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THE ADMINISTRATION AND COORDINATION OF HEALTH INSTRUCTION, HEALTH SERVICE, AND HEALTH GUIDANCE IN CITY SCHOOL SYSTEMS

A T h e s is P re se n ted to The F a c u lt y o f t h e S c h o o l o f E d u c a tio n The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a

In P a r t i a l F u l f i l l m e n t o f t h e R e q u ir e m e n ts f o r t h e D e g r e e M a s te r o f S c ie n c e i n E d u c a tio n

by R ic h a r d M* C lin e June 1 9 5 0

UMI Number: EP56125

All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion.

Dissertation Publishing

UMI EP56125 Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code

ProQuest LLC. 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106- 1346

Th is thesis, writ ten under the direction o f the Chair man of the candidate’s G u id an ce C o m m it te e a n d a p p r o v e d hy all me m be rs of the C o m m i t t e e , has been pr es e nt e d to an d ac ce pte d by the F acu lty of the Sc h o o l of E du c at io n of the Unive rsi ty of Southern California in p a r ti a l fu lfillment of the requirements f o r the degre e of M a s t e r of Science in Education. D ate

Ju n e„.1950..................

Dean Guidance Committee

Chairman

TABLE OF CONTENTS CHAPTER I,

PAGE

THE PROBLEM AND DEFINITIONS OF TERMS USED . . .

1

The p r o b le m •

2

The s t a t e m e n t o f t h e p r o b l e m ...............................

2

The im p o r ta n c e o f t h e p r o b le m • • * * • • •

2

D e f i n i t i o n s o f te r m s u s e d .............................................. H e a lt h .........................................................

. . . . *

4

.

H e a lth i n s t r u c t i o n . . * • • • • * • • •

4 •

H e a lt h g u id a n c e ♦ .............................................................. H e a lt h s e r v i c e ................................................................. H e a lt h e d u c a t i o n

..............................

L i m i t a t i o n o f t h e p r o b l e m ......................... The s c o p e

. . . . . . . . .

I n q u ir y

...................................

5

6 •

S o u r c e o f d a ta an d m e th o d s o f p r o c e d u r e . . . I n te r v ie w s • « • •

5

6

..............................

W e a k n e sse s ..........................

5 .



5

. . . . .

.........................

6 7 8 8

R e l a t e d l i t e r a t u r e .........................................................

9

The q u e s t i o n n a i r e ..............................................................

9

T o t a l r e s p o n s e ......................... ....

. 10

The o r g a n i z a t i o n o f t h e r e m a in d e r o f t h i s t h e s i s .......................• • • • ....................................... 10

iil CHAPTER II.

PAGE

REVIEW OF RELATED LITERATURE............................... ..... .

12

The im p o r ta n c e o f h e a l t h t o th e s t u d e n t and s o c i e t y

• ......................................................................

12

The h e a l t h s t a t u s o f t h e s c h o o l c h i l d a n d o f th e g e n e r a l p o p u la tio n . • • . • • * • * The r e l a t i o n s h i p o f h e a l t h t o a tten d a n ce * • « • • • What i t

c o sts

• •

14

sch o o l « « . . « * .

th e s c h o o l f o r c h ild r e n

••

to be

ab sen t a s a r e s u lt o f i l l n e s s • • . » • • • Im p rovem en t i n h e a l t h a n d a t t e n d a n c e .

17

18

• •

19

M oney s a v e d a s a r e s u l t o f a g o o d h e a l t h p rogram .

..................................................

22

The s t a t u s o f h e a l t h k n o w le d g e among sc h o o l c h ild r e n

...................................

24

C h a p te r summary • III.

25

THE ADMINISTRATION, COORDINATION AND PERSONNEL OF THE HEALTH PROGRAM................................

28

P r a c t ic e and th in k in g e x p r e sse d in a u th o r ita tiv e lite r a tu r e

• • • • • • • . •

28

The a d m i n i s t r a t i o n o f t h e p rogram . . . . .

28

C o o r d in a t in g t h e h e a l t h p rogram . . . . . .

54

R e tu r n s from t h e i n q u i r y .......................... ..... Q u e s t i o n n a i r e r e t u r n s • • » . . .........................



38 41

The a d m i n i s t r a t i o n an d c o o r d i n a t i o n o f a g o o d h e a l t h p rogram i n a c i t y

s c h o o l s y s te m 4 1

iv CHAPTER

PAGE The a d m i n i s t r a t i o n an d c o o r d i n a t i o n o f t h e h e a l t h program i n

th e

in d iv id u a l sc h o o l .

............................................ 48

.

C h a p te r summary • • • • » • • • .................. ....... IV .

55

HEALTH SERVICE INSTRUCTION AND GUIDANCE IN THE HEALTH PROCRAM

...........................................

T r en d s a n d p r a c t i c e s in h e a l t h

s e r v ic e

59

• • .

59

The p r a c t i c e s a n d t h i n k i n g r e v e a l e d b y l i t e r a t u r e on t h e s u b j e c t . . . . . . . .

59

R e tu r n s from th e q u e s t i o n n a i r e i n reg a rd to h e a lth s e r v ic e • • « • • • •



62

H e a lth s e r v i c e p e r s o n n e l a n d p r a c t i c e s i n t h e s c h o o l s y s t e m ............................................... 62 H e a lt h s e r v i c e p e r s o n n e l an d p r a c t i c e s ................................................68

in th e sc h o o l

R eco m m en d a tio n s a n d p r a c t i c e s i n h e a lth in s tr u c t io n

............................................................

L i t e r a t u r e on t h e s u b j e c t ..............................

75 75

Summary o f h e a l t h i n s t r u c t i o n , p r a c t i c e s an d o p i n i o n s i n r e l a t e d l i t e r a t u r e . . .

79

R e tu r n s from t h e q u e s t i o n n a i r e r e l a t i v e to h e a lt h i n s t r u c t io n

...................................

81

The p e r s o n n e l and p r a c t i c e s o f h e a l t h I n s t r u c t i o n i n t h e s y s t e m * .........................* .

81

V

CHAPTER

PAGE The p e r s o n n e l an d p r a c t i c e s o f h e a l t h i n s t r u c t i o n in th e s c h o o l H e a lt h g u id a n c e . .

.

•• • • . . . .

...................................................

88 94

T r en d s a n d p r a c t i c e s i n h e a l t h g u id a n c e a s r e v e a l e d b y t h e l i t e r a t u r e on t h e p r o b le m * .............................................................

95

R e t u r n s from t h e q u e s t i o n n a i r e r e l a t i v e t o h e a l t h g u i d a n c e ............................................................... 9 9 The p e r s o n n e l a n d p r a c t i c e s o f h e a l t h g u id a n c e i n t h e s y s t e m .....................................................99 The p e r s o n n e l a n d p r a c t i c e s o f h e a l t h g u id a n c e i n t h e s c h o o l . . . . . C h a p te r summary . . . . . . V.

. . . . .

104

.................................

108

SUMMARY IMPLICATIONS AND CONCLUSIONS..............................1 1 3 Summary I m p lic a tio n s

............................................. ................................................

115 126

BIBLIOGRAPHY.......................................................................................................... 1 3 1 APPENDIX A.

140

APPENDIX B.................................................................................................................. 1 49

LIST OF TABLES TABLE I.

PAG-E The A d m i n i s t r a t i v e O f f i c e r f o r t h e H e a lt h P rogram i n

II.

t h e S c h o o l S y stem • • • • • • » •

43

Time D e v o te d t o H e a lth P rogram by A d m i n i s t r a t i v e O f f i c e r ....................................................

III.

A s s i s t a n t s t o t h e A d m in i s t r a t o r f o r t h e C i t y S y s t e m .........................

IV .

45

.

47

The O f f i c e r Who C o o r d in a t e s t h e H e a lth P rogram i n t h e J u n i o r a n d S e n io r H igh S c h o o l . . . .

V.

49

The O f f i c e r Who C o o r d in a t e s t h e H e a lth Program i n t h e E le m e n ta r y S c h o o l

V I.

51

The S c h o o l H e a lt h C o u n c il o r S t a f f Who A s s i s t t h e S c h o o l H e a lt h C o o r d in a t o r . . . .

V II.

The T e s t i n g P rogram i n t h e S c h o o ls R e p o r te d i n t h e I n v e s t i g a t i o n

V III.

.

.

63

.

66

N u r s e - P u p il R a t io f o r t h e S ystem o r th e S ch ool . . . . . .

X I.

56

A s s i s t a n t s to t h e D i r e c t o r o f H e a lth S e r v i c e f o r t h e S ystem

X.

.

The O f f i c e r f o r t h e H e a lt h S e r v i c e Program i n t h e S y s t e m

IX .

53

..........................

. . . . .

67

P h y s i c a l E x a m in a tio n s o r I n s p e c t i o n s o f S tu d e n ts by P h y s ic ia n s o r D e n t is t s in th e S ch o o l

.............................................

69

viI

ta ble

X II. X III. XIV.

pa g e

I m m u n iz a tio n an d V a c c i n a t i o n R e q u ir e m e n ts S p e c i a l F a c i l i t i e s f o r P r o m o tin g

• • • • • • • • • • • . 8 3

The C u r r ic u lu m i n H e a lt h I n s t r u c t i o n

XIX.

.....................................

..............................................................

C o u r s e s o f H e a lt h I n s t r u c t i o n

in

th e S c h o o l

H e a lt h I n s t r u c t i o n

.

The O f f i c e r

. .

92

. . . . . . . . . .

93

f o r t h e H e a lt h G u id a n ce

Program i n t h e S y s t e m ................. ..................................... X X II.

90

in A d d i t i o n t o t h a t

G iven i n C l a s s ..................... XXT.

87

C o n te n t an d P r o c e d u r e s i n .C o u r s e s o f H e a lt h I n s t r u c t i o n ..........................................

XX.

85

Aims o f t h e C u rr icu lu m i n H e a lth I n s tr u c tio n

X V III.

74

Time D e v o te d t o t h e O f f i c e b y t h e D i r e c t o r

f o r th e S ystem X V II.

H e a lt h . . . .

i n t h e S y s t e m ..................................... . 8 2

o f H e a lt h I n s t r u c t i o n XVI.

. 72

The O f f i c e r R e s p o n s ib le f o r H e a lt h I n s tr u c tio n

XV.

• .

A s s is ta n ts to

101

t h e O f f i c e r o f H e a lth

G u i d a n c e ................................................. ......................................102 X X III. XXIV.

P r a c t i c e o f H e a lt h G u id a n ce i n t h e S c h o o l . G u id a n ce T e c h n iq u e s i n t h e

School . . . . . .

.

105 107

CHAPTER I THE PROBLEM AND DEFINITIONS OF TERMS USED The f u n c t i o n s o f h e a l t h e d u c a t i o n o r t h e h e a l t h p ro g ram i n grou p s:

th e sc h o o l a re g e n e r a lly d iv id e d in t o th r e e

h e a l t h i n s t r u c t i o n , h e a l t h s e r v i c e , and h e a l t h

g u id a n c e .

The p r e s e n t a n d f u t u r e p h y s i c a l an d m e n t a l w e l l ­

b e in g o f th e s tu d e n t i s

d e p e n d e n t , i n no s m a ll d e g r e e , upon

th e p r o p e r d is c h a r g e o f t h e s e f u n c t io n s by th e

s c h o o l.

The h e a l t h s t a t u s o f s c h o o l c h i l d r e n an d o f t h e g e n e r a l p o p u la tio n , a s r e v e a le d by v a r io u s i n v e s t i g a t io n s a n d b y t h e d r a f t b o a r d s o f t h e l a s t tw o w o r ld w a r s , i s b e lo w a r e a s o n a b l e e x p e c t a t i o n .

If,

th e r e fo r e ,

th is

fa r

co n ­

d i t i o n i s t o be c o r r e c te d I t w i l l be n e c e s s a r y f o r th e s c h o o l a s w e l l a s o th e r a g e n c i e s w h ic h i n f l u e n c e h e a l t h t o e x a m in e t h e i r p r a c t i c e s an d l e a d e r s h i p make su c h c h a n g e s a s w i l l r a i s e

i n t h i s r e g a r d and

th e h e a lt h s t a t u s o f th e

p o p u l a t i o n t o an a c c e p t a b l e s t a n d a r d . The s c h o o l m u st n o t o n l y e x a m in e and c o r r e c t i t s p r a c tic e s ,

own

i t m u st l e n d l e a d e r s h i p t o a i l o t h e r a g e n c i e s and

s e t up p a t t e r n s o f c o n d u c t a n d w ays o f t h i n k i n g am ong i t s s t u d e n t s t h a t w i l l c a u s e them to l i v e

h e a l t h f u l l y an d c r e a t e

h e a l t h f u l c o m m u n itie s f o r t h e f u t u r e .

The b e s t way t o do

th is is

t h e p r o b le m w i t h w h ic h t h i s t h e s i s i s

concerned.

2 I.

THE PROBLEM

The s t a t e m e n t o f t h e p r o b le m . The p u r p o s e o f t h i s i n v e s t i g a t i o n w as t o d i s c o v e r t h e p r a c t i c e i n r e g a r d t o t h e p e r s o n n e l u s e d an d m e th o d s i n v o l v e d i n t h e a d m i n i s t r a t i o n and th e c o o r d in a tio n o f h e a lt h i n s t r u c t i o n , a n d h e a l t h s e r v i c e in

h e a lt h g u id a n c e ,

s c h o o ls w ith good h e a lt h p rogram s.

The im p o r ta n c e o f t h e p r o b le m . The P h i l o s o p h e r John L ocke h a s been g iv e n c r e d i t m in d i n a so u n d bod y i s

f o r t h e s t a t e m e n t t h a t 11A so u n a

a sh o r tc u t f u l l d e s c r ip tio n o f a

h ap p y s t a t e i n t h i s w o r l d ." S u s ta in e d s u c c e s s ,

o v e r a p e r io d o f y e a r s , i n th e

v a r io u s u n d e r ta k in g s o f l i f e

i s a lw a y s d e p e n d e n t on t h e

p o w er an d z e s t t h a t f l o w from h e a l t h .

For th e in d iv id u a l,

s u r v i v a l i t s e l f may d e p e n d upon t h e p o w e r t h a t com es from a g o o d m ind an d a b od y o r g a n i c a l l y so u n d , good c o n d itio n , v e a ls th a t th e

s k illfu l,

t o u g h , a n d e n d u r in g .

s u r v iv a l o f a n a tio n i s

p o w er t h a t f l o w s from t h e h e a l t h o f i t s is

s t r o n g o f m u s c le ,

in

H is t o r y r e ­

d e p e n d e n t upon t h e c itiz e n s .

" N ot o n l y

h e a lth th e b a s is o f th e in d iv id u a l's w e ll-b e in g b u t, a s

D i s r a e l i rem ark ed , i t

is

th e

f o u n d a t io n o f th e p e o p l e ' s

p o w e r a s a s t a t e . " -*■

" H e a lt h i n S c h o o l s ," T w e n t ie t h Y e a r b o o k . A m erloan A s s o c i a t i o n o f S c h o o l A d m in i s t r a t o r s (W a s h in g to n , D. C .: Am erica n A s s o c i a t i o n o f S c h o o l A d m i n i s t r a t o r s , 1 9 4 2 ) , p . 5 .

3 T hat th e h e a lt h s t a t u e o f th e p o p u la tio n o f t h i s c o u n t r y I s f a r b e lo w a r e a s o n a b l e e x p e c t a t i o n an d f a r below t h a t w h ic h s c i e n c e i n d i c a t e s

it

s h o u ld b e i s e v i d e n t from

t h e h i g h p e r c e n t a g e o f r e j e c t i o n s f o r h e a l t h r e a s o n s among c a n d i d a t e s f o r t h e arm ed s e r v i c e s i n w o r ld w a r s o n e an d tw o , t h e l o s s o f man h o u r s i n i n d u s t r y , a s a r e s u l t o f i l l n e s s , t h e p e r c e n t a g e o f o u r p o p u l a t i o n who a r e fo u n d i n t i o n s f o r t h e p h y s i c a l l y an d m e n t a l l y i l l ,

in s titu ­

and t h e p o o r

h e a lt h s t a t u s o f sc h o o l c h ild r e n a s a r e s u l t o f p r e v e n ta b le m e n ta l and p h y s ic a l d e fe c ts * The f o l l o w i n g s t a t e m e n t s i n d i c a t e w hat o u t s t a n d i n g le a d e r s in th e f i e l d

o f e d u c a t i o n t h i n k o f t h e im p o r ta n c e

o f h e a l t h e d u c a t i o n , and o f t h e r e s p o n s i b i l i t y o f t h e s c h o o l f o r p r o p e r ly a d m in is te r in g i t s v a r io u s f u n c t io n s . S in c e t o t h e s c h o o l i s a s s i g n e d a l a r g e p a r t i n t h e e d u c a t i o n p r o c e s s , p a r t i c u l a r l y i n th e f o r m a t i v e y e a r s o f c h i ld h o o d and y o u t h , e d u c a t io n i n h e a l t h b e c o m e s a d ir e c t r e s p o n s ib ilit y o f th e s c h o o l. 3 * H e a lt h th e n r e f e r s t o y o u r a b i l i t y t o su p p le m e n t y o u r h e r e d i t a r y c a p a c i t y b y su c h p r a c t i c e s a s w i l l r a i s e t h e pow er l e v e l o f you r body t o th e h ig h e s t a t t a i n a b l e p o in t ; and t h i s t o a la r g e e x te n t i s th e r e s p o n s i b i l i t y o f e d u c a tio n . 5 R e f e r e n c e t o t h e l a w s o f C a l i f o r n i a and o f many o t h e r s t a t e s in r e sp e c t to

h e a l t h e d u c a t io n i n t h e s c h o o l s i n d i c a t e

2 XblA*, p. 14. ® J . B. N a sh , T e a c h a b le M om ents (New Y o rk i B a r n a r d Company, 1 9 3 8 ; ,' p . 1 6 .

A. S.

4 t h a t th e p e o p le ,

sta te

s c h o o l o f f i c i a l s an d l e g i s l a t u r e s

e x p e c t t h e s c h o o ls o f th e c h i l d w h il e h e i s i n

s t a t e to p r o t e c t th e h e a lt h o f th e

s c h o o l and t o g iv e i n s t r u c t io n th a t

w i l l c a u s e him t o - l i v e h e a l t h f u l l y i n p o s t s c h o o l y e a r s . 4 S in c e n e i t h e r t h e s ib le

s c h o o l n o r o th e r a g e n c ie s r esp o n ­

f o r c h i l d and a d u l t h e a l t h h a v e d e v e lo p e d t h e p r o ­

c e d u r e s an d l e a d e r s h i p n e c e s s a r y t o r a i s e t h e h e a l t h s t a t u s o f th e p o p u la tio n to a p r o p e r l e v e l , in v e s tig a tio n tio n

it

is

e v i d e n t t h a t an y

w h ic h d i s c o v e r s o r d e v e lo p s m e th o d s i n

educa­

t h a t s e c u r e an d p e r p e t u a t e a h ig h s t a t u s o f h e a l t h and

h e a lth fu l liv in g i s

im p o r t a n t t o t h e i n d i v i d u a l , t h e s c h o o l ,

and to s o c i e t y . II.

DEFINITIONS OF TEBMS USED

F or t h e p u r p o s e o f e s t a b l i s h i n g a common fram e o f r e f e r e n c e w i t h t h o s e who w i l l r e a d t h i s s t u d y , a d v is a b le

it

seem s

t o d e f i n e t h o s e te r m s t h a t i n v o l v e t h e m ain p u r ­

p o s e s o f t h is pap er. H e a lt h . H e a lt h i s

a s t a t e o f b e i n g w h ic h i s

f r e e from

d i s e a s e o r p a i n , i n w h ic h a l l o r g a n s and p a r t s o f t h e bod y a r e n o r m a l an d f u n c t i o n e a s i l y , H e a lth ,

fu r th e rm o r e,

r e g u l a r l y an d p l e a s a n t l y .

endow s i t s p o s s e s s o r w i t h a b u n d a n t p o w er

4 S c h o o l C ode, S t a t e o f C a l i f o r n i a r C a l i f o r n i a S t a t e P r in tin g O ffic e , 1937, p . 150.

5 f o r a l l o f th e a c t i v i t i e s o f l i f e ,

d i s p o s i n g him t o a f e e l ­

i n g o f w e l l - b e i n g , g o o d c h e e r , a n d c o n f id e n c e * H e a lt h i n s t r u c t i o n *

T h is term r e f e r s t o

e x p e r ie n c e s *

t h a t p r o m o te t h e a c q u i s i t i o n o f n e e d e d i n f o r m a t i o n , a c t i v i ­ tie s

d e s i g n e d t o d e v e lo p g o o d h e a l t h h a b i t s and t o g e t n e e d e d

c o r r e c t i o n s m ad e, a id t h e d e v e lo p m e n t o f an a p p r e c i a t i o n o f t h e im p o r t a n c e o f h e a l t h . H e a lt h g u id a n c e *

H e a lt h g u id a n c e r e f e r s t o

f a c t o r s a s e n c o u r a g e m e n t,

c o u n s e lin g ,

d is c ip lin e ,

su c h in te r e s t,

d i r e c t i o n and h e lp t h a t k e e p s t h e s t u d e n t p r o g r e s s i n g tow ard and a t t a i n i n g on s c h e d u l e ,

d e s i r a b l e g o a l s i n h e a l t h and

h e a l t h b e h a v io r * H e a lt h s e r v i c e .

In t h i s

t o th e s e r v ic e ren d ered to

stu d y , h e a lth s e r v ic e r e f e r s

s t u d e n t s b y s c h o o l o f f i c e r s and

a g e n c i e s d e s i g n e d t o p r o m o te and c o n s e r v e h e a lt h * H e a lt h e d u c a t i o n .

H e a lt h e d u c a t i o n d e s i g n a t e s a

c o o r d in a tio n o f th e p r o c e s s e s of i n s t r u c t i o n , s e r v i c e i n h e a l t h t h a t make a v a i l a b l e

g u id a n c e , and

to th e s tu d e n ts th o s e

e x p e r i e n c e s w h ic h w i l l e n a b le them t o a c q u i r e t h e u n d e r s t a n d ­ in g s , liv e life .

in te r e s ts ,

h a b i t s a n d s k i l l s t h a t w i l l c a u s e them t o

h e a l t h f u l l y w h ile t h e y a r e i n

s c h o o l an d i n p o s t s c h o o l

6 III. The s c o p e .

LIMITATION OF THE PROBLEM T h is r e s e a r c h w as l i m i t e d t o an i n v e s t i ­

g a tio n o f th e p r a c t ic e s u se d in

s c h o o ls o r s c h o o l sy stem s

known to h a v e o u t s t a n d i n g p r o g ra m s i n h e a l t h .

I t a im e d t o

d is c o v e r ; 1. The a d m i n i s t r a t i v e p r a c t i c e s i n v o l v e d in program .

su c h a

2 . What t e c h n i q u e s and m e th o d s w ere u s e d i n c o o r d i n a t i n g t h e f u n c t i o n i n g o f t h e h e a l t h p rogram — i . e . h e a l t h i n s t r u c t i o n , h e a l t h g u id a n c e an d h e a l t h s e r v i c e . 3 . The s t a t u s and d u t i e s o f t h e v a r i o u s m em bers o f t h e s t a f f i n v o l v e d in th e p r o g r a m . 4 . And s o l i c i t e d t h e o p i n i o n s a n d r e c o m m e n d a tio n s o f th o s e c o n ta c te d i n th e c o u r se o f th e i n v e s t i g a t i o n , i n r e g a r d t o t h e s e a s p e c t s o f t h e h e a l t h p ro g ra m . W eak n esses. to

One o f t h e f a c t o r s t h a t made i t

d iffic u lt

a r r i v e a t v a l i d c o m p a r is o n s o r c o n c l u s i o n s I n r e g a r d t o

t h e p r a c t i c e s i n t h e h e a l t h program I n t h e v a r i o u s s c h o o l s a n d s c h o o l s y s t e m s w as t h e sy ste m s.

s iz e o f th e s c h o o ls o r sc h o o l

W h ereas a l l th e h e a l t h p r o g r a m s s t u d i e d w ere i n

s c h o o l sy s te m s 'r e c o m m e n d e d f o r h a v in g g o o d h e a l t h p r o g r a m s , p r a c t i c e s d i f f e r e d i n many r e s p e c t s I n s m a ll s y s t e m s from th o se u sed in la r g e sy stem s.

