Health Education Research, Vol. 19, No. 1, 85-97,
February 1, 2004
© 2004 Oxford University Press
Health rights in secondary schools: student and staff perspectives
1 Children’s Issues Centre and 2 Faculty of Education, University of Otago, Dunedin 9001, New Zealand 3 Correspondence to: A. B. Smith; e-mail: anneb.smith{at}stonebow.otago.ac.nz
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This paper examines the perspectives of secondary school students and staff about the extent to which young people’s health rights are catered for at school. The United Nations Convention on the Rights of the Child and the concept of Health-Promoting Schools encourage the provision of healthy school environments. A postal survey of secondary schools in New Zealand elicited responses from 821 Year 11 (15–16 year olds) students and 438 staff in 107 schools. Most students and staff reported that sources of health advice were available at their schools, but only a minority of students saw these sources as accessible or trustworthy. In every area of health promotion, students saw information and advice as less accessible than staff did. Most staff and students identified mental health problems such as depression as a source of concern in schools, but only a quarter of students (compared to half of staff) thought that this topic was covered during classtime. Students in lower-income schools reported the school environment as slightly less healthy than did students in high-income schools. The paper concludes that schools and policy makers should seek the voices and opinions of young people in order to improve effectiveness in catering for health rights.
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Introduction |
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This study reports on secondary student and staff perceptions on whether young people’s health rights are catered for at school. The project is part of a wider investigation of constructions of four rights of children [the United Nations Convention on the Rights of the Child (UNCROC) defines a child as aged from birth to 18 years of age] at school—participation, safety, recreation and health. In this paper we focus on children’s right to a healthy school environment. [While we acknowledge that safety and physical integrity is also implicit in health, we have reported on this issue separately (Nairn and Smith, 2002, 2003
)].
According to Hartrick et al., contemporary views of health have evolved away from predominantly disease-treatment models to those characterized by understanding health as ‘deeply rooted in human nature and societal structures’ [(Hartrick et al., 1994), p. 85]. The implications for health and education professionals is that health promotion is embedded in everyday activities and interactions (including those at school). Hartrick et al. argue that ‘health promotion includes effective and concrete public participation where people are active agents and decision makers, as opposed to consumers of a service provided by health professionals’ [(Hartrick et al., 1994), p. 86].
That schools can play a major role in promoting health is recognized by the WHO (WHO, 1997) in its Health-Promoting Schools (HPS) initiatives (Nader, 2000). HPS are centered on a holistic idea of health and wellness within the context of everyday life and community, rather than sickness or services for sick people (Raeburn and Rootman, 1998). HPS initiatives take advantage of the opportunity offered by students and staff being at school for a large proportion of their time, when young people are at a stage in their lives when they are amenable to long-term influences on their health and lifestyle. Other principles of HPS include an emphasis on equity of access, empowerment through the development of knowledge and skills, and links with families and the wider community (Booth and Samdal, 1997). The taught curriculum and school ethos (physical environment, social relationships, organization and daily activities at school) are two important aspects of schools as an environment for health promotion.
That schools can play a major role in promoting health is recognized in the New Zealand Health and Physical Education curriculum [(Ministry of Education, 1999), p. 6], which is underpinned by the concepts of well-being and health promotion. The first aim of the curriculum is to:
...develop the knowledge, understandings, skills and attitudes needed to maintain and enhance personal health and physical development’ and the fourth aim is ‘participating in creating healthy communities and environments by taking responsible and critical action. [(Ministry of Education, 1999
A participatory model of health promotion (Hartrick et al., 1994; Morrow, 2001), suggests we should examine how school students and staff construct their school environment in terms of its health promotion properties. Such a participatory perspective sits well alongside our previous research [e.g. (Smith et al., 2000)] which has integrated sociology of childhood, children’s rights and sociocultural frameworks. All of these theoretical perspectives emphasize children’s agency within their everyday lives and cultural contexts.
