This article discusses health education in U.S. public schools. American health education aims to promote social, physical, intellectual, spiritual, environmental, and emotional wellness in its students. However, health education has increasingly become the responsibility of physical education teachers, either as a singular course (secondary education) or integrated into the elementary physical education curriculum. The coordinated school health programs model integrates the health education concepts into all aspects of a student's education. Not all teachers work in a school or district that utilizes the coordinated health program model and this presents challenges to teachers in how to integrate a health education curriculum that meets the National Standards for Health Education into the physical education curriculum without compromising a teacher who is aiming to meet the National Standards for Physical Education in his/her curriculum. It is suggested that teachers attend professional development opportunities to broaden their knowledge and develop ideas to creatively and effectively meeting these goals.
Keywords Health Education; Healthy Lifestyles; Lifestyle Choices; Physical Activity; Physical Education; Wellness; Dimensions of Wellness
Many Americans think of health simply as the absence of disease, but health education focuses on more of a wellness approach to educating students about a variety of health-related topics that are encompassed in the six dimensions of wellness The “dimensions of wellness are physical wellness, emotional wellness, intellectual wellness, spiritual wellness, interpersonal and social wellness, and environmental (or planetary or occupational) wellness” (Insel & Roth, 2006). These dimensions include the following health-related topics: mental and emotional health, personal health, prevention and control of disease, injury prevention, intimate relationships, consumer health, environmental health, family life, substance use and abuse, and community health. With these dimensions of wellness in mind, health or wellness can then be defined as the "ability to live life fully-with vitality and meaning" (Insel & Roth, 2006, p. 1). Health education is important because people need to understand how controllable factors can affect their health. For example, heart disease is the number one cause of death for both men and women in the United States and obesity is on the rise (CDC, 2007). In 2010, according to the Centers for Disease Control and Prevention, the adult obesity rate in the United States was over 35 percent; the percentage of adults who are overweight (which includes obesity) was over 69 percent. Also in 2010 over 18 percent of both children from the ages of six to eleven and adolescents from twelve to nineteen were obese. The threat of these diseases can be reduced by engaging in and making healthy lifestyle choices. The alarming rate in increase of overweight and obese children and adults is of major concern due to the multiple diseases and conditions that these individuals become more susceptible to, for example heart disease, hypertension, sleep apnea, stroke, Type 2 diabetes, some cancers, and osteoarthritis (CDC, 2007). With deaths attributed to these and other diseases, health education provides a venue for discussing and educating students about how to prevent, recognize symptoms, and understand treatment of these and other diseases. Health education provides students with the tools to make personal decisions about how to live their lives (Insel & Roth, 2006).
In general, health behaviors are learned during childhood (Cox, Mazzacco & Herauf, 2003). This is a critical time for children to learn positive health behaviors, including those that will decrease the risk of premature death and disabling disease (Cox, Mazzacco & Herauf, 2003). By incorporating health education into formal education early on, students begin to learn about healthy behaviors and choices while they are forming their own personal health habits. Generally, health is taught as a separate class at the middle school and high school level; however, physical education teachers, particularly at the elementary level, have become increasingly responsible for incorporating health education concepts into their physical education curriculum (Beighle, 2004). Nevertheless in districts with budgetary challenges, physical educators may be required to teach health education as a separate class in the secondary school setting (Larson, 2003).
Physical education teachers may or may not have been formally trained as health educators, which poses a challenge for these teachers in feeling competent to teach some of the health topics, particularly those not closely related to their academic training in physical education. Larson (2003) conducted research to examine physical education teachers' perceived readiness to teach K-12 health. Of the 229 physical education teachers that responded to the online survey, 78 teachers were also teaching health but only nine of these teachers had been formally trained in health education. Results of the study indicated that the respondents were confident teaching some of the topics required in health education including safety education, exercise, tobacco use, personal safety and nutrition, yet felt least prepared to teach death education, cancer, relationships, behavior change, stress management, consumer health, and sexual orientation (Larson, 2003). The results of this study support the notion that during professional preparation and/or professional development activities health education should be included in some capacity. Despite these challenges, school physical education programs provide a unique opportunity to influence health and well-being as well as to promote physical activity, teach skills, and form or change behaviors especially at the elementary level (Lambert, 2000).
In an effort to address health-related problems with American youth, the United States Department of Education put forward the concept of a Coordinated School Health Program (CSHP) in the 1980's (Johnson & Deshpande, 2000). The Department of Education recognized physical education and health education as the two essential components of the CSHP. When it was proposed in the 1980's, the focus was on providing students with knowledge, skills, and fun as compared to current goals of the CSHP, which now focus on the development of the health and wellness of the whole person (Johnson & Deshpande, 2000). Despite the legislation and programs that promote and teach health education and physical activity, research has provided evidence that participation in these educational programs do not necessarily protect youth from the risks that occur as a result of a sedentary lifestyle (Johnson & Deshpande, 2000), yet McKenzie and Richmond (1998) found that coordinated school health programs may help to reduce absenteeism, reduce classroom behavior problems, reduce the number of students and staff who smoke, reduce the rate of teen pregnancy, and improve academic performance, interest in healthy diets, and increased participation in physical activity. This evidence suggests that there needs to be a concerted effort on the part of the U.S. government, the U.S. Department of Education, state departments of education, and local school districts to provide students with physical education and health education curricula that are comprehensive and well-rounded (Johnson & Deshpande, 2000).
The American Association for Health Education (AAHE) is part of the American Association of Health, Physical Education, Recreation and Dance (AAHPERD) and has set forth eight National Standards for Health Education. These standards include the following; students will demonstrate the ability to:
- Comprehend concepts related to health promotion and disease prevention to enhance health;
- Analyze the influence of family, peers, culture, media, technology, and other factors on health behaviors;
- Access valid information and products and services to enhance health;
- Use interpersonal communication skills to avoid or reduce health risks;
- Use decision-making skills to enhance health;
- Use goal-setting skills to enhance health;
- Practice health-enhancing behaviors and avoid or reduce health risks; and
- Advocate for personal, family, and community health (AAHE, 2007).
Physical education classes provide a setting for teachers to incorporate content related to meeting the above standards alongside the National Standards for Physical Education. In schools where there is a...
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