Academic journal article Journal of School Health

Coping with Controversy: The Professional Epidemic of the Nineties

Academic journal article Journal of School Health

Coping with Controversy: The Professional Epidemic of the Nineties

Article excerpt

School health has become almost synonymous with controversy. Health topics once considered routine -- even boring -- now inspire heated and emotional school board meetings. Health educators and school nurses now find themselves having to justify their curricula. Meanwhile, adolescent risk-taking behavior continues. Slightly more than half (53%) of U.S. high school students report having had sexual intercourse. Some 18.8% reported having had four or more partners, while 37.6% reported having sex during the three months prior to the survey.[1] The percentage of school health professionals having such controversy probably approaches 100%.

Parents and school health professionals would like to reduce the risks faced by adolescents, yet the most frustrating challenges involving controversy often relate to how adolescent risks are perceived. Do school health programs increase or decrease risk-taking behaviors? No one would disagree with the statement from the Me, My World, My Future middle school curriculum published by Teen-Aid, Inc.: "The Bottom line...is that teens can postpone sexual activity. Premarital abstinence is reasonable, legal, moral and ethical, and is the healthiest possible lifestyle for teens." However, the Teacher's Manual later compares teaching about contraceptives to giving a dieter recipes and ingredients for gourmet desserts.[2] The curriculum seems to imply that only by removing "temptation," or in this case information about temptation, can we prevent risk-taking behavior. Thus the debate becomes, Is information empowering or tempting? Is a complete message a mixed message? Is ignorance, especially ignorance of contraception, preventive."

The National Commission on Adolescent Sexual Health, convened by the Sexuality Information and Education Council of the United States (SIECUS), issued a report supporting comprehensive sexuality education, including information on sexual health and contraception.[3] The Joint Committee on National Health Education Standards in The National Health Education Standards defines health literacy as "the capacity of an individual to obtain, interpret, and understand basic health information and services and the competence to use such information in ways that are health enhancing."[4] No exception is made for sexuality education. Evidence suggests students are becoming more literate in at least one area. Condom use by high school students increased from 46.2% in 1991 to 52.8% in 1993.[1] It does not make sense to argue that if these students did not know about condoms they would be abstinent.

Health professionals must come to terms personally and professionally with our philosophies of risk and behavior. We must understand intellectually that students possess the capacity to use information and make responsible choices, and we must be prepared to explain and defend our position. Withholding information about sexuality will not prevent sexual activity, since society does not withhold mixed messages about sex. One study found 27 instances of sexual behavior on television every hour or 65,000 instances annually.[5] Some 25 messages encouraging sexual activity occur for every message urging caution; moreover, "caution messages" often are given within the context of a joke.[6] In addition, sexuality is used to sell everything from beer to sunglasses. Condemning a behavior frequently glamorized by the media is not an effective prevention strategy.

It is important to emphasize that, although teens constantly receive mixed messages, many teens still choose to make responsible decisions. Part of the challenge involves presenting not only negative statistics, but positive ones. For example, almost half of all high school students are sexually abstinent.[1] The purpose of health education is to promote abstinence as normative behavior and to provide the balanced information students need to attain health literacy. We must take a stand for comprehensive sexuality education. …

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