A comprehensive review of the evolution of school health worldwide: From traditional to modern approaches
Journal of Behdasht dar Arseh (i.e., Health in the Field),
Vol. 14 No. 1 (1405),
24 October 2026
,
Page 28-36
https://doi.org/10.22037/jhf.v14i1.51981
Abstract
Background and Aims: Schools have traditionally been important settings for health interventions. As understanding of the role of schools in promoting health has changed, school health has gradually moved from traditional approaches toward more comprehensive and health-focused models. This article reviews the development of school health worldwide and describes the main approaches that have emerged in recent decades.
Materials and Methods: This brief report was based on a review of relevant national and international literature, documents, and reports. The development of school health, major World Health Organization (WHO) programs, and current health-focused approaches in school settings were reviewed and discussed. Ethical principles were observed throughout the study.
Results: The reviewed literature shows that the concept of school health has undergone several stages of development. In the 1950s, schools were primarily considered settings for delivering health interventions. Over time, they came to be viewed as educational environments, social organizations, and, more recently, complex adaptive social systems. This change in perspective has influenced the structure, objectives, and implementation of school health programs worldwide.
Conclusion: Reviewing the development of school health helps clarify the foundations of current approaches in this field. With the reintroduction of the undergraduate School Health program in Iran, consideration of international experiences may support the further development of education, research, and planning in school health.
- School health
- Health Promotion
- World Health Organization
- Health-Promoting Schools
- Evolution
How to Cite
References
1- Keshavarz Mohammadi N. Complexity Science, Schools and Health: Applications for management of change in schools to promote health and education. Saarbrücken: LAP Lambert Academic Publishing; 2010.
2- O'Byrne D, Jones J, Yu SH, Macdonald H. WHO's global school health initiative. World Health 1996; 49(4):5–6.
3- Allensworth D, Lawson E, Nicholson L, Wyche J. Evolution of school health programs. In: Schools and Health: Our Nation's Investment. Washington (DC): National Academies Press; 1997. p. 33–80. https://doi.org/10.17226/5153
4- WHO. School health. Available from: https: // www. who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/adolescent-and-young-adult-health/school-health .
5- WHO. Promoting health through schools: Report of a WHO expert committee on comprehensive school health education and promotion: WHO technical report series N°870.Available from: https://www.who.int/publications/i/item/WHO-TRS-870
6- WHO. report of the technical meeting of building school partnership for health, education achievements and development. Vancouver, Canada, 5–8 June 2007. Geneva: World Health Organization; 2007.
7- WHO. Global standards for health promoting schools: Available from: https://www.who.int/docs/default-source/health-promoting-schools/global-standards-for-health-promoting-schools-who-unesco.pdf
8- Meng XD, Blum RW. School health services in the People's Republic of China. Journal of School Health 1990; 60(10):483–86.
9- Vilian C. In France, school health education. Hygie. 1984; 3(4):26–28.
10- Barker B. Values and practice: history teaching 1971–2001. Cambridge Journal of Education 2002; 32(1):61–72. https://doi.org/10.1080/03057640220116436
11- Langford R, Bonell C, Jones H, Pouliou T, Murphy S, Waters, et al. The World Health Organization's health promoting schools framework: A cochrane systematic review and meta-analysis. BMC Public Health 2015; 12(15):130. https://doi.org/10.1186/s12889-015-1360-y
13- Means RK. historical perspectives on school health. Thorofare (NJ): Charles B. Slack; 1975.
14- Wallace HM, Patrick K, Parcel GS, Igoe JB. The school health program: Historical perspectives and future prospects. In: Principles and Practices of Student Health. Oakland (CA): Third Party Publishing Company; 1992. p. 247–61.
15- Rosenstock L, Helsing K, Rimer BK. Public health education in the United States: Then and now. Public Health Reviews 2011; 33(1):39–65. https://doi.org/10.1007/BF03391620
16- Duffy J. School vaccination: the precursor to school medical inspection. Journal of the History of Medicine and Allied Sciences 1978; 33(3):344–55. https://doi.org/10.1093/jhmas/XXXIII.3.344
17- Lynagh M, Perkins J, Schofield M. An evidence-based approach to health promoting schools. Journal of School Health 2002; 72(7):300–302. https://doi.org/10.1111/j.1746-1561.2002.tb01337.x
18- Nutbeam D. The health promoting school: closing the gap between theory and practice. Health Promotion International 1992; 7(3):151–53.
19- Young I. Health promotion in schools: A historical perspective. Promotion & Education 2005; 12(3–4):112–17. https://doi.org/10.1177/10253823050120030103
20- WHO. Health Promoting Schools: A framework for action. Manila: WHO regional office for the western pacific; 2009.
21. Lee A, Lo A, Li Q, Keung V, Kwong A. Health promoting schools: An update. Applied health economics and health policy 2020; 18(5):605–23. https://doi.org/10.1007/s40258-020-00575-8
22- WHO. Report on the first regional conference on health promoting schools in the eastern mediterranean region. Damascus, Syrian Arab Republic, 3–5 September 2007. Cairo: WHO Regional Office for the Eastern Mediterranean; 2007.
23- Nader PR. The concept of "comprehensiveness" in the design and implementation of school health programs. Journal of School Health 1990; 60(4):133–38. https://doi.org/10.1111/j.1746-1561.1990.tb05422.x
24- Allensworth DD, Kolbe LJ. The comprehensive school health program: Exploring an expanded concept. Journal of School Health 1987; 57(10):409–12.
25- Joerger C, Hoffmann AM. FRESH: A comprehensive school health approach to achieve EFA. Paris: United Nations Educational, Scientific and Cultural Organization (UNESCO); 2002.
26- Jourdan D. Health, literacy and education in Persian speaking countries: Achievements, challenges and the link [Internet]. UNESCO Chair Global Health & Education; 2020 Nov 10 [cited 2026 Oct 14]. Available from: https://unescochair-ghe.org/health-and-education-in-persian-speaking-countries-achievements-challenges-and-the-link/
27- Pridmore P. Children as health educators: the child-to-child approach [dissertation]. London: Institute of Education, University of London; 1996.
28- Lal Monfared E, Ghased Qale Bala E, Kamel Khodabandeh A, Peyman N. Effect of education based on the theory of planned behavior on fruit and vegetable consumption among female students in the city Mashhad. Journal of Health in the Field 2025; 13(1):30–38 (In Persian). https://doi.org/10.22037/jhf.v13i1.47848
29- Eslamimehr F, Rakhshani F, Ramezankhani A, Khodakarim S. Assessment of an educational intervention effectiveness on promoting menstrual knowledge and related health behaviors in female high school students in Khamir city in 2015–2016. Journal of Health in the Field 2017; 5(1):53–62 (In Persian).
30- Keshavarz N, Nutbeam D, Rowling L, Khavarpour F. Schools as social complex adaptive systems: a new way to understand the challenges of introducing the health promoting schools concept. Social Science & Medicine. 2010; 70(10):1467–74. https://doi.org/10.1016/j.socscimed.2010.01.034
- Abstract Viewed: 25 times