Sociocultural theory suggests that children construct their understanding jointly through their activities in communication with others (Bruner and Haste, 1987; Rogoff, 1995; Smith, 2002). Specific contexts and participants need to be studied, because development is embedded in and shaped by the social interactions of daily life, social institutions and historical events. The school is a powerful setting where enacted roles, activities and relationships influence the well-being of young people. The use of both adults’ and young people’s voices in this study balances young people’s agency against their dependency, and recognizes that young people construct their understanding jointly in a context largely controlled by adults.
Children and young people have been re-conceptualized in the sociology of childhood theory as citizens, equal in value to adults, with a voice to be listened to, and specific viewpoints on their own well-being, and the institutions and the social groups with which they interact (Jenks, 1996; Mayall, 1996, 2000; Prout and James, 1997; Smith et al., 2000). Previous studies of childhood emphasize an external view of children’s behaviour, knowledge and competency, the importance of socialization and environmental influences, and what children will become rather than how they experience the world now. According to this view children and young people are seen as vulnerable, in need of protection, lacking in competence, having their lives shaped by adult determination, and as an invisible and excluded group neglected by the social sciences, just as women were until 10 years ago (Oakley, 1994; Morrow and Richards, 1996). Sociologists of childhood, in contrast, perceive children as competent social actors who can provide valuable insights into their own experience.
The other important framework for this research is the UNCROC, particularly Article 24 (although health constructs are reflected in many other articles), which states that children and young people have a right to a high standard of health and facilities for the treatment of illness. Article 24 places special emphasis on the provision of primary and preventative health care and public health education. UNCROC was ratified by New Zealand in 1993, and is an important international document which has encouraged a variety of initiatives to develop indicators and monitor the rights of children (Qvortrup et al., 1994; Cohen and Hart, 1996; Ennew and Miljeteig, 1996; Hodgkin and Newell, 1996; Fanjoy and Sullivan, 1997).
UNCROC, however, has been used very little in the education or health sectors in New Zealand, even though it is a helpful tool for evaluating the quality of children and young people’s everyday environments. Within the health sector the Ottawa Charter for Health Promotion has been more prominent. This programme was developed in the WHO in 1986 as a means of supporting strategies for health promotion (Ministry of Health, 1998). Researchers and policy makers can, however, make good use of the standards set by UNCROC, and its authority as an almost universally accepted document, to empower children and optimize their well-being (Freeman, 1996).
Our research uses Article 24 as one basis for examining children’s rights in school environments, from the perspective of students and staff. Article 2 in the Convention emphasizes that all of the rights in the Convention are for all children irrespective of status. Hence it is important that all schools, regardless of the characteristics of the children and young people they serve, should cater for children’s rights.
There is currently widespread concern about how the well-being of children and young people has been affected by social and economic changes, and whether appropriate resources, practices and policies are in place to promote children’s well-being (Atwool, 1999; Wood and Blaiklock, 1999; Smith et al., 2000). Davey [(Davey, 1998), p. 101] identifies the main threats to the health and well-being of New Zealand 15–24 year olds as:
...mainly psycho-social and behavioral—mental and sexual health, drug and alcohol problems, accidents and injuries. Many young people are not accessing health services in these areas because they are seen as unwelcoming, unsuitable or inappropriate.
It is impossible to separate physical, psycho-social and emotional well-being at school, and academic achievement, since health is closely related to achievement (Peterson et al., 2001). The main focus of schools has been to teach academic skills (Thrupp, 1999), but the most effective schools overall are likely to be those which foster young people’s sense of belonging, connection and participation, and cater for their physical well-being (Wilcockson, 1996; Maeroff, 1998; Tasker, 1998; Thomson, 1999). Powney et al. [(Powney et al., 2000), p. 7] found that health was an important influence on school attainment throughout a child’s life, from before birth to the end of schooling. Some schools have, in accord with this view, moved to a ‘full service’ arrangement whereby they act as the coordinating site for a range of health services for students and the wider community (Lugg and Boyd, 1993; Boyd et al., 1997).
