Health is not just the absence of disease – it is complete physical, mental, and social well-being. A school that effectively addresses students’ health will improve their ability to learn. A healthy school includes eight components that reflect the best supports possible for youth in schools and communities today.   They are:

•  Healthy School Climate/Culture

• Family and Community Involvement

• Counseling, Psychological, and Social Services (including attendance and discipline)

• Health Promotion for Faculty and Staff

• School Health Services

• School Nutrition Services

• Physical Education

• Skills-Based Health Education (Link to Navigate…)

These components have been proven to make a difference in the academic achievement of kids in schools and in their health behaviors and outcomes. Each component makes a unique contribution while complementing the others, ultimately creating a whole that is more than just the sum of its parts.  (Link to "Connecting Academic Achievement and Health: NYS Style")  The components encompass a school's student support services, instruction, and physical and social environments. Leadership, partnerships, and coordination within the school and community serve as the "glue" that holds the different pieces together to form a coherent whole. Because individuals, institutions, needs, and resources differ from community to community, variety is both necessary and expected.  Each setting will bring together a unique group of people and agencies to determine the specific needs facing young people in their schools and build on the many resources that are already in place to support youth youth in their academic and personal development.

1.   Healthy school environment: The physical, emotional, and social climate of the school. Designed to provide both a safe physical plant and a healthy, supportive and welcoming environment that fosters learning.

2.   Family and community involvement: Partnerships among schools, families, community groups, and individuals. Designed to maximize resources and expertise to address the healthy development of children, youth, and their families.

3.   Counseling, psychological, and social services: Activities that focus on cognitive, emotional, behavioral, and social needs of individuals, groups, and families. Designed to prevent and address problems, facilitate positive learning and healthy behavior, and enhance healthy development.

4.   Health promotion for school personnel: Assessment, education, and fitness activities for school faculty and staff. Designed to maintain and improve the health and well-being of school staff who serve as role models for the students.

5.   School health services: Preventive services, education, emergency care, referral, and management of acute and chronic health conditions. Designed to promote the health of students, identify and prevent health problems and injuries, and ensure appropriate care for students.

6.   School nutrition services: Integration of nutritious, affordable, and appealing meals; nutrition education; and an environment that promotes healthy eating habits for all children. Designed to maximize each child’s education and health potential for a lifetime.

7.   Physical education: Planned, sequential instruction that promotes lifelong physical activity. Designed to develop basic movement skills, sports skills, and physical fitness as well as to enhance mental, social, and emotional abilities.

8.   Skills-Based Health Education:  Classroom instruction that addresses the physical, mental, emotional, and social dimensions of health; promotes knowledge, attitudes, and skills; and is tailored to each age/developmental level. Designed to motivate and assist students in maintaining and improving their health and reducing their risk behaviors.
 

Action Steps

Healthy schools are not built in one fell swoop. They are the product of many smaller steps over the years. Taking specific action in selected areas can produce actions that are responsive to the needs of students in your school.

Action Steps for Implementing a Healthy School Environment

A school’s environment is the thread that connects the multitude of activities on a campus. In many respects this thread is almost invisible, yet everyone experiences its influence. Positive social relationships and attitudes about school are as important to the environment as are safe and well-kept buildings and grounds. A safe, clean, and well-maintained school with a positive psychosocial climate and culture can foster school connectedness, which in turn enhances student and staff health as well as students’ educational achievement.

A school’s physical environment includes the school building and related elements such as noise, temperature, and lighting, as well as physical, biological, or chemical agents. The psychosocial school environment encompasses the attitudes, feelings, and values of students and staff. Physical and psychological safety, positive interpersonal relationships, recognition of the needs and success of the individual, and support for learning are all part of the psychosocial environment. Other factors that can affect a school’s environment include:

• the economy; social, cultural, and religious influences;

• geography;

• socioeconomic status of the school community;

• local tax bases; and

• legal, political, and social institutions.

Creating a healthy school environment requires the involvement of virtually everyone in the school—students, administrators, support staff, teachers, custodial and maintenance staff, school counselors, school nurses, nutrition services workers. In addition, schools need involvement of families and community agencies - environmental, public health, public safety, public welfare, and other.

A school’s attention to the healthfulness of its environment will evolve and adapt to changing circumstances. Below you will find action steps and resources to help build a healthy school environment.