F or i n s t a n c e , i n many l a r g e

s y s t e m s an a d m i n i s t r a t o r w as made r e s p o n s i b l e f o r th e h e a l t h p ro g ra m on a f u l l t im e b a s i s w it h many f u l l tim e a s s i s t a n t s ; w h i l e i n a s m a l l sy s te m an a d m i n i s t r a t o r c a r r i e d t h i s a s s i g n ­ m en t a lo n g w i t h s e v e r a l o t h e r a s s ig n m e n t s w i t h few o r n o f u l l

7 tim e a s s i s t a n t s . w h at s i z e

It,

t h e r e f o r e , w as i m p o s s i b l e t o d e te r m in e

t h e s c h o o l s y s te m

s h o u ld b e b e f o r e i t

was n e c e s ­

s a r y t o a s s i g n t h e f u l l t im e o f o n e a d m i n i s t r a t o r t o t h e h e a lt h program . A n o th e r f a c t o r t h a t c o n t r i b u t e d t o

th e d i f f i c u l t y o f

e v a lu a t in g th e p r a c t i c e s d is c o v e r e d in th e v a r io u s sy ste m s w as fo u n d i n t h e p la c e m e n t o f r e s p o n s i b i l i t y p ro g ra m .

In many s t a t e s an d c i t i e s

th e c i t y ,

f o r th e h e a lt h c o u n ty , o r

s t a t e h e a l t h d e p a r tm e n t a r e p r i m a r i l y r e s p o n s i b l e

fo r th e

h e a l t h p rogram i n t h e s c h o o l an d t h e s c h o o l a u t h o r i t i e s c o o p e ra te in w h ereas,

t h e p rogram a s o u t l i n e d by t h e s e a u t h o r i t i e s ;

in o th e r l o c a l i t i e s

th e

s c h o o ls are r e s p o n s ib le

f o r t h e program and h a v e a s t a f f t h a t a d m i n i s t e r s an d c o o r d in a te s a l l th e

f u n c t i o n s o f t h e h e a l t h p rogram a n d i s

in d e p e n d e n t o f t h e a b o v e p o l i t i c a l tio n

u n its ex ce p t fo r coopera­

in th e l e g a l r a m if ic a t io n . IV .

SOURCE OF DATA AND METHODS OF PROCEDURE

I n o r d e r t o m ake t h i s i n v e s t i g a t i o n a s s i g n i f i c a n t a s p o s s i b l e i t w as d e c id e d * t o

c o n s u lt th e le a d in g ed u ca­

to r s in

some o f t h e f a c t o r s t h a t

th e a r e a in r eg a r d to

seem ed im p o r t a n t t o a s o l u t i o n o f t h e p r o b le m a n d t o s e c u r e from them s u g g e s t i o n s i n

reg a r d to th e p roced u re

to be fo llo w e d .

Tw enty i n t e r v i e w s

w ere h e l d

as

a re­

s u l t o f w h ic h i t

was d e c id e d to b a s e th e r e s e a r c h on an

8

in q u ir y ,

lite r a tu r e

on t h e s u b j e c t a n d on a q u e s t i o n n a i r e

o r g a n i z e d an d u s e d a s d e s c r i b e d h e r e a f t e r . I n te r v ie w s , p a ls ,

I n th e i n t e r v i e w s w i t h t e a c h e r s , p r i n c i ­

s u p e r i n t e n d e n t s , a n d a u t h o r i t i e s on t h e s c h o o l h e a l t h

p rogram t h e f o l l o w i n g q u e s t i o n s w ere d i s c u s s e d * 1* What i n y o u r o p i n io n a r e t h e m o st im p o r ta n t f a c ­ t o r s i n s e c u r i n g a g o o d h e a l t h p rogram i n th e c i t y s c h o o l s y s te m ? 2.

Whom do y o u c o n s i d e r to b e o u t s t a n d i n g a u t h o r i t i e s i n r e g a r d t o t h e s c h o o l h e a l t h p rogram ?

3 . What a r e some o f t h e q u e s t i o n s t h a t y o u t h i n k s h o u ld b e i n c l u d e d i n a q u e s t i o n n a i r e a b o u t t h e h e a l t h p rogram i n t h e c i t y s y s t s a ? 4 . What l i t e r a t u r e do y o u c o n s i d e r o f o u t s t a n d i n g v a l u e i n r e l a t i o n t o t h i s p ro b lem ? 5 . Bo y o u know o f a n y s c h o o l s o r s c h o o l s y s te m s t h a t h a v e g o o d h e a l t h p ro g ra m s? I n q u ir y *

A l e t t e r o f i n q u i r y w as s e n t t o t h e a u t h o r i ­

t i e s recom m ended i n t h e i n t e r v i e w s a s w e l l a s t o a num ber o f o t h e r o u t s t a n d i n g e d u c a t o r s an d s c h o o l h e a l t h a u t h o r i t i e s . The p u r p o s e o f t h e i n q u i r y w as t o th e se

s e c u r e th e o p in io n s o f

e d u c a t o r s on c e r t a i n im p o r t a n t c o n s i d e r a t i o n s i n r e ­

gard to

t h e p r o b le m a n d to

s e c u r e from them l i s t s o f s c h o o l s

and s c h o o l sy ste m s t h a t had o u t s t a n d in g program s in h e a lt h

-

a s w e l l a s t h e p r o p e r s c h o o l a u t h o r i t y w i t h whom t o c o r r e s p o n d in ea ch in s t a n c e . F o r t y - t h r e e r e p l i e s w ere r e c e i v e d from t h e i n q u i r y and

9 a n d I t w as t o t h e s c h o o l s o r s c h o o l s y s te m s recom m ended i n t h e s e r e p l i e s t h a t a l a r g e p e r c e n t a g e o f th e q u e s t i o n n a i r e s w e re s e n t . B e la te d l i t e r a t u r e .

The l i t e r a t u r e

t h a t recom m ended i n t h e i n t e r v i e w s ,

s t u d i e d c o m p r is e d

th e r e p o r t s o f n u m erou s

c o n v e n t i o n s a n d m e e t i n g s , u n p u b lis h e d t h e s e s a n d r e s e a r c h p a p e r s , p r o f e s s io n a l b ook s and r e p o r t s d e a lin g w ith th e su b je ct. The q u e s t i o n n a i r e .

The q u e s t i o n n a i r e w as d e s i g n e d t o

a s c e r t a i n t h e m e th o d s a n d p e r s o n n e l u s e d i n t h e a d m i n i s t r a ­ t i o n a n d c o o r d i n a t i o n o f t h e h e a l t h program i n s c h o o l s o r s c h o o l s y s t e m s t h a t h a v e o u t s t a n d i n g h e a l t h p r o g r a m s an d w as s e n t to th e

s c h o o l s y s t e m s t h a t w e re t h u s d e s i g n a t e d i n t h e

r e t u r n s from t h e I n q u i r y , la te d lite r a tu r e ,

and to

su g g e ste d in in te r v ie w s o r i n s t a t e and c i t y

re­

s u p e r v is o r s o f th e

h e a l t h program a n d t o o t h e r e d u c a t o r s . The o u t l i n e a n d q u e s t i o n s f o r t h e q u e s t i o n n a i r e w e re th o s e s u g g e s te d in t h e i n t e r v ie w s ,

th e I n q u i r y a n d th e r e ­

la te d lite r a tu r e . F i f t y - s i x r e p l i e s r e p r e s e n tin g tw e n ty -e ig h t c i t y sy ste m s,

665 j u n i o r a n d s e n i o r h ig h s c h o o l s an d 1 ,4 5 4

e le m e n t a r y s c h o o l s w i t h a p o p u l a t i o n o f 1 , 526,042 c h i l d r e n w ere r e c e iv e d .

10 T o ta l r e s p o n s e # Q u e s tio n n a ir e ,

T h ere w ere f i f t y - s i x

r e p l i e s to t h e

f o r t y - t h ^ e e r e p l i e s to th e I n q u ir y and tw e n ty

i n t e r v i e w s m a k in g a t o t a l o f o n e h u n d r e d and n i n e t e e n i n d i ­ v i d u a l s who r e s p o n d e d t o th e v a r i o u s p a r t s o f th e i n v e s t i g a ­ tio n .

They r e p r e s e n t a l l p h a s e s o f e d u c a t i o n ,

p r in c ip a ls ,

c ity

s u p e r in te n d e n ts ,

o f h e a lt h and p h y s ic a l e d u c a tio n ,

te a c h e r s,

c o u n ty a n d s t a t e d i r e c t o r s an d o t h e r a u t h o r i t i e s on

t h e s c h o o l h e a l t h p ro g ra m . V.

THE ORGANIZATION OF THE REMAINDER OF THIS THESIS The s e c o n d c h a p t e r r e v i e w s t h e l i t e r a t u r e

fo u n d t o

b e s i g n i f i c a n t t o an u n d e r s t a n d in g a n d s o l u t i o n o f th e p r o b le m w i t h w h ic h t h e i n v e s t i g a t i o n w as c o n c e r n e d . The p r e s e n t s t a t u s and p r a c t i c e s i n t h e v a r i o u s a s ­ p e c t s a n d f u n c t i o n s o f t h e h e a l t h program a r e p r e s e n t e d an d d is c u s s e d .

The o p i n i o n s ,

tr e n d s,

and s u g g e s tio n s o f o u t­

s ta n d in g a u t h o r i t i e s and g ro u p s, in r e fe r e n c e to h e a lt h c a t i o n a r e r e v ie w e d .

ed u ­

M eth od s and p r a c t i c e s t h a t h a v e b een

fo u n d t o be s u c c e s s f u l a r e d e s c r i b e d . In c h a p te r t h r e e th e p r a c t i c e s and t h in k in g in r e g a r d to th e a d m in is t r a t io n ,

c o o r d i n a t i o n , an d p e r s o n n e l o f t h e

h e a l t h p rogram i n t h e c i t y

s c h o o l s y s te m an d i n

sc h o o l a s r e v e a le d in a u t h o r it a t iv e l i t e r a t u r e an d i n

th e i n d i v i d u a l i n th e

I n q u ir y

t h e Q u e s t i o n n a ir e a r e p r e s e n t e d . The d a t a from t h e r e l a t e d , l i t e r a t u r e ,

th e I n q u i r y an d

11 t h e Q u e s t i o n n a ir e r e l a t i v e g u id a n c e i n

to th e in s t r u c t io n ,

s e r v ic e and

t h e h e a l t h p rogram a r e c o m p ile d a n d e v a l u a t e d

b y m ean s o f d i s c u s s i o n ,

t a b l e s an d s u m m a r iz a tio n i n C h a p te r

fo u r . A l l im p o r t a n t f i n d i n g s a r e su m m a rized , a n d c o n c l u s i o n s a n d r e c o m m e n d a tio n s i n r e g a r d t o th e a d m i n i s t r a t i o n , th e c o o r d in a tio n

o f in s tr u c tio n ,

g u id a n c e and s e r v i c e i n th e

h e a l t h p rogram a n d t h e p e r s o n n e l n e e d e d t o im p le m e n t t h e s e r e c o m m e n d a tio n s a r e p r e s e n t e d i n C h a p te r f i v e .

REVIEW OP RELATED LITERATURE The l i t e r a t u r e r e a d f o r t h i s i n v e s t i g a t i o n

r e p r e se n te d

a w id e v a r i e t y o f s o u r c e s a n d w as fo u n d t o be h e l p f u l a s a b a c k g r o u n d f o r a n d an a p p r o a c h t o t h e p r o b le m . s in c e i t

w o u ld b e i m p o s s i b l e

stu d y , i t

se em e d d e s i r a b l e ,

H ow ever,

t o r e v i e w much o f i t

in a sh o rt

fo r th e p u rp o se o f t h i s r e s e a r c h , %

to

d is c u s s th a t p o r tio n o f i t

th a t r e la te d i t s e l f

to th e in -

%

v e s tig a tlo n

w i t h tw o m ain p u r p o s e s i n m in d .

s id e r i t

s u c h a m anner t h a t a s b r o a d a p i c t u r e

o f th e

in

s c h o o l h e a l t h p rogram b e p r e s e n t e d .

F ir s t,

to

con­

a s p o s s ib le

S e c o n d ly , t o r e ­

f e r p r im a r ily t o th a t l i t e r a t u r e

t h a t came from c r e d i t a b l e

s o u r c e s a n d w as r e c e n t en o u g h t o

fit

i n t o the p r e s e n t p i c t u r e .

The im p o r ta n c e o f h e a l t h t o t h e s t u d e n t a n d s o c i e t y . L ite r a tu r e in

th e

f i e l d o f e d u c a tio n ,

a lm o s t w i t h o u t e x c e p t i o n ,

c o n s i d e r e d h e a l t h t o b e o f g r e a t im p o r t a n c e t o t h e i n d i v i d u a l in

ev ery p h a se o f h is e x is t e n c e .

I t h e ld th a t h e a lt h i s

im p o r t a n t t o t h e c h i l d 1 s p r o g r e s s a s a s t u d e n t .

very

The f o l l o w ­

i n g q u o t a t i o n s an d f i n d i n g s e x p r e s s t h e p r e v a i l i n g fram e o f s.

r e fe r e n c e in t h i s reg ard . The p r e s e n t i n v e s t i g a t o r , i n a c o m p a r a tiv e s t u d y o f th e p h y s ic a l c h a r a c t e r is t ic s o f f i f t y - f i v e th o se o f f i f t y - f i v e

d u ll b o y s,

b r i g h t b o y s w it h

fo u n d t h a t t h e d u l l g r o u p h ad

13 5 7 .7 p e r c e n t m ore m em bers who h a d p h y s i c a l d e v i a t i o n s from n o rm a l th a n h ad t h e b r i g h t g r o u p . o t h e r s c o n s id e r e d in t h e stu d y ,

T h is f a c t o r ,

a lo n g w it h

in d ic a t e d th a t th e b r ig h t

b o y s w e r e m ore i n t e l l i g e n t b e c a u s e t h e i r i n t e l l i g e n c e p o t e n ­ tia litie s

had n o t been red u ced by bad h e a lt h . 1

M onroe o f L ong I s l a n d U n i v e r s i t y i s n ew sp ap er a r t i c l e w ith s t a t i n g , in g c h ild r e n ,

c r e d ite d in a

a f t e r s i x t e e n y e a r s e x a m in ­

an d a s

a r e s u lt

o f an

f o o d w as r e s p o n s i b l e

f o r much

lo w I n t e l l i g e n c e .

he fe d eggn og to

c h ild r e n

tw ic e

in te llig e n c e

ten

o f n in e

Term an, i n h i s

in v e s tig a tio n , In

th a tpoor on e t e s t

d a i l y a n d fo u n d

th a t th e

in c r e a s e d . stu d y o f g i f t e d

c h ild r e n in a n a ly z in g

t h e h e a l t h f a c t o r o f t h e s e c h i l d r e n i n c o m p a r is o n w i t h o t h e r c h i l d r e n o f lo w e r I . Q . ,

fo u n d t h a t th e b r i g h t g rou p w as m

s u p e r i o r i n a lm o s t e v e r y f a c t o r t h a t c o n t r i b u t e d t o good h e a lth . 2 M oore, an a s s o c i a t e o f Term an, s a y s : . . . I have a s tr o n g c o n v ic t io n t h a t o o t h e r t h in g s b e in g e q u a l^ t h e r e i s a d i r e c t c o r r e l a t i o n b e tw e e n t h e p h y s i c a l h e a l t h an d m e n t a l i t y i n c h i l d r e n s t u d i e d i n g r o u p s . In my o p i n i o n t h e p h y s i c a l s u p e r i o r i t y o f t h e g i f t e d g ro u p i s i n d i c a t e d b y t h e h i g h e r a v e r a g e n u t r i t i o n an d by s u p e r i o r s t a b i l i t y , p h y s i c a l and m e n t a l . 3

. R ic h a r d M. C l i n e , The C o r r e l a t i o n o f H e a lth and I n - . t e l l i g e n c e , a ter m p a p e r s u b m it t e d t o th e S c h o o l o f E d u c a t io n , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , 1 9 3 9 , p . 1 5 . 2 L ew is M. Term an, C e n e t ic S t u d i e s o f Q-enius ( P a lo A l t o : S t a n f o r d U n i v e r s i t y P r e s s , 1 9 2 5 ) , p p . 1 6 9 - 1 7 1 an d 2 1 0 - 2 1 2 . 3 Ib id . , p.

251.

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fo u n d i n o n e g rou p o f 7 5 5 b o y s

t h a t 7 2 .3 p e r c e n t had n e e d o f h e a lth

s e r v ic e in r e s p e c t to

5 wP h y s i c a l F i t n e s s T h rou gh H e a lt h E d u c a t io n , 11 V i c t o r y C o r p s S e r i e s P a m p h le t No. 3 (W a s h in g to n , D. C. : U n it e d S t a t e s O f f ic e o f E d u c a tio n ), p . 8. 6 n How t h e F i r s t M i l l i o n D r a f t e d Men M ea su re d Up P h y s i c a l l y , 11 C u r r e n t O p in io n , L X X III, J u l y t o D ecem b er, 1 9 1 9 . ^ W h ite H ouse C o n f e r e n c e , A d d r e s s e s an d A b s t r a c t s o f C o m m ittee R e p o r t s (New Y ork : The C e n tu r y C om pany), p p . 2 3 2 - 3 4 . 8 T# D. Ward a n d H. S . P o w e l l , H e a lt h S u p e r v l s i on an d M e d ic a l I n s o e c t i o n o f S c h o o ls (W* B* S a u n d e r s Company, 1 9 2 7 ) , p p • 260—6 1 •

16 p o stu r e , h e a r t,

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o th e r s im ila r c o n d itio n s * b o y s an d g i r l s o f t h e

An e x a m in a t io n o f a b o u t 1 ,4 0 0

same s t u d e n t - b o d y r e v e a l e d t h a t 70 p e r

c e n t had n e e d o f c o r r e c t io n or tre a tm e n t f o r c o n d it io n o f t h e e y e s , n o s e , t h r o a t , an d t e e t h .

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made o f c h i l d r e n who h ad b e e n s u b j e c t e d f o r tw o y e a r s t o q u i t e a c o m p r e h e n s iv e p rogram o f h e a l t h e d u c a t i o n . p e r c e n ta g e s,

T h e se

t h e r e f o r e , h i g h a s t h e y a r e , p r o b a b ly a r e much

l o w e r than t h e a v e r a g e . 9 11T h r e e - f o u r t h s o f a l l t h e c h i l d r e n i n th e U n i t e d S t a t e s r e c e i v e n o d e n t a l c a r e . 1*10

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t h e i r h a n d ic a p s w i t h th em . 11

day o f s c h o o l b r in g

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a r e c e n t e x a m in a t io n o f 10,000 b o y s a n d g i r l s

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s e r io u s ly a f f e c t s th e

a d o le s c e n c e .^

9 R ic h a r d M. C l i n e , 11An A d e q u a te H e a lt h P rogram W ith E co n o m y , 11 ( u n p u b lis h e d r e s e a r c h , U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 3 5 ) , p . 1 3 . ^ A m erica n D e n t a l A s s o c i a t i o n C o n v e n tio n A s s o c i a t e d P r e s s R e p o r t . C l e v e l a n d , O h io , S ep tem b er 1 2 , 1 9 4 1 . 11

ib ia .

12 I b i d .

17 The r e l a t Io n s h ip o f h e a l t h t o

sc h o o l a tte n d a n c e »

The

fo r e g o in g p r e s e n ta tio n o f th e h e a lth s t a t u s o f sc h o o l c h i l d r e n b e c o m e s m ore s i g n i f i c a n t when c o n s i d e r e d i n i t s r e la tio n s h ip

t o t h e a b s e n c e from s c h o o l o f c h i l d r e n a s a

r e s u lt o f illn e s s * In a s t u d y o f t h e s c h o o l s o f Hammond, I n d i a n a , i t fo u n d t h a t 7 3 * 6 4 p e r c e n t o f a l l a b s e n c e w as du e t o

w as

I lln e s s .

A s t u d y c o n d u c te d i n t w e n t y - e i g h t L os A n g e le s e le m e n ­ t a r y s c h o o l s f o r o n e w eek sh ow s t h a t o f a l l a b s e n c e s 7 7 . 1 p e r c e n t w ere t h e r e s u l t o f i l l n e s s . ^ ” I t w as fo u n d from d a t a f o r a s c h o o l m onth .

. • th a t

c h i l d r e n i n H a g er to w n , M a r y la n d , l o s t on a c c o u n t o f i l l n e s s e s , fo u r p e r c e n t o f th e t o t a l p o s s i b l e

days o f a tte n d a n c e .

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a lo s s o f p o s s ib le

as a r e s u lt o f illn e s s , c e n t.

days o f a tte n d a n c e ,

r a n g i n g from 4 . 1 p e r c e n t t o 5 . 8 p e r

I n a s c h o o l p o p u l a t i o n , t h e r e f o r e , o f 3 0 ,0 0 0 t h e r e

w o u ld b e on a n y on e day a minimum a v e r a g e o f a b o u t 4 * 1 p e r c e n t o f t h e t o t a l e fir o I lm e n t, o r 1 ,2 3 0

stu d e n ts a b sen t a s a

r e s u lt o f illn e s s .

^ 0 . M* H o y t, D i r e c t o r , and J* W. L ib b y , A s s i s t a n t , A t t e n d a n c e a n d E m ploym ent o f M inors* S e c t i o n , " S tu d y o f O a u se s o f A b s e n c e — i n T w e n ty -E ig h t E le m e n ta r y S c h o o l s , ” L os A n g e le s C i t y B o a rd o f E d u c a t io n , L o s A n g e l e s , C a l i f o r n i a . 14 S e lw y n D* C o l l i n s , A s s o c i a t e S t a t i s t i c i a n , ” I n c i ­ d e n c e o f S i c k n e s s Among W h ite S c h o o l C h i l d r e n ,” R e p o r t N o. 9 9 3 (W a s h in g t o n , D. C. : T r e a s u r y D e p a r tm e n t, U n it e d S t a t e s G overnm ent P r i n t i n g O f f i c e ) .

18 What i t

c o s t s th e

s c h o o l f o r c h ild r e n t o be a b se n t

a s a r e s u lt o f I lln e s s * I t i s e s tim a te d by th e s c h o o l a u t h o r i t i e s o f th e C ou n ty t h a t o p e r a t i o n a n d m a in te n a n c e o f s c h o o l s o f t h e C i t y o f H a g er sto w n f o r t h e s c h o o l y e a r . . . c o s t $ 2 3 5 ,7 4 3 . I f d u r in g t h a t y e a r , a s i n th e p r e c e d i n g y e a r , f o u r p e r c e n t o f t h e d a y s e n r o l l e d w e re l o s t on a c c o u n t o f s i c k n e s s , t h e n f o u r p e r c e n t o f $ 2 3 5 ,7 4 3 , a b o u t $ 9 , 5 0 0 , w as r e a l l y s p e n t f o r o p e r a t i o n a n d m a in ­ t e n a n c e o f t h e s c h o o l s when c h i l d r e n w ere s i c k an d u n ­ a b le to a t t e n d s c h o o l* 15 C o n s id e r e d on t h i s b a s i s i n a s c h o o l s y s te m w i t h an a n n u a l o p e r a tin g budget o f te n m illio n

d o lla r s ,

f o r o p e r a t i o n o f t h e s c h o o l when t h e

t h e am ount s p e n t

c h ild r e n a re a b s e n t a s

a r e s u l t o f I l l n e s s w o u ld b e $ 4 1 0 ,OCX) i f

th e p e r c e n ta g e o f

a b s e n c e w as t h e p r o b a b le minimum o f 4 . 1 p e r c e n t . ever,

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5 .8 p e r c e n t,

t h e am ount t h e y s p e n t w o u ld b e $ 5 8 0 ,0 0 0 .

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sch o o l

from t h e s t a t e b a s e d on a v e r a g e d a l l y a t t e n d a n c e ,

t h e am ount r e c e i v e d w o u ld b e from 4 . 1 p e r c e n t t o 5 . 8 p e r c e n t l e s s th a n m ig h t h a v e b e e n r e c e i v e d e x c e p t f o r a b s e n c e r e s u l t i n g from i l l n e s s ,

u n le s s , a s in C a lif o r n ia ,

a n a llo w a n c e made f o r t h i s .