Schools in New Zealand in the 1990s became increasingly polarized according to income as a result of the marketization of education (Lauder et al., 1999). The introduction of educational markets in New Zealand in the late 1980s and early 1990s meant that schools had to compete against each other to attract students. Education became a commodity to be marketed on the assumption that parents would make rational choices about schools based on market information and performance. It was wrongly assumed in the market model that parents from different cultural and social backgrounds had equal knowledge and means to act on that knowledge, so that all would be able to access good schools for their children. Schools that did not perform in the marketplace were expected to lose consumers and be eliminated, while schools which did perform would be stronger and survive. Lauder et al. (Lauder et al., 1999) found that young people from lower income families became less likely to access high performing schools, with consequent adverse effects on their achievement. The present study looks at whether school environments also differ according to family income in the degree to which they support health and young people’s health rights.
The underlying issue is whether schools can make a positive difference in the lives of young people who come from low-income families or do they simply act as an agent of social polarization? The optimistic view is that schools can and do make a difference, and can help to build social capital for children from low-income backgrounds whose family contexts cannot provide this support (Maeroff, 1998; Thomson, 1999). Social capital involves trust, reciprocal support, civic engagement, community identity and social networks [Putnam, cited by (Morrow, 2001)], and is usually provided through a ‘set of familial and age-peer resources’ [(Nash, 1999), p. 267]. Nash’s (Nash, 1999) research suggests that schools exacerbate rather than ameliorate the differences in social capital that are influenced by family income.
The present study investigates how Year 11 students in secondary schools, and staff in the same schools, construct support for young people’s health rights in school, and what barriers and supports they perceive to attainment of rights to a healthy environment. Whether or not the health of school environments (as judged by students) was related to the socioeconomic status or decile of the school was also explored. [Schools in New Zealand are divided into 10 decile groups according to the socioeconomic status of children’s families from 1 (lowest) to 10 (highest).]
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A postal survey was targeted at a sample of students (10 Year 11 students from each secondary school, aged 15–16) and staff working in schools (five from each school including a senior administrator, teachers, and health professionals such as school nurses and counselors). (The postal survey is the first phase of the complete project. The second phase of the study is a more in-depth ethnographic study in four case-study schools.) A letter was sent to all 449 New Zealand secondary and composite schools in September 1999 and a total of 107 schools from across New Zealand agreed to participate. The sample included 76 co-educational, 22 girls’ schools, nine boys’ schools; four 4 private, 16 integrated and 87 state schools; schools in rural and urban settings. The mean decile rating was 5.95 and the median 6, so there were slightly more high- than low-decile schools. (There were 45 schools with deciles 5 or lower and 52 schools with deciles 6 or higher.)
The 821 students who participated consisted of 469 girls (57.1%) and 350 boys (42.6%). (Two students did not specify their gender.) Of the participants, 635 (77.3%) were Pakeha (New Zealanders of European origin), 121 were Maori (14.7%) and 60 of other ethnic origin (7.3%). Of the 438 staff who participated in the survey, 411 (94%) were Pakeha, 14 (3%) were Maori and 11 (2.5%) were of other ethnic origin. There were 253 (58%) females and 181 (41%) males. Just over half (53%) of the adult participants were teachers, 25% were senior administrative staff (principals, deputy principals, heads of departments and deans), 19% were counselors, 6% special needs teachers and 4% school nurses.