Action Steps for Schools

• Provide leadership and support for creating and sustaining a healthy school environment
• Establish a set of measurable goals and objectives and design activities around improving the school’s physical and psychosocial environment
• Develop and implement policies and a plan for creating and sustaining a healthy school environment that clearly define acceptable and unacceptable school conditions
• Help teachers develop activities for students that emphasize the importance of an overall healthy school environment
• Involve the parents and community about any school construction or renovation plans and/or policies regarding school safety
• Emphasize the importance of communication between teachers and students which includes issues of listening to feelings and physical ailments
• Empower students by involving them in planning, creating, and sustaining a school culture of safety and respect
• Evaluate healthy school activities periodically to assess progress toward achieving your goals and objectives and use results to revise, improve and strengthen your program

Action Steps for Families and Communities

• Identify stakeholders within the community who have an interest in creating and maintaining a safe and healthy school environment
• Promote the importance of overall health, well-being, and social competence among youth, especially youth at risk
• Write to newspapers, speak at school board meetings and policymakers about the health, academic and cost benefits a healthy school environment would provide
• Request parenting and student courses or workshops on communication skills, discipline, and building children’s self-esteem
• Volunteer to become the parent liaison to address school safety and building issues in your child’s school

Action Steps for Implementing Family and Community Involvement
in School Health

Supportive families and social support within communities contribute to students’ success. When children feel valued, they are more likely to develop healthy skills, avoid risky behaviors and remain in school. When parents are involved, students achieve more, regardless of socio-economic status, ethnic/racial background, or the parents’ education level. The more substantive the parent involvement, the higher the student achievement. Negative student behaviors, such as alcohol and substance abuse, violence, and antisocial behavior decrease as parent involvement increases. Students are less likely to succeed:

• when communities are economically deprived, disorganized, and lack opportunities for employment or youth involvement;
• when families do not set clear expectations, monitor children’s behavior, or model appropriate behaviors; and
• when schools present a negative climate and do not involve students and their families.

School-community partnerships have contributed to the success of school health programs across the country. Communities expect schools and families to prepare students to become healthy, productive citizens. Communities in turn have a responsibility to join with schools and families in support of efforts that can help achieve this goal. To be successful, school and community partnerships must: have clear, concise responsibilities and expectations for each participant; allow for flexibility in organization and implementation; acknowledge that partnerships require a time commitment and that initial gains may be small; and provide appropriate training for teachers, administrators, and community members.

The school, the family, and the community each has its own unique resources. Each can reach students in ways the others cannot. Each influences young people’s behaviors in different ways. Together, as partners in a coordinated school health program, they can provide an environment in which students can learn and mature successfully. Below you will find action steps and resources to help build family and community involvement.

Action Steps for Schools and School Districts

• Create a an environment in which parents feel valued and welcome, and that is culturally sensitive, including supportive mission and policy statements
• Outreach to encourage participation of parents who might have limited literacy skills and/or from whom English is a second language
• Involve parents and other family members in planning, curriculum and policy development, and decision making related to school health
• Disseminate information on school reforms, policies, discipline procedures, assessment tools, and school goals, and include parents in any related decision-making process
• Link parents to programs and resources within the community that provide support services to families; collaborate with community agencies to provide family support services and adult learning opportunities
• Encourage immediate contact between parents, teachers, principles, and other administrative staff when concerns arise
• Communicate with parents regarding positive student behavior and achievement, not just regarding misbehavior or failure
• Use creative forms of communication with families that make optimal use of new communication technologies
• Encourage parents and students to volunteer and provide ample training on volunteer procedures and school protocol
• Ensure that parents who are unable to volunteer in the school building are given options for helping other ways
• Enlist community volunteers from civic groups, service clubs, religious groups, seniors’ groups, and law enforcement
• Develop partnerships with local businesses and services groups to advance student learning and assist schools and families
• Survey parents regarding their interests, talents and availability, then coordinate the parent resources with needs that exist within the school and community.

Action Steps for Families and Students

• Encourage children's healthy behaviors by praising appropriate behaviors and acting as positive role models
• Cooperate with schools and others in the community to provide for children's physical and mental health services
• Learn about and reinforce the skills and messages in children's health and physical education curricula and, if uncomfortable with a message, discuss concerns with school decision makers
• Communicate with teachers and administrative staff regarding the child’s progress and behavior
• Use community resources that provide opportunities for children and other family members to engage in positive social and learning experiences
• Participate in any parenting skill courses that may be offered by the school and/or community groups
• Participate whenever possible in all decision-making regarding school polices
• Volunteer in the child’s school by joining the PTA, other parent organization, or parent advisory committees
• Vote in school board elections
• Distribute notices and handouts at markets, clinics, community centers, and religious institutions to inform families and other community members about health issues and to garner broader community support