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th e r e i s

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d i s t r i c t h a v in g an a v e r a g e num ber b e l o n g i n g f o r t h e y e a r o f 3 0 , 0 0 0 a n d i n w h ic h t h e s t a t e c o n t r i b u t e d $ 9 0 p e r u n i t o f A . D. A . , t h e maximum am ount r e c e i v a b l e b y th e d i s t r i c t from

15 S elw y n D. C o l l i n s ,

lo c .

c it.

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s t a t e w o u ld b e $ 2 , 7 0 0 , 0 0 0 . i l l n e s s w as 5 . 8 p e r c e n t ,

I n t h e e v e n t t h e a b s e n c e due

t h e am ount r e c e i v e d from t h e

s t a t e w o u ld b e r e d u c e d b y $ 1 5 6 ,6 0 0 . i l l n e s s w as 4 . 1 p e r c e n t ,

I f t h e a b s e n c e due t o

t h e am ount w o u ld b e r e d u c e d b y

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is

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v e r y c o n s i d e r a b l e and c o n s t i t u t e s

a p r o b le m t h a t c a n n o t w e l l b e i g n o r e d . Im p ro v em en t I n h e a l t h and a t t e n d a n c e -

In th e fo llo w ­

i n g s i t u a t i o n s w h ere a d e q u a t e t e a c h e r , n u r s e , an d d o c t o r t im e w as a s s i g n e d t o w ith i l l n e s s ,

s o l v e a t t e n d a n c e p r o b le m s c o n n e c t e d

t h e h e a l t h o f t h e c h i l d r e n a n d a t t e n d a n c e im­

p roved g r e a tly .

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s t a f f o f th e

s c h o o l p r e v e n t e d many s m a ll i l l s

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P h y s i c i a n s who a t t e n d c h i l d r e n ’ s w ard s i n h o s p i t a l s know t h a t a l a r g e p e r c e n t a g e o f t h e c h i l d r e n i n b e d i n t h e s e w a r d s w o u ld n o t be t h e r e i f t h e y h a d r e c e i v e d b e t t e r c a r e i n t h e home . ♦ . T h e se a r e c h i e f l y t h e i l l n e s s e s w h ic h may b e lo o k e d u p on a s c o im p li c a t i o n s o f m ore s im p le a i l m e n t s . 1 6 The f o l l o w i n g d e s c r i p t i o n

o f a p rogram o f h e a l t h i n ­

s t r u c t i o n a n d s e r v i c e w i t h t h e r e s u l t s a t t a i n e d g i v e s some \

16 Howard R. C a r d e r , L os A n g e le s C it y S c h o o l D i s t r i c t , "D on’ t L e t L i t t l e T h in g s Becom e B i g , ’* The H e a lth N ew sO c to b c r , 1 9 3 9 , p . 4 .

20 in d ic a tio n

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i n a J u n i o r H igh

I t w as c a r r i e d o u t w i t h t h e

c o o p e r a t i o n o f t h e home room , t h e o r t h o p e d i c , t h e p h y s i c a l e d u c a tio n te a c h e r and th e o f th e

s c h o o l n u r s e w ith th e a s s is t a n c e

sc h o o l p h y s ic ia n and th e sc h o o l d e n t i s t .

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cen t o f th e

and t e e t h # stu d e n ts

from d e f e c t s o r n e e d e d c o r r e c t i o n s i n In J u n e , 1 9 3 2 ,

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s t u d e n t s w e re f r e e o f d e f e c t s o r h a d h a d r e q u i r e d c o r r e c t i o n s made#

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th e

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i n d i c a t i v e o f w h at can b e d o n e .

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c h i l d r e n w ere fo u n d t o b e O .K . ( i . e . fects),

When t h e

in r e s p e c t to th e

f r e e from d e n t a l d e ­

c o n d itio n o f t h e i r t e e t h ;

a v e r a g e num ber o f d e c a y e d t e e t h p e r c h i l d w as 2 .2 4 #

and t h e In J u n e,

1 9 3 2 , 6 4 .9 3 p e r c e n t o f t h e c h i l d r e n w ere fo u n d t o b e f r e e fro m d e n t a l d e f e c t s o r h a v in g h a d them c a r e d f o r ;

and th e

a v e r a g e num ber o f d e c a y e d t e e t h p e r c h i l d h a d d r o p p e d t o .5 7 1 .

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21 1 2 3 .8 p e r c e n t and in th e

se c o n d i n s t a n c e , 1*669 fe w e r de­

cayed t e e t h p er c h ild . W h ile t h i s program w as i n o p e r a t i o n , f o u r t e e n hom e­ r o o m s w ere g r a d u a t e d 1 0 0 p e r c e n t O.K*

T hat i s ,

every c h ild

i n e a c h o f t h e s e home room s w as O.K* a s f a r a s t h e a r e a s i n ­ v o l v e d w ere c o n c e r n e d o r h a d h ad a l l r e q u i r e d c o r r e c t i o n m a d e .^ Many o t h e r p r o g r a m s w ere fo u n d i n d i c a t i n g t h a t a g o o d h e a l t h p rogram r e s u l t s i n b e t t e r h e a l t h a n d i n b e t t e r a t t e n ­ dan ce.

The f o l l o w i n g r e p o r t I s s i g n i f i c a n t .

P la n o f t h e I n v e s t i g a t i o n . T h e p u r p o s e o f t h e i n ­ v e s t i g a t i o n w as t w o f o l d : to map o u t t h e g e n e r a l g r o w th p a t t e r n s o f a g rou p o f h e a l t h y c h i l d r e n d u r in g t h e d e ­ v e lo p m e n t a l p e r i o d an d t o d e t e r m in e t h e e f f e c t o f h e a l t h , c o n d i t i o n d u r in g i n f a n c y a n d c h i l d h o o d on t h e r a t e o f d e v e lo p m e n t o f c e r t a i n o f t h e s e g r o w th p a t t e r n s . The i n q u i r y h a s e x t e n d e d o v e r t w e l v e y e a r s . M ea su re­ m e n ts w ere made a n n u a l l y d u r in g t h e y e a r s o f m id d le a n d l a t e c h i ld h o o d . A l i m i t e d i n v e n t o r y w as made a t t h e h i g h s c h o o l l e v e l , and c o m p le te m e a s u r e m e n ts w ere a g a i n ta k e n a t th e e a r ly -m a tu r ity l e v e l . . . . The s p e c i f i c p r o b le m s o f t h i s r e s e a r c h w ere t o d e t e r m in e : ( l ) t h e e x t e n t t o w h ic h p a r t i c i p a t i o n i n a b r o a d h e a l t h - e d u c a t i o n program d u r in g c h i ld h o o d t e n d s t o i n f l u e n c e r a t e o f g r o w th a n d d e v e lo p m e n t; ( 2 ) t h e e f f e c ­ t i v e n e s s o f p r e s e n t m e th o d s o f h e a l t h e d u c a t i o n a s a m eans o f im p r o v in g h e a l t h c o n d i t i o n ; and ( 3 ) t h e im p o r ­ ta n c e o f p o s i t i v e h e a lth a s a f a c to r in th e co u rse o f g r o w th d u r in g t h e l a s t t w e l v e y e a r s o f t h e e x p e r im e n t a l

^ 1A

R ic h a r d M. C l i n e , o p . c l t . . p p . 1 6 - 1 7 .

M a rth a Crumpton H ardy a n d C a r o ly n H. H o e f e r , H e a lt h y G ro w th * C h ic a g o (T h e U n i v e r s i t y o f C h ic a g o P r e s s , 1 9 3 6 ) .

22 p e r io d . ♦ . . A t t h e f i n a l e x a m in a t io n t h e r e s u l t s w ere o v e r ­ w h e lm in g ly t o t h e a d v a n ta g e o f t h e e x p e r i m e n t a l g r o u p . S in c e a l l c a s e s w ere ex a m in ed b y t h e same d o c t o r , v a r i ­ a t i o n s i n ju d gm en t w o u ld n o t b e a f a c t o r i n t h e s e com­ p a r a tiv e d iffe r e n c e s * In g e n e r a l c o n d itio n and n u t r i­ t i o n a l s t a t u s , a s w e ll a s in s p e c i f i c te r m s, s i g n i f i c a n t d i f f e r e n c e s w e r e fo u n d . I t ca n b e s t a t e d w ith c o n fid e n c e th a t a f t e r th r e e y e a r s o f h e a lth in s t r u c t io n th e e x p e r i­ m e n ta l g r o u p w as i n a b e t t e r a l l - r o u n d c o n d i t i o n , w i t h a la r g e r p r o p o r tio n o f th e group h a v in g a go o d n u t r i t i o n ­ a l s t a t u s , e r e c t p o s t u r e , norm al e a r s , n o n - p a t h o lo g ic a l t o n s i l s , a n d c l e a n t e e t h th a n t h e c o n t r o l g r o u p . • • • The v a l u e o f t h e h e a l t h p rogram t o t h e c h i l d and t o t h e com m unity i s f u l l y a t t e s t e d b y t h e im p ro v em en t in th e p h y s i c a l c o n d it io n o f th e c h ild r e n in t h i s stu d y who p a r t i c i p a t e d i n a n y p a r t o f t h e h e a l t h w o r k . I t is c e r t a i n l y n o s m a ll r e t u r n t o f i n d t h a t a t t h e c o m p le t io n o f th r e e y e a r s o f h e a lt h e d u c a tio n 80 p er c e n t o f a s c h o o l g ro u p w ere d e s c r i b e d b y a p e d i a t r i c i a n a s i n * g ood t o e x c e l l e n t h e a l t h . 1 No l e s s s i g n i f i c a n t i s t h e f i n d i n g t h a t an i n c r e a s e i n m e n t a l e f f i c i e n c y a n d a t e n d e n c y to w a r d an a c c e l e r a t e d g r o w t h - r a t e p a r a l l e l e d t h e t r a i n i n g an d im p r o v e m e n t. S in c e a l l r e p o r t e d c h a n g e s i n d e v e lo p m e n t w ere o b s e r v e d d u r in g t h e p r o g r e s s o f t h e t r a i n i n g , t h e v a l u e o f c o n s i s t e n t d i f f e r e n c e s , e v en when t h e s e w ere s m a l l , w o u ld be g r e a t l y a u g m e n te d . M oney s a v e d a s a r e s u l t o f & g o o d h e a l t h p ro g ra m . th e

fo r e g o in g s e c t io n

t h a t in s c h o o l's

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In

w as d i s c o v e r e d

w i t h t h e c o n v e n t i o n a l p rogram i n h e a l t h ,

th e

a n n u a l a b sen ce o f c h ild r e n a s a r e s u l t o f i l l n e s s ra n g ed from 4 . 1 t o

5 .8 p er c e n t o f th e e n r o l l m e n t . T h i s

r e s u l t s i n th e e x p e n d itu r e o f la r g e

ab sen ce

sum s o f m oney when t h e

c h i l d r e n a r e a b s e n t a n d do n o t r e c e i v e t h e b e n e f i t .

19 G-. M. Hoyt' an d J . W. L ib b y , l o o , c i t . S elw y n D. C o l l i n s , l o c . c i t .

In th e

23 c a s e o f s c h o o l d i s t r i c t s t h a t r e c e i v e an a l lo w a n c e from t h e s t a t e b a se d on a v era g e d a ily a tte n d a n c e ,

i t r e s u lts ,

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to a c o n s id e r a b le r e d u c tio n i n

fro m t h e s t a t e .

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budget o f ten m illio n

d o lla r s ,

t h e am ount s p e n t when t h e

c h i l d r e n a r e a b s e n t a n d do n o t r e c e i v e t h e b e n e f i t r a n g e d fro m $ 4 1 0 ,0 0 0 t o |5 8 0 ,0 0 0 .

I n a s c h o o l d i s t r i c t o f 3 0 ,0 0 0

a v e r a g e a n n u a l e n r o llm e n t w h ic h r e c e i v e d $ 9 0 p e r u n i t o f a v era g e d a ily a tte n d a n c e ,

t h e a m o u n t r e c e i v a b l e from t h e

s t a t e w as r e d u c e d by an am ount r a n g i n g from $ 1 1 0 ,7 0 0 t o $ 1 5 6 ,6 0 0 . I t w as a l s o

d i s c o v e r e d t h a t by th e i n s t a l l a t i o n

good h e a lth p r o g r a m , t h e d a n c e w as im p r o v e d .

h e a lt h o f th e

of a

c h ild r e n and a t t e n ­

I n v ie w o f t h e f i n d i n g s , on e t o tw o p e r

c e n t im p ro v em en t i n t h e m a t t e r o f a t t e n d a n c e w o u ld b e a v e r y m o d est e x p e c t a t io n .

The d i f f e r e n c e b e tw e e n t h e p r o b a b le

minimum o f 4 . 1 p e r c e n t and t h e p r o b a b le maximum o f 5 . 8 p e r c e n t , o r 1 . 7 p e r c e n t , m ig h t b e u s e d a s an im p ro v em en t t h a t c o u l d b e e x p e c t e d on t h e i n s t a l l a t i o n

o f a good h e a lth p ro­

gram . If,

th e r e fo r e , th is

s a v i n g s h o u ld b e a p p l i e d t o t h e

d i s t r i c t w it h t h e t e n m i l l i o n d o l l a r b u d g e t , t h e am ount

R ic h a r d M. C l i n e , l o c . c i t . M arth a Crumpton H ardy an d C a r o ly n H. H o e f e r , l o c . c i t .

24

s a v e d o r s p e n t m ore e f f e c t i v e l y w o u ld be $ 1 7 0 ,0 0 0 . c a se o f th e

In th e

s c h o o l w i t h 3 0 ,0 0 0 e n r o ll m e n t w h ic h r e c e i v e d

$ 9 0 p e r u n i t o f A .D .A ., t h e am ount r e c e i v e d from t h e s t a t e w o u ld b e i n c r e a s e d by $ 4 5 ,0 0 0 . d is tr ic t, b o th t o

th e

sta te

In th e c a se o f th e l a t t e r

s a v i n g o r m ore e f f e c t i v e

s p e n d in g w o u ld a p p ly

f u n d s a n d f u n d s r e c e i v e d from o t h e r s o u r c e s .

T h is c o n t e m p la t e d im p r o v em e n t i n th e h e a l t h s t a t u s w o u ld u n d o u b t e d ly r e d u c e t h e num ber o f r e p e a t s o f c o u r s e s a n d g r a d e s and t h e r e b y e f f e c t a d d i t i o n a l e co n o m y .

The

am ount t h u s s a v e d m ig h t b e e x p e c t e d t o m ore t h a n p a y t h e d i f f e r e n c e b e tw e e n an o r d in a r y h e a l t h p rogram and a g o o d h e a lt h program . The s t a t u s o f h e a l t h k n o w le d g e among s c h o o l c h i l d r e n . I n a n s w e r t o t h e q u e s t i o n , 11I s p r o v id e d f o r s t u d e n t s in

s u f f i c i e n t h e a lth in s t r u c t io n

s e c o n d a r y s c h o o l s ? ” a s k e d o f 122

a d m i n i s t r a t o r s from s e c o n d a r y s c h o o l s a l l o v e r C a l i f o r n i a , n i n e t y - n i n e a n s w e r e d 11n o , M and t w e n t y - t h r e e a n s w e r e d « y e s . M21 A t e s t r e c e n t l y g i v e n t o 1 ,0 2 7 h i g h s c h o o l s e n i o r s in

L os A n g e l e s ,

C a l i f o r n i a , p r o d u c e d an a v e r a g e

score o f

2 W. K. Dunn, WA S u r v e y o f O p in io n o f A d m in i s t r a t o r s C o n c e r n in g P h y s i c a l E d u c a tio n i n t h e S e c o n d a r y S c h o o ls o f C a l i f o r n i a , 11 ( u n p u b l i s h e d M a s t e r 1 s t h e s i s , U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , I© s A n g e l e s , 1935*), p p . 4 9 - 7 0 .

25 7 0 p e r c e n t* The r e s u l t s o f a h e a l t h k n o w le d g e t e s t g i v e n e n t e r ­ in g fre sh m en t a t th e U n iv e r s it y o f I l l i n o i s

sh ow ed a p e r ­

c e n t a g e o f a c c u r a c y o f 3 9 .2 3 A r e v i s e d t e s t b a s e d on th e F o r s y th e -R u g e n t e s t w as g i v e n a t th e K a n sa s S t a t e C o l l e g e t o 1 ,0 0 2 fr e sh m e n who sc o r e d a p e r ce n ta g e o f a ccu ra cy o f 4 4 .4 .2 4 I n e a c h i n s t a n c e t h e s e t e s t s w ere o r g a n i z e d an d g i v e n b y r e c o g n i z e d a u t h o r i t i e s and i n e a c h c a s e , t h e r e s u l t s sh o w ed t h a t t h e a v e r a g e s c o r e o r p e r c e n t a g e s o f a c c u r a c y w a s f a r b e lo w t h a t w h ic h t h e a u t h o r i t i e s i n v o l v e d c o n s i d e r e d a f a i r e x p e c t a t i o n f o r y o u n g p e o p l e g r a d u a t i n g from o r i n t h e i r l a s t y e a r o f h i g h s c h o o l* C h a p te r summary.

S in c e t h e v a l u e o f an i n v e s t i g a t i o n

d e p e n d s p r i m a r i l y on t h e v a l u e o f t h e p rogram i n v e s t i g a t e d , t h e l i t e r a t u r e p r e s e n t e d i n C h a p te r Two w as t h a t w h ic h r e -

11H e a lt h E d u c a tio n f o r E le m e n ta r y and S e c o n d a r y S c h o o l s , ” Lob A n g e le s C i t y S c h o o ls P u b l i c a t i o n No* 3 3 0 , 1 9 4 0 , p* 2 . W arren F o r s y t h e and M ab el E. R u g en , ” A H e a lt h K n o w led g e T e s t , ” D e v i s e s o f H y g ie n e an d P u b l i c H e a l t h - The R e s e a r c h Q u a r t e r ly o f t h e H e a lt h , P h y s i c a l E d u c a tio n and R e c r e a t i o n A s s o c i a t i o n , M ay, 1 9 3 5 , p . 1 0 5 . 2 4 D a v id T* L oy an d M* W* H u sb an d , ” A H e a lt h Know­ l e d g e S u r v e y ,” K a n sa s S t a t e C o l l e g e S t u d e n t H e a lt h S e r i e s . T h e R e s e a r c h Q u a r t e r ly o f t h e H e a l t h , P h y s i c a l E d u c a t io n , an d R e c r e a t i o n A s s o c i a t i o n , May, 1 9 3 9 , p . 5 3 .

26 l a t e d t o t h e h e a l t h o f th e

s c h o o l c h i l d w i t h th e p u r p o s e i n

m in d o f d i s c o v e r i n g t h e w o r th o f h e a l t h t o t h e o v e r a l l w e l ­ f a r e o f th e c h i ld and h i s p r o g r e s s i n

sc h o o l and to d is c o v e r

w hat c o n t r ib u t io n s to th e h e a lt h o f th e s c h o o l h e a lt h p rogram s.

c h i l d w ere made b y

A b r i e f summary o f th e

t h e s e r e s p e c t s a s fo u n d i n t h e l i t e r a t u r e

fin d in g s in

s tu d ie d i s

summar­

i z e d b e lo w . 1 . H e a lt h w as c o n s i d e r e d n o t o n l y im p o r t a n t t o t h e s t u d e n t an d t o to

s o c ie t y in a g e n e r a l se n se ; b u t,

t h e p r o g r e s s i n s c h o o l o f th e

tio n

a l s o im p o r t a n t

s t u d e n t and t o t h e p r e s e r v a ­

o f h is in te llig e n c e p o t e n t ia lit ie s . 2 . The h e a l t h

s t a t u s o f th e p o p u la tio n i s

c o n s id e r e d

so f a r b e lo w w hat c o u l d be r e a s o n a b l y e s p e e t e d t h a t i t

co n ­

s t i t u t e s a s o u r c e o f r e a l c o n c e r n f o r e v e r y o n e i n anyway r e s p o n s ib le

fo r i t

o r a f f e c t e d by i t *

3 . The i l l n e s s o f s e h o o l c h i l d r e n i s a b s e n c e from s c h o o l . t o 5 .8 p e r c e n t o f th e

A b se n c e from s c h o o l r a n g e s from 4 . 1 sc h o o l p o p u la tio n .

o f a l l a b s e n c e from s c h o o l i s 4.

a m a jo r c a u s e o f

A bout 75 p e r c e n t

th e r e s u l t o f i l l n e s s .

S c h o o l s t h a t r e c e i v e p a r t o f t h e i r fu n d s from th e

s t a t e on t h e b a s i s o f A .D .A * m ay, on th e

p resen t sta tu s of

t h e h e a l t h p r o g r a m , e :x p e c t t o l o s e a t l e a s t 4 . 1 p e r c e n t o f t h is p o s s ib le

in com e a s a r e s u l t o f a b s e n c e s due t o i l l n e s s .

T h i s , h o w e v e r , r e p r e s e n t s o n l y a s m a ll p a r t o f th e

lo s s ,

m uch o f t h e m oney s p e n t from s o u r c e s o f in c o m e , o t h e r th a n

27 A .D .A * i s b e n e fit

s p e n t when s t u d e n t s a r e a b s e n t and do n o t g e t f u l l

from i t .

R e p e t i t i o n s o f c o u r s e s a n d g r a d e s made

n e c e s s a r y a s a r e s u l t o f s tu d e n t i l l n e s s r e p r e s e n t a con­ s id e r a b le l o s s . 5 . W h erever a d e q u a t e h e a l t h p r o g r a m s h a v e b e e n i n s t a l l ­ ed,

t h e h e a l t h s t a t u s h a s shown r e m a r k a b le im p r o v e m e n t. 6.

An im p r o v em e n t o f l o r 2 p e r c e n t i n a t t e n d a n c e i n

a d is tr ic t,

a v ery m od est e x p e c ta tio n

on th e

in s ta lla tio n

a g o o d h e a l t h p r o g r a m , w o u ld n o t o n ly i n d i c a t e a f i n e b u t i o n ,t o t h e h e a l t h , p r o g r e s s a n d w e l f a r e o f i t s

of

c o n tr i­

stu d e n ts,

b u t w o u ld s a v e an am ount o f m oney t h a t w o u ld p r o b a b ly be m ore th a n e n o u g h t o p a y t h e d i f f e r e n c e b e tw e e n t h e u s u a l h e a l t h p rogram a n d a g o o d o n e . 7 . The o p i n io n am ong e d u c a t o r s t h a t i n s t r u c t i o n h e a lth ,

in th e

s c h o o l s , w as i n s u f f i c i e n t ,

in

w as q u i t e g e n e r a l .

T he o p i n io n t h a t g r a d u a t i n g h i g h s c h o o l s t u d e n t s do n o t h a v e s u f f i c i e n t h e a l t h k n o w le d g e w as a l s o q u i t e g e n e r a l .