The schools agreed to distribute 10 questionnaires to fifth formers on behalf of the research team. The researchers never knew the names or addresses of students and staff. A package was prepared for each participant containing a letter asking them to participate, a pamphlet about the study, a questionnaire and a self-addressed envelope. Schools selected the 10 students whose birthdays were closest to a specific date (randomly assigned to each school) and gave the package to these students. The schools also distributed, on the research team’s behalf, similar packages to a range of five staff, including teachers, administrators and support staff (such as counselors), chosen at the discretion of each schools’ contact person. The return rates were high: 80% of all staff and 75% of all students from the 107 schools returned their questionnaires. The high return rate may have been due to the careful liaison work done with the schools and the school’s support for the study. A reminder was also sent out to schools where there were low return rates, which probably helped boost the numbers of returned questionnaires.
The student questionnaire was 19 pages long and focused on four rights in UNCROC. The part of the questionnaire discussed in this paper is Section 5 on Health Rights (Article 24 in UNCROC), which is 5 pages long and is a combination of closed-ended items with limited options to select (e.g. Yes, No, Sometimes, Don’t Know), Likert rating scales (e.g. circling agreement/disagreement, frequency, etc., on a five-point scale) and open-ended questions.
The questions from Section 5 of the survey covered the following topics:
• Access to health advice at school
• Confidentiality of personal information
• Perceived health problems amongst peers (e.g. depression, eating disorders)
• Health topics covered in class
• Perceived healthiness of school environment measured by Likert scales rating hygiene and safety of physical environment, health facilities and resources, healthiness of available food, quality of staff and student relationships, cultural safety and sensitivity, inclusion of young people with disabilities, and smoking and substance abuse (and help offered).
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Availability of advice
Table I indicates that most students (95%) report that their school has a counselor, about three-quarters that their school has a school health nurse and that they can get advice about health at school. These figures are similar to staff reports for availability of a counselor (97%) and a health nurse (77%). Staff, however, were more likely to think that health advice was available at school (93%). Staff were somewhat more likely than students (86% compared to 55%) to think that the counselor was easy to talk to and that the health nurse was easy to talk to (79% of staff compared with 36% of students). There was a big discrepancy between percentages of students and staff who thought that students could talk to other staff members. Less than half of the students agreed, compared to almost all of the staff. Only about half of the students were confident that what they said would be kept confidential, while about four-fifths of staff thought this.
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Some of the student responses to an open-ended question about this section of the survey indicate why students may not access health advice. Where the help is seen to be ineffective or unavailable, students talk about problems such as lack of privacy, reluctance to admit to a problem, concern about being labeled as having a problem and feeling uncomfortable talking to staff. There were also some students who acknowledged good quality support and advice. In all, there were 204 written answers from students elaborating on the prevalence, causes of and responses to the health problems we mentioned in the survey. The responses below are a selection from those which highlight barriers to gaining help.
Our school counselor is the town gossip, you wouldn’t tell her shit because she would go and tell the whole world.
I think that a lot of the students are reluctant to go to the counselor because of the stereotypes attached.
People with the above problems [The ‘problems’ refer to depression, eating disorders and other mental health problems referred to specifically in the questionnaire] don’t really like to admit they have something wrong with them, or they are maybe not aware, and they can only get help if they want it or consent to it.
Most teenagers don’t speak out about these problems, or only to close friends.
There needs to be more help available, the people we have you can’t trust, or speak to.
I think teenagers should have a young person who is ‘in’ with the world for us to talk about anything and everything. This person shouldn’t worry about time factors and help us. People aren’t talking to older teachers as they will ‘speak out’.
The health nurse is only here on certain days of the week/month so it can be hard to get an appointment.
I saw a counselor because I was depressed and psychotic. She did not help me, but instead insulted me and made me very resentful. We don’t really have a lot of people to talk to.
Student responses highlight concerns about confidentiality, trust and confidence in the staff members available and difficulties faced by students in seeking help or admitting that they have a problem.
Mental health issues
Table II indicates student and staff perceptions of the extent of mental health issues among students at school. The student and staff responses indicate that they do think that there are problems with depression, eating disorders and other mental health issues, with more staff reporting these problems than students. The students were, however, only about a third as likely to believe that help was available to deal with these problems compared to staff. It should be noted that some of the differences between staff and students’ reports could be due to staff having a wider view of issues across year levels, while students are likely to be drawing on their more limited experiences of 3 years of secondary education.
