Promoting the health and well being of children and adolescents is a generally accepted value of our society. In part, this value stems from their vulnerability. They lack the resources, knowledge, and skills to function independently. Support also represents the realization that the children an adolescents of today are the leaders and citizens of tomorrow; they are our future. Schools can and should play an important role with respect to the health of this important population, and a comprehensive school health program can help achieve this goal.
The Importance of the School Setting
Schools are a major institution which can influence the health and well being of our youth. Except for the family, schools have more influence on our youth than any other institution. In the United States more than 95% of those ages 5-17 are enrolled in school. This translates to about 48 million youth attending almost 110,000 elementary and secondary schools for about six hours of classroom time a day for approximately 180 days per year. At the federal level, the importance of the role that schools can play has been highlighted by Dr. Michael McGinnis (McGinnis, 1981), former Director of the U.S. Public Health Service Office of Disease Prevention and Health Promotion, who indicated that factors which shape our lifestyles and our environment play a dominant role in our health status. Also, he indicated that the nation's schools provide an appropriate and efficient medium for educating our children about the increasingly complex risks to health and about the ways in which individuals and society can control those risks. More recently this message was reinforced by the Centers for Disease Control and Prevention Director, Dr. David Satcher, (Satcher, 1995) who stated, "Schools are the only public institution that can reach nearly all youth; therefore schools are in a unique position to improve not only the educational status but also the health status of young people throughout the nation" (p. 289).
Health and Learning
Health and learning are inextricably intertwined. Simply, a child who is sick cannot learn or learn to the extent of his or her potential (American Cancer Society, 1995). Similarly, most would agree that education is an important component in one's ability to function successfully in society. Health is an essential component of that equation. Those involved with education have long recognized the link between health and learning. In support of this relationship, Shane (Shane, 1976) cites the original 1918 Cardinal Principles of Secondary Education that indicate the health of the individual is essential to the vitality of the Nation. As such, health was place first with regards to the objectives of education. Additional support for this position is provided by McGinnis (1981), who points out, "A student who is not healthy, who suffers from an undetected vision or hearing deficit, or who is hungry, or who is impaired by drugs or alcohol, is not a student who will profit optimally from the educational process. Likewise, an individual who has not been provided assistance in the shaping of healthy attitudes, beliefs, and habits early in life, will be more likely to suffer the consequences of reduced productivity in later years" (p. 13). This relationship between health and learning has been reinforced by the National Association of School Boards (NASB, 1991) who maintained that a combination of instruction, health services and the establishment of a safe and healthy school environment offer the most efficient means for improving academic achievement opportunities and solving behavior-related problems which are major steps toward meeting our national need for healthier and more productive citizens. They also indicate that comprehensive school health programs, can provide the means for addressing the plethora of health and safety issues that confront school districts-from absenteeism and AIDS to steriod use and suicide. …