Early School Health

health schoolHorace Mann, elected secretary of the Massachusetts Board of Education in 1837, is cited as the first advocate for teaching health in schools (Cottrell, Girvan & McKenzie, 2002). In 1850, Lemuel Shattuck authored the Report on the Sanitary Commission of Massachusetts that offered a number of recommendations for improving the health of the public. Shattuck stated that: “…every child should be taught early in life, that to preserve his own life and his own health and the lives of others; is one of the most important and abiding duties. Everything connected with wealth, happiness, and long life depend upon health…” (pp.178-179).

During the late 19th and early 20th centuries a lack of national effort provided for awkward and inconsistent school health efforts (Cottrell et al, 2002). However, large numbers of World War I and II draftees rejected due to poor health caused the nation to reassess school health education, but as each crisis disappeared so did interest in providing school health education and services. In the 1960s the School Health Education Study exposed major problems in the organization and administration of school health programs (Sliepcevich, 1964). Whereas many advocated for school health education, utilization of schools as delivery mechanisms for health care services was not stressed.

During the 1980s the concepts of comprehensive school health programs and comprehensive school health education emerged (Cottrell et al, 2002). Comprehensive school health consists of “an organized set of policies, procedures, and activities designed to protect and promote the health and well being of students and staff which traditionally includes health services, healthful school environment, and health education” (Joint Committee on Health Education Terminology, 1991, p.181) and provides an alternate mechanism for the assurance function of public health. Whereas the potential of comprehensive school health programs has been advocated since 1987, it has rarely been realized (Cottrell et al, 2002). Reasons for this include a low priority on health by school administrations, lack of leadership, and adverse reactions from some community groups (Cottrell et al, 2002).