Introduction of the national and international school health promotion approaches

Abstract

Background: The health status of the Hungarian population lags behind the developed EU member states. The losses of health are mainly attributed to the risks associated with behavior. The health behavior developed in childhood plays a key role in the improvement of population health. The aims of the paper are to present different school health promotion approaches and the exploration of causes behind the detectable conceptual differences of them. Furthermore new possible development directions are introduced and recommendations for professionals and policy makers. Method: Literature review was performed using national and international databases (MATARKA and PubMed, ScienceDirect, Cochrane Library). The literature research was conducted with the following keywords: school health promotion, health-promoting school, school interventions, organizational interventions, complexity, comprehensiveness, system. Results: Fundamental differences can be observed in the view of health promotion between the cutting edge countries and Hungary. While in our country, the health promotion operates isolated at the margin of health care, meanwhile in the states with more favorable health indicators (e.g. United Kingdom, Canada), the health promotion operates as a multi-stakeholder, intersectorial system. In the above mentioned countries the health promotion is regarded as a participative, coordinated, complex adaptive system which is integrated and embedded within the local community. According to other approaches the health behavior like unhealthy diet resulting in obesity is a complex problem and influenced by the culture. It may be assumed that the failures of the health promotion efforts like the obesity reducing are explain with some kind of „vicious cycle”: the culture in a given community is its own obstacle to change. Conclusions: Legal prescribing comprehensiveness for school health promotion alone is not sufficient for the effective implementation of health promotion activities in the public educational institutions in Hungary. However the school health promotion can be the opportunity for breaking the vicious cycle of changing the culture of health. Complex approach is needed for effective health promotion and for coordinated activities of the social actors at different levels. Community health planning prescribed by law at the district level provides opportunities for the implementation of the complex school-health promotion in Hungary.