Coordinated School Health

Coordinated School Health
Coordinated school health (CSH) is recommended by CDC as a strategy for improving students'
health and learning in our nation’s schools. This page outlines the rationale and goals for
coordinated school health and provides a model framework for planning.
Why Schools?
The healthy development of children and adolescents is influenced by many societal institutions.
After the family, the school is the primary institution responsible for the development of young
people in the United States.
Schools have direct contact with more than 95 percent of our nation’s young people aged
5–17 years, for about 6 hours a day, and for up to 13 critical years of their social,
psychological, physical, and intellectual development.
Schools play an important role in improving students’ health and social outcomes, as well
as promoting academic success.
Why School Health?
The health of young people is strongly linked to their academic success, and the academic success
of youth is strongly linked with their health. Thus, helping students stay healthy is a fundamental
part of the mission of schools. After all, schools cannot achieve their primary mission of education if
students and staff are not healthy.
Health-related factors, such as hunger, chronic illness, or physical and emotional abuse,
can lead to poor school performance.1
Health-risk behaviors such as substance use, violence, and physical inactivity are
consistently linked to academic failure and often affect students' school attendance, grades,
test scores, and ability to pay attention in class.2-4
The good news is that school health programs and policies may be one of the most efficient means
to prevent or reduce risk behaviors and prevent serious health problems among students.5 Effective
school health policies and programs may also help close the educational achievement gap.6
Framework for Coordinating School Health
CDC has proposed a framework7 for planning and coordinating school health activities. This
coordinated school health framework centers around eight critical, interrelated components:
Health education
Physical education
Health services
Mental health and social services
Nutrition services
Healthy and safe environment
Family and community involvement
Staff wellness
Individually, each of these components can contribute to students’ health and well-being. However,
when all of the individual components work together to support the adoption of health-enhancing
behaviors, students’ health and learning are improved.
Why Coordinate School Health?
School health programs and policies in the United States have resulted, in large part, from a wide
variety of federal, state and local mandates, regulations, initiatives, and funding streams. The
result, in many schools, is a “patchwork” of policies and programs with differing standards,
requirements, and populations to be served. In addition, the professionals who oversee the different
pieces of the patchwork come from multiple disciplines: education, nursing, social work, psychology,
nutrition, and school administration, each bringing specialized expertise, training, and approaches.
Coordinating the many parts of school health into a systematic approach can enable schools to
Eliminate gaps and reduce redundancies across the many initiatives and funding streams.
Build partnerships and teamwork among school health and education professionals in the
Build collaboration and enhance communication among public health, school health, and
other education and health professionals in the community.
Focus efforts on helping students engage in protective, health-enhancing behaviors and
avoid risk behaviors.
What are the Goals of School Health?
Ultimately, school health has four interrelated goals:
health knowledge, attitudes, and skills
health behaviors and health outcomes
educational outcomes
social outcomes
These goals are most effectively and efficiently achieved when all the goals are addressed
simultaneously through a coordinated approach.
Strategies for Schools and States
To help schools coordinate their school health activities and achieve their school health goals, CDC
has identified a series of strategies that schools can use to coordinate their school health activities
and achieve their school health goals.
In addition, because state-level support and guidance can be instrumental to the success of local
school health efforts, CDC has identified priority actions to support the development of effective
school health programs statewide.
Fact Sheets
The School Health Policies and Practices Study (SHPPS), the largest, most comprehensive
assessment of school health policies and practices in the United States, assesses the characteristics
of eight components of school health at the elementary, middle, and high school levels. The
following fact sheets about CSH are based on the findings of CDC’s School Health Policies and
Programs Study 2006:
Overview [pdf 250K]
School Health Coordination[pdf 230K]
Faculty and Staff Health Promotion [pdf 184K]
Family and Community Involvement [pdf 188K]
Health Education [pdf 169K]
Health Services [pdf 194K]
Mental Health and Social Services [pdf 187K]
Nutrition Services [pdf 148K]
Physical Education [pdf 181K]
Physical School Environment [pdf 187K]
National, State, and Local Programs
CDC provides funding for 22 state education agencies and one tribal government to help schools use
the CSH approach to promote physical activity and nutrition and prevent tobacco use among
Dunkle MC, Nash MA. Beyond the Health Room. Washington, DC: Council of Chief State School Officers,
Resource Center on Educational Equity; 1991.
Dewey JD. Reviewing the relationship between school factors and substance use for elementary, middle,
and high school students. Journal of Primary Prevention 1999;19(3):177–225.
Mandell DJ, Hill SL, Carter L, Brandon RN. The impact of substance use and violence/delinquency on
academic achievement for groups of middle and high school students in Washington. Seattle, WA:
Washington Kids Count, Human Services Policy Center, Evans School of Public Affairs, University of
Washington; 2002.
Shephard RJ. Habitual physical activity and academic performance. Nutrition Reviews 1996;54(4 Pt
Kolbe L. Education reform and the goals of modern school health programs. The State Education
Standard 2002;3(4):4–11.
Institute of Medicine. Schools and Health: Our Nation’s Investment. Washington, DC: National
Academies Press; 1997.
Allensworth DD, Kolbe LJ. The comprehensive school health program: Exploring an expanded concept. Journal of
School Health 1987;57(10):409–412.