CHAPTER I I I THE ADMINISTRATION, COORDINATION AND PERSONNEL OF THE HEALTH PROGRAM I # PRACTICE AND THINKING EXPRESSED IN AUTHORITATIVE LITERATURE The a d m l n i s t r a t i o n o f t h e p r o g r a m . I t i s t h e r e s p o n s i b i l i t y o f th e s u p e r i n t e n d e n t t o e s t a b l i s h a s c h o o l o r g a n i z a t i o n w h ic h w i l l d e v e lo p f a v o r ­ a b le c o n d it io n s f o r h e a lt h f u l l i v i n g . He s u p p l i e s t h e p e r s o n n e l , d e f i n e s t h e i r u n iq u e a n d c o o p e r a t i v e d u t i e s , a n d s e r v e s t o i n t e g r a t e a l l t h e h e a lt h y a c t i v i t i e s w i t h i n t h e s c h o o l an d t o b r i n g i n t o p r o p e r f u n c t i o n i n g r e l a t i o n ­ s h i p s w i t h o t h e r a c t i v i t i e s i n t h e co m m u n ity . H is a p p r a is a l o f th e e f f e c t i v e n e s s o f h e a lt h e d u c a tio n in th e s c h o o ls w i l l in c lu d e n o t o n ly th e a t t i t u d e s o f th o s e c o n c e r n e d , t h e h a b i t s t h e y d e v e l o p , and t h e k n o w le d g e t h e y h a v e g a i n e d , b u t a l s o t h e h e a l t h s t a t u s o f th e c h i l d r e n i n th e s c h o o l a n d o f th e com m unity o f w h ic h t h e s c h o o l i s a p a r t* To h i s s c h o o l , p o t e n t i a l l y a v i t a l h e a l t h a g e n c y , come m o s t o f t h e c h i l d r e n o f t h e co m m u n ity , a n d h i s r e s p o n s i b i l i t y i s a s w id e a s t h e c o m p le x s o c i a l a rea th e y r e p r e se n t. I n e s c a p a b l y , t h e s u p e r i n t e n d e n t * s p o s i t i o n w it h r e ­ s p e c t t o t h e s c h o o l h e a l t h p rogram i s on e o f o u t s t a n d i n g im p o r t a n c e . The f i n a l ite m on an i n q u i r y from d e a l i n g w i t h h e a l t h e d u c a t i o n a s k e d , "What f a c t o r do y o u t h i n k i s p a r t i c u l a r l y im p o r t a n t i n d e t e r m i n i n g t h e s u c c e s s o f t h e s c h o o l h e a l t h p r o g r a m ? ’* From o n e o f t h e n a t io n * s . . o u t s t a n d i n g c i t i e s i n h e a l t h e d u c a t i o n came t h i s suecPqknft? r e p l y , 11The u n d e r s t a n d in g i n t e r e s t , and s u p p o r t o f th e s c h o o l a d m i n i s t r a t i o n ." 3The a t t i t u d e o f t h e p r i n c i p a l to w a r d h e a l t h s t a n d a r d s can b e ^ i t a l i z in g in f lu e n c e in th e l i f e o f th e s c h o o l, o r h e may h i n d e r , b y h i s i n d i f f e r e n c e t o h e a l t h f u l l i v i n g

^ " H e a lth i n

S c h o o l s ,"

op .

c i t * f p. 272.

29 a l l t h e I n f l u e n c e o f a n y b t h e r w is e m ent* 2 *

I d e a l h y g ie n ic e n v ir o n ­

To a s s u r e harm ony i n a c t i o n w i t h maximum e f f i c i e n c y t h e r e m u st b e u n i t d i r e c t i o n o r c o n t r o l b y t h e a d m in i­ s t r a t o r , e i t h e r d i r e c t l y b y t h e s u p e r i n t e n d e n t o r some o n e d e s i g n a t e d b y him a s an a s s i s t a n t s u p e r i n t e n d e n t , d i r e c t o r o r c o o r d in a to r * * 5 I n B in g h a m p to n , New Y o rk , p ro g ra m i s

th e d ir e c t o r o f th e h e a lt h

on e o f l i v e a d m i n i s t r a t o r s who r a n k n e x t t o t h e

s u p e r i n t e n d e n t t h u s p l a c i n g him i n a p o s i t i o n

o f im p o r ta n c e

and a u th o r ity * Some o f t h e e s s e n t i a l s l i s t e d i n

t h e o r g a n i z a t i o n an d

a d m i n i s t r a t i o n o f t h e h e a l t h p rogram w e r e : A r e c o g n i t i o n o f t h e o p p o r t u n i t y a id r e s p o n s i b i l i t y o f th e sc h o o l in r e la t io n to h e a lth . An a c c e p t a n c e b y t h e s c h o o l a d m i n i s t r a t i o n o f t h i s r e s p o n s ib ility . A p r o p e r p la c e m e n t o f h e a l t h e d u c a t i o n i n t h e a d m in i­ s t r a t i v e s e t - u p o f th e s c h o o l or s c h o o l sy stem . A c e n t r a liz e d c o n tr o l d e f i n i t e l y e s ta b lis h e < y to a s s u r e sm ooth r u n n in g an d maximum a c h ie v e m e n t i n a t t a i n i n g t h e a im s . ^ A c o m p r e h e n s iv e p rogram o f h e a l t h e d u c a t i o n i n the p u b lic

s c h o o l s w as a d v o c a t e d b y J o s e p h W* P i c h t e r ,

o f t h e N a t i o n a l G ra n g e.

2 I b id .

, p,

244.

3 IM & . , P. 1 8 . 4 I b id . , p . 2 5 .

c h a irm a n

F i c h t e r , who a l s o i s m a s t e r o f t h e

50 O h io S t a t e O ra n g e, C o lu m b u s, m ade t h e s e s u g g e s t i o n s : Ther© s h o u ld b e a s t a t e s u p e r v i s o r o f h e a l t h i n e a c h s t a t e d e p a r tm e n t o f e d u c a t i o n and a l s o i n e a c h c i t y a n d c o u n ty s c h o o l sy stem * I n ea ch s d h o o l th e r e s h o u ld b e a t e a c h e r i n c h a r g e o f h e a l t h , e x c e p t i n th e s m a l l e r s c h o o l s w h ic h m ig h t be s e r v e d b y a c i r c u i t t e a c h e r . A s c h o o l h e a l t h c o u n c i l w o u ld b e h e l p f u l f o r e a c h s c h o o l . . . . E ach c h i l d s h o u ld r e c e i v e a c o m p le te p h y s i c a l e x a m in a t io n b e f o r e e n t e r i n g s c h o o l a n d a t l e a s t e v e r y two y e a r s t h e r e a f t e r , s u c h e x a m in a t io n s b e i n g f o l l o w e d 11p r o m p tly a n d p e r s i s t e n t l y * 1 b y c o r r e c t i v e m e a s u r e s when n e c e s s a r y .^ I n Long B e a c h , tio n

C a lifo r n ia ,

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t h e C o m m issio n on E d u ca ­

( t h i s w as o n e o f f o u r c o m m is s io n s

a p p o i n t e d by t h e fo r m e r S u p e r in t e n d e n t o f s c h o o l s , F rench,

to

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s u r v e y a n d make r e c o m m e n d a tio n s f o r t h e e d u c a t io n

o f th e young c it iz e n )

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r e g a r d to th e a d m in is t r a t iv e s e t - u p

f o r th e h e a lt h program .

T h is p l a n p r o v i d e s f o r s t r o n g c e n t r a l i z e d c o n t r o l from t h e s u p e r i n t e n d e n t 1s o f f i c e ten d e n t, s c h o o l,

down th r o u g h an a s s i s t a n t s u p e r i n ­

a s s o c ia te s or d ir e c to r s ,

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and an a s s i s t a n t p r i n c i p a l o r h e a l t h c o o r d i n a t o r

in th e s c h o o l. ^ I n o r d e r t o c a r r y o u t e f f e c t i v e l y th e v a r i o u s p r o ­ p o s a l s p r e s e n t e d a b o v e , i t i s recom m end ed t h a t p r o v i s i o n b e made f o r t h e f o l l o w i n g a d m i n i s t r a t i v e p e r s o n n e l?

5

A s s o c i a t e d P r e s s D i s p a t c h , C h ic a g o , I l l i n o i s , F eb ru ary 7 , 1948. ^ nP h y s i c a l F i t n e s s , H R e p o r t o f The C o m m issio n o n The E d u c a t io n o f The Y oung C i t i z e n , Long B e a c h . The Long B each C it y S c h o o ls , 1 9 4 4 , p p . 2 7 - 2 9 .

31 1 . An A s s i s t a n t S u p e r in t e n d e n t r e s p o n s i b l e p h y s i c a l f i t n e s s a n d w e lf a r e * S p e c ific s u p e r v i s i o n and c o o r d i n a t i o n o f :

fo r g e n e ra l d u tie s —

a* H e a lt h s e r v i c e , h e a l t h i n s t r u c t i o n , h e a l t h g u id a n c e (in c lu d in g p h y s ic a l in v e n to r y o f s tu d e n ts , f o llo w up c a r e , an d e s s e n t i a l m o d i f i c a t i o n s o f p r o g r a m s ) , h e a l t h f u l s c h o o l l i v i n g , and h e a lt h o f t e a c h e r s . b* P h y s i c a l e d u c a t i o n c l a s s a c t i v i t i e s an d h a n d ic a p p e d *

fo r norm al

e* I n t r a m u r a l and i n t e r s c h o l a s t i c a t h l e t i c

sp o rts*

d* S c h o o l r e c r e a t i o n * e* S a f e t y e d u c a t io n * f* 2.

G u id a n ce an d w e l f a r e .

T h ree A s s o c ia t e s to

se r v e a s d ir e c t o r s or s u p e r v is o r s .

a* D i r e c t o r o f h e a l t h s e r v i c e , h e a l t h i n s t r u c t i o n , an d h e a l t h g u id a n c e w i t h a s t a f f o f d o c t o r s , d e n t i s t s , p s y c h i a t r i s t s , an d n u r s e s . b . D ir e c to r o f p h y s ic a l e d u c a tio n , r e c r e a t io n , and s a f e t y e d u c a tio n , w ith a t l e a s t th r e e a s s i s t a n t s u p e r v i s o r s ( o n e e a c h f o r e le m e n t a r y s c h o o l s , h i g h s c h o o l g i r l s , an d h i g h s c h o o l b o y s ) w i t h a s t a f f o f p h y s ic a l e d u c a tio n i n s t r u c t o r s , o r th o ­ p e d i c i n s t r u c t o r s , a t h l e t i c c o a c h e s , p la y g r o u n d d i r e c t o r s , a d u l t r e c r e a t i o n d i r e c t o r s , and s a f e t y e d u c a tio n in s t r u c t o r s * c* D i r e c t o r o f g u id a n c e and w e l f a r e w i t h a s t a f f o f s p e c i a l i s t s i n g u id a n c e a n d w e l f a r e , work f o r t h e h a n d ic a p p e d , an d v o c a t i o n a l a d ju s t m e n t s * 3* C o o r d in a t o r s o f h e a l t h , p h y s i c a l f i t n e s s , an d w e l f a r e , one f o r e a c h s c h o o l (e le m e n ta r y , ju n io r h ig h , s e n io r h i g h , an d j u n i o r c o l l e g e ) e a c h w i t h t h e o f f i c i a l s t a t u s o f an a s s i s t a n t p r i n c i p a l , on a f u l l - t i m e a d m i n i s t r a t i v e a s s ig n m e n t ; p a r t - t i m e m o s t l i k e l y i n e le m e n t a r y s c h o o l s . S p e c if ic d u t ie s — c o o r d in a tio n o f: a* H e a lt h s e r v i c e , h e a l t h i n s t r u c t i o n , g u id a n c e *

an d h e a l t h

32 b . P h y s i c a l e d u c a t i o n c l a s s e s f o r n o r m a l and h a n d i­ capped, c . I n t r a m u r a l and i n t e r s c h o o l a t h l e t i c

sp o r ts,

d . S c h o o l r e c r e a tio n * e.

S a fe ty e d u c a tio n , 9

f. 4.

W e lf a r e .

I

H e a lt h a n d p h y s i c a l f i t n e s s c o m m itte e 4 r e^ ea e h s c h o o l . M em bers: p r i n c i p a l , v i c e - p r i n c i p a l , h e a l t h c o o r d in a ­ to r , sch o o l d o c to r , sch o o l n u r se , sc h o o l d e n t is t , p h y s i c a l e d u c a t i o n h e a d s (m en an d w om en ), c u s t o d i a n , and l a y m em bers o f th e P a r e n t - T e a c h e r A s s o c i a t i o n .

5 . H e a lt h a n d p h y s i c a l f i t n e s s c o m m is s io n t o c o o r d in a t e t h e work ib r t h e e n t i r e s c h o o l s y s t e m , c o n s i s t i n g o f t h e A s s i s t a n t S u p e r in t e n d e n t a n d h i s t h r e e A s s o c i a t e s , e x - o f f i c i o , w i t h a d d i t i o n a l p e r s o n n e l t o b e d e t e r m in e d and s e l e c t e d . 6 . I t i s recom m end ed a l s o t h a t i n - s e r v i c e t r a i n i n g c o u r s e s be e s t a b l i s h e d and r e q u i r e d o f a l l t e a c h e r s ( n o t a l r e a d y w e l l - q u a l i f i e d ) t o p r e p a r e them b e t t e r t o c a r r y o u t t h e a b o v e recom m ended p r o p o s a l s . S u ch t r a i n i n g s h o u ld i n c l u d e , a s n e e d e d , t h e fu n d a m e n t a ls o f p h y s i c a l , s o c i a l , and e m o t i o n a l a d j u s t m e n t s ; e s s e n t i a l s o f p o s t u r a l b od y m e c h a n ic s ; h e a l t h i n ­ s p e c t i o n , h e a lt h g u id a n c e , h e a l t h c o o r d in a t io n , and i n t e r p r e t i n g h e a l t h r e c o r d s , an d a d j u s t i n g c h i l d r e n ’ s a c t i v i t i e s fo r l im i t e d p a r t i c i p a t i o n ; p e r s o n a l hy­ g i e n e ; d i s e a s e c o n t r o l ; lu n c h s u p e r v i s i o n ; f i r s t a i d a n d a c c i d e n t p r e v e n t i o n ; v e n t i l a t i o n and l i g h t i n g ; t e c h n iq u e s o f e f f e c t i v e c o o p e r a tio n w ith s c h o o l p h y s i c i a n , n u r s e , and h e a l t h c o o r d i n a t o r , an d w e l f a r e and v o c a t io n a l s u p e r v is in g H s tu d e n t r e s t i n g p e r io d s and s o c i a l a c t i v i t i e s , and r e c r e a t io n a l p la y a c t i v i ­ t i e s ; a n d f o r t h e e le m e n t a r y t e a c h e r s , t h e fundam en­ t a l s o f i n s t r u c t i o n in p h y s ic a l e d u c a tio n a c t i v i t i e s . ? I n U n i v e r s i t y H ig h , O a k la n d , C a l i f o r n i a ,

n

op.

r The C om m ission on E d u c a tio n c i t . * pp. 2 7 -2 9 .

th e l i n e

of

fo r P h y s ic a l F it n e s s ,

33

a u th o r ity i s

from t h e s u p e r i n t e n d e n t t o a n a s s i s t a n t

in te n d e n t, p r in c ip a l,

a s s is t a n t p r in c ip a l in

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g u id a n c e * 8 V I c t o r y C orp s P a m p h le t No* 3 h a s t h i s t o s a y a b o u t t h e a d m i n i s t r a t i v e s e t up; What i s e v e r y o n e ^ b u s i n e s s so o n b e c o m e s no o n e ' s b u s in e s s . I n e a c h s c h o o l o n e p e r s o n s h o u ld b e g i v e n t h e r e s p o n s i b i l i t y f o r c o o r d in a tin g a l l s c h o o l h e a lt h a c t i v i ­ t i e s a n d f o r r e l a t i n g them t o o t h e r h e a l t h a c t i v i t i e s i n t h e com m u n ity*9 I n t h e L os A n g e le s s c h o o l s y s t e m a h e a l t h c o m m itte e f o r e a c h s c h o o l i s recom m en d ed w i t h a h e a l t h c o o r d i n a t o r t o a d ­ m i n i s t e r an d c o o r d i n a t e t h e p rogram i n t h a t s c h o o l .

The tim e

a l lo w e d t h i s c o o r d i n a t o r v a r i e s w i t h t h e s i z e a n d o t h e r f a c t o r s o f a n d i n t h e s c h o o l fr o m o n e p e r i o d t o S a i d D o c to r P a u l K en n ey , C h ie f P h y s i c i a n

f u l l tim e * i 0 In sp e c to r ,

P a s a d e n a S c h o o ls ; H e a lt h E d u c a tio n can becom e f u n c t i o n a l l y e f f e c t i v e . I n f a c t i t i s f u n c t i o n a l l y e f f e c t i v e when we h a v e a d m in i­ s t r a t i v e b a c k in g * T h is i m p l i e s t h e w h o le - h e a r t e d s u p p o r t o f s u p e r i n t e n d e n t s , p r i n c i p a l s a n d d e p a r tm e n t h e a d s . We n e e d f o r t h r i g h t d i r e c t i v e s from s u p e r i n t e n d e n t s to th e e f f e c t t h a t t h e t e a c h i n g o f h e a l t h i s o f p r im a r y im p o r ­ t a n c e ; t h a t c u r r i c u l f r a d j u s t m e n t s a r e t o b e m ade, so

Q

M a rio n B row n, HThe H e a lt h Program i n U n i v e r s i t y H ig h S c h o o l," U n i v e r s i t y H ig h S c h o o l J o u r n a l , Volum e 1 7 , Number 1 , O c to b e r , 1 9 3 8 , p . 5. 9 P h y s i c a l F i t n e s s V i c t o r y C orp s P a m p h le t No* 3 , c it . , p. 83. ^ ^ " H e a lt h E d u c a tio n ," c i t . , p. 4.

op*

L os A n g e le s C i t y S c h o o l s , o p *

34 t h a t n e c e s s a r y a d j u s t m e n t s i n t e a c h i n g p e r s o n n e l may b e made so t h a t t h i s p ro g ra m o f h e a l t h e d u c a t i o n w i l l b e ­ come e f f e c t i v e . H Some o f t h e p o l i c i e s

c o n s id e r e d e s s e n t i a l to in s u r e

a g o o d p ro g ra m a r e g i v e n i n t h e f o l l o w i n g

sta te m e n t.

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f o r th e s c h o o l h e a lt h program .

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s h o u ld b e

som e o n e r e s p o n s i b l e f o r t h e e n t i r e h e a l t h p rogram in t h e sy stem w ith th e d ir e c to r .

s t a t u s o f an a s s i s t a n t s u p e r i n t e n d e n t o r

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s u p e r in te n d e n t i n a c i t y

s h o u l d h a v e o n e o r m ore a s s i s t a n t s w i t h a d e q u a te ea ch h e a lth In

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s c h o o l. C o o r d in a t in g t h e h e a l t h p r o g r a m .

a w id e s p r e a d c o n v i c t i o n t h a t t h e r e i s

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f u n c t io n s o f th e h e a lt h program , h e r e t o f o r e l a c k ­

in g ,

i n o r d e r t o make t h e p rogram e f f e c t i v e

C o o r d in a t io n i s t h e r e s u l t o f t h e

and f u n c t io n a l.

e f f i c i e n t a d m in is tr a tio n

o f a l l t h e f a c t o r s i n v o l v e d an d o f a p r o p e r r e l a t i o n s h i p

and

^ MR e g i o n a l I n s t i t u t e o n P h y s i c a l F i t n e s s , ” P r o c e e d ­ i n g s . U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , F e b r u a r y , 1 9 4 4 .

35 c o o p e r a t i o n among t h e a d m i n i s t r a t o r s a n d o t h e r p e r s o n n e l e m p lo y e d i n t h e program *

The f o l l o w i n g o p i n i o n s and p r a c ­

t i c e s e x p r e s s e d t h e p o s i t i o n t a k e n i n m o st o f t h e l i t e r a ­ t u r e s t u d ie d * The s c h o o l h e a l t h p rogram i s made up o f s e v e r a l com­ p o n e n t s , e a c h w it h i t s own d i s t i n c t i v e p u r p o s e b u t a t t h e sam e tim e so in t e r w o v e n w it h t h e o t h e r t h a t no one can f u n c t i o n c o m p l e t e l y b y i t s e l f w h il e a l l h a v e t h e same u l t i m a t e o b j e c t i v e — h e a lt h * To a c h i e v e t h e m o st s a t i s f a c t o r y r e s u l t s , a l l p h a s e s o f t h e h e a l t h p rogram m u st b e i n c l u d e d a n d c o o r d i n a t e d . F or e x a m p le , t h e r e i s t h a t s e c t i o n w h ic h i n t r o d u c e s t h e d o c t o r s , n u r s e s , and o th e r s p e c i a l i s t s . I t s w ork i s b a s e d s t r i c t l y on t h e k n o w le d g e and s k i l l o f th e m e d i c a l a n d d e n t a l p r o f e s s i o n . Y et t h e s e w ork ers are n e v e r to a c h ie v e th e r e s u l t s so u g h t u n l e s s t h e p r i n c i p a l s and c l a s s room t e a c h e r s a s w e l l a s c u s t o d i a l and j a n i t o r i a l s t a f f a d d t h e i r i n t e l l i g e n t , w h o le - h e a r t e d e f f o r t . I n e v e r y s c h o o l a n d s c h o o l s y s t e m t h e r e s h o u ld b e a p e r so n in g e n e r a l ch arge o f th e e n t i r e program . T h is p e r s o n s h o u ld b e f u l l y p r e p a r e d b y t r a i n i n g a n d e x p e r i ­ e n c e t o d i r e c t an d c o o r d in a t e t h e v a r i o u s p h a s e s o f t h e p rogram a n d t o s e e t h a t n o n e o f them i s n e g l e c t e d . An a d v i s o r y c o m m itte e may be fo u n d h e l p f u l b y t h i s c o o r d i ­ n a t in g d ir e c t o r o f s c h o o l h e a lt h a c t i v i t i e s . 13 The f o l l o w i n g s t a t e m e n t from t h e Long B e a c h Commis­ s i o n p r o b a b ly a p p l i e s i n g r e a t e r o r l e s s in s ta n c e s g r e a te r , -th r o u g h o u t th e

degree,

i n m o st

i n e v e r y s c h o o l an d s c h o o l s y s te m

c o u n tr y .

P e r h a p s t h e m o st s t r i k i n g w e a k n e s s i n t h e t o t a l p h y s i c a l f i t n e s s p ro g ra m f o r t h e e n t i r e s c h o o l s y s te m

12 HH e a lt h i n S c h o o l s , ”

c it* f p . 16

S t a t e D e p a r tm en t o f E d u c a t i o n , D i v i s i o n o f P h y s i ­ c a l and H e a lt h E d u c a t i o n , News L e t t e r No* 5 1 . S a c r a m e n to , C a l i f o r n i a , O cto b er , 1 9 3 9 .

36 I s t h e l a c k o f an o v e r - a l l c o o r d i n a t i n g p l a n w it h t r a i n ­ e d p e r s o n n e l , w o r k in g c o o p e r a t i v e l y I n a l l d i v i s i o n s from t h e s u p e r i n t e n d e n t ’ s o f f i c e down, t o s y n c h r o n iz e t h e e f f o r t s o f a l l a g e n c i e s an d p e r s o n n e l i n f l u e n c i n g th e c h ild ’ s p h y s ic a l f i t n e s s . Two e x i s t i n g d e p a r tm e n ts t h o s e o f h e a l t h s e r v i c e and p h y s i c a l e d u c a t i o n a r e w e l l o r g a n iz e d , b u t n e i t h e r h a s s u f f i c i e n t h e lp n or s u f f i c i ­ e n t a u t h o r i t y t o s e e t h a t an e f f e c t i v e c o o r d i n a t e d p r o ­ gram i s c a r r i e d th r o u g h t o e a c h c h i l d c o n t i n u o u s l y and p r o g r e s s i v e l y i n e v e r y s c h o o l se g m e n t. I n d i v i d u a l P h y s i c a l F i t n e s s C o o r d in a t o r s i n e a c h s c h o o l a i d e d b y a p p r o p r i a t e g u id a n c e c o m m it t e e s seem t o o f f e r t h e o n l y p o s s i b l e m ean s o f c a r r y i n g o u t an e f f e c t i v e program . Some o f t h e e s s e n t i a l

f a c t o r s th a t e n te r in to th e

c o o r d i n a t i n g p r o c e s s o f a g o o d h e a l t h p rogram a s s u g g e s t e d fro m v a r i o u s 1.

so u rces are

su m m a rized a n d l i s t e d

T h e r e I s an a d m i n i s t r a t i v e o f f i c e r

b e lo w . in th e

sy ste m ,

i n e a c h se g m e n t a n d i n e a c h s c h o o l o n e o f w h o se d u t i e s i t is

to

c o o r d i n a t e t h e v a r i o u s f u n c t i o n s o f t h e h e a l t h p ro g ra m

and a ls o

to

c o o r d in a t e t h e h e a l t h

c o n tr ib u tio n s o f o th e r

d e p a r tm e n ts. 2.

A l l th e v a r io u s h e a lt h f a c t o r s i n r e g a r d t o a

s t u d e n t a r e a s s e m b le d i n on e p l a c e i n t h e s c h o o l and c o n ­ s titu te

a h e a lt h in v e n to r y f o r t h a t stu d e n t fo r th e con ­

v e n i e n t u s e o f t e a c h e r s an d h e a l t h p e r s o n n e l . 3.