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Some of the open-ended student responses identified mental health issues as a real problem.
Most people I’ve talked to have contemplated suicide. A close friend of mine has an eating disorder, but nobody knows what to do about things like that.
A big percentage of the school may be depressed but no one talks about it.
I think depression is a big issue because young people have a lot going on, and if you’re not what everyone wants you to be, life can be horrible.
I think that the school environment can be very depressing to a lot of students who are not accepted. It can influence their life greatly in and out of school.
A girl at our school committed suicide this year.
Among the causes identified for these mental health problems were lack of peer acceptance, boredom and stress from pressure of work.
Students and teachers take advantage of the opportunity to make fun of one person at my school.
Individuality is very important to all students in our school. With that comes self-consciousness and personal insecurity because they still want to be accepted.
Depression here is brought on by the pressure of work. The students cannot cope and get depressed.
Eating disorders and being overweight were perceived as key health issues by many of the students.
There is usually a lot pressure from students, fashion and TV, to be skinny, so some girls fall into depression and eating problems. But this issue happens all over the world.
Because we are an all girls’ school, eating disorders are the biggest problem, because girls always compare themselves and we can also be cruel on what girls look like.
Availability of information about health issues
Another issue addressed in the survey was the extent to which information about health issues was available at school. The previous section and the responses below indicate the problems where information would be helpful.
We need people to talk to us about dieting.
Counselors and health nurses have done nothing for an anorexic girl in sixth form. We need people to come in and tell us about the problems of youth.
People need more education on the problems mentioned above. Especially depression and stress related to school work.
Table III shows staff and students’ reports on the extent of coverage of health issues in class. Most of the students and even more staff report that drug education takes place. Most students and an even larger number of staff also view sex/sexuality and contraception as being covered in class. More than half of students and staff think that information is offered on STDs, exercise, healthy eating and relationships. Less than half of the students believed that employment, healthy environments, eating disorders, depression/mental health and parenting were covered, whereas more than two-thirds of the staff believed these topics were dealt with. In almost every area, more staff than students thought that the topics were covered, but it is interesting that both staff and students thought that depression and parenting were least likely to be covered.
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The healthiness of the school environment
Table IV shows the mean agreement by students and staff with a number of statements about the healthiness of school environments. The topics are ordered according to the statements which students were most likely to agree with. Statements 1–15 have a student mean of between 1 and 2.5 indicating that students tend to agree with the statement (1 is strongly agree, 2 is agree). For almost every statement, staff were more likely to agree with the statement than the students.
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On the whole, students and staff agree that drug or alcohol use at school results in suspension; that if students bring weapons to school it is taken seriously; that some students don’t bring lunch to school; that there are facilities to dispose of sanitary waste; that facilities for sick students are good; that teachers try to stop students smoking and do not smoke in front of the students; that there are positive attitudes to students speaking Maori; and that school grounds look good.
The statements with which student agreement was more muted (i.e. in between agree and disagree—having a mean lower than 2.5) include whether students from different cultural groups felt welcome, relationships between staff and students were good, canteen food was healthy, help was available for students with drug/alcohol problems, and emergency supplies were available. The students were least likely to agree that there were hazards in the school grounds or classrooms; that hot water and soap were available; that toilets were clean; that the school was smoke-free; and that drinking fountains were clean.
There are four statements where the difference between means for the students and staff are one scale point apart or more—where the disagreement between the two groups is greatest. The mean for the statement ‘Our school is smoke-free’ was 3.35 for students and 2.22 for staff. This indicates that students considered the environment as considerably less smoke-free than the staff. Likewise, the staff seem to agree that the toilet areas and drinking fountains are clean (means 2.15 and 2.14, respectively), whereas the students are more neutral (means 3.26 and 3.40, respectively). These two differences may indicate that staff are being asked to evaluate facilities they do not use themselves. The other statement that revealed a difference is whether students with drug and alcohol problems get help (mean for students is 2.60 and for staff is 1.63). The difference seems to indicate that fewer students than staff feel there is support available.
