Professionally speaking

Demands of the job put teachers at high risk for voice problems

Teachers’ voices are the primary tools of their profession. Talking is the way they communicate with their students. Research shows that teachers are at high risk of developing voice problems because of the vocally demanding nature of their jobs. Most teachers spend at least two to three hours a day lecturing—a pace that allows little time for their voices to recover, which experts say is necessary.

“Most teachers never really get vocally rested,” says Ingo Tizte, director of the National Center for Voice and Speech at the University of Iowa. As a result, at least half of all teachers experience problems with their voices at some point in their career, he says.

The most common problems reported are hoarseness, aching or tiredness in the throat, and complete loss of voice.

Fortunately, most of the problems associated with voices can be prevented,  says Julie Ostrem, project director for the Voice Academy, a program run by the National Center for Voice and Speech.

“A few adjustments can help teachers preserve their voices.”

All too often, teachers must contend with external noises created by the heating and cooling systems, windows with loose frames or thin panes, and other background noise in the classroom.

“Noise from other areas just creeps in, and it pushes the teachers’ voice systems over the edge,” Ostrem notes. “It’s more than most people can handle, and most teachers can’t consistently produce that loud voice day after day.”

Putting up bulletin boards, placing houseplants around the classroom and putting bookcases against classroom walls help to absorb sound and prevent voice reflection, Ostrem says.

“If classrooms can’t be improved, a teacher might wear a portable amplification system to give the voice just a little extra power,” suggests Ostrem.

Voice disorders are also associated with poor indoor air quality, says Darryl Alexander, director of the AFT health and safety program. “Teachers who are chronically exposed to particles, bacteria and fungi are at risk of chronic inflammation of the vocal cords,” says Alexander.

Teachers should keep in mind that a healthy body can help make a healthy voice. A nutritious diet, adequate sleep and hydration, controlled stress levels, adequate breath support and good body alignment are important for healthy voice production.

In addition, allowing time for your voice to recover is important. Vocal researcher Titze recommends that teachers structure their school day to allow them to speak for short periods and then take short breaks.

“Teachers should learn to get the kids to talk and do much more dialogue. That would solve many problems,” says Titze.

Voice problems are a good topic for AFT locals to consider when negotiating for health and safety committees, says Alexander. “It’s important that teachers and paraprofessionals don’t consider voice disorders a personal health issue, they are work-related health problems.”

Alexander recommends that AFT locals get together with their school districts to find solutions that work, whether it is better acoustics, improved air quality or providing amplification devices.  Most important, teachers should have all information necessary for vocal health.

To learn more about caring for your speaking voice, visit the Voice Academy at www.voiceacademy.org.

The healthcare cost-shift paradigm

By John Abraham, AFT Research and Information Services

A U.S. Census Bureau report that recently made its way into national headlines shows that about 44 million people, or 15.2 percent of the population, were without insurance coverage in 2002—an increase of about 2.4 million people from 2001 when the proportion of uninsured stood at 14.6 percent. Equally alarming is that the number of workers covered by employer-sponsored health insurance dropped from 153 million (62.6 percent) in 2001 to 150 million (61.3 percent) in 2002.

Contrary to popular belief, most of this country’s uninsured are employed. More than 80 percent of the uninsured live in families with a full-time or part-time worker. However, these workers earn too much to be covered by Medicaid ($16,000 for a family of three) and too little to afford the cost of private insurance (two-thirds of the uninsured families earn under $30,000 per year).

The rise in the number of uninsured and the drop in employment-based coverage go hand in hand. As healthcare costs rise, fewer employers are able to bear the cost and therefore drop coverage. The impact of rising costs is especially felt by small employers, who are least able to afford higher premiums. According to the Census Bureau, only 31 percent of employers with fewer than 25 employees offered insurance coverage in 2002, compared to 69 percent of employers with 1,000 or more employees.

The federal and state governments compound the cost problem by paying doctors and hospitals less than the cost of care for Medicare and Medicaid patients. The practical effect of these arbitrary pricing caps, which are typically used to help governments balance their budgets, is that providers are encouraged to shift more costs to privately insured employers and employees. This hidden tax on the health insurance premiums of employers and employees alike helps explain why a couple of aspirin can cost as much as $10 in an emergency room.

While employers abandon increasingly expensive insurance coverage, people without insurance continue to receive healthcare. Some of the drop-off in private coverage was picked up by Medicaid and the State Children’s Health Insurance Program (SCHIP), but coverage is limited. The uninsured will receive healthcare, however, because laws require hospital emergency rooms to accept and care for all patients who present themselves for treatment, regardless of their ability to pay. Analysts put the amount of cost shifting from uncompensated care at $35 billion to $40 billion per year.

Democratic presidential candidate John Kerry proposes to reach out to the uninsured by expanding access to group coverage. Among the proposals is support for employer-sponsored healthcare through a premium rebate of up to 75 percent of the cost of catastrophic care. Another idea is to relieve state governments of a large part of the Medicaid financing by having the federal government pay the cost for all children enrolled in Medicaid.

President Bush offers a different approach. He proposes to subsidize the purchase of individual private health coverage through a variety of tax credits or deductions to offset part of the cost. He believes that individuals can “out-negotiate” corporations over premium costs and plan design through direct bargaining with doctors and hospitals over the cost of care. He therefore wants to eliminate employer-sponsored healthcare and shift the risk and responsibility for healthcare costs and coverage to individuals.

As president, Kerry would keep employer-sponsored plans alive, while Bush would speed up their demise.