The h e a l t h i n v e n t o r y o f t h e s t u d e n t i s

on w h ic h t h e p rogram o f h e a l t h f o r t h e

stu d e n t i s

th e b a s i s b u ilt;

14 i^Qng B e a c h C o m m issio n on E d u c a t io n f o r P h v s i £ a l E ltoff.fi.fl, op.. £ i £ . , p . 3 7 .

37 th a t i s ,

th e ty p e o f p h y s ic a l a c t i v i t y ,

e x tr a c u r r ic u la r lo a d ,

a c a d e m ic l o a d ,

c l a s s a s s ig n m e n t s from t h e s t a n d p o i n t

o f n e e d e d h e a l t h i n s t r u c t i o n , a n d s p e c i a l p rogram f o r t h e c o r r e c tio n o f d e fe c ts i s

g o v ern ed by th e h e a lt h in v e n to r y

o f t h a t stu d e n t* 4 . E v e r y d e p a r tm e n t m akes i t s u s u a l c o n t r i b u t i o n t o t h e h e a l t h o f t h e s t u d e n t and t o h e a l t h i n s t r u c t i o n ; th ese

but

c o n t r i b u t i o n s a r e p r e d i c a t e d on a common fram e o f

r e f e r e n c e s an d made

to

su p p le m e n t a n d r e i n f o r c e

each o th e r .

5 . A t e s t i n g p r o c e d u r e t h a t m ak es i t p o s s i b l e t o e v a l u a t e t h e p rogram o r d e te r m in e t h e h e a l t h

s t a t u s , h e a lth

k n o w le d g e , o r h e a l t h p r a c t i c e s o f t h e g ro u p o r t h e i n d i v i d u a l a t a n y t im e i s

in u s e .

6 . C o u r s e s o f i n s t r u c t i o n i n h e a l t h t o im p a r t d e s i r e d a n d n e e d e d h e a l t h k n o w le d g e s a s r e v e a l e d b y t h e t e s t i n g p r o ­ gram a r e g i v e n a t v a r i o u s l e v e l s . in s tr u c tio n

T h ese c o u r s e s o f h e a lt h

a r e i n t e n s i v e f o r a t l e a s t tw o s e m e s t e r s i n

j u n i o r and s e n i o r h i g h s c h o o l .

H e a lt h i n s t r u c t i o n i s g i v e n

i n p r o p e r l y e q u ip p e d c la s s r o o m s an d c l a s s e s a r e s m a ll en o u g h t o g e t g o o d r e s u l t s . tio n

U n its o f t h i s h e a lt h i n s t r u c ­

a re b u i l t around th e h e a lt h n e e d s o f ea ch stu d e n t and

t h e c o r r e c t i o n o f t h e s e n e e d s b e c o m e s an o b j e c t i v e o r r e ­ q u ir e m e n t o f t h e 7.

co u rse.

T h e se c l a s s e s i n c l u d e a l l s t u d e n t s .

The s c h o o l a n d com m u nity p ro g ra m i n h e a l t h i s

c o o r d in a te d .

28 II.

RETURNS FROM THE INQUIRY

One p u r p o s e o f t h e I n q u i r y w as t o f i n d

s c h o o l s and

s c h o o l sy ste m s th a t had good program s in h e a lt h by r e q u e s t­ in g th e v a r io u s a u t h o r i t i e s in to l i s t

them f o r u s .

th e f i e l d o f p u b lic e d u c a tio n

The r e s u l t s o f t h i s p a r t o f t h e i n ­

q u i r y , I te m I . , w ere p r e s e n t e d i n The o t h e r o p in io n o f th e s e

C h a p te r O ne, p a g e e i g h t .

p u r p o s e o f t h e i n q u i r y w as t o g e t t h e a u t h o r i t i e s in th e f i e l d

of

p u b lic educa­

t i o n i n r e g a r d t o p o l i c i e s c o n s i d e r e d fu n d a m e n ta l t o t h e e s t a b l i s h m e n t o f an e f f e c t i v e h e a l t h p ro g ra m . and r e tu r n s fo llo w

h e r e w ith .

The q u e s t i o n s

S in c e som e o f t h e s e q u e s t i o n s

p a r a l l e l t h o s e o f t h e q u e s t i o n n a i r e , t h e r e s u l t s a r e com­ b in e d w ith th o s e o f th e q u e s t io n n a ir e in t h e i r th e n e x t s e c t io n I n an sw er

o f t h i s stu d y . t o I te m I I , 11What f a c t o r do

p a r t i c u l a r l y im p o r ta n t i n s c h o o l h e a l t h program

o f th e

d e t e r m in in g t h e

you c o n s id e r

su ccess o f a

, t h e m a j o r i t y o p i n io n o f th e f o r t y

e d u c a t o r s who r e p l i e d i s 1.

tr e a tm e n t in

su m m a rized i n t h e

two s t a t e m e n t s :

wThe m o st im p o r t a n t f a c t o r i n a s s u r i n g t h e

s c h o o l h e a l t h p rogram i s

a p r o g r e s s iv e ,

su ccess

s y m p a t h e t ic

and c o o p e r a t i v e a d m i n i s t r a t i o n . 11 2. Ha d e q u a t e ,

The n e x t m o st f r e q u e n t l y m e n t io n e d f a c t o r w a s , t r a i n e d c o o p e r a t i v e p e r s o n n e l . 11

S in c e t h e c o o p e r a t i v e p e r s o n n e l i n t h e

secon d s t a t e -

39 m en t in c lu d e d th e a d m in is t r a t o r s , i t u n a n im o u s o p i n io n o f t h e s e m in is tr a tiv e th e

e d u c a t o r s t h a t t h e p r o p e r ad­

s e t u p w as t h e m o st im p o r t a n t f a c t o r

in s e c u r in g

s u c c e s s o f th e h e a lt h program . I te m I I I .

I n I t e m num ber t h r e e , " S h o u ld t h e r e b e a

f u l l t im e a d m i n i s t r a t o r r e s p o n s i b l e i n th e c it y

f o r t h e h e a l t h p rogra m

s y s te m ? ” , f o r t y o r 1 0 0 p e r c e n t o f t h o s e r e p l y ­

in g an sw ered y e s .

The m a j o r i t y o p i n i o n

e ^ r e s s e d in th e f o llo w in g is

seem ed t o b e t h e a lm o s t

a c o m p le x a r e a i n

sta te m e n t.

In t h i s r e g a r d i s "The h e a l t h p r o g r a m

e d u c a t io n a n d n e e d s t r a i n e d and a b l e

le a d e r s h ip ." I te m

IV .

I n r e p l y t o it e m

sy stem r e s p o n s ib le

f o u r , "The o f f i c e r

f o r t h e a d m i n i s t r a t i o n and c o o r d i n a t i o n

o f t h e h e a l t h p rogram s h o u ld h a v e t h e t h r e e p r o p o s e d th e

in th e

s t a t u s o f : " , tw e n ty -

sta tu s o f a s s is ta n t

su p e r in te n d e n t and

s e v e n te e n t h a t o f d ir e c t o r o f th e h e a lt h program , in b o th i n s t a n c e s i n d i c a t i n g an o f f i c e r o n t h e to p l e v e l . r e a so n s fo r t h is

c h o i c e a r e su m m a rized i n t h e

The

fo llo w in g

sta te m e n ts. 1. a d ir e c to r

"The a u t h o r i t y o f an a s s i s t a n t s u p e r i n t e n d e n t o r i s n e e d e d to a d m in is te r and c o o r d in a te a t o t a l

h e a l t h p ro g ra m ." 2 . " H e a lt h s h o u ld r e c e i v e f i r s t

c o n s id e r a t io n and

th e c o n se q u en t a d m in is tr a tiv e a t t e n t io n ." I te m V.

In a n s w e r t o i t e m

fiv e ,

"For th e o v e r a l l

40 s u p e r v i s i o n o f t h e h e a l t h p rogram i n c l u d i n g h e a l t h h e a lt h g u id a n c e , you fa v o r :

!•

an d h e a l t h i n s t r u c t i o n

in th e

a 1d o c t o r o f m e d i c i n e 1 o r 2 .

s e r v ic e ,

s y s te m do

1an e d u c a t o r

w i t h s u i t a b l e b a c k g r o u n d f o r h e a l t h a d m i n i s t r a t i o n 1. 11 T h i r t e e n c h o s e a d o c t o r o f m e d ic in e a n d t w e n t y - s e v e n c h o s e an e d u c a to r . In th e

f i r s t in s ta n c e s i t

is

in t e r e s t in g to n o te

t h a t a l l t h e M .D .! s t h o u g h t t h a t t h i s o f f i c e r

s h o u ld b e a

d o c to r o f m e d ic in e . In th e seco n d in s ta n c e th e

c h o i c e on t h e p a r t o f t h e

e d u c a t o r s w as tw o t o o n e i n f a v o r o f an e d u c a t o r f o r t h i s o ffic e . The c o n s e n s u s o f o p i n i o n w as t h a t an a d m i n i s t r a t i v e e d u c a t o r w i t h a d o c t o r o f m e d ic in e i n

an a d v i s o r y c a p a c i t y

m ade t h e b e s t s e t up f o r t h i s p u r p o s e . I te m V I . To t h e

f i n a l q u e s t io n i n th e I n q u ir y ,

e a c h s c h o o l s h o u ld on e p e r s o n be r e s p o n s i b l e

”ln

f o r c o o r d in a ­

t i n g a n d s u p e r v i s i n g t h e h e a l t h p ro g ra m ? ” , t h i r t y - e i g h t an sw ered y e s .

The r e a s o n s f o r t h i s

c h o ic e a re

su m m arized

a s fo llo w s : 1 . No o t h e r way w i l l g e t c o o r d i n a t i o n an d r e s u l t s . 2.

I t i s n ecessa ry fo r e ffic ie n c y .

41 III.

QUESTIONNAIRE RETURNS

The r e t u r n s from t h e q u e s t i o n n a i r e s s e n t o u t i n c o n n e c tio n w ith t h i s

stu d y r e v e a l th e p r a c t ic e s in th e

a d m i n i s t r a t i o n a n d c o o r d i n a t i o n o f t h e s c h o o l H e a lt h P r o ­ gram . 15 T h is p a r t an d t h e n a i r e w ere d i v i d e d i n t o t h e C ity

s u b s e q u e n t p a r t s o f t h e Q u e s t io n ­ tw o m ain s e c t i o n s , wP r a c t i c e s i n

System** a id n P r a c t i c e s i n t h e I n d i v i d u a l S c h o o l . 11 THE ADMINISTRATION AND COORDINATION OF A GOOD HEALTH PROGRAM IN A CITY SCHOOL SYSTEM

A . The A d m i n i s t r a t i v e O f f i c e r f o r t h e H e a lt h P rogram i n t h e S y s te m .

(T h e p r a c t i c e s i n t h i s r e s p e c t a r e i l l u s t r a t e d

i n T a b le I , p a g e The t i t l e s

4 3 ).

and s t a t u s g i v e n t o t h e o f f i c i a l s who h a v e

t h i s a s s ig n m e n t i n t h i s T a b le *

th e v a r io u s sy ste m s a re l i s t e d

I n Column O ne, I te m E i g h t , t w e n t y - s e v e n

sc h o o l sy ste m s,

o r 9 6 . 4 p e r c e n t o f th e

h a v e s u c h an o f f i c e r . g iv e th e t i t l e sev en

in

sy ste m s.

sy ste m s r e p o r te d ,

The o t h e r i t e m s i n

or sta tu s o f th is o ffic e r

th is

colum n

in th e s e tw e n ty -

Colum n Two g i v e s t h e p e r c e n t a g e i n

i n s t a n c e b a s e d on t h e num ber o f s y s t e m s r e p o r t e d *

O f* o o s t . A p p e n d ix , p . 1 5 0 .

each

42 S in c e p r a c t i c e g e n e r a l l y i n d i c a t e s a p p r o v a l , t h e p r a c t i c e s r e p o r t e d i n Column One a r e c o m b in e d i n Column T h ree w ith th o s e a p p ro v ed in th e r e p l i e s r e c e iv e d to i n d i c a t e t h e t o t a l o f t h e recom m en d ed p r a c t i c e s i n e a c h item *

Column Four g i v e s th e p e r c e n t a g e i n

each ca se o f

t h e t o t a l r e p l i e s r e c e iv e d * I n Colum n T h r e e o f I t e m s One and Two a r e t h e t o t a l s o f t h e p r a c t i c e s shown jn t h e f i r s t a p p r o v a ls r e p o r te d in n a ir e in

colu m n and th e

th e I n q u i r y l S

t h e Q u e s t io n ­

each in s ta n c e .

The p e r c e n t a g e s f o r t h e s e i t e m s a r e f i g u r e d on t h e r e p l i e s r e c e iv e d in th e I n q u ir y and Q u e s tio n n a ir e , or n in e ty -s ix .

The p e r c e n t a g e s f o r t h e o t h e r i t e m s i n

Column T h r e e a r e

shown i n Column Four and a r e b a s e d on

t h e r e p l i e s from t h e Q u e s t i o n n a i r e , o r f i f t y - s i x . r e a d i n g Ite m One from l e f t t o r i g h t ,

T h u s,

s e v e n te e n o r 6 0 .7

p er c e n t o f th e tw e n ty -e ig h t sy ste m s r e p o r te d gave th e title

o f D i r e c t o r o f th e H e a lt h P rogram t o t h i s o f f i c e r .

F o r ty -n in e o r 5 1 .0 p e r c e n t o f th e tie s

a n s w e r in g t h i s q u e s t i o n i n

sy ste m s o r a u th o r i­

t h e I n q u i r y and t h e

Q u e s t i o n n a ir e recom m end ed t h i s p r a c t i c e . I f th e

fir s t

tw o i t e m s i n Colum n T h r e e a r e c o m b in e d ,

s e v e n t y - s e v e n o r 8 0 . 2 p e r c e n t o f t h o s e i n Column T h r e e

1

R e t u r n s from t h e I n q u i r y , Ite m I V , P a g e 3 9 .

43 TABLE I THE ADMINISTRATIVE OFFICER FOR THE HEALTH PROGRAM IN THE SCHOOL SYSTEM

TITLE OR STATUS

ITEM 1.

PRACTICE RECOMMENDED F requ en cy P e r c e n t F req u en cy P er cen t COLUMNS - 1

D i r e c t o r o f H e a lt h P rogram

2

17

3

60* 7

4

*49

5 1 .0

2.

A s s i s t a n t S u p e r in t e n d e n t

2

7*1

*28

2 9 .2

3.

D i r e c t o r o f H e a lt h and P h y s i c a l E d u c a tio n

4

1 4 .2

4

7 .1

4* O f f i c i a l from C it y H e a lt h D ep a rtm en t

2

7*1

2

2. 2

5* D i r e c t o r o f H e a lt h E d u c a tio n

.1

3*6

1

1*8

6* H e a lt h C o o r d in a t o r

1

3*6

1

1.8

7 . D i r e c t o r o f H e a lth S e r v ic e 8.

S y s te m s H a v in g S u ch O ffic e r s

1.8

27

9 6 .4

*86

S y s te m s r e p o r t e d - 2 8 R e p l i e s R e c e i v e d from t h e Q u e s t i o n n a i r e s - 56 ♦ R e p l i e s R e c e i v e d from I n q u i r y and Q u e s t i o n n a ir e - 96

8 9 .6

44 who a p p r o v e d t h e u s e o f s u c h an o f f i c e r

in

t h e s y s te m

i n d i c a t e a v e r y s t r o n g p r e f e r e n c e f o r an o f f i c e r w i t h g r e a t a u t h o r i t y t o a d m i n i s t e r t h e H e a lt h P rogram . B . Time D e v o te d t o t h e H e a lth P rogram b y t h e A d m i n i s t r a t i v e O f f ic e r in th e

S y s te m .

The am ount o f t im e d e v o t e d t o th is

sch o o l o ffic e r

o f th e

sy stem .

v a r i e d to

th e a d m in is t r a t io n by

some e x t e n t w i t h t h e

s iz e

In a l l sy ste m s, h ow ever, e x c e p t th e

s m a ll

o n e s , p r a c t i c e and o p i n i o n s f a v o r e d t h e u s e o f a l l h i s t im e f o r t h i s

fu n c tio n .

C olum ns One and Two,

Ite m O ne, T a b le I I , p a g e 4 5 ,

show e i g h t e e n

sy stem s o u t o f tw e n ty -

e i g h t o r 6 4 .3 p e r c e n t h ad f u l l tim e a d m i n i s t r a t o r s . C olum ns T h r e e an d F o u r show s e v e n t y - s i x o u t o f n i n e t y - s i x o r 7 9 . 2 p e r c e n t o f t h o s e a n s w e r in g t h i s q u e s t i o n i n Q u e s t i o n n a ir e an d i n

th e

t h e I n q u i r y 17 recom m end ed a f u l l

tim e a d m i n i s t r a t o r f o r t h e H e a lt h P rogram . C . A l l t h e F u n c t io n s o f t h e H e a lth P rogram a r e C o o r d in a t e d t h r o u g h t h e A d m in is t r a t o r o f t h e

H e a lt h P rogram .

One o f t h e f a c t o r s t h a t w as c o n s i d e r e d e s s e n t i a l t o th e

s u c c e s s o f t h e H e a lt h P ro g ra m , a s fo u n d i n t h e r e ­

la te d lite r a tu r e ,

w as a c o o r d i n a t i o n o f t h e

fu n c tio n s o f

t h e p ro g ra m t h r o u g h a c o m p e te n t a d m i n i s t r a t o r .

1 7 .Qf* a n t e , I n q u i r y , I te m I I I , p .

39.

The r e -

45 TABLE I I TIME DEVOTED TO HEALTH PROGRAM BY ADMINISTRATIVE OFFICER

TIME DEVOTED TO PRACTICE ASSIGNMENT F requ en cy P e r c e n t ITEM 1* A l l

COLUMNS - 1

2

RECOMMENDED F requency 3

P er cen t 4

18

64*3

♦76

7 9 .2

2* T w o - t h ir d s

2

7 .1

4

7 .1

3 . O n e -h a lf

6

2 1 .4

10

1 7 .9

4 . O n e -th ir d

2

7 .1

10

1 7 .9

S y s te m s R e p o r t e d - 2 8 R e p l i e s R e c e i v e d from th e Q u e s t i o n n a ir e - 56 ♦ R e p l i e s R e c e i v e d from t h e I n q u i r y a n d Q u e s t i o n n a ir e -

96

t u r n s from th e Q u e s t i o n n a ir e an d t h e I n q u ir y r e i n f o r c e t h i s p o in t o f v ie w . T w e n ty -sev e n o r 96*4 p e r c e n t o f th e t w e n t y - e ig h t r e p o r t e d e m p lo y e d t h i s j p r a c t i c e .

Of th e f i f t y - s i x

e d u c a t o r s an d a u t h o r i t i e s who a n s w e r e d t h e q u e s t i o n , fifty

o r 8 9 .3 p e r c e n t ap p roved I t .

A s s i s t a n t s t o t h e A d m in i s t r a t o r f o r t h e P i t y I f th is o ffic e r s tr a tio n

is

t o do a g o o d jo b i n

t h e a d m in i­

and c o o r d i n a t i o n o f t h e H e a lt h p rogram w hat

a d m in is tr a tiv e a s s i s t a n t s

s h o u ld h e h a v e ?

The r e t u r n s i n t h e Q u e s t i o n n a ir e th e

S y s te m .

show t h a t i t

w as

g e n e r a l p r a c t i c e f o r th e D ir e c t o r , o r S u p e r v is o r ,

o f H e a lt h S e r v i c e , tio n

an d t h e D i r e c t o r o f H e a lt h I n s t r u c ­

a n d P h y s i c a l E d u c a tio n t o b e on h i s

sta ff.

The p r a c t i c e s a n d r e c o m m e n d a tio n s i n r e g a r d t o t h i s q u e s t i o n a r e shown i n T a b le I I I , p a g e 4 7 . I te m O ne, r e a d i n g from l e f t

to r ig h t ,

T h u s, i n

C olum ns One a n d

Two show t h a t t w e n t y - f o u r o r 8 5 . 1 p e r c e n t o f t h e tw e n ty e ig h t sy ste m s r e p o r t e d th e D ir e c t o r or S u p e r v is o r o f H e a lt h S e r v i c e on t h e H e a lt h P ro g r a m .

s t a f f o f t h e A d m in i s t r a t o r o f t h e

C olum ns T h r e e a n d Four show t h a t t h i r t y -

e i g h t o r 6 7 .9 p e r c e n t o f t h e f i f t y - s i x who r e p l i e d h a v e in d ic a t e d t h e ir a p p ro v a l o f th e p r a c t ic e by u s in g or reco m m en d in g i t .

47 TABLE I I I ASSISTANTS TO THE ADMINISTRATOR FOR THE CITY SYSTEM

DIRECTOR OR SUPERVISOR PRACTICE RECOMMENDED OF; F r e q u e n c y P e r c e n t F r e q u e n c y P e r cent ITEM

COLUMNS

-

1

2

3

4

1.

H e a lt h S e r v i c e

24

85*1

38

6 7 .9

2*

H e a lt h I n s t r u c t i o n

20

7 1 .4

38

6 7 .9

16

5 7 .1

35

6 2 .5

3* P h y s i c a l E d u c a tio n a n d R e c r e a tio n 4*

S c i e n c e D ep a r tm en t

2

7 .1

3

5 .3

5.

C u r r ic u lu m D ep a rtm en t

1

3 .6

2

3 .5

6.

C o r r e c t i v e D ep a r tm en t

1

3. 6

2

3 .5 \

S y s te m s R e p o r t e d - 2 8 R e p lie s R e c e iv e d - 56

48 THE ADMINISTRATION AND COORDINATION OF THE HEALTH PROGRAM IN THE INDIVIDUAL SCHOOL I t i s n o t o n l y im p o r t a n t t o know t h e p r a c t i c e s and p e r s o n n e l t h a t s y s t e m s w it h Good H e a lt h P ro g ra m s u s e , it

is

a ls o

im p o r t a n t t o know how s u c h a p rogram i s

ed and c o o r d in a te d in a c tu a lly

a d m in is te r ­

t h e i n d i v i d u a l s c h o o l w h ere t h e c h i l d r e n

come In c o n t a c t w it h i t .

e m in e n t a u t h o r i t i e s ,

but

The f o l l o w i n g o p i n i o n s o f

an d t h e r e s u l t s o f t h i s

stu d y , p r e s e n t

v a l u a b l e i n f o r m a t i o n on t h e p r o b le m ; A. T h ere I « a H e a lt h C o o r d in a to r i n t h e

S c h o o l.

I n t h i s i n s t a n c e some d i f f e r e n c e s w e re fo u n d i n th e s t a t u s and t i t l e

o f t h e c o o r d i n a t o r , b e tw e e n J u n io r an d

S e n io r H igh S c h o o l a n d E le m e n ta r y S c h o o ls * sa ry ,

th e r e fo r e ,

to

I t w as n e c e s ­

c o n s i d e r them s e p a r a t e l y *

T a b le I V , p a g e 4 9 , r e a d in g from l e f t

to r ig h t ,

Ite m O n e, C olum ns One and Two show t h a t o n e h u n d r e d a n d t h i r t y - e i g h t o r 2 7 . 5 p e r c e n t o f 6 6 5 J u n io r a n d S e n io r H igh S c h o o l s t h a t r e p o r t e d h a v e a H e a lt h C o o r d in a t o r . C olum ns T h re e and F o u r show t h a t t w e n t y - t w o o r 3 9 . 3 p e r c en t o f f i f t y - s i x r e p l i e s fa v o r t h i s t i t l e *

I te m

S ix

sh ow s t h a t tw o h u n d r e d a n d s e v e n t y - e i g h t o r 4 1 . 8 p e r cenifc o f t h e s i x h u n d r e d and s i x t y - f i v e have

s u c h an o f f i c e r *

show t h a t f i f t y - f i v e

H igh S c h o o l s r e p o r t e d

C olum ns T h re e a n d F o u r , Ite m o r 9 8 .2 p e r c e n t o f t h e r e p l i e s

S ix ,

49 TABLE IV THE OFFICER WHO COORDINATES THE HEALTH PROGRAM IN THE JUNIOR AND SENIOR HIGH SCHOOL

TITLE

PRACTICE F requ en cy

ITEM

COLUMNS

P er cent

F requ en cy

P er cen t

1

2

138

2 7 .5

22

3 9 .3

52

7 .8

5

8 .9

3 . A s s is ta n t P r in c ip a l

39

5 .9

7

1 2 .5

4 . V ic e P r i n c i p a l

25

3 .8

10

1 7 .8

1.