The effect of decile rating on perceived healthiness of school environments
In order to determine whether there was a relationship between school decile and the healthiness of the school environment, the student scores for the items in Table IV were re-coded (using SPSS) to come up with an overall dependent variable score for Healthiness of School Environment. The score was derived by coding the Likert items for Question 29 (see Table IV) to add weight to strongly agreeing or agreeing with positive items (e.g. ‘The toilets are clean’) and subtracting weight for strongly disagreeing or disagreeing with positive items. Also, for negative items (e.g. there are hazards in the school grounds) weight was given for strongly disagreeing or disagreeing with the item and weight was subtracted for strongly agreeing or agreeing with the item. Items which were not relevant to all schools (e.g. feminine hygiene) were not included. The healthiness of school environment scores were higher when students rated the health of their school environments positively.
School decile was re-coded from 10 decile groups into three—high, medium and low. The low-decile group included decile 1–3 schools, the medium-decile group included decile 4–6 schools and the high-decile group included decile 8–10 schools. A one-way analysis of variance was carried out on Healthiness of School Environments to compare the scores of high-, medium- and low-decile schools. There was a significant effect of decile on perceived Healthiness of School Environment (F = 3.62, d.f. = 2, 807, P < 0.03), with high-decile schools being perceived by students as most healthy, medium-decile schools being perceived as of medium health and low-decile schools being perceived as least healthy (see Figure 1). A post hoc test (Scheffé) showed that the mean difference was significant only for the comparison between the high- and low-decile group (mean difference = 1.665, P < 0.03).
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Support and barriers for young people’s health rights in school
This survey of New Zealand secondary school students and staff suggests some concerns about whether schools are supportive of children and their health rights, and whether they can be considered health promoting environments. Health rights as expressed within UNCROC emphasizes the provision of primary and preventative health care and public health education, and the study sought to determine the extent to which these aims were achieved in New Zealand secondary schools.
Most students (and staff) reported that students had access to health advice at school. However, a significant minority (about a quarter) of students reported lack of access to a health nurse or counselor. Staff were much more likely than students to perceive that students had access to advice and that the advice was user friendly. The main barriers perceived by students were reluctance to approach those providing advice mainly because of concerns about confidentiality and not wanting to be stigmatized as ‘having a problem’ by seeking help. While most of the schools surveyed did have services that offered information and advice, it is clear that many students did not perceive it to be offered by friendly, trustworthy adults. This finding supports Davey’s (Davey, 1998) view that young people do not access health services because they see them as unwelcoming. Several students said that friends were more trustworthy than counselors or teachers, and that they relied on peers for support and information. That students without friends feel very unsupported and alone is attested to by a number of students.
Putnam [cited by (Morrow, 2001)] argues that social capital accumulates when there is trust, reciprocity, civic engagement, community identity and social networks. These factors are also very relevant in a school environment. A message coming through clearly from this study is that while school health services are a potential positive source of social capital, students do not see these services as supportive. Students trust and support their friends, but given that not all students have access to a close group of friends, other sources of support need to be available in school. The present study suggests that there is a gap between the perceptions of young people and the professionals who work with them. If schools are to be effective sites of health promotion, young people’s own ideas about health issues and appropriate health-promoting contexts should be heard, understood and acted upon.
We asked students and staff whether mental health issues, such as depression or eating disorders, were a problem for students. There was strong agreement (more than half for students and more than three-quarters for staff) that depression and other mental health issues were difficulties experienced by many students. While more adults than young people were concerned about mental health issues, they were also much more likely to think that help was available.
