Schools and critical public health: towards dialogue, collaboration and action

For a field that generates so many research publications, school health is the focus of remarkably little critical scholarly analysis. This is a curious situation for many reasons, not least because so much of what does happen in schools is the subject of heated disagreement. The purpose of schools and the optimal methods for educating children are regularly the context for both healthy public debate and ideological warfare. With the possible exception of sex education, however, the health-related role of schools tends to slip peacefully under the radar. In fact, something of a becalmed consensus seems to pervade school health, leaving its many advocates and practitioners to go about their business largely untroubled by the kinds of probing questions which might seem worth asking. School health is a necessarily fuzzy term because of the huge variety of health-related activities schools have involved themselves in. In the late nineteenth and early twentieth centuries, they were the site of medical inspections and vaccination programmes across the Western world. In some contexts, this kind of intervention survives to the present day, as does the practice of compulsory physical education classes, another invention of the Victorian era. As Progressive ideas about the child and the purposes of education gathered converts, the twentieth century saw the health mission of schools expand to include, amongst other things, sexuality, physical fitness, nutrition, alcohol and mental health. In more recent decades, particularly but not only in Australia and New Zealand, officially sanctioned health education curricula – often combined with physical education have been developed (see Macdonald in this issue). This has happened at a time when the concept of health itself has broadened so that health education curricula can extend to include anything from relationships education, first aid, anger management and conflict resolution to water safety and self-esteem. ‘Official’ school health can also include responses to single issues that emerge from time to time, often fuelled by media attention. ‘Cyber bullying’, ‘sexting’ and young people’s use of social media more generally have recently become hot topics, prompting governments in a number of countries to draft policies and create resources aimed at responding to these concerns. Official health curricula, however, probably represent only a small fraction of the explicitly health-related activities that take place in schools. In many cases, schools instigate their own informal ‘in-house’ initiatives to meet a perceived need, such as breakfast programmes, healthy school canteen strategies or after-hours fitness classes. School health interventions are also created by a range of non-state actors and then offered to schools for free or sold for profit. For example, Powell’s (2014) article for this special edition describes the work of multinational food and soft drink companies to create their own health education resources in order to counter negative publicity about the contribution of their products to increasing childhood obesity. Organisations with medical, religious and a range of other agendas are also players in this complex space.