H e a lt h C o o r d in a t o r

2.

H ead o f D e p t, o f H e a lt h and P h y s i c a l E d u c a tio n

-

RECOMMENDED

5

4

5.

T each er D ir e c to r

24

3 .6

11

1 9 .6

6.

J r . a n d S r . H ig h S c h o o ls H a v in g S u ch an O f f i c e r 2 7 8

4 1 .8

55

9 8 .2

J u n io r and S e n io r H igh S c h o o ls R e p o r t e d R e p l i e s R e c e i v e d - 56

665

50 r e c e i v e d f a v o r h a v in g s u c h an o f f i c e r * I n th e - E le m e n ta r y S c h o o ls f o u r h u n d re d a n d t h i r t y e ig h t o r 3 0 .1 p e r c e n t , fo u r s c h o o ls ,

o u t o f f o u r t e e n h u n d r e d and f i f t y -

r e p o r t e d h a v in g a h e a l t h c o o r d in a t o r and tw o

hundred f i f t y - s e v e n

o r 10*8 p e r c e n t have a te a c h e r d ir e c ­

to r ,

in T a b le V , p a g e 5 1 .

as illu s tr a te d

S i n c e , i n a n s w e r t o th e q u e s t i o n i n

th e I n q u i r y ,I B

” I n e a c h s c h o o l s h o u ld o n e p e r s o n b e r e s p o n s i b l e f o r c o o r d i ­ n a t i n g and s u p e r v i s i n g t h e H e a lt h P rogram ?” , t h i r t y - e i g h t o u t o f f o r t y who r e p l i e d tic e

an d o p i n i o n a r e

o f f i c e r in th e

s a id y e s ,

s tr o n g ly in

it

is

e v id e n t t h a t p r a c ­

f a v o r o f h a v in g s u c h an

s c h o o l.

3. The S o h o o l O f f i c i a l R e s p o n s i b l e f o r t h e H e a lt h P rogram C o o r d in a t e s t h e S c h o o l H e a lth P rogram w it h O u t - o f - S c h o o l H e a lt h A g e n c i e s a n d P r o g r a m s. T h is w as th e p r a c t i c e i n o n e th o u s a n d e i g h t y - f o u r o r 51 p e r c e n t o f a l l

s c h o o ls r ep o rted *

F o r t y - f o u r a d m in i­

V.J

s t r a t o r s recom m end ed t h e p r a c t i c e . • A l l S c h o o l P e r s o n n e l C o o p e r a t e s w it h t h e ” H e a lt h C o o r d in a ­ to r ” in

C o o r d in a t in g A l l o f t h e F u n c t i o n s and F a c t o r s i n

t h e H e a lt h P rogram o f t h e S c h o o l . T h ir te e n h u n d red , o r 61 p e r c e n t , o f th e

18 ££* a n t e , I n q u i r y , Ite m V I, p . 4 0 .

s c h o o ls r e -

51 TABLE V THE OFFICER WHO COORDINATES THE HEALTH PROGRAM IN THE ELEMENTARY SCHOOL

PRACTICE

TITLE

RECOMMENDED

F requen cy P er c e n t F req u en cy P er c e n t ITEM 1.

COLUMNS -

H e a lt h C o o r d in a t o r

1

2

3

4

438

3 0 .1

27

4 8 .2

2 • T each er D ir e c to r

257

1 0 .8

16

2 8 .5

3* H ead o f D ept* o f H e a lt h a n d P h y s i c a l E d u c a t io n

1 16

7 .9

12

2 1 .3

4 . E le m e n ta r y S c h o o ls H a v in g S u ch an O f f i c e r 811

5 5 .8

55

9 8 .2

E le m e n ta r y S c h o o ls R e p o r t e d R e p l i e s R e c e i v e d - 56

1454

52 p o r te d t h i s p r a c tic e a s th e p o lic y , th e f i f t y - s i x

and f o r t y - e i g h t o f

e d u c a t o r s recom m en d ed t h e p r a c t i c e *

The C o u n c il or S t a f f o f th e

S c h o o l H e a lt h P ro g ra m *

E le v e n h u n d r e d and t e n

s c h o o ls r e p o r te d th a t th ey

h a d a H e a lt h C o u n c il o r S t a f f c o m p o sed o f v a r i o u s s c h o o l o ffic ia ls ,

a s i l l u s t r a t e d i n T a b le V I, p a g e 53*

T h u s,

i n I te m O ne, C olum ns One a n d Two, o n e t h o u s a n d o n e hun­ d red and te n o r 5 2 .3 p e r c e n t o f th e s c h o o ls r e p o r te d i n c l u d e t h e t e a c h e r o f h e a l t h i n s t r u c t i o n on t h e s c h o o l H e a lt h C o u n c il o r S t a f f . fifty -fiv e

I n Colum ns T h re e a n d F o u r ,

o f f i f t y - s i x h e a lth a u t h o r it ie s r e p ly in g , or

9 8 .2 p e r c e n t , recom m end t h a t t h i s t e a c h e r b e i n c l u d e d on t h e c o u n c i l . It is

e v i d e n t from th e r e s u l t s

t h a t t h e H e a lt h C o u n c il j n t h e

show n i n

th is

ta b le

s c h o o l h a s w id e u s e i n

s c h o o l s w i t h g o o d H e a lt h P ro g ra m s a n d h a s a lm o s t t h e u n a n im o u s a p p r o v a l o f t h e e d u c a t o r s who r e p l i e d t o t h e in v e s tig a tio n .

The r e m a r k s o n t h e r e t u r n s i n d i c a t e d t h a t

t h e H e a lt h C o u n c il w as on e o f t h e m o st e f f e c t i v e i n s t r u ­ m e n ts i n c o o r d i n a t i n g t h e H e a lt h P rogram i n t h e S.

s c h o o l.

A T e s t i n g P rogram De s i g n e d t o E v a lu a t e O utcom e s . P r a c t i c e s . p r o c e d u r e s , an d t h e H e a lth The r e s u l t s o f t h i s

S ta tu s o f S tu d e n ts I g in U se . s e c tio n

o f th e Q u e s t i o n n a ir e

i n d i c a t e t h a t t h e m ark s o f a g o o d p rogram a r e g o o d t e s t i n g

53 TABLE VI THE SCHOOL HEALTH COUNCIL OR STAFF WHO ASSIST THE SCHOOL HEALTH COORDINATOR

iEMBERS

PRACTICE

RECOMMENDED

F requ en cy P e r c e n t F requ en cy P e r c e n t ITEM 1.

COLUMNS - 1

3

4

1110

5 2 .3

55

2 . N u r se

1109

5 2 .2

56

3* P r i n c i p a l

1096

5 1 .6

53

94. 6

4.

1003

4 7 .2

44

7 8 .5

5 . A tte n d a n c e

982

4 6 .2

43

7 6 .7

6*

S ch ool D e n tis t

940

4 4 .2

36

6 4 .3

7.

H ead o f D e p t , o f H e a lt h & P h y s i c a l E d u c a tio n

920

4 3 .3

51

9 1 .1

8.

H e a lt h C o o r d in a t o r

907

4 2 .2

55

9 8 .2

9.

C o u n s e lo r

907

42*2

47

84.

• o H

T e a c h e r o f H e a lt h I n s tr u c tio n

2

H o m em a k in g .T ea ch er

861

4 0 .6

43

7 6 .7

11.

T ea ch er o f C o r r e c tio n o r O r t h o p e d ic Gym.

807

3 3 .3

34

6 0 .7

1 2 . H ead C a r e t a k e r

247

11. 6

10

1 7 .8

1 3 . P .T .A . R e p r e s e n t a t i v e o r Lay P e r s o n

237

1 1 .0

12

2 1 .3

1 4 . C a f e t e r i a M anager

173

8 .1

8

1 4 .3

S c h o o l D o cto r

9 8 .2 100.

54 TABLE VI ( c o n t i n u e d ) THE SCHOOL HEALTH COUNCIL OR STAFF WHO ASSIST THE SCHOOL HEALTH COORDINATOR

PRACTICE

MEMBERS

RECOMMENDED

F requ en cy P e r c e n t

ITEM 15.

COLUMNS - 1 S c ie n c e T ea ch er

3

4

78

3*7

4

7*1

39

1 .8

3

5 .3

S c h o o l s H a v in g H e a l t h C o u n c ils 1110

5 2 .3

16* B o a r d o f H e a lt h R e p r e s e n ta tiv e 17.

2

F requ en cyP er c e n t

S c h o o ls R e p o r te d - 2 1 2 3 R e p l i e s R e c e iv e d 56

55 p r o c e d u r e s a n d a c o m p le t e h e a lt h , r e c o r d f o r e a c h s t u d e n t a c c e s s a b le

t o and u s e d b y e a c h o f h i s t e a c h e r s .

A s i n d i c a t e d i n T a b le V I I , p a g e 5 6 ,

C olum ns One

and Two, Ite m O ne, o u t o f two t h o u s a n d o n e h u n d re d a n d tw e n ty -th r e e

s c h o o l s r e p o r t e d , o n e th o u s a n d e i g h t hun­

d r e d t w e n t y - e i g h t o r 8 6 * 1 p e r c e n t k e e p a HC o m p r e h e n siv e an d C u m u la tiv e R e c o r d f o r E a c h S t u d e n t . 11 T h re e an d F o u r , f i f t y - s i x ,

I n Colum ns

or 100 p er c en t o f r e p lie s

r e c e i v e d , recom m end t h i s p r a c t i c e * Two v e r y s i g n i f i c a n t f e a t u r e s o f t h i s T a b le r e ­ v e a l t h a t o n e th o u s a n d t h r e e h u n d r e d an d t w e n t y - t w o s c h o o ls

su rv ey th e h e a lt h p r a c t i c e s o f a l l

s t u d e n t s an d

b a s e t h e p rogram o f h e a l t h g u id a n c e and i n s t r u c t i o n on t h e n e e d s d is c o v e r e d *

N in e h u n d r e d an d s i x

t h e r e s u l t s o f h e a l t h k n o w le d g e t e s t s to

s c h o o ls u se

g iv e n a l l

g u id e i n t h e d e v e lo p m e n t o f c o u r s e s o f s t u d y .

stu d e n ts T h e se

p r a c t i c e s a re in l i n e w ith th e t r e n d s a s r e v e a le d in th e lit e r a t u r e

s tu d ie d fo r t h i s in v e s t ig a t io n .

C h a n te r summary. I n t h i s

summary t h e

i s u s e d a s t h a t u s e d i n th e q u e s t io n n a ir e .

sam e o u t l i n e The p r a c t i c e

i n m o st g e n e r a l u s e a s shown b y t h e r e t u r n s from t h e q u e s ­ tio n n a ir e

is

g iv e n i n

each in s ta n c e .

The r e c o m m e n d a tio n s

t h a t w ere made i n t h e r e p l i e s a n d t h e o p i n i o n s e x p r e s s e d in

t h e l i t e r a t u r e w ere i n

fin d in g s *

s u b s t a n t i a l a g r e e m e n t w it h t h e s e

56 TABLE V II THE TESTING- PROGRAM IN THE SCHOOLS REPORTED IN THE INVESTIGATION

PRACTICE

TIPE OF TESTS & RECORDS

RECOMMENDED

F requ en cy P er c e n t ITEM

COLUMNS - 1

1 , A C o m p r e h e n siv e an d C u m u la tiv e R e c o r d i s K e p t f o r E ach S t u d e n t

2

F requ en cy P er cen t 3

4

1828

8 6 .1

56

1 0 0 .0

H e a lt h R e c o r d s A re So A r r a n g e d T h at t h e H e a lt h S t a t u s Can Be A s c e r t a i n e d a t Any Tim e .

1777

8 3 .2

56

1 0 0 .0

5* H e a lt h P r a c t i c e s o f A l l S t u d e n t s A re S u rv ey ed to D is c o v e r N e e d s f o r G u id a n ce and I n s t r u c t io n

1322

6 3 .2

56

1 0 0 .0

968

4 0 .9

56

1 0 0 .0

906

4 0 .8

53

9 4 .6

2.

4.

T h er e i s a T e s t i n g P rogram i n t h e S c h o o l

5* H e a lt h K n ow led ge T e s t s A re G iven A l l S t u d e n t s t o G u id e i n D e v e l o p in g C o u r s e s o f S tu d y

S c h o o l s R e p o r te d - 2 1 2 3 R e p l i e s R e c e i v e d - 56

57 THE ADMINISTRATION AND COORDINATION OF A GOOD HEALTH PROGRAM IN A CITY SCHOOL SYSTEM

\ P a r t I*

The c i t y

sy stem .

A. The a d m i n i s t r a t i v e o f f i c e r th e

c ity

s y s te m i s

B* The D i r e c t o r i s

f o r t h e h e a l t h p rogram i n \

t h e D i r e c t o r o f t h e H e a lt h P ro g ra m .

a s s i g n e d f u l l t im e t o t h e h e a l t h

program . C. A l l

th e f u n c t i o n s o f t h e h e a l t h p rogram i n

t h e s y s te m

a re c o o r d in a te d b y t h i s D ir e c t o r . D. A s s i s t a n t s o r a s s o c i a t e s o f t h e D i r e c t o r o f th e H e a lt h P rogram a r e a d i r e c t o r o r s u p e r v i s o r o f : S e r v ic e ;

2.

1 . H e a lt h

H e a lt h I n s t r u c t i o n an d 5 . H e a lt h P h y s i ­

c a l E d u c a tio n an d R e c r e a t i o n . P art I I .

The a d m i n i s t r a t i o n and c o o r d i n a t i o n o f t h e h e a l t h

p ro g ram i n

th e i n d iv i d u a l s c h o o l.

A . T h e r e i s an o f f i c e r i n e a c h s c h o o l t o a d m i n i s t e r a n d c o o r d i n a t e t h e h e a l t h p rogram w i t h t h e t i t l e

of

H e a lt h C o o r d in a t o r , B. The H e a lt h C o o r d in a t o r i s th is

fu n c tio n e x c e p t in

a s s i g n e d f u l l t im e f o r

s m a ll s c h o o ls *

C* A l l t h e f u n c t i o n s and f a c t o r s i n

t h e h e a l t h p rogram

i n t h e s c h o o l a r e c o o r d i n a t e d by t h i s o f f i c e r . D* The H e a lt h C o o r d in a t o r i s C o u n c il o f t h e

s c h o o l.

t h e c h a irm a n o f t h e H e a lt h

The H e a lt h C o u n c il i s g e n ­

58 e r a l l y co m p o se d o f the f o l l o w i n g p e r s o n n e l * n u r s e , p r in c ip a l, d e n tis t,

s c h o o l d o c to r , a tten d a n ce o f f i c e r ,

h e a d s o f th e p h y s i c a l e d u c a tio n

m e n t s - - b o y s and g i r l s , hom em aking a n d th e E.

sch ool

d e p a r t-

c o u n s e lo r s , h ea d s o f th e

s c i e n c e d e p a r tm e n ts *

He a d m i n i s t e r s a t e s t i n g p r o g r a m .

In t h i s t e s t in g

p rogram t h e p h y s i c a l i n s p e c t i o n s f u r n i s h t h e d a t a o n w h ic h i s p r e d i c a t e d t h e h e a lth fu l l iv i n g ,

an d from w h ic h i s

c u m u la t iv e h e a l t h h i s t o r y * k n o w le d g e t e s t s

s tu d e n t’ s p r o j e c t s in record ed h is

The r e s u l t s o f h e a l t h

form t h e b a s i s f o r t h e c o u r s e i n

h e a lth in s tr u c tio n * Some o f t h e f a c t o r s fo u n d t o b e e s s e n t i a l t o t h e c o o r d i n a t i o n o f t h e h e a l t h program f o l l o w . 1.

T h er e i s an a d m i n i s t r a t i v e o f f i c e r e a c h s e g m e n t, a n d i n to

in th e

sy s te m i n

e a c h s c h o o l w h o se d u ty i t

is

c o o r d in a te th e v a r io u s f u n c t io n s o f t h e h e a lt h

program . 2* T h e r e i s a h e a l t h c o u n c i l b o th on t h e in th e

c ity

l e v e l an d

s c h o o l co m p o sed o f a l l t h e p e r s o n n e l i n

each

i n s t a n c e w h o se s u b j e c t s make c o n t r i b u t i o n t o t h e h e a l t h p rogram a n d o f t h o s e w h ose f u n c t i o n i t w ork w it h t h e 3.

is

to

c u r r ic u lu m .

The h e a l t h p ro g ra m i n

t h e s y s te m an d i n t h e s c h o o l

h a s t h e i n t e r e s t a n d a c t i v e b a c k in g o f t h e s u p e r i n ­ t e n d e n t an d o f th e p r i n c i p a l i n e a c h i n s t a n c e .

CHAPTER IV HEALTH SERVICE INSTRUCTION AND GUIDANCE

.

IN THE HEALTH PROGRAM I.

TRENDS AND PRACTICES IN HEALTH SERVICE

H e a lt h S e r v i c e r e f e r s t o t h o s e s e r v i c e s r e n d e r e d t o s tu d e n ts by sc h o o l o f f i c e r s and a g e n c ie s d e s ig n e d to p r o te c t a n d c o n s e r v e t h e i r h e a lt h * The P r a c t i c e s an d T h in k in g R e v e a le d b y L i t e r a t u r e on th e S u b je c t* I t is

e v i d e n t from t h i s l i t e r a t u r e t h a t l e a d e r s i n

e d u c a t i o n a n d i n a l l w a lk s o f l i f e a v a ila b le to

e x p e c t t h e s c h o o l t o make

th e c h i l d a l l th o s e s e r v i c e s t h a t w i l l p r o t e c t

a n d p r o m o te h i s h e a l t h . F o r e v e r y c h i l d , h e a l t h p r o t e c t i o n from b i r t h th r o u g h a d o l e s c e n c e , i n c l u d i n g p e r i o d i c a l h e a l t h e x a m i n a t io n s , a n d , w hen n e e d e d , c a r e o f s p e c i a l i s t s a n d h o s p i t a l t r e a t ­ m e n t, r e g u l a r d e n t a l e x a m i n a t io n s a n d c a r e o f th e t e e t h ; p r o t e c t i v e an d p r e v e n t i v e m e a s u r e s a g a i n s t c o m m u n ic a b le d i s e a s e s , t h e i s s u i n g o f p u r e f o o d , p u r e m ilk a n d p u r e w a t e r .1 " C u r r e n t s c h o o l h e a l t h s e r v i c e may b e c o n s i d e r e d w oe­ fu lly

i n a d e q u a t e i n te r m s o f t o t a l c o v e r a g e ." s The f o l l o w i n g r e q u ir e m e n t s f o r an a d e q u a t e H e a lt h

S e r v i c e P rogram a r e a c o m p o s it e l i s t

o f t h e r e c o m m e n d a tio n s

S e c t i o n V, " C h i ld r e n ’ s C h a r te r ." ^ " H e a lt h In S c h o o l s ,"

op.

c i t . , p* 5 6 1 .

60 and p r a c t ic e s d e s c r ib e d in th e r e f e r e n c e s l i s t e d

a t th e

c lo s e o f t h i s s e c tio n * 1* An e n v ir o n m e n t c o n d u c iv e t o

good h e a lth :

c la s s ­

r o o m s , t o i l e t s a n d a l l o t h e r room s p r o v i d e d w i t h p r o p e r lig h tin g ,

v e n tila tio n ,

te m p e r a t u r e an d s a n i t a r y f a c i l i t i e s ;

s p a c io u s grou n d s w ith g r a s s and sh ad e; a d e q u a te p r o p e r ly e q u ip p e d an d s u r f a c e d p l a y g r o u n d s ; m e n t a l a n d p h y s i c a l h e a lt h o f t e a c h e r s and o th e r p e r s o n n e l a ss u r e d ; p a r t o f th e s c h o o l t o

e f f o r t on

s e c u r e h e a l t h f u l e n v ir o n m e n t i n t h e

home an d com m unity* 2.

The s e r v i c e s o f d o c t o r s ,

a s s is ta n ts ,

d e n tis ts , p s y c h ia tr is ts ,

a n d n u r s e s t o m e e t a l l t h e dem ands o f an a d e ­

q u a t e program *

The c o n s e n s u s o f o p i n i o n se e m e d t o b e t h a t

e a c h s c h o o l w i t h an e n r o llm e n t o f f i v e h u n d r e d o r m ore s h o u ld have a f u ll- t im e n u r se . 3 . T h a t p r o v i s i o n b e made f o r an e x t e n s i v e m e d ic a l a n d p h y s i c a l e x a m in a t io n o f a l l

stu d e n ts;

o n e , upon f i r s t

e n te r in g s c h o o l;

tw o , p e r i o d i c a l l y

t h e r e a f t e r on e n t r a n c e

t o e a c h s e g m e n t;

th r e e , o f p r o s p e c tiv e p a r tic ip a n ts b e fo r e

ea ch s e a s o n o f s p o r t o r o th e r a c t i v i t y o f a v ig o r o u s n a tu r e ; f o u r , o n r e t u r n from s e r i o u s o r r e p e a t e d i l l n e s s ;

fiv e ,

as

o c c a s i o n may dem and. 4 . A c u m u la t iv e h e a l t h r e c o r d b e k e p t f o r e v e r y s t u ­ dent in

t h e a d m i n i s t r a t i v e o f f i c e t o w h ic h t e a c h e r s an d a d ­

m i n i s t r a t o r s may r e f e r a n d w h ic h w i l l go from se g m e n t t o

61 se g m e n t w i t h t h e s t u d e n t . in g s o f p h y s ic ia n s ,

T h is r e c o r d w o u ld c a r r y t h e

d e n tis ts ,

and o t h e r r e s u l t s

fin d ­

s ig n ific a n t

to h e a lt h . 5.

The c la s s r o o m

t e a c h e r s h o u l d be f a m i l i a r w i t h t h e

h e a l t h s t a t u s o f e a c h s t u d e n t a n d s h o u ld so o r g a n i z e t h e e la s s w o r k t h a t th e h e a l t h o f t h e s t u d e n t s i s p r o t e c t e d a n d p r o m o te d .

T h is t e a c h e r s h o u ld a d d s i g n i f i c a n t h e a l t h f i n d ­

in g s in r eg a r d to

s tu d e n ts to th e

s t u d e n t s 1 H e a lt h R e c o r d s .

6 . T h a t a d e q u a te c l e r i c a l tim e b e a s s i g n e d t o do t h e r e q u i r e d c l e r i c a l w o rk . 7 . T h at q u i e t ,

s u i t a b l y e q u ip p e d r e s t r o o m s be p r o ­

v i d e d f o r b o y s a n d g i r l s w h ere t h e y may l i e th e n eed i s

in d ic a te d .

down w h e n e v e r

Such r e s t r o o m s s h o u ld b e u n d e r a d u l t

s u p e r v i s i o n when i n u s e . 8.

T h a t c o n d i t i o n s c o m p a ta b le t o h e a l t h p r e v a i l i n

c a f e t e r i a and lu n c h e o n a r r a n g e m e n t s , i n c l u d i n g b a la n c e d m e a ls a n d n o o n h o u r s t h a t a l l o w a m p le tim e f o r e a t i n g an d r e l a x a ­ tio n . 9.

T h a t a d e q u a t e h a n d w a sh in g f a c i l i t i e s w i t h h o t

w a t e r , l i q u i d so a p a n d p a p e r t o w e l s b e p r o v i d e d . 10.

T h a t some q u a l i f i e d p e r s o n b e a s s i g n e d t o a d m in i­

s t e r and c o o r d in a te t h e s e s e r v i c e s ,

and to

c o o r d i n a t e them

62 w i t h t h e o t h e r f u n c t i o n s o f t h e H e a lt h P r o g r a m .3 R e t u r n s From t h e Q u e s t i o n n a i r e i n R e g a r d t o H e a lt h S e r v ic e . I n t h i s p a r t o f C h a p te r I V , th e p r a c t i c e s a n d r e c o m ­ m e n d a t io n s i n r e g a r d t o h e a l t h s e r v i c e ,

as r e v e a le d in

r e t u r n s from th e Q u e s t i o n n a i r e , a r e p r e s e n t e d .

th e

The h e a d i n g s

a nd s u b - h e a d in g s u s e d i n t h e Q u e s t i o n n a i r e a r e u s e d i n t h e sam e o r d e r i n t h i s p r e s e n t a t i o n .

