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Definition of Terms
About School Health Promotion
The World Health Organization describes Health promoting schools as follows:
A health promoting school can be characterized as a school constantly strengthening its capacity as a healthy setting for living, learning and working. Towards this goal, a health promoting school engages health and education officials, teachers, students, parents and community leaders in efforts to promote health. It fosters health and learning with all the measures at its disposal, and strives to provide supportive environments for health and a range of key school health education and promotion programs and services. A health promoting school implements policies, practices and other measures that respect an individual’s self esteem, provide multiple opportunities for success, and acknowledge good efforts and intentions as well as personal achievements. It strives to improve the health of school personnel, families and community members as well as students, and works with community leaders to help them understand how the community contributes to health and education.
The term health promoting school (used in Europe, Asia-Pacific, Latin America) has become synonymous with similar terms such as coordinated school health programs, healthy schools, school health promotion, and comprehensive school health that are used in North America. All of these terms now signify a comprehensive approach by several agencies and educators to promote the health, social development and educational achievement of students through the school as a key setting in the community. This comprehensive approach integrates the responses to linked health/social behaviours and factors. These leads to coordinated school health programs that are delivered through community-agency-school and whole school strategies. The result is a health-promoting school that promotes health, socual development and learning more effectively.
Similar Historical Developments around the World
Schools have long been viewed as important settings for promoting the health and social development of children. In many countries, the first public schools were often established by churches, charities and other to socialize and take care of the children whose parents had moved into cities during industrialization. Later, health education was introduced in schools, driven primarily by the medical professions to prevent various diseases. The school was, and still is, seen by many as a receptacle for health messages, materials and prevention programs with a captive audience of young people.
Consequently, there is a wide variety of issue-specific and narrowly framed approaches to school health promotion come, stay or go across the educational landscape. Active schools, drug-free schools and safe schools are just three examples of approaches developed in response to health and social problems. Interestingly, these health driven models developed separately from models derived from the human services sector such as community schools or full-service schools. The education sector also developed their own holistic models, including effective schools and learning communities.
Another approach, which combined teaching and learning with the delivery of preventive health services and measures to maintain a healthy physical and social environment in the school, emerged in Europe and North America in the 1980s and 1990s (Allensworth & Kolbe, 1987; Young & Williams, 1989). This multi-faceted approach gained impetus from the emerging, concepts and principles about health promotion that were reflected in the Ottawa Charter (World Health Organization, 1984; World Health Organization, 1986).
This concept of school-based and school-linked health promotion evolved along similar, yet slightly different paths on five continents. In Europe it was called the health promoting school (Young & Williams, 1989). With the support of the European Commission and the Council of Europe, the European Network for Health Promotion Schools (ENHPS) was established and is now present in over 43 countries in the region.
In North America, the concept of Comprehensive School Health Education was used widely in the 1980s denoting a curriculum-focused approach. This was broadened in the 1990s to a comprehensive approach (addressing multiple health issues, by multiple agencies at multiple levels) through the delivery of coordinated school health programs (Kolbe 1993, World Health Organization, 1991).
The Western Pacific Region of the WHO developed ‘Guidelines for Health Promoting Schools’ for its 32 member states in 1995 (WHO, 1996). Developments similar to these have fostered Health Promoting Schools (HPS) and Coordinated School Health (CSH) in Latin America, North America, South America, the Middle East, Asia and Africa.
Lingering Confusion about Terms
However, there is still confusion about what school health promotion, which has major implications for assessing its effectiveness as well as implementing sustainable programs. The WHO Expert Committee (1997) noted some confusion with the concept. Is it an outcome (a healthy school), a comprehensive approach (emphasis on different agencies working together to address all health issues at all levels), a set of values (based on a holistic view of health and well-being), an issue-specific prevention program (coordinated interventions to prevent one problem) or a coordinated set of programs and services (to address several health problems or to promote health in general)? Clearly, each of these perspectives led to different measures of success and different strategies.
More recently, as the evidence about effective and sustainable policies and programs in both health promotion and the education sector has accumulated, our attention is turning to a more ecological understanding of the school setting. This understanding recognizes the need to build capacity in the systems, agencies and professions that deliver school health programs. This also leads to a greater recognition that the core business of schooling is learning, not health, so we cannot view the school as simply a convenient recipient of health messages and materials.
Research and policy attention is now focusing more clearly on diffusion of innovations, systems capacities/characteristics/change and the inherent non-linear complexity in real-life situations, where family characteristics, individual traits and the community context interact with the school environment to promote or hinder healthy development. This recognition leads to policies and programs that are iterative rather than directive and to research/evaluation that is multi-layered rather than the controlled (and often non-sustainable) trials of the past.