While schools emphasize health hazards like drugs, alcohol, early pregnancy and smoking in their health promotion efforts, the coverage of the very serious issue of mental health is not as strong, even though both staff and students perceive the threats to young people’s mental health as very real. Since New Zealand has the highest rate of youth suicide for both males and females aged 15–24 in the OECD (Ministry of Health, 2002), it is good to know that both young people and adults in schools are aware of the problem. However, it is a concern that students perceive more support to be needed in this area. Possibly this issue is avoided in school health promotion efforts, as it may be perceived as too sensitive. It may even be that schools feel that they may do more harm than good by discussing such issues as suicide or mental illness openly. (Just as media coverage has avoided mention of suicide cases for fear of provoking others to copy such acts.)
From the reports on coverage of health topics in class, it appears that both students and staff agreed that there are opportunities to learn about drugs, drug abuse, sexuality issues, smoking, fitness and nutrition. Staff were, however, much more likely than students to perceive that information about drugs and alcohol was available. (Both students and staff agreed that drug or alcohol use resulted in suspension!) While the majority of staff thought that all of the health issues we named were covered, it is interesting that only about half of them thought that mental health issues (including depression) were discussed in class. (The coverage of this health topic was reported by the smallest proportion of staff.) Students were even less likely to think that they learned about mental health issues in class, with only a quarter of students reporting this. Staff were much more confident than students that the full range of health topics was covered.
The least likely health topic to be reported as being covered was parenting (less than a quarter of students reported this). Schools are seemingly focusing more on preventing parenthood than on viewing young people as prospective parents. It is understandable that the focus is on prevention of premature pregnancy, but it is of concern that there should be so little focus on this important future role for so many young people (Dennison, 2002).
Students and staff are more likely on the whole to agree than disagree that their school environments are healthy, although there is obviously diversity in experiences and judgments. Students were less positive about the healthiness of their school environment mainly in the social and physical areas. Students were not particularly positive about tolerance for people from different cultures or about the relationship between students and staff. They were unenthusiastic also about hygiene (cleanliness of toilets and drinking fountains) and the healthiness of school food. Students tended to be more negative than staff on these issues, but since they are the ones who directly experience these facilities, this finding is perhaps unsurprising.
Students who attended schools serving lower-income communities were slightly more likely to judge their school environments as unhealthy. The differences according to decile were quite small (accounting for less than 1% of the variance) although they were significant. Lauder et al. (Lauder et al., 1999) found polarization of schools educationally. Our findings suggest that these educational differences may be paralleled by similar differences in the health-promoting qualities of schools. Nash (Nash, 1999) found that schools catering for young people from less advantaged home backgrounds actually increased their disadvantage. The present study provides some modest support for that view. Further research with a more intensive and systematic focus on schools as a context for health promotion is necessary to follow-up this suggestive finding.
Schools can be an important site for the implementation of the UNCROC, as these institutions can do much to enhance the potential of young people as well as support their ongoing well-being and rights. If schools are to cater effectively for young people’s health and education rights, it is important that their participation rights should also be respected. The notion of schools as cohesive communities where the participants (including young people) are conceptualized as active agents and decisions makers receives support from health promotion (Hartrick et al., 1994; Raeburn and Rootman, 1998), and children’s rights and sociology of childhood literature (Freeman, 1998; Mayall, 2000). This study endorses the view that children and young people are active, competent agents, who are able to articulate their needs and assess the effectiveness of their school environments in promoting health. We strongly recommend that young people’s voices be listened to and heeded in efforts to make schools a resource for young people’s health. Young people are the most likely to be able to suggest effective strategies. At the local school level it is essential that school staff respect and prioritize young people’s health rights, and encourage them to participate in planning the promotion of health rights at school.
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Acknowledgements |
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This study would not have been possible without the financial support of the Royal Society of New Zealand which funded the project out of the Marsden Science Fund, and the cooperation and support of the schools who participated in the study.
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References |
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Received on May 8, 2002; accepted on January 23, 2003
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