Actions for Community Members

• Meet with school personnel to determine what support can be offered to advance the school's or district's health and academic objectives
• Infuse community-based school health services into the school’s overall school health plan
• Provide mentoring and after-school programs to give children safe havens from violence and alternatives to drugs
• Provide school-to-work programs that lead to college, technical training, or good jobs after high school
• Provide programs for parents that include academic classes, literacy training, career preparation, early childhood education, children’s health, and assistance in finding helpful services in the community
• Offer summer learning programs through cultural institutions, parks and recreation, and other public and private agencies; activities might include programs at recreation centers, science and art museums, and libraries
• Nurture relationships between schools and community organizations that can provide young people with needed physical and mental health services

Action Steps for Implementing School Counseling, Psychological,
and Social Services

Actions for Schools

• Revise the school's mission statement to include a comprehensive focus on addressing barriers to learning and enhancing healthy development
• Identify and analyze resources in the school and community
• Increase the amount of staff development devoted to strategies for addressing barriers to learning and enhancing healthy development

Action Steps for Implementing Health Promotion
for Faculty and Staff

Actions for Schools and Local Districts

• Develop school-site health promotion initiatives that go beyond individual-level risk reduction activities
• Improve methods for evaluating the health outcomes and cost effectiveness of worksite health promotion programs
• Address the well-being of administrators, faculty, and school support staff, including school bus drivers, food service workers, office staff, building custodians, and classroom aides
• Integrate health promotion and disease prevention into employee benefit plans and make such efforts compatible with the goals of managed care

Action Steps for Implementing School Health Services

For all students, health problems impair academic performance. Those students who experience health disparities also often experience education disparities. Some of the major health problems that confront American children and adolescents include overweight and obesity, asthma and other respiratory afflictions, HIV/AIDS, and psychosocial and behavioral disorders. Schools can meet these student needs by offering prompt and efficient on-site access to school-based health services. School health services include prevention education, screening, diagnostic, treatment, and health counseling services provided at the school. Such services are typically provided by school nurses

Below, you will find action steps to help you incorporate school-based health services into a school health program.

Actions for Schools and Communities

• Identify community and school resources, identify gaps, and develop action plans to improve health outcomes for students
• Ensure that schools employ professional healthcare personnel
• Develop strong school-community health partnerships with a health center, public health entity and/or hospital
• Solicit community input to address unmet health needs and support the operations of the program
• Encourage students’ active, age appropriate participation in decisions regarding health care and prevention services
• Involve parents as supportive participants in the student's health care
• Coordinate and integrate efforts with existing systems to optimize complementary programs, improve continuity of care, reduce fragmentation, prevent duplication, and maintain affordable services

Action steps were updated (2002) and adapted from the National Assembly on School-Based Health Care (NASBHC) resources.

Action Steps for Implementing School Nutrition Services

Everyone has a responsibility to promote good eating habits among school-aged children. With an increase in obesity, it is essential that schools become places for promoting healthy eating. Recent research shows that the number of overweight children aged 6 to 11 years has increased from 7% in 1976-1980 to 13% in 1999. Among adolescents aged 12 to 19 years it has increased from 5% to 14%.¹ These findings are important because obesity is linked to an increase in Type 2 diabetes, high blood pressure, high cholesterol, heart disease and stroke, certain types of cancers, and number of other illnesses.²

Today, it isn’t enough that schools provide students with proper nutritional guidance. Hungry, malnourished children have a harder time focusing on basic core subjects. Poor nutrition, combined with a lack of physical activity, can affect a child’s intellectual performance. School Breakfast Programs have been demonstrated to improve academic, behavioral and emotional functioning, and reduce tardiness and absenteeism.³ Thus, schools need to create an environment that allows for a child’s overall academic success; providing school meals can be one part of this solution.

Below, you will find action steps to incorporate healthy eating into a coordinated school health program and links to useful websites and documents.

¹Journal of School Health Vol. 71, No. 7, SHPPS 2000: School Health Policies and Programs Study
²Call to Action TEAM Nutrition
³Action for Healthy Kids Fact Sheet Nutrition, Physical Activity and Achievement

Actions for Schools and Districts

• Establish a school health or nutrition advisory committee to assess school nutrition needs and develop a strategic plan for addressing those needs
• Establish a school breakfast program to complement the school lunch program
• Implement nutrition education from preschool through secondary school as part of a sequential, comprehensive school health using engaging, interactive learning strategies
• Have counselors and school nurses provide information and support students on issues such as healthy body image, weight management and eating disorders
• Coordinate nutrition activities between food services staff and health and physical education teachers
• Involve families and community organizations in policy development and program planning to ensure that school meal options are culturally sensitive and special dietary needs are included
• Replace foods of minimal nutritional value in vending machines with more nutritional options
• Establish policies to limit access to vending machines, snack bars, school stores and other food outlets on school property
• Urge parent associations and student clubs to sell healthy foods or nonfood items for fund-raising activities
• Allow sufficient time for meals
• Provide students with adequate and pleasant dining space

