Academic journal article Australian Journal of Education

Finding a Place for Health in the Schooling Process: A Challenge for Education

Academic journal article Australian Journal of Education

Finding a Place for Health in the Schooling Process: A Challenge for Education

Article excerpt

It is common in schools for health and education goals to be seen as agendas that are in competition. However schools do attempt to find time in crowded curriculums to cover health issues as part of their responsibility towards advancing the health of their students. A qualitative approach was used in this study to explore perceived outcomes of a Health Promoting School intervention project. The project schools targeted for in-depth study were purposefully sampled to include diversity based on location, level, system and specific health activities. The results showed that the schools involved were moving beyond oppositional constructions of health and education towards approaching health as an element of effective schooling. It is concluded that in any effective health promotion activity in schools, the agenda needs to be driven primarily by an education sector that has demonstrated it can embrace holistic approaches to health, with the health sector acting as partner and facilitator.


   We should be doing more in the health area but the curriculum is already 
   overcrowded ... The development of literacy and numeracy skills must be 
   priorities, and time and professional development opportunities must be 
   found to continue progress in these area ... And we must develop 
   initiatives to improve student welfare and continue to improve teaching and 
   learning throughout the school ... How do we find the time for health? 
   (Primary school principal) 

Health in schools: An acknowledged area of concern

As part of a school review and forward planning process, the primary school principal above verbalised a range of demands that his school was facing, including learning outcomes, teaching, welfare and health. There are two key issues in this extract. First, the quote reflects a common discourse in schools that there is trade-off between health and education outcomes--you invest in one at the expense of the other. However recent work in comprehensive health promotion in schools has begun to call into question this kind of dichotomy. Although the research reveals differences in health and education agendas, it also points to a good deal of overlap and synergy between the agendas of the two sectors (Kolbe, 1993; Samdal, Nutbeam, Wold, & Kannas, 1998; Symons, Cincelli, James, & Groff, 1997; World Bank, 1993; World Health Organisation, 1996). Second, traditionally the health and education sectors have taken quite different approaches to promoting health. The health sector has tended to focus on single issues (e.g. nutrition, STDs, drugs) and conceive of schools as convenient settings for reaching a particular target group to influence behaviours (St Leger, 1992; St Leger & Nutbeam, 2000a). The education sector, on the other hand, has understood health more as one of a number of key learning areas and, in dealing with health, has focused on knowledge, understanding and cognitive skills. In practice, the school contribution to health is seen by schools as finding time in a crowded curriculum to develop knowledge and skills that will promote better learning and healthier approaches. In this way, schools have accepted their responsibility to respond to wider community health concerns but, like the principal in the above vignette, schools are aware of their limitations.

Extending health education beyond curriculum content

Health, as part of schooling, has been promoted since 1910. From that time, the focus of school health has gone through three phases:

1 health instruction (1910 to mid-1950s): where students were instructed to be fit (called physical culture), not use alcohol (temperance instruction), and have `pure thoughts'--the first foray into moral education;

2 health education (mid-1950s to 1980s): where emerging health knowledge was incorporated into the curriculum (particularly in the fields of nutrition and biological sexuality), and focused on classroom-based education with few formal links to the health sector; and

3 health promotion (early 1980s until the present): where health-related interventions in schools are incorporating the curriculum and include school-based policies and links to the local community. …

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