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Health Curriculum Framework
Building Resilience Through Comprehensive Health

January 1996

Core Concept

Building Resilience

Building resilience in students is the shared responsibility of families, schools, and communities. The aim of teaching comprehensive school health education is to develop and nurture resilience, which is the ability to thrive, persevere, and maintain a positive attitude and healthy body. Resilient students are responsible, taking initiative and weighing risks carefully. They are adaptable and purposeful, even in the face of adversity. By beginning in the early years to educate and promote the well-being of all students, school health programs help them avoid future problems like substance abuse, sexually transmitted diseases, eating disorders, and school failure. Students learn how to develop and maintain their own physical wellness and personal relationships; they discover that health means much more than the absence of disease or the avoidance of danger. Making choices that promote health and well-being can make life more satisfying, productive, and rewarding.

A resilient student, and the adult that she or he will become, possesses problem-solving skills, social skills, autonomy, responsibility, and a sense of purpose and hope. A learner becomes resilient through a complex interaction of protective factors that may be found within the learner and peers, the family, the school, and community.1

A Classroom Snapshot

Ms. Kuan asks her first graders, "In what ways do other people help us to be healthy?" The discussion elicits a variety of responses: "I get shots at the clinic to keep from getting sick." "My dad packed my lunch today." "My big sister took me to the playground to learn how to shoot baskets, and we got lots of exercise." "My grandma holds my hand when we cross the street."

"You've thought of many ways that other people can help us to be safe and healthy," says Ms. Kuan. "They can help to protect us from getting sick or getting hurt. They can help us to eat well and get exercise. And they can help us feel better -- even our pets can do that. Each one of us needs some help from other people, and we can give help, too. When we all try to be helpful to each other, we are happier and healthier."

Students learn that a person's health is influenced not only by individual behavior, but also by interactions with family members, friends, and other community and environmental factors. Through comprehensive health education, schools help students to understand and demonstrate their individual, family, and civic responsibilities to act in ways that enhance health for themselves and others, both now and in the future.

The Massachusetts Common Core of Learning states that all students should:

  • Know basic concepts of human development, mental health, sexuality, parenting, physical education and fitness, nutrition, and disease prevention, and understand the implications of health habits for self and society;
  • Make informed and responsible judgments regarding personal health, including avoidance of violence, tobacco, alcohol, drugs, teen pregnancy, and sexually transmitted diseases;
  • Develop skills and participate in physical activities for personal growth, fitness, and enjoyment;
  • Manage money, balance competing priorities and interests, and allocate time among study, work, and recreation;
  • Know career options and the academic and occupational requirements needed for employment and economic independence;
  • Learn to resolve disagreements, reduce conflict, and prevent violence;
  • Treat others with respect and understand similarities and differences among people.

Comprehensive health education includes a broad range of content areas covering knowledge and skills in relationship to the home, school, community, and workplace. These content areas are described further in the Comprehensive Health Content section of this document. (See Figure 2, page 21.) These areas are:

  • community health
  • disease prevention and control
  • environmental health
  • family life
  • healthy relationships
  • mental and emotional health
  • nutrition
  • personal health
  • personal safety
  • physical activity and fitness
  • resource management
  • sexuality
  • tobacco, alcohol, and other drug use

Historical Context

Massachusetts has a tradition of leadership in comprehensive school health education. In 1763, the headmaster of Dummer Grammar School in Byfield "ardently supported" a physical activity program modeled on Benjamin Franklin's recommendations that schools establish physical exercise as one of the primary subjects in the curriculum. In the mid-1800s, state law required physiology and hygiene instruction for all students.

The Normal Institute of Physical Education founded in 1861 by physician and Boston School Committee member Dioclesian Lewis was among the first programs in the nation to prepare teachers of health and physical education. Similarly, Dudley Sargent's School of Physical Training, started in 1878 at Harvard University, graduated more than 7,000 health and physical education teachers who served schools nationwide.

Two alumni of Sargent's school, Luther Gulick and Thomas Wood, had a major influence on education. Both held degrees in physical education and medicine. Gulick went on to direct Physical Education at Springfield College and influence the development of the YMCA, the "play" movement in early education, and the teaching of physical education worldwide. In 1911, Wood organized the Joint Committee on Health Problems in Education. For more than twenty-five years, he chaired this collaboration of the National Education Association and the American Medical Association that laid the groundwork for health education in our nation's schools.

The first school health services in the United States were begun in Boston in 1894. In 1906, the nation's first School Health Law was passed by the Massachusetts Legislature.

Boston philanthropist Mary Hemenway played a key role in health education, physical education, and family and consumer sciences. With Amy Morris Homens, she organized the first national conference of the Association for the Advancement of Physical Education in 1889 at the Massachusetts Institute of Technology. Hemenway founded the Boston Normal School of Gymnastics, a school which became nationally famous for preparing teachers of health and physical education until it merged with Wellsley College in the 1930s. Hemenway also donated funds to start the program in family and consumer sciences (then home economics) at the institution that was to become Framingham State College.

In 1909, MIT Professor Ellen H. Richards founded the American Home Economics Association (now the American Association of Family and Consumer Sciences). During the early 1900s, home economics students were taught family and community health together with household management.

The (then) Harvard-MIT School of Public Health undertook the Malden Study in 1921, based on a pilot study in Somerville, "to see if the health habits of children could be influenced measurably." The longitudinal study, with experimental and control groups, followed students in grades 4-6 through succeeding grades, and concluded that "The health education program proves to be a sound, practicable and acceptable public school procedure. Definite improvement in health habits was shown."2

In 1922, Abagail Adams Eliot assumed directorship of the Ruggles Street Nursery School in Roxbury. Based on the public health model of British Infant Schools, its program was among the first to integrate health instruction. Eliot's innovation was to provide classes for families to learn about parenting, child development, and related health issues. Her concern for health education for children and families has meant its incorporation in state and national programs for which her school has served as a model; these include the Kaiser Corporation's preschools and Head Start.

In intervening decades, the Commonwealth has continued to provide many examples of leadership in school health education and services, physical education, and family and consumer sciences. Renewed collaboration between these disciplines builds comprehensive health programs that can help students and their families deal with current health challenges.

Current Challenges

Today's students face potential health problems due primarily to the social environment and behaviors that are largely preventable. According to the Centers for Disease Control and Prevention, the major health problems now facing our nation are primarily caused by six types of behavior:

  • tobacco use
  • alcohol and other drug use
  • behaviors that result in unintentional and intentional injuries
  • sexual behaviors that result in unintended pregnancy and sexually transmitted diseases, including HIV infection
  • dietary behavior, specifically the excessive consumption of fat and calories
  • insufficient physical activity.

Among adolescents there are increasing rates of pregnancy and sexually transmitted diseases. One fifth (20%) of all of the AIDS cases in the U.S. were diagnosed in individuals between twenty and twenty-nine years old; many of those became infected as teenagers.4

A recent survey of Massachusetts high school students noted that these behaviors are highly prevalent among youth in the Commonwealth.5 These interrelated behaviors are usually established during youth and persist into adulthood. Besides affecting health, these behaviors impair learning and teaching. Because they are also preventable, they warrant energetic intervention among young people.

Recent research documents the effectiveness of comprehensive health education in improving the health-related knowledge, attitudes, skills, and behaviors of elementary and secondary students dealing with current health problems.6 The Comprehensive Health Curriculum Framework, together with the Common Core of Learning, provides guidance to schools and communities as they help students to become healthy, resilient, and responsible citizens.

Last Updated: January 1, 1996
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