Actions for Families and Communities

• A culturally appropriate, positive suggestions for nutritious foods to food service managers
• Advocate for courses in nutrition, health and physical education to school administrators and board members
• Encourage schools to offer and students to participate in the school lunch and breakfast program
• Urge parent associations and student clubs to sell healthy foods or nonfood items for fund-raising activities
• Practice healthy eating by eating with students to serve as role models in the school dining areas
• Provide students with a variety of nutritious foods if students bring bag lunches from home

Action steps were updated (2002) and adapted from the USDA's TEAM Nutrition Call to Action: Healthy School Nutrition Environments, Changing the Scene: Improving the School Nutrition Environment, Action for Healthy Kids' Fact Sheet: Nutrition, Physical Activity and Achievement, and CDC's Guidelines for School Health Programs to Promote Lifelong Healthy Eating

Action Steps for Implementing Physical Education

High-quality physical education programs are an integral part of any school health program. In childhood and adolescence, regular participation in physical activity helps prevent many chronic diseases and maintain an overall healthy lifestyle.¹ Unfortunately, many schools are decreasing the availability of physical education programs and daily recess. From 1991 to 1999, the percentage of students who attended daily physical education classes declined from 42% to 29%. The majority of high school students take physical education for only one year between 9^th and 12^th grades.² Currently, only 8% of elementary schools, 6% of middle/junior high schools, and 6% of senior high schools provide daily physical education, or its equivalent, for the entire school year.

With standards based achievement now mandatory for all schools, research shows that increased physical activity leads to higher test scores in math, reading and writing, increased concentration in class, and a decrease in disruptive behavior.³ This research reveals that schools need to be places where youth learn the benefits of and participate in a quality physical education program. Achieving this can be as simple as mandating daily recess periods and integrating extracurricular activities, such as after-school competitive sports, into school policy. Below you will find action steps and resources to help implement physical education. 

¹Journal of School Health Vol. 71, No. 7, SHPPS 2000: School Health Policies and Programs Study
²Action for Healthy Kids Fact Sheet Nutrition, Physical Activity and Achievement
³ Ibid

Actions for Schools

• Provide effective, enjoyable instructional programs of physical education, preferably daily, for all students, based on a curriculum consistent with national standards for physical education.
• Offer programs that meet the needs of special populations
• Ensure that physical education is taught by a qualified teacher with a degree in physical education
• Provide teachers with in-service training in physical activity promotion and coaches with appropriate coaching competencies
• Make sure indoor and outdoor facilities are adequate, clean, safe and open to students during non-school hours and vacations
• Develop and enforce policies that support physical education
• Create an environment that supports physical activity as part of a school health program
• Involve families and communities in the promotion of physical activity

Actions for Families and Communities

• Advocate for physical education classes and after-school programs that are attractive to all students by encouraging school administrators and board members to support activities that promote lifelong physical fitness, not just competitive sports
• Make sure the physical education program includes adequate student participation in practices and contests with no discrimination based on ability, gender or race
• Volunteer to help children's sports teams and recreation programs
• Ensure that physical facilities meet or exceed safety standards
• Work with schools, businesses, and community groups to ensure that low-income young people have transportation and appropriate equipment for physical activity programs
• Communicate with schools, teachers and coaches about appropriate physical education including competitive sports teams

Action steps were updated (2002) and adapted from the National Association for Sport & Physical Education It's Time for Your School's Physical Education Checkup: How Are You Doing? and CDC's School Health Program Guidelines Promoting Lifelong Physical Activity Amount Young People

Action Steps for Implementing Comprehensive School Health Education

Actions for Schools and Districts

To Strengthen Curriculum Planning and Development

• Increase community awareness of and support for comprehensive school health education
• Assess student health needs, interests, strengths, and cultures during curriculum planning
• Develop a plan for funding, selecting or developing, implementing, and assessing a comprehensive health education curriculum through a collaborative
• Review and revise school policies and enforcement strategies on a regular basis

To Facilitate Curriculum Implementation

• Provide adequate support for implementation
• Establish a system to ensure materials distribution, professional development, and student assessment
• Provide at least 50 hours of health education at every grade level
• Use information technologies in the health education curriculum
• Encourage team building and collaborative curriculum planning between health education teachers and their colleagues
• Implement a variety of strategies that foster family involvement

To Ensure that Teachers Are Adequately Prepared

• Select teachers who are academically prepared and qualified and can use active teaching and authentic assessment strategies
• Provide ongoing professional development opportunities and incentives for teachers, administrators, board members, and other staff responsible for implementation
• Provide follow-up booster sessions and ongoing technical assistance

To Assess and Evaluate Health Education