In the United States, 53 million young people attend nearly 129,000 schools for about 6 hours of classroom time each day for up to 13 of the most formative years of their lives.1 More than 95% of young people aged 5–17 years are enrolled in school. Because schools are the only institutions that can reach nearly all youth, they are in a unique position to improve both the education and health status of young people throughout the nation.
Supporting school health programs to improve the health status of our nation's young people has never been more important. Many of the health challenges facing young people today are different from those of past decades. Advances in medications and vaccines have largely reduced the illness, disability, and death that common infectious diseases once caused among children. Today, the health of young people, and the adults they will become, is critically linked to the health-related behaviors they choose to adopt. Certain behaviors that are often established during youth contribute markedly to today's major causes of death, such as heart disease, cancer, and injuries. These behaviors include
• Using tobacco.
• Eating unhealthy foods.
Not being physically active.
Using alcohol and other drugs.
Engaging in sexual behaviors that can cause HIV infection, other sexually transmitted diseases, and unintended pregnancies. Engaging in behaviors that can result in violence or unintentional injuries.
Three of these behaviors—tobacco use, unhealthy eating, and inadequate physical activity—contribute to chronic diseases such as cardiovascular disease, cancer, and type 2 diabetes. These behaviors are typically established during childhood and adolescence, and recent trends have been alarming. Young people are clearly at risk, as the following data show: Every day, nearly 5,000 young people try their first cigarette.2 In 2001, only 32% of high school students participated in daily physical education classes, compared with 42% of students in 1991.3 Seventy-nine percent of young people do not eat the recommended five servings of fruits and vegetables each day.4 • Each year, more than 900,000 adolescents become pregnant,5,6 and about 3 million become infected with a sexually transmitted disease.7
Rigorous studies in the 1990s showed that health education in schools can reduce the prevalence of health-risk behaviors among young people.
• Studies using a multiple-session school curriculum based on the social influences model and delivered to sixth and seventh grade students achieved significant reductions in smoking among these students through the ninth grade.8 • The prevalence of obesity decreased among girls in grades 6–8 who participated in a school-based intervention program.9 9–2 BUILDING A HEALTHIER FUTURE THROUGH SCHOOL HEALTH PROGRAMS • Middle/junior high school students enrolled in the school-based Life Skills Training Program were less likely than other students to use tobacco, alcohol, or marijuana, and these effects lasted through the 12th grade (www.lifeskillstraining.com).10
School health programs can play a critical role in promoting healthy behaviors while enhancing academic performance. In 1998, Congress noted the opportunity our nation's schools offer when it urged CDC to "expand its support of coordinated health education programs in schools."
Healthy People 2010
Healthy People 2010 outlines 467 national health objectives, of which 107 are directed specifically toward adolescents and young adults (i.e., 10- to 24-year-olds). Among these 107 objectives, 21 are identified as "critical" on the basis of two criteria: 1) they involve critical health outcomes or behaviors that contribute to them, and 2) state-level data necessary to measure progress in meeting the objective are available or soon will be.4
Healthy People 2010 Critical Objectives Related to Chronic Disease Prevention Among Adolescents and Young...