The Scottish Executive has set a target for all schools to be health promoting by 2007.
As it is important to reach as many people as possible with positive and relevant health messages, preferably before health problems occur, this model focuses on the social model of health as opposed to the medical model. Using health promotion measures is an effective way of tackling health issues and promoting positive well-being. Health promotion seeks to reduce health inequalities, challenge lifestyle and cultural norms and use preventative measures aimed at the well population. It can be instrumental in changing life circumstances and enabling people to learn, so that they can alter their lives positively.
Schools are perceived as ideal settings for promotion work on health issues, since they can target the vast majority of young people. Young people spend a large proportion of their lives at school, and so it is possible to raise awareness at an early age. This idea is reflected in the national targets set by the Scottish Executive in relation to improving young people’s health and lifestyles, covering the specific issues of physical activity; smoking; alcohol; sexual health; diet; oral health and emotional health and well-being.
Schools are therefore powerful players in the challenging area of tackling health issues at a local level, in relation to national targets. They are also well placed to begin tackling health inequalities, through the very nature of their educative and enabling role. The work in schools sits within a wider context of decreasing poverty and improving life circumstances. Although these are key targets from the Scottish Executive, the idea of the health promoting school goes beyond topic-based approaches towards a holistic model involving the whole school community. Using health promotion methods and philosophy, young people can be supported, enabled and empowered to engage with relevant health and lifestyle issues. By promoting positive health messages and ideas , schools can improve health and well-being and help to reduce health inequalities and Scottish health problems.
The History of the Health Promoting School
In 1995, the World Health Organisation (WHO) set out the broad definition of health promoting schools, which is still relevant today:
“A health promoting school is one in which all members of the school community work together to provide pupils with integrated and positive experiences and structures, which promote and protect health. This includes both the formal and the informal curriculum in health, the creation of a safe and healthy school environment, the provision of appropriate health services and the involvement of the family and wider community in efforts to promote health.” This was expanded the following year:
“A health promoting school can be characterised as a school that is constantly strengthening its capacity as a healthy setting for living, learning and working.” (Promoting Health Through Schools – The WHO Global School Health Initiative, WHO 1996)
The health promoting school approach is a way of thinking and working in which health is valued by the school community and considered holistically throughout all areas of the school, with the involvement of the whole school community.
Underpinning the health promoting school is the understanding that:
- health and learning are inextricably linked
- health is a resource for living and learning
- the promotion of both health and learning is core business for schools.
The approach is one that considers the broad (physical, emotional and social) health needs of all the entire school community. These health needs are addressed both collaboratively and comprehensively using a variety of strategies linked to the interrelated characteristics as proposed by the national framework Being Well – Doing Well (2004).
(Healthy Schools, 04)
In any development within a school, it is important to consider the aims and reasons behind the change. Consideration should be given here to the reasons for the development of the health promoting school scheme.
The health promoting school scheme in Scotland is embedded in the values and ethos created by the European Network of Health Promoting Schools. This network aims to develop the capacity of schools to be health promoting environments for staff and pupils, parents and communities.
This means that becoming a health promoting school is not merely about “doing” but about “being” – adjusting thinking, and developing values and principles core to the school community. The health promoting school is not a method for “health” messages to be taken on by “education”, but about all services recognising the school as an environment which impacts on the well-being of all.
Consideration of these underlying values means that it becomes clear why it is important to become a health promoting school. The emphasis moves away from activities or scores (the how to become a health promoting school) to the real aim of the movement.
The European Network cites the following as key in the development of any health promoting school:
- Democracy – that the school and its structures are democratic, involving everyone
- Equity – that there is an understanding of the importance of every person within the school community
- Empowerment and Action Competence – that the health promoting school should enable all members of the school community to realise their potential through being empowered and developing skills and knowledge
- Sustainability – that both the school and relevant departments make change and development which have a long-term view and can have a lasting impact.
Within the Quality Standards there are also key values and aims within a school which can again be translated into working practice within the health promoting school. These are that people are:
- able to achieve
All these values stem from developing individual and community mental health and well-being. Given that “there is no health without mental health” (1997 ), it is essential that positive emotional health and well-being lies at the core of all work schools do to become health promoting.
It is well evidenced that school can be a place of both risk and protective factors for mental health. Issues such as bullying, racism, poor physical environment and lack of pupil involvement in school development can all have a negative effect on young people’s emotional well-being. Conversely, feeling attached to school, positive peer groups, opportunities for praise, recognition of achievements and good pupil-staff relationships can all have a protective effect on emotional well-being.
School as an environment for both staff and pupils has a great impact on mental and emotional health. It is therefore important to introduce a set of core principles or values which will underlie all developments to make the school health promoting, and will act as a buffer to protect emotional well-being within the school environment.