The r e s u l t s a r e l i s t e d

in

th e o r d e r o f h ig h e s t fr e q u e n c y . HEALTH SERVICE PERSONNEL AND PRACTICES IN THE SCHOOL SYSTEM A. The S t a t u s o f t h e O f f i c e r i n C h arge o f H e a lt h S e r v i c e i n t h e S y s te m . The s t a t u s

th a t i s

g iv e n to

t h i s o f f i c e r i n th e

s y s t e m s r e p o r t e d a r e i l l u s t r a t e d i n T a b le V I I I , p a g e 6 3 . T h u s, i n Ite m O ne, Colum ns One a n d Two, s e v e n t e e n

sy ste m s

o r 5 0 . 7 p e r c e n t o f th e t w e n t y - e i g h t r e p o r t e d g i v e t h i s o f f i c e r t h e s t a t u s o f D i r e c t o r o f H e a lt h S e r v i c e .

In

^ n H e a lt h i n S c h o o l s , M o p . c i t . , p p . 2 5 - 2 7 . 11H e a lt h E d u c a t i o n ,” S c h o o l s P u b l i c a t i o n N o . 3 3 0 , O f f i c e o f S u p e r i n t e n d e n t , L os A n g e l e s C i t y S c h o o l s . ” The H e a lt h P rogram i n U n i v e r s i t y H i g h / 1 The U n i­ v e r s i t y H ig h S c h o o l J o u r n a l . 1 7 : 1 - 1 6 , O c t o b e r , 1 9 3 8 . 11R e p o r t o f t h e C om m ission i n E d u c a t io n f o r P h y s i c a l F i t n e s s , L ong B e a ch C it y S c h o o l s , J u n e 1 , 1 9 4 4 , p p . 7 - 8 .

63 TABLE V I I I THE OFFICER FOR THE HEALTH SERVICE PROGRAM IN THE SYSTEM

STATUS

PRACTICE

RECOMMENDED

F requ en cy P er c e n t ITEM

COLUMNS

F requ en cy P e r 'c e n t 3

4

- 1

2

17

6 0 .7

39

6 9 .6

S u p e r v is o r o f H e a lth S e r v ic e

8

2 8 .6

12

2 1 .4

3 . D i r e c t o r o f H e a lt h and P h y s ic a l E d u c a t io n

2

7 .1

2

3 .5

4 . C i t y H e a lt h O f f i c e r

1

3 .6

6

1 0 .7

17

6 0 .7

34

6 0 .7

D i r e c t o r o f H e a lt h S e r v ic e 2.

5.

He i s a D o c t o r o f M e d ic in e

S y s te m s R e p o r t e d - 2 8 R e p l i e s R e c e i v e d - 56

64 C olum ns T h r e e an d F o u r , t h i r t y - n i n e

o r 6 9 .6 p e r c e n t o f t h e

r e p l i e s r e c e i v e d recom m ended t h a t t h i s o f f i c e r b e g i v e n t h a t sta tu s.

I n Ite m F i v e ,

s e v e n t e e n o r 6 0 .7 p e r c e n t o f t h e

s y s te m r e p o r t e d t h e em p loym en t o f a d o c t o r o f m e d ic in e f o r t h i s fu n c t io n r e g a r d le s s o f th e t i t l e .

T h i r t y - f o u r o r 6 0 .7

p e r c e n t recom m end t h a t t h i s o f f i c e r b e a d o c t o r o f m e d i e i n e . The r e t u r n s a s p r e s e n t e d i n T a b le V I I I show b o th by p r a c t i c e a n d a p p r o v a l , a v e r y s t r o n g p r e f e r e n c e f o r an o f f i ­ cer fo r t h is

f u n c t io n , w ith th e a u t h o r it y o f a d i r e c t o r ,

and in t h i s I n s t a n c e , a d o c to r o f m e d ic in e . ►SfL iiL fL Member o f t h e H e a lt h C o u n c il f o r t h e T w e n ty -o n e o r 7 5 e m p lo y e d t h i s p r a c t i c e ,

per

S y s te m .

c e n t o f th e sy ste m s r e p o r tin g

and f o r t y - t h r e e o r 7 6 . 8 p e r c e n t o f

th e r e p l i e s r e c e iv e d a p p ro v ed t h i s p r a c t i c e . ► He C o o r d in a t e s t h e H e a lt h S e r v i c e P rogram o f t h e S y stem w i t h O u t-o f- S c h o o l A g e n c ie s . T w e n t y -s e v e n o r 9 6 . 4 p e r c e n t o f th e s y s t e m s r e p o r t e d u sed t h i s p r a c t ic e ,

an d f o r t y - n i n e o r 8 7 . 5 p e r c e n t a d v o c a t e d

it. , He S e e s t h a t t h e E n v ir o n m e n t i n t h e

S c h o o ls i s

S u ch T h a t

t h e H e a lt h o f S t u d e n t s a n d T e a c h e r s i s P r o m o te d a n d C o n s e r v e d . N i n e t e e n , o r 6 7 .9

per

c e n t o f th e sy ste m s r e p o r te d ,

a s s ig n e d t h i s r e s p o n s ib i li t y to t h i s o f f i c e r , o r 8 7 . 5 p e r c e n t recom m end t h i s p r a c t i c e .

and f o r t y - n in e

65 E . He H as A s s i s t a n t s W hose A c t i v i t i e s He C o o r d i n a t e s . I te m O ne, C olum ns One a n d Two, o f T a b le IX , p a g e 6 6 ,. sh ow s t h a t t w e n t y - e i g h t , sy stem s r e p o r te d ,

a s s i g n n u r s e s a s a s s i s t a n t s to t h e

D i r e c t o r o f H e a lt h S e r v i c e . fifty

o r 100 p e r c e n t o f th e

I n C olum ns T h r e e a n d F o u r ,

o r 8 9 .3 p e r c e n t o f th e r e p l i e s r e c e iv e d ap p roved

t h is p r a c tic e . T h is T a b le sh ow s t h a t a l a r g e m a j o r i t y , b y p r a c ­ t i c e and a p p r o v a l,

f a v o r a s s i g n i n g t h e n u r s e s , m e d ic a l

h e a lth in s p e c to r s ,

d e n t i s t s and d e n ta l I n s p e c t o r s ,

p lo y e d by th e

em­

sy s te m , to th e s t a f f o f th e D ir e c to r o f

H e a lt h S e r v i c e .

F b r ty -fo u r and s i x - t e n t h s p e r c e n t

th o u g h t t h a t m e n t a l h y g e n i s t s s h o u l d b e s o a s s i g n e d ;

and

3 3 .9 p e r c e n t recom m end ed t h a t t h e d i e t i c i a n s b e p l a c e d on h i s

sta ff.

F. f f u r s e - P u p i l R a t io i n t h e S y s te m . T a b le X, p a g e 6 7 ,

sh o w s a w id e v a r i e t y o f p r a c t i c e

i n r e g a r d t o t h e num ber o f n u r s e s e m p lo y e d , i n p r o p o r ­ t io n to th e p u p il p o p u la t io n , o f th e sy s te m s r e p o r te d . A r a tio

o f on e n u r s e t o

e a c h on e th o u s a n d p u p i l s ,

as

show n i n I te m Two, w as f a v o r e d b y q u i t e a l a r g e m a r g in . T h u s, i n Ite m Two, C olum ns One a n d Two, n i n e o r 3 2 . 1 p e r c e n t o f th e sy ste m s r e p o r te d u s e t h i s p r a c t ic e ;

tw e n ty -

one o r 3 7 .5 p e r c e n t ap p rove t h i s n u r s e - p u p il r a t i o . T h is w id e d i v e r g e n c e i n p r a c t i c e se e m s t o r e s u l t

66 TABLE I X ASSISTANTS TO THE DIRECTOR OF HEALTH SERVICE FOR THE SYSTEM

TITLE

ITEM

PRACTICE

RECOMMENDED

F requ en cy P er c e n t

F requ en cy P er c e n t

COLUMNS

- 1

2

1. N u rses

28

1 0 0 .0

50

8 9 .3

2* M e d ic a l H ea lth . In sp e c to r s

22

7 8 .6

44

7 8 .6

3* D e n t a l a n d D e n t a l H y g ie n is ts In ­ sp e c to r s

20

7 1 .4

41

7 2 .9

4 . M e n ta l H y g i e n i s t s

9

3 2 .1

24

4 4 .6

11

3 9 .3

19

3 3 .9

5. D ie tic ia n s

S y s te m s R e p o r te d - 2 8 R e p l i e s R e c e i v e d - 56

3

4

67 TABLE X NURSE-PUPIL RATIO FOR THE SYSTEM OR THE SCHOOL

ONE NURSE TO EACH?

PRACTICE

RECOMMENDED

F requ en cy P e r c e n t

F requ en cy P e r c e n t

2

3

4

4

1 4 .2

8

1 4 .2

2. 1 0 0 0 S t u d e n t s

9

3 2 .1

21

3 7 .5

3. 1500 S tu d e n ts

5

1 7 ,9

7

1 2 .5

4 . 2000 S tu d e n ts

5

1 7 .9

6

1 0 .7

5 . 2500 S tu d e n ts

6

2 1 ,4

8

1 4 .2

ITEM 1.

COLUMNS

500 S tu d e n ts

S y s te m s R e p o r t e d - 2 8 R e p l i e s R e c e i v e d - 56

- 1

68 from a d i f f e r e n c e i n t h e d u t i e s a s s i g n e d to t h e n u r s e s in

th e d if f e r e n t

sy stem s.

I n s c h o o l s t h a t u s e th e n u r s e

p r im a r ily f o r in s p e c t io n and s u p e r v is io n , a r e n e e d e d th a n i n

s c h o o ls th a t a s s i g i

s p o n s i b i l i t y to h e r fo r g u id a n c e ,

fe w e r n u r s e s

c o n s id e r a b le r e ­

f i r s t a id and h e a lt h

p la n n in g . HEALTH SERVICE PERSONNEL AND PRACTICES IN THE SCHOOL M eth o d s o f H e a lt h S e r v i c e u s e d i n tw o t h o u s a n d o n e h u n d r e d a n d t w e n t y - t h r e e s c h o o l s r e p o r t e d t o h a v e g o o d H e a lt h P ro g ra m s a r e

su m m a rized i n t h i s

s e c tio n o f th e in v e s tig a tio n .

The summary o f t h e r e c o m m e n d a tio n s o f t h e f i f t y - s i x

educa­

t o r s who r e p l i e d t o t h e Q u e s t i o n n a i r e s i s a l s o p r e s e n t e d . A . C o m p r e h e n siv e P h y s i c a l E x a m in a tio n s b y S c h o o l D o c t o r s a n d D e n t i s t s a r e G iv e n t o A l l S t u d e n t s . B o th t h e u s e a n d r e c o m m e n d a tio n o f t h i s p r a c t i c e in d ic a te th a t ap p roval o f i t

a s a d e s ir a b le fe a tu r e o f a

g o o d H e a lt h P rogram i s u n a n im o u s,

a lt h o u g h a w id e r a n g e

a s t o w hen and how o f t e n t h e e x a m in a t io n s a r e made w as shown a s i l l u s t r a t e d i n T a b le X I , p a g e 6 9 . I n t h i s T a b l e , I te m O ne,

Colum ns One an d Two show

t h a t t h i r t e e n h u nd red n in e ty -tw o o r 6 5 .6 p e r c e n t o f th e s c h o o l s r e p o r t e d e x a m in e d a l l sy stem .

c h i l d r e n on e n t r a n c e t o t h e

Colum ns T h r e e an d F o u r show t h a t f i f t y - f o u r o r

69 TABLE XI PHYSICAL EXAMINATIONS OR INSPECTIONS OF STUDENTS BY PHYSICIANS OR DENTISTS IN THE SCHOOL

PHYSICAL EXAMINATIONS PRACTICE ARE GIVEN: F requ en cy P e r c e n t ITEM

COLUMNS - 1

2

RECOMMENDED F requ en cy P er c e n t 3

-

4

1 . On E n tr a n c e t o t h e S y stem

1392

6 5 .6

54

9 6 .4

2 . On E n tr a n c e t o e a c h S egm en t

1144

5 3 .8

28

5 0 .0

3* On R e tu r n t o S c h o o l A fte r I l ln e s s

838

39*5

37

6 6 .1

4* A s n e e d e d

818

3 8 .5

33

5 8 .9

5* P r e - s c h o o l C h ild r e n

542

2 5 .5

28

5 0 .0

'6 . B e f o r e E ach S p o r t S ea so n

352

5 2 .8

35

6 2 .5

7 . E v e r y tw o Y e a r s

388

1 8 .2

20

35. 6

8 . E a ch Y e a r

294

1 3 .9

20

3 5 .6

S c h o o ls R e p o r t e d - 2 1 2 3 * H ig h S c h o o l s R e p o r t e d - 665 R e p lie s R e c e iv e d - 56

70 9 6 .4 p e r c e n t o f t h o s e r e p ly in g ap p rov ed t h i s p r a c tic e * The o t h e r i t e m s i n t h e T a b le i l l u s t r a t e

th e p ra c­

t i c e s an d r e c o m m e n d a tio n s i n b o t h E le m e n ta r y a n d J u n io r a n d S e n io r S c h o o l s e g n e n t s ,

e x c e p t i n Ite m

i t e m a p p l i e s p r i m a r i l y t o H ig h S c h o o l s .

S ix *

T h is

S in c e t h e r e ­

t u r n s from t h e Q u e s t i o n n a i r e d id n o t make i t p r a c t i c a l to

d i s t i n g u i s h b e tw e e n t h e J u n i o r a n d S e n io r H ig h

S c h o o l,

t h e p e r c e n t a g e s w ere f i g u r e d a g a i n s t t h e t o t a l

num ber o f t h e s e s c h o o l s .

I n v ie w o f t h e f a c t t h a t many

J u n i o r H ig h S c h o o l s do n o t h a v e t h e ty p e o f a t h l e t i c p r o g r a m s t h a t make s u c h e x a m in a t io n s n e c e s s a r y , f i g u r e s i n d i c a t e t h a t m o st H ig h S c h o o ls f o l l o w p r a c tic e .

T h u s, i n I te m S i x ,

th e th is

th r e e h u nd red f if t y - t w o

o r 5 2 . 8 p e r c e n t o f t h e J u n i o r a n d S e n io r H ig h S c h o o l s r e p o r t e d e x a m in in g p a r t i c i p a n t s b e f o r e e a c h s p o r t s e a s o n . C olum ns T h r e e a n d P ou r show t h a t t h i r t y - f i v e o r 6 2 . 5 p e r c e n t app rove th e p r a c tic e . B. P s y c h i a t r i c S e r v i c e i s A v a i l a b l e As N e e d e d . Pour h u n d r e d an d t h i r t y - s i x cen t o f th o se r e p o r te d , sp e c t.

s c h o o ls ,

o r 2 0 .5 p e r

fu r n is h e d s e r v ic e in t h i s r e ­

F o r ty -o n e , o r 7 2 .9 p e r c e n t o f t h o s e r e p ly in g ,

recom m end t h e p r a c t i c e . C* I m m u n lz a tlo n a n d V a c c i n a t i o n A re R e q u ir e d o f A l l . The l i t e r a t u r e r e a d i n t h i s r e g a r d i n d i c a l c e s t h a t

71 m a ss e d u c a t i o n a s p r a c t i c e d i n t h e m odern s c h o o l w o u ld h e i m p o s s i b l e I f t h e im p o r t a n t h e a l t h m e a s u r e o f im m uni­ z a t i o n a g a i n s t e p id e m ic d i s e a s e s w ere n o t a l m o s t u n i ­ v e r s a l. A s shown i n T a b le X I I , p a g e 7 2 , a p p lie d to c e n t.

t h is p r a c tic e a s

c h i l d r e n w as a p p r o v e d a lm o s t on e h u n d r e d p e r

T h u s, I te m O ne, C olum ns One a n d Two, show t h a t

on e th o u sa n d fo u r hundred and t w e n t y - f o u r , c e n t o f th e s c h o o l s r e p o r t e d , be Im m u n ized , a n d f i f t y - t h r e e ,

o r 6 7 .1 p e r

r e q u ir e d a l l s tu d e n ts to o r 9 4 .6 p e r c e n t o f th o s e

who r e p l i e d , recom m en d ed t h i s p r a c t i c e . D* S e l e c t i o n o f T e a c h e r s a n d T e a c h in g C o n d i t i o n s A re Such T h a t P u p i l a n d T e a c h e r R e a c t i o n s P ro m o te Good M e n ta l an d S o c i a l H e a lth . In t h i s in s ta n c e ,

fo u r hund red and t h i r t y - s i x

s c h o o ls , o r 2 0 .5 p e r c e n t o f t h o s e r e p o r te d , had t h i s p o lic y . p lie d ,

F if ty -t h r e e ,

o r 9 4 .6 p e r c e n t o f t h o s e who r e ­

recom m end ed t h e p o l i c y .

S p e c ia l F a c i l i t i e s

f o r t h e P r o m o t io n o f H e a l t h .

D u r in g t h e c o u r s e o f i n t e r v i e w s a n d i n r e l a t e d lite r a tu r e ,

c e r t a i n f a c i l i t i e s w e r e fo u n d t o b e c o n s i d e r ­

ed e s s e n t i a l to th e p r e s e r v a t io n o f th e h e a lt h o f s t u d e n t s . The p r a c t i c e a n d o p i n i o n i n r e g a r d to t h e s e a re i ll u s t r a t e d in

T a b le X I I I .

I te m O ne,

fa c ilitie s

Colum ns One a n d

72

TABLE X II IMMUNIZATION AND VACCINATION REQUIREMENTS

PRACTICE

REQUIRED OF ALL:

recommended

F requ en cy P e r c e n t F req u en cy P er c e n t ITEM 1.

COLUMNS -

1

2

3

4

S tu d e n ts

1424

6 7 .1

53

9 4 .6

2 . T each ers

1350

6 3 .1

39

6 9 .6

3 , O th e r P e r s o n n e l

1334

6 2 .9

35

6 2 .5

S c h o o ls R e p ly in g - 2 1 2 3 R e p lie s R e c e iv e d - 56

73 Two sh o w , i n t h e c a s e o f b o y s , t h a t t h r e e h u n d r e d a n d th ir ty -th r e e ,

o r 10*9 p e r c e n t , have a s u p e r v is e d r e s t ­

room w i t h one c o t p e r p e a k gym l o a d - t h a t o r 3 2 .1 p e r c e n t o f th o s e r e p ly in g , In th e

case o f g i r l s ,

p e r c e n t had a r a t i o o p in io n , g ir ls .

e ig h te e n ,

fa v o r t h i s r a t i o .

fo u r hu nd red f o r t y - f i v e ,

o r 2 0 .9

o f o n e c o t p e r p e a k gym l o a d o f 5 0 ;

how ever, fa v o r e d a r a t i o

o f o n e c o t p e r tw e n t y

S u p e r v is e d r e s t r o o m s , w i t h o n e c o t p e r gym l o a d

of fifty fo r g i r l s

fo r b o y s,

a n d o n e c o t p e r gym l o a d o f tw e n t y

i s r a t e d a s e x c e l l e n t o n th e

c a l E d u c a tio n S c o r e C ard num ber tw o ,

H e a lt h an d P h y s i ­

f o r J u n io r a n d S e n i o r

H ig h S c h o o ls a s d e v i s e d by W illia m R a lp h La P o r t e , P r o ­ f e s s o r o f P h y s i c a l E d u c a t io n a t t h e U n i v e r s i t y o f S o u th ­ ern C a lif o r n ia ,

and h i s a s s o c i a t e s ,

in h is

book The P h y s i ­

c a l E d u c a tio n C u r r ic u lu m . 4 The p e r c e n t a g e i n I te m P o u r , T a b le X I I I , p a g e 7 4 , I s b a s e d on t h e num ber o f J u n i o r an d S e n io r H ig h S c h o o ls r e p o r te d . P . The A d m i n i s t r a t i v e P e r s o n n e l o f t h e S c h o o l S e e s T h a t S c h e d u l e s . P r o g r a m s . A c t i v i t i e s . C u r r i c u l a . E n v ir o n m e n ta l a n d Com munity F a c t o r s . I n s o f a r a s P o s s i b l e . A re a t A l l T im es C o n d u c iv e t o H e a lt h .

4

W illia m R a lp h L a P o r te , The P h y s i c a l E d u c a tio n Cur­ r ic u l u m . U n i v e r s i t y o f S o u th e r n C a l i f o r n i a P r e s s , L os A n g e l e s , 1942, p. 74.

74 TABLE X I I I SPECIAL FACILITIES FOR PROMOTING HEALTH

FACILITIES ADEQUATE TO PROMOTE HEALTH:

PRACTICE

RECOMMENDED

F requ en cy P e r c e n t F req u en cy P e r c e n t ITEM

COLUMNS - 1

1* S u p e r v i s e d R e s tr o o m s , One C ot p e r P eak Gym L oad : Of 100 boys n 75 boys 11 50 boys Of 50 g i r l s n 30 g i r l s 11 20 g ir ls 2 . H a n d w a sh in g F a c i l i t i e s : H ot W ater Soap P a p e r T o w e ls 3 . L u n ch eon F a c i l i t i e s : C a f e t e r i a P r o v id e d B a la n c e d M e a ls P r o m o te d Lunch P e r i o d s *4* O r t h o p e d ic Gyms

S c h o o ls R e p o r te d - 2 1 2 3 *Hlg£x S c h o o l s O n ly - 6 6 5 R e p lie s R e c e iv e d - 56

2

3

4

106 18 333 445 45 119

5 .0 .8 1 0 .9 2 0 .9 2 .1 5. 6

9 7 18 15 5 22

1 6 .1 1 2 .5 3 2 .1 2 6 .8 8*9 3 9 .3

1199 1391 1436

56. 5 6 5 .5 6 7 .6

49 51 50

8 7 .5 9 1 .1 8 9 .3

1530

7 2 .1

51

9 1 .1

1542 1240

7 2 .6 5 8 .4

46 49

8 2 .1 8 7 .5

261

3 9 .2

37

6 6 .1

75 T h is p o l i c y was t h o u g h t , b y many o f t h o s e w r i t i n g on S c h o o l H e a lth ,

t o be o n e o f t h e k e y p o l i c i e s i n a

g o o d H e a lt h Program *

.R e t u r n s from t h e i n v e s t i g a t i o n

th e f o llo w in g r e s u l t s : p e r c en t o f th e

show

tw o h u n d r e d e i g h t y - t h r e e , o r 1 3 . 3

s c h o o ls r e p o r te d , have t h i s p o lic y ;

fif­

t y o r 8 9 . 3 p e r c e n t o f th e r e p l i e s r e c e i v e d f a v o r i t . I I * HECOMMENNATIONS AND PRACTICES IN HEALTH INSTRUCTION H e a lt h I n s t r u c t i o n r e f e r s t o e x p e r i e n c e s t h a t p r o m o te t h e a c q u i s i t i o n o f n e e d e d in fo r m a tio n ," a c t i v i t i e s t o d e v e lo p g o o d h e a l t h h a b i t s a n d t o

d e s ig n e d

g e t n eed ed c o r r e c tio n s

m ade, a n d t h e d e v e lo p m e n t o f an a p p r e c i a t i o n o f t h e im p o r ­ ta n ce o f h e a lth . L i t e r a t u r e on t h e

S u b je c t.

