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School Health


A Bridge Between Public Health and Health Care
Conceptual Framework and Definition

When the recent IOM Committee began to wrestle with the question of what exactly do we mean by comprehensive school health, it came up with four basic assumptions:

  1. The primary goal of schools is education.

  2. Education and health are linked. Educational outcomes are related to health status, and health outcomes are related to education.

  3. There are certain basic health needs of children and young people. These include: nurturing and support; timely and relevant health information, knowledge and skills necessary to adopt healthful behavior; and access to health care.

  4. The school has the potential to be a crucial part of the system to provide these basic health needs. Schools are where children and youth spend a significant amount of their time, and schools can reach entire families. However, the school is only part of the broader community system; the responsibility does not and should not fall only on the schools.

Traditionally, school health programs have included health services, health education, and the health environment of the school. Most frameworks include these elements, usually in more detail. Two formulations that have been frequently referred to include the CDC's eight-program components and the American Academy of Pediatrics' seven program goals. These are shown in below.

Table 1
Comprehensive School Health Programs

GOALS 1

COMPONENTS 2

1. Access to primary health care

1. Health education

2. System for crisis medical situations

2. Physical education

3. Provide mandated screening

3. Health services

4. Identification and solution of student health

4. Nutrition services

5. Comprehensive and appropriate health

5. Health promotion for staff

6. Healthful and safe school environment that
facilitates learning

6. Counseling, psychological, social
education services

7. Provide a system for evaluation of the school health program

7. Healthy school environment

 

8. Parent and community involvement

1. American Academy of Pediatrics. School Health, Policy and Practice. Elk Grove Village, 111; 1993.
2. Allensworth DD, and Kolbe LJ. The Comprehensive School Health Program: Exploring an expanded concept. J School Health 1987;57(10):409-411.

Most conceptual school health models reflect program factors. One, from the early 1990s, places the child more centrally, emphasizing that the school, community, and family/friends are three important systems influencing children's health status and their educational achievement. This model is shown in the Figure. Another model, also from the 1990s, regards the school as an institution that is a microcosm of society where students spend much of their developmental years. Key areas need to interact in order to provide a comprehensive school health program. The models are shown in the figures below.

Conceptual Models

Figure 2 
 

Figure 3 
  


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