The Role of Education in Health Promotion - examples from Health Promoting Schools

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The Role of Education in Health Promotion-
examples from Health Promoting Schools

• Bjarne Bruun Jensen
• Professor, Programme Director
• Research Programme for Environmental and Health
  Education
• Danish University of Education
• bjbj_at_dpu.dk

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The Settings Approach

• A very popular term a HP buzzword
• Starting point The Ottawa Charter
• Hospitals, prisons, cities, workplaces, islands,
  schools ..
• Few critical voices in the debate
• Keith Tones is the health educational component
  disappearing?
• Health Promotion Health Education x Health
  Policy
• Coherence between health education and health
  policy?
• A common value basis?

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Socio-cultural environment
Physical environment
Outcome
Health Education
Staffs Competencies
Collaboration school - community
Collaboration at the school
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Socio-cultural environment
Physical environment
Outcome
Collaboration school - community
Collaboration at the school
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Socio-cultural environment
Physical environment
Outcome
Health Education
Staffs Competencies
Collaboration school - community
Collaboration at the school
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- Example Health Promoting Schools (HPS)

• Ottawa (WHO 1986)
• Health is created and lived by people within
  the settings of their everyday life where they
  learn, work, play and love
• Enabling people to improve their health
  satisfy their needs change or cope with the
  environment
• First conference resolution of European HPS (WHO
  1997)
• Empowerment and Action Competence HPS improves
  young people abilities to take action and
  generate change achieved through policies and
  practices, which provide opportunities for
  participation and critical decision-making
• HPS in Denmark
• Develop pupils action competence to influence
  their living conditions and lifestyle through
  participatory and action-oriented education
  approaches

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Trends in Participation- developments in HPS

• Top down approach dominated by experts
• Bottom up approach dominated by the target
  groups
• Dialogue approach the content and the
  professional has an important role to play

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Participation - in Relation to What? and How?
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Different Forms of Actions
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The IVAC approach

• Investigation
• why is it important to us?
• do lifestyle and living conditions make an
  influence?
• how was it in former times and how has it change?
• Visions
• what alternatives can we imagine?
• how are the conditions in other countries and
  cultures?
• what do we prefer and why?
• Actions Change
• what changes will bring us closer to the visions?
• changes in our own life, in the class, in the
  society?
• what action possibilities exist in order to reach
  the changes?
• which actions will we carry out?

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Example 1 Social inequality in health

• A research and development project involving
  schools, teacher education institutions and the
  Danish University of Education
• Financial support from the Ministry of Health
• Starting point
• Inequality in health is caused by a
  multifactorial network of factors in the society
• Consequently, it is naive to believe that schools
  are able to solve the problem of inequality in
  health

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Health and equalityThe contribution from HPS?

• Four areas (key questions) have been identified
• Which socio-cultural environment supports all
  students?
• What kind of teaching and learning approach
  improves the competencies of all students at
  school?
• How can inequality in health be dealt with as
  content in schools teaching (as part of the
  taught curriculum)?
• What kind of stakeholders in the local community
  can collaborate with the school and in which
  ways?

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What is young peoples understanding of
inequality in health?
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Does inequality in health exist in our society?
(3.660, 13-15 years old)

• In our society there are differences between
  different peoples health risks
• Totally agree/agree 96
• Totally disagree/disagree 4
• According to your opinion, is it important
  that all people in our society have the same
  possibilities to live a healthy life?
• Very important/important 97
• Not important at all/not important 3

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Inequality in health - why? (3.660, 13-15 years
old)

• Social and structural causes dominating
• Homeless/rich
• Worksite environment and social class
• It has something to do with rich or poor,
  popular or unpopular
• If you live in a big city the risks of getting
  ill are greater
• Poor public hospital. Rich private hospital

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Health and equality as content?

• Inequality in health has been integrated into
  the national curriculum guide for Health
  Education (Danish Ministry of Education 2005)
• As part of Health Education in schools students
  have to develop their visions of a society with
  less inequality in health!
• The idea is that all students have to make a
  contribution to the development of a society with
  less inequality in health - now and in the future
  
• The survey shows they are ready to do so!
• Will we allow them to?

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Actions
Socio-cultural environment
Physical environment
Pupils - empowerment - action competence
Health Education - participatory -
action-oriented
Staffs pedagogical competencies
Collaboration school - community
Collaboration at the school
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Example 2 School health policies

• Starting point the municipality developed a
  policy for nutrition at the public institutions
• The school debated the policy among students,
  staff and parents and several teaching projects
  were carried out
• They (teachers, students and parents) agreed to
  change the policy towards a policy on food and
  meals at the school
• They decided a number of things, e.g.
• - longer lunch breaks
• - focus on the social dimension of the lunch
  break
• - quality criteria for education on food and
  meals
• - the meals and food policy will continuously be
  discussed and revised

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A comprehensive concept of food as framework for
teaching and education
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Actions
Socio-cultural environment
Physical environment
Pupils - empowerment - action competence
Health Education - participatory -
action-oriented
Staffs pedagogical competencies
Collaboration school - community
Collaboration at the school
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Example 3 Indicators for a HPS

• A current project within the European network of
  HPS
• Indicators need to reflect the different
  components of a HPS
• All indicators need to build on the same values
  (comprehensiveness)
• Consequently, outcome indicator should always
  be linked to process indicators and they all
  have to reflect the overall aim of a HPS

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Conclusion

• Health Education is a key component in the HPS
• Health Education and the context have to be
  developed and assessed within the same value
  framework
• A given value framework will always reflect basic
  notions related to democracy and the role of a
  school in a democratic society