over 2,000 African American high school students were labeled as “dropouts” in the St. Louis. Unmet health needs and destructive health patterns contribute to the risk for dropping out, one being childhood illness. Untreated child illnesses are highly likely to impact students’ abilities and achievement in school (For the Sake of All, 2014).

The Little Bit Foundation works to eliminate barriers to learning by providing for the basic needs of disadvantaged children in the St. Louis area. The organization currently serves 7,000 students in 25 partner schools in St. Louis city and North County. Little Bit is committed to maintaining a weekly presence in school communities, working one-on-one with every child and serving as the backbone of distribution for programs and services that address the needs of the whole child, be it physical, mental or emotional. The results are positive personal growth and increased self-esteem in students impacted by poverty, leading to improved attendance, behavior and academic success.

Is your model focused on any of the following traditionally underserved communities?

  • Communities of color
  • Low-income communities

Does your model work within any of the following sectors?

  • Education

Year Founded


Project Stage

  • Established (the solution has passed the previous stages, and has demonstrated success)

Example: Walk the network through a specific example of what happens when a person or group engages with your solution.

The Little Bit Foundation, Institute for Family Medicine & SLU School of Nursing created Healthy Kids, Better Learners, which provides general health screenings and wellness education to students in Little Bit sponsored schools. By providing early detection and prevention services, the Healthy Kids, Better Learners program helps remove barriers to education, creating a positive, healthy environment for children to learn. As a result of this program we have identified undiagnosed heart murmurs, pre-hypertension, rotting teeth, vision issues, skin issues and undiagnosed asthma. During one service day a child was diagnosed in asthmatic distress. This child had been at school struggling to breath all day, but no one knew he had asthma.

Impact: What was the impact of your work last year? Please also describe the projected future impact for the coming years.

During the 2015-16 school year, 513 children were screened and 135 referrals were made. During the day of service, Little Bit staff and nurses take the opportunity to give personal hygiene education and to determine if there are other issues that might be affecting the child. Issues identified included: Tooth Decay, Severe Cavities, Ear wax build up, High Blood Pressure, Heart Murmurs, Irregular Heart Beat, Gun Safety Issues, Bullying, Home Safety, Glasses Needed, Lice, Asthma . HKBL acts as a cornerstone for all health and wellness services brought into the school. We have convened a care team of affiliate supports to provide glasses, dental treatment, food supports and behavioral health services and HKBL is able to act as a direct referral source to each of these interventions that are coordinated through Little Bit’s services.

Organization Type

  • nonprofit/NGO/citizen sector

Annual Budget

  • $1mil - $5mil

Financial Sustainability Plan: What is your solution’s plan to ensure financial sustainability?

This project will be sustained through grants and corporate and individual gifts.

Unique Value Proposition: How else is this problem being addressed? Are there other organizations working in the same field, and how does your project differ from these other approaches?

The main focus around health care in St. Louis centers around providing primary care. However, due to lack of transportation, insurance and a shortage of health care providers in impoverished areas, primary care is often not an option. We believe the key to getting kids access to health care is to bring it to their school communities. We are the only organization in St. Louis who is providing free access to health screenings in the schools.

Reflect on the Field and its Future: Stepping outside of your project, what do you see as the most important or promising shifts that can advance children’s wellbeing?

Health and wellness are fundamental to a child’s development and readiness to learn, as students who are healthy experience increased test scores, higher rates of engagement and better attendance. The goals of this project are: Identify conditions that require further medical or dental attention and ensuring necessary follow-up; Offering instruction in health and hygiene that may lead to lasting changes; Equipping children with essential dental and hygiene items; Observing students for other basic needs. Providing health care services at the schools ensures students get the care they need.

Source: How did you hear about the Children’s Wellbeing Challenge? (the answer will not be public)

  • Email

Program Design Clarity

We serve 7000 children ages PK-8th, 98% african american, 95-100% at or below poverty level. At HKBL we screen height, weight, vision, hearing and identify other conditions (asthma, skin conditions, rotten teeth) that require further medical or dental attention, we offer health and hygiene instruction and observe for other basic needs. Every school receives one HKBL per year during the school day. A Nurse Practitioner and nursing students provide the service. LBF staff and volunteers ensure a smooth running event. Student nurses conduct classroom presentations on health and wellness.

Community Leadership

All programs Little Bit creates come from conversations with school staff and administrators. When a barrier to education is identified, we seek a solution to break down that barrier. In talking with school nurses and principals, lack of access to health care was identified as a major barrier to students being focused and ready to learn. In order to provide access to health and wellness programs to all students, we conduct them at school.

Age of Children Impacted

  • 3 - 5
  • 6 - 12

Spread Strategies

Little Bit currently sponsors 25 schools in St. Louis City and North County in 6 school districts. We have a waiting list of over 35 schools wanting our services. We have also been approached by entire school districts to serve all of their schools. We work to serve an additional 1000 children each year. We seek connections with funders, superintendents and community leaders to create partnerships to bring our services to more children.

Reflect on how your work helps children to thrive. How are you cultivating children’s sense of self, belonging, and purpose through your model?

For Little Bit, it is all about each child's dignity and self-esteem. Our program is designed to support the whole child- physically, mentally, emotionally. Our model of consistent, caring, personal interaction shows our students that they are important, respected and cared for. We want to help them realize their full potential by removing any barriers to education and help them be ready to learn and succeed.

Leadership Story

Little Bit began in 2001 when a friend and I were doing a coat drive. After receiving a call from a city teacher, on a frigid day we delivered 170 coats to a school of 250. I was shocked at the level of need so close to my home. That day I met a little boy who was wearing his father's coat. It was so big the sleeves hit the steps as he walked. When I put a warm new coat on him the joy in his eyes was overwhelming. Such a small thing had such an impact. We committed ourselves to helping these children. Today we have evolved to being a backbone of support serving the whole child.

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Description of Healthy Kids. Better Learners.


Join the conversation:

Photo of Doug Gould

I really like the innovation of taking the program into schools to make sure all kids get a screening. The education component can be very helpful since some of the referrals could be caused by lack of knowledge. It would be interesting to see if the number of referrals goes down as you revisit these schools. Do you have any data on change in health related absenteeism since you started your program?

Photo of Amy Lottes

I spoke with our Programs Team about your comment/suggestion.  We do not currently have any data on health related absenteeism, but it is something we want to be able to identify.  We begin  a new data platform last fall tracking four schools for attendance, discipline, reading proficiency, classroom engagement and self-esteem.  We expect it to take 2-3 years to really see results.  

Thanks for the feedback and question!

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