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Schools that neglect health education could be ‘actively harming’ pupils

PSHE Pupil wellbeing
Academics have this week warned that the narrow focus on academia promoted by performance measures and government policy could be ‘actively harming’ young people’s health and wellbeing. Pete Henshaw reports.

Schooling in England is neglecting, and could be ‘actively harming’, the health and wellbeing of students, a group of academics has warned.

They argue that education policy is increasingly encouraging schools to “maximise academic attainment and ignore broad wellbeing, personal development and health”.

They have called for PSHE to be made a statutory subject and for “health education” to be integrated into the wider curriculum.

The claims come in an editorial written by academics from the Institute of Education, including Chris Bonell, professor of sociology and social policy, and Rona Campbell, professor of public health research, and published by the British Medical Journal.

The article cites evidence showing that a focus on health promotion, both explicit teaching and via the school environment, improves academic outcomes.

However, it claims that schools are neglecting this agenda because performance measures focus only on “a narrow range of academic subjects”. The academics also point to the fact that government targets and funding for the National Healthy Schools Programme have been dropped, as has the specific focus in Ofsted reports on how well schools promote health or personal development. 

They add: “PSHE remains a non-statutory subject, and schools spend less and less time teaching it because of pressure to focus on academic subjects.”

The editorial acknowledges concerns that making time for health and wellbeing will result in less time for academic learning and therefore lower attainment, but says that this suggestion is “deeply flawed”.

It states: “Research suggests that education and health are synergistic. Those who are well educated have better health and wellbeing. Students in better health have higher academic attainment.

“Multi-level studies suggest that schools where students do better academically than might be expected from their social profile also do better in terms of health.”

The academics say that many high-performing education systems, such as in Finland and Singapore, all place greater emphasis than schools in England do on students’ overall development and social and emotional learning: “This suggests that academic and broader development is not a zero-sum game,” they add.

“The clinching evidence comes from experimental studies, which suggest that programmes to promote students’ broader wellbeing and development also benefit their academic learning. 

“A systematic review of coordinated school health programmes, which aim to promote health through both explicit teaching in the curriculum and broader work to produce a healthier school environment, suggests that these programmes have positive effects on attainment.”

The academics also attack the idea that academic attainment is singularly crucial to economic competitiveness: “There is evidence that an effective labour force does not merely require cognitive skills gained from academic learning. Non-cognitive skills, such as resilience and team-working skills, are also needed, and productivity increases as workers’ health status improves.”

They go as far as to warn that an overly academic focus could be harming some students: “Some schools not only neglect students’ health but may actively harm it. A systematic review of all qualitative research in this area suggests that in school systems that focus on narrow academic metrics, such as those in England and the United States, some schools respond by focusing on the more able students, and not engaging other students or recognising their efforts.

“This is associated with many students, especially those from disadvantaged backgrounds, disengaging from school and instead investing in ‘anti-school’ peer groups and risk behaviours, such as smoking, taking drugs, and violence.

“Furthermore, research suggests that ‘teaching to the test’, which commonly occurs in school systems with a narrow focus on attainment, can harm students’ mental health.

“This all suggests that schools need to teach students not only academic knowledge and cognitive skills, but also the knowledge and skills they will need to promote their own mental and physical health, and successfully navigate the world of work.”

The editorial argues for a renewed focus on wider health education in schools, including PSHE activities as well as whole-school interventions, and that this should be supported by the upgrading of PSHE to a statutory subject: “Health education can be integrated into academic subjects and not taught only in PSHE lessons. Education policy could support health interventions by making PSHE a statutory subject, by mandating school inspectors to report specifically on health and personal development, and requiring schools to deploy evidence-based PSHE and health-promoting interventions to achieve ‘outstanding’ status overall.”

The full editorial is available at www.bmj.com/content/348/bmj.g3078

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