The World Health Organization describes Health promoting schools as follows:
A health promoting school can be characterized as a school constantly strengthening its capacity as a healthy setting for living, learning and working. Towards this goal, a health promoting school engages health and education officials, teachers, students, parents and community leaders in efforts to promote health. It fosters health and learning with all the measures at its disposal, and strives to provide supportive environments for health and a range of key school health education and promotion programs and services. A health promoting school implements policies, practices and other measures that respect an individual’s self esteem, provide multiple opportunities for success, and acknowledge good efforts and intentions as well as personal achievements. It strives to improve the health of school personnel, families and community members as well as students, and works with community leaders to help them understand how the community contributes to health and education.
The term health promoting school (used in Europe, Asia-Pacific, Latin America) has become synonymous with similar terms such as coordinated school health programs, healthy schools, school health promotion, and comprehensive school health that are used in North America. All of these terms now signify a comprehensive approach by several agencies and educators to promote the health, social development and educational achievement of students through the school as a key setting in the community. This comprehensive approach integrates the responses to linked health/social behaviours and factors. These leads to coordinated school health programs that are delivered through community-agency-school and whole school strategies. The result is a health-promoting school that promotes health, socual development and learning more effectively.
Similar Historical Developments around the World
Schools have long been viewed as important settings for promoting the health and social development of children. In many countries, the first public schools were often established by churches, charities and other to socialize and take care of the children whose parents had moved into cities during industrialization. Later, health education was introduced in schools, driven primarily by the medical professions to prevent various diseases. The school was, and still is, seen by many as a receptacle for health messages, materials and prevention programs with a captive audience of young people.
Consequently, there is a wide variety of issue-specific and narrowly framed approaches to school health promotion come, stay or go across the educational landscape. Active schools, drug-free schools and safe schools are just three examples of approaches developed in response to health and social problems. Interestingly, these health driven models developed separately from models derived from the human services sector such as community schools or full-service schools. The education sector also developed their own holistic models, including effective schools and learning communities.
Another approach, which combined teaching and learning with the delivery of preventive health services and measures to maintain a healthy physical and social environment in the school, emerged in Europe and North America in the 1980s and 1990s (Allensworth & Kolbe, 1987; Young & Williams, 1989). This multi-faceted approach gained impetus from the emerging, concepts and principles about health promotion that were reflected in the Ottawa Charter (World Health Organization, 1984; World Health Organization, 1986).
This concept of school-based and school-linked health promotion evolved along similar, yet slightly different paths on five continents. In Europe it was called the health promoting school (Young & Williams, 1989). With the support of the European Commission and the Council of Europe, the European Network for Health Promotion Schools (ENHPS) was established and is now present in over 43 countries in the region.
In North America, the concept of Comprehensive School Health Education was used widely in the 1980s denoting a curriculum-focused approach. This was broadened in the 1990s to a comprehensive approach (addressing multiple health issues, by multiple agencies at multiple levels) through the delivery of coordinated school health programs (Kolbe 1993, World Health Organization, 1991).
The Western Pacific Region of the WHO developed ‘Guidelines for Health Promoting Schools’ for its 32 member states in 1995 (WHO, 1996). Developments similar to these have fostered Health Promoting Schools (HPS) and Coordinated School Health (CSH) in Latin America, North America, South America, the Middle East, Asia and Africa.
Lingering Confusion about Terms
However, there is still confusion about what school health promotion, which has major implications for assessing its effectiveness as well as implementing sustainable programs. The WHO Expert Committee (1997) noted some confusion with the concept. Is it an outcome (a healthy school), a comprehensive approach (emphasis on different agencies working together to address all health issues at all levels), a set of values (based on a holistic view of health and well-being), an issue-specific prevention program (coordinated interventions to prevent one problem) or a coordinated set of programs and services (to address several health problems or to promote health in general)? Clearly, each of these perspectives led to different measures of success and different strategies.
More recently, as the evidence about effective and sustainable policies and programs in both health promotion and the education sector has accumulated, our attention is turning to a more ecological understanding of the school setting. This understanding recognizes the need to build capacity in the systems, agencies and professions that deliver school health programs. This also leads to a greater recognition that the core business of schooling is learning, not health, so we cannot view the school as simply a convenient recipient of health messages and materials.
Research and policy attention is now focusing more clearly on diffusion of innovations, systems capacities/characteristics/change and the inherent non-linear complexity in real-life situations, where family characteristics, individual traits and the community context interact with the school environment to promote or hinder healthy development. This recognition leads to policies and programs that are iterative rather than directive and to research/evaluation that is multi-layered rather than the controlled (and often non-sustainable) trials of the past.
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