A greem en t a s t o th e n e c e s ­

s i t y a n d t h e m eth o d s an d p r i n c i p l e s i n v o l v e d i n h e a l t h i n ­ s tr u c tio n

is

i n d i c a t e d i n q u o t a t i o n s from a nu m ber o f

a u th o r ita tiv e so u r c e s. As f o r t h e a im s i n h e a l t h e d u c a t i o n , n o b e t t e r p r e ­ s e n t a t i o n h a s b e e n made t h a n t h a t g i v e n b y t h e J o i n t C o m m ittee on H e a lt h P r o b le m s i n E d u c a tio n o f t h e N a t i o n a l E d u c a t io n A s s o c i a t i o n a n d t h e A m e rica n M e d ic a l A s s o c i a ­ tio n : 1. To i n s t r u c t c h i l d r e n a n d y o u t h s o t h a t t h e y may c o n s e r v e a n d im p r o v e t h e i r own h e a l t h . S. To e s t a b l i s h i n them t h e h a b i t s a n d p r i n c i p l e s o f l i v i n g w h ic h t h r o u g h o u t t h e i r s c h o o l l i f e an d i n l a t e r y e a r s w i l l a id in p r o v id in g t h a t abundant v ig o r and v i ­ t a l i t y w h ic h a r e a f o u n d a t i o n f o r t h e g r e a t e s t p o s s i b l e

76 h a p p in e s s and s e r v ic e i n p e r s o n a l, life .

f a m i l y , a n d com m u nity

3. To p r o m o te s a t i s f a c t o r y h a b i t s a n d a t t i t u d e s am ong p a r e n t s a n d a d u l t s th r o u g h p a r e n t an d a d u l t e d u c a t i o n a n d t h r o u g h t h e h e a l t h e d u c a t i o n p rogram f o r c h i l d r e n , so t h a t t h e s c h o o l may becom e an e f f e c t i v e a g e n c y f o r th e advan cem en t o f th e s o c i a l a s p e c t s o f h e a lt h e d u c a tio n in t h e f a m i l y a n d i n t h e com m u nity a s w e l l a s i n t h e s c h o o l its e lf. 4* To im p r o v e t h e i n d i v i d u a l an d com m u nity l i f e o f th e fu tu r e ; to in s u r e a b e t t e r seco n d g e n e r a tio n , and a s t i l l b e t t e r t h i r d g e n e r a tio n ; to b u ild a h e a l t h i e r and f i t t e r n a tio n and r a c e . 5 Dr* D. O b e r t e u f f e r o f O h io S t a t e U n i v e r s i t y h a s made a c o m p ila tio n o f c r i t e r i a

fo r th e

s e l e c t i o n and o r g a n iz a tio n

o f le a r n in g e x p e r ie n c e s in h e a lth in s t r u c t io n , a r e q u o te d h e r e .

some o f w h ic h

He h a s p r o c e e d e d o n t h e i d e a t h a t e d u c a t i o n ­

a l p s y c h o l o g y a n d p h i l o s o p h y s h o u l d l e n d much t o t h e t e c h ­ n iq u e s and su b s ta n c e o f h e a lt h i n s t r u c t i o n and t h a t e f f e c t i v e t e a c h i n g can go f o r w a r d o n l y i n a c c o r d a n c e w i t h w h a t i s known and b e l i e v e d a b o u t t h e l e a r n i n g p r o c e s s . The s t u d y se e m s p a r t i c u l a r l y

s ig n ific a n t

s in c e i t

a b a c k g r o u n d o f r e f e r e n c e s o f some t w e n t y - f i v e o r t h i r t y t h e m o s t p r o m in e n t a u t h o r i t i e s i n t h e p s y c h o lo g y , and p h y s i c a l and h e a lt h

fie ld

has of

o f e d u c a tio n ,

e d u c a tio n .

C r ite r ia to

• • • The e x p e r i e n c e s s h o u l d be s e l e c t e d i n r e s p o n s © . d a t a from s t u d e n t l i f e w h ic h i n d i c a t e s t h e n e e d s a n d

R e p o r t o f t h e N a t i o n a l E d u c a t io n A s s o e l a t i o n a n d A m e r ic a n M e d ic a l A s s o e l a t i o n . J o i n t C om m ittee o n H e a lt h P r o b le m s i n E d u c a t i o n . W a s h in g to n , D* C*; t h e N a t i o n a l Educa­ tio n A s s o c ia tio n , 1 9 4 1 , p . 1 5 .

77 i n t e r e s t s o f th e l e a r n e r s , a n d n o t c h o s e n s o l e l y I n te r m s o f w h a t c o u r s e m a k e rs b e l i e v e s h o u ld b e in c lu d e d * The e x p e r i e n c e s s h o u ld be a r r a n g e d o n an a c t i v i t y b a s i s , g iv in g c o n s ta n t o p p o r tu n ity f o r h e a l t h f u l p r a c ­ t i c e , a n d a im e d m ore a t t h e d e v e lo p m e n t o f c o n d u c t t h a n a t t h e a c q u i s i t i o n o f k n o w le d g e . The o r d e r o f t h o u g h t p r e s e n t a t i o n s h o u ld b e from t h e p a r t i c u l a r t o t h e g e n e r a l , e a c h new p r i n c i p l e , a b ­ s t r a c t i o n o r g e n e r a l i z a t i o n b e i n g d e v e l o p e d th r o u g h in t im a t e , c o n c r e te in d iv id u a l e x p e r ie n c e b e fo r e r e a c h ­ i n g i t s f i n a l fo rm . . . . The e x p e r i e n c e s s e l e c t e d s h o u ld b e p r o g r e s ­ s i v e l y g r a d e d so a s t o p r o v i d e f o r c o n t i n u o u s g r o w th i n h e a l t h f u l l i v i n g a n d , i f p o s s i b l e , r e l i a b l e in s tr u m e n ts o f m e a su r em e n t s h o u ld b e a p p l i e d t o n o t e t h e p r o g r e s s o f each le a r n e r . ♦ ... . The e x p e r i e n c e s s h o u l d p r o v i d e f r e q u e n t a n d s p e c i f i c o p p o r tu n ity fo r c o r r e la t io n w ith o th e r a r e a s i n t h e c u r r ic u lu m a n d w i t h o t h e r p a r t s o f t h e h e a l t h e d u c a tio n program . The a c t i v i t i e s o f th e c o u r s e s h o u ld l e a d to c o o p e r a ­ t i o n a n d u n d e r s t a n d in g b e tw e e n t h e s c h o o l a n d t h e home a n d com m u n ity. In g e n e r a l, o p p o r tu n itie s fo r h e a lth I n s tr u c tio n may b e p r o v i d e d i n : ( a ) S p e c i a l h e a l t h c o u r s e s ; (b ) I n t e g r a t e d c o u r s e s ; and ( c ) U n its in o t h e r c o u r s e s in t h e c u r r ic u lu m . S p e c i a l h e a l t h c o u r s e s do n o t t a k e t h e p l a c e o f c o n t r i b u t i o n s t o h e a l t h I n s t r u c t i o n from o t h e r c o u r s e s , n o r can s u c h c o n t r i b u t i o n s b y t h e m s e l v e s f i l l t h e n e e d f o r a w e l l- r o u n d e d p r o g r a m . . When d e p e n d e n c e i s p l a c e d e n t i r e l y on i n s t r u c t i o n t h r o u g h o t h e r c o u r s e s some s t u d e n t s a r e l i k e l y t o m i s s e s s e n t i a l i n s t r u c t i o n , a n d im p o r t a n t a r e a s o f h e a l t h a r e a p t t o b e l e f t o u t o f th e in s t r u c t io n a lto g e t h e r . I n p la n n in g f o r h e a lt h i n s t r u c t i o n , t h e r e f o r e , ad­ m i n i s t r a t o r s s h o u l d make s u r e t h a t a d e q u a t e i n s t r u c t i o n i n a l l im p o r ta n t a r e a s o f h e a l t h i s a v a i l a b l e to a l l s t u d e n t s .®

6 V i c t o r y C o rp s S e r i e s P a m p h le t H o. 3 c i t i n g D r. D* O b e r t e u f f e r , H e a lth I n s t r u c t i o n , o p . c i t . , p . 8 4 .

78 T h ere s h o u ld b e an a d e q u a t e h e a l t h i n s t r u c t i o n p r o ­ gram i n t h e s e c o n d a r y s c h o o l , r e q u i r e d o f a l l p u p i l s , c o o r d in a te d and d i r e c t e d by t e a c h e r s c e r t i f i c a t e d f o r su ch s e r v ic e . T h is i n s t r u c t i o n s h o u ld form an i n t e g r a l p a r t o f t h e e n t i r e s c h o o l program . The v a l u e o f a l l h e a l t h s e r v i c e a c t i v i t i e s s h o u ld b e f u l l y u t i l i z e d a s e d u c a t io n a l e x p e r ie n c e s * The minimum tim e a l l o t m e n t s h o u ld p r o v i d e f o r a d a i l y program o r i t s e q u i v a l e n t f o r a t l e a s t one s e m e s t e r i n e a c h o f t h e J u n i o r H i^ i a n d S e n io r H ig h d i v i s i o n s o f th e se c o n d a r y s c h o o l. More t im e th a n t h i s may be d e s i r ­ a b l e t o m ee t t h e n e e d . An i n t e g r a t e d h e a l t h p rogram s h o u l d o p e r a t e th r o u g h o u t t h e e n t i r e p e r i o d o f s e c o n d a r y e d u c a tio n . The s i z e o f c l a s s e s i n h y g ie n e s h o u ld be no l a r g e r t h a n t h o s e i n o t h e r a c a d e m ic s u b j e c t s . C la s s r o o m s , a s w e l l a s t e x t s , r e f e r e n c e s , c h a r t s , s l i d e s , m o d e ls , m o v in g p i c t u r e s , and o t h e r i n s t r u c t i o n a l a id s sh o u ld be p ro ­ v id e d fo r t e a c h e r s and p u p i l s . In o rd er th a t th e h e a lth i n s t r u c t i o n p ro g ra m may be f u r t h e r v i t a l i z e d , p r a c t i c a l h e a l t h a c t i v i t i e s s h o u ld b e i n i t i a t e d . S c h o o l s s h o u ld p l a c e c o u r s e s i n h e a l t h i n s t r u c t i o n on a p a r w i t h t h o s e i n o t h e r s u b j e c t s , a n d g i v e th em t h e same r e c o g n i t i o n i n t h e c u r r ic u lu m . P a r tic u la r ly i s t h i s t r u e i n v ie w o f t h e f a c t t h a t h e a l t h i s r e c o g n i z e d a s t h e f i r s t o b j e c t i v e o f e d u c a t i o n . *7 O th e r s u g g e s t i o n s f o r h e a l t h i n s t r u c t i o n

are:

T h a t p r o v i s i o n be made f o r c o o r d i n a t e d h e a l t h i n ­ s t r u c t i o n e m p h a s iz in g h e a l t h h a b i t s a n d a t t i t u d e s i n b o t h t h e e le m e n t a r y and s e c o n d a r y s c h o o l s , an d f o r i n ­ t e n s i v e c o u r s e s i n h e a l t h I n s t r u c t i o n f o r a t l e a s t tw o s e m e s te r s e a c h i n b o th j u n io r and s e n io r h ig h s c h o o ls . T hat th e b e s t q u a l i f i e d t e a c h e r s in th e s e v e r a l h ig h s c h o o ls be s e le c t e d fo r th e in t e n s iv e h e a lth in s tr u c t io n , r e g a r d le s s o f d e p a r tm en ta l a f f i l i a t i o n . T h a t a d e f i n i t e tim e b e p r o v i d e d i n t h e s c h e d u l e

7

C a l i f o r n i a S t a t e D e p a r tm en t o f E d u c a t io n , D i v i s i o n o f P h y s i c a l a n d H e a lt h E d u c a t io n , N ew s L e t t e r , N o. 3 1 , O c to b e r , 1 9 3 9 .

79 fo r i n t e n s i v e h e a lt h i n s t r u c t io n c o u r s e s , and t h a t s p e c i a l c la s s r o o m s w i t h a p p r o p r i a t e e q u ip m e n t b e made a v a ila b le fo r su ch in s t r u c t io n , A p u p i l may b e e x e m p te d from a b o v e c o u r s e o r c o u r s e s o n l y upon s a t i s f y i n g b a s i c s t a n d a r d s s e t up b y H e a lt h S e r v i c e D e p a r t m e n t.8 The c h i l d n e e d s t o know a g r e a t d e a l a b o u t h e a l t h , and i t i s th e r e s p o n s ib i li t y o f th e s c h o o l to in s t r u c t h im . F o r e x a m p le , he n e e d s t o know how to d e v e lo p g o o d h e a l t h f o r h i m s e l f , how t o a v o i d i l l n e s s a n d a c c i d e n t s , a n d how t o p r o t e c t t h e h e a l t h o f o t h e r s . S im ila r ly , he m u st u n d e r sta n d su ch t h in g s a s t h e d if f e r e n c e b e­ tw e e n an a d e q u a t e a n d an i n a d e q u a t e d i e t , t h e e f f e c t o f d ru gs and s t im u la n t s , and th e v a lu e o f v a c c in a t io n a n d im m u n iz a t io n . U n fo r tu n a te ly , th e c h i ld i s c o n s t a n t ly r e c e iv in g much m i s i n f o r m a t i o n by m eans o f t h e r a d i o , n e w s p a p e r s , a n d m a g a z in e s . He i s b e i n g m i s l e d b y s u p e r s t i t i o n , s a l e s t a l k s , and f a d d is t s . H is b e s t h o p e o f f i n d i n g t h e t r u t h i s th r o u g h h i s s c h o o l . 8 Summary o f H e a lt h I n s t r u c t i o n . P r a c t i c e s a n d O p in io n s in R e la te d L it e r a t u r e .

A g reem en t on t h e f o l l o w i n g p o l i c i e s

an d s t a t e m e n t s w as w id e s p r e a d .

T h er e a r e a g r e a t many h e a l t h

k n o w le d g e s t h a t a r e I m p o r ta n t f o r c h i l d r e n t o know . In a d d it io n to

c o n tr ib u tio n s to h e a lth

o th e r d e p a r tm en ts th e r e tio n in

in s tr u c tio n by

s h o u ld b e c o u r s e s i n h e a l t h i n s t r u c ­

b o th J u n i o r a n d S e n io r H ig h S c h o o l .

tim e a l l o t m e n t s h o u l d b e o n e p e r i o d d a i l y

The minimum

fo r a se m ester in

e a c h s e g m e n t.

Q

The C o m m issio n on E d u c a t io n f o r P h y s i c a l F i t n e s s , op. c i t . , p. 24. 9

c it . , p.

A m e r ic a n A s s o c i a t i o n o f S c h o o l A d m i n i s t r a t o r s , o p . 12.

80 T each er t r a in in g in

s c h o o l s o f e d u c a t i o n and i n i n -

t r a i n i n g s e r v i c e s h o u l d b e p r o v i d e d t o e q u ip t e a c h e r s f o r t h i s w o rk . H e a lt h I n s t r u c t i o n r e in fo r c e ,

s h o u ld b e c o o r d i n a t e d w i t h , a n d

th e o t h e r f u n c t i o n s o f t h e H e a lt h P ro g ra m .

The a d m i n i s t r a t o r ,

su p e r in te n d e n ts , p r in c ip a ls ,

and

a s s i s t a n t s a r e p r i m a r i l y r e s p o n s i b l e t o im p le m e n t e f f e c t i v e H e a lt h I n s t r u c t i o n . A s s ig n a l l o f,

th e

c u r r e n t h e a l t h p r o b le m s im p o r t a n t t o ,

stu d e n t to one t e a c h e r .

s tr u c to r in

T h is t e a c h e r w o u ld b e i n ­

t h e c o u r s e o f h e a l t h e d u c a t i o n , a n d w o u ld b e

” m a ste r te a c h e r ” i n ity

th is area.

I t w o u ld b e t h e r e s p o n s i b i l ­

o f t h i s t e a c h e r to c o o r d in a te a l l h e a lt h a c t i v i t i e s

th e s tu d e n t w h ile in th e c l a s s and to h a d p r o p e r g u id a n c e an d i n s t r u c t i o n liv in g ,

and

s e e t h a t th e

fo r

stu d e n t

in m a tte r s o f h e a lt h f u l

as fo llo w s : 1.

D e v e lo p i n e a c h s t u d e n t h a b i t s o f h e a l t h f u l l i v i n g a s w e ll a s s u b s t it u t e good h a b its f o r bad.

2.

G u id e t h e s t u d e n t i n s e c u r i n g I m m e d ia te c o r r e c t i o n f o r r e m e d ia l d e v i a t i o n s . ( i t i s e x p e c te d th a t t h is o b j e c t i v e w o u ld b e s t r e s s e d . )

3 . A r o u se s t u d e n t i n t e r e s t i n a n d a p p r e c i a t i o n o f m a t t e r s r e l a t i v e t o p e r s o n a l a n d com m u nity h e a l t h w h ic h w i l l l e a d t o f u r t h e r s t u d y an d t o c o o p e r a t i o n b o th in p e r s o n a l h e a l t h f u l l i v i n g and in p r e s e r v in g com m u nity h e a l t h . 4.

S e t up a p ro g r a m t h a t t h e s t u d e n t may u s e i n e v a l u ­ a t i n g an d c h e c k in g h i s h e a l t h , s o t h a t t h i s program may b e u s e d from tim e t o t im e d u r in g h i s s c h o o l c a r e e r w h ic h w i l l h e l p him m a in t a in a h i g h s t a n d a r d o f h e a l t h f u l l i v i n g a n d d e v e lo p a l l h i s r e s o u r c e s o f h e a lth .

81 R e t u r n s from t h e Q u e s t i o n n a i r e R e l a t i v e t o H e a lt h I n s tr u c tio n ,

The c o n v i c t i o n am ong e d u c a t o r s t h a t H e a lt h

I n s tr u c tio n has been n e g le c te d h a s sp rea d a s a r e s u lt o f th e h e a lt h s t a t u s o f ou r p o p u la tio n , two w a r s , u n t i l i t

is

r e v e a l e d i n th e l a s t

a lm o s t u n i v e r s a l .

As a r e s u l t o f

t h i s c o n v i c t i o n t h e r e h a s d e v e lo p e d a s t r o n g m ovem ent i n th e p u b l i c s c h o o l s y s t e m th r o u g h o u t th e n a t i o n in s tr u c tio n

in t h i s r e g a r d .

T h is i s

t o im p r o v e

a p p a r e n t i n v ie w o f

t h e f a c t t h a t t h e p r o c e e d i n g s o f t h e A m erica n A s s o c i a t i o n o f S c h o o l A d m i n i s t r a t o r s , in 1 9 4 2 , w e r e d e v o t e d t o t h e t o p i c o f wH e a lt h i n t h e

S c h o o l s , 1* T h e s e

e x t e n s i v e l y q u o ted in

t h is in v e s tig a tio n .

F in d in g s o f t h i s T a b le s on t h e

p r o c e e d in g s h ave b een

stu d y i n

t h i s r e s p e c t a r e fo u n d i n

fo llo w in g p a g e s,

THE PERSONNEL AND PRACTICES OF HEALTH INSTRUCTION IN THE SYSTEM A, The O f f i c e r R e s p o n s i b l e f o r H e a lt h I n s t r u c t i o n i n th e S y s te m , The t i t l e o n th e

o f t h i s o f f i c e r an d t h e tim e h e s p e n d s

f u n c t i o n o f h e a l t h i n s t r u c t i o n a r e show n i n T a b le s

F o u r t e e n a n d F i f t e e n , p a g e s 8 2 and 8 3 .

I n Columns One

a n d Two, Ite m O ne, T a b le XIV, t e n , o r 3 5 , 7 p e r c e n t o f

11H e a lt h i n

S c h o o l s , 11 o p ,

c it.

82 TABLE XIV THE OFFICER RESPONSIBLE FOR HEALTH INSTRUCTION IN THE SYSTEM

TITLE

PRACTICE

RECOMMENDED

F requency P er c e n t F requency P er c e n t ITEM

COLUMNS - 1

1 . D i r e c t o r o f H e a lt h I n s tr u c tio n

4.

3

4

10

3 5 .7

30

5 3 .6

8

28. 6

9

1 6 .1

S u p e r v i s o r o f H e a lt h a n d P h y s i c a l E d u ca­ tio n

4

1 4 .3

4

7 .1

S u p e r v is o r o f H e a lt h I n s tr u c tio n

4

1 4 .3

4

7 .1

2

7 .1

3

5 .4

2* S u p e r v i s o r o f E d u c a t io n 3.

2

5* A s s i s t a n t S u p e r in ­ ten d en t

S y s te m s R e p o r t e d - 2 8 R e p lie s R e c e iv e d - 56

83 TABLE XV TIME DEVOTED TO THE OFFICE BY THE DIRECTOR OF HEALTH INSTRUCTION

PRACTICE

TIME:

RECOMMENDED

F requency P er c e n t F requency P er c e n t ITEM .

.COLUMNS - 1

£I

3

4

15

5 3 .6

24

4 2 .9

2* H a l f - t i m e

5

1 7 .9

6

1 0 .7

3* O n e - t h i r d

3

1 0 .7

6

1 0 .7

1. A ll

S y s te m s R e p o r te d - 2 8 R e p l l e s R e c e iv e d - 5 6

84 th e tw e n ty -e ig h t sy stem s r e p o r te d have a d ir e c t o r o f h e a lth in s tr u c tio n ;

t h i r t y , o r 5 3 .6 p e r c e n t o f th e

f i f t y - s i x r e p li e s r e c e iv e d fa v o r t h i s p r a c t ic e . I n n e a r l y a l l o f th e l a r g e s y s t e m s r e p o r t e d , t h i s o f f i c i a l d e v o te d h is

f u l l tim e t o t h i s

fu n c tio n .

I n s m a l l e r s y s t e m s , o n l y p a r t o f h i s tim e w as a s s i g n e d to t h i s d u ty .

T h u s, i n T a b le XV, p a g e 8 3 ,

5 3 .6 p e r c e n t o f th e sy stem s r e p o r t e d , d ir e c to r o f h e a lth

in s tr u c tio n ;

fifte e n ,

or

h a d a f u l l tim e

tw e n t y - f o u r , o r 4 2 .9

p e r c e n t o f th o s e r e p ly in g fa v o r e d t h i s p r a c t ic e . I n t h e r e c o m m e n d a tio n o f t h e Long B ea ch Commis­ s i o n on E d u c a t io n f o r P h y s i c a l F i t n e s s , 1 1 t h e r e s p o n s i ­ b ility

f o r h e a l t h I n s t r u c t i o n w as a s s i g n e d t o t h e D i r e c ­

t o r o f H e a lt h S e r v i c e who w as a l s o r e s p o n s i b l e f o r h e a lt h g u id a n c e . w o u ld f o l l o w

I n t h i s r e c o m m e n d a tio n ,

t h a t o n e - t h i r d o f h i s tim e w o u ld b e a s s i g n ­

ed to h e a lth I n s tr u c tio n . L on g B e a c h i s

th e re fo re , i t

The s c h o o l p o p u l a t i o n o f

a b o u t 4 0 ,0 0 0 .

C u r r ic u lu m i n H e a lth I n s t r u c t i o n i s t h e R e s u l t o f a C o o p e r a t iv e E n t e r p r i s e o f t h e H e a lt h C o u n c il f o r t h e S y s te m . Ite m O n e, T a b le XVI, p a g e 8 5 ,

Column One sh o w s

^ R e p o r t o f The C om m ission on E d u c a t io n f o r P h y s ic a l. F i t n e s s , oj>. c i t . . p . 3 1 , I te m 2 ( a ) .

85 TABLE XVI THE CURRICULUM IN HEALTH INSTRUCTION FOR THE SYSTEM

RECOMMENDED HEALTH COUNCIL MEMBERS PRACTICE WHO COOPERATE IN SETTING­ UP THE CURRICULUM: F requency P e r cen t F requency P er c e n t ITEM

...

COLUMNS - 1

2

3

4

1 . The C u r r ic u lu m i s a C o o p e r a t iv e E n t e r p r i s e o f t h e H e a lt h C o u n c il

21

7 5 .0

46

8 2 .1

2* D i r e c t o r o f H e a lt h I n s tr u c tio n

21

7 5 .0

36

6 4 .3

D i r e c t o r o f H e a lth and P h y s i c a l E d u c a tio n

19

6 7 .9

34

6 0 .7

4 . A s s * t . S u p e r in t e n d e n t o r D i r e c t o r i n C h arge o f t h e H e a lt h P rogram

19

6 7 .9

30

5 3 .6

5 . D i r e c t o r o f C u r r ic u lu m

15

5 3 .6

30

53. 6

6* The S u p e r in t e n d e n t

12

4 2 .9

22

3 9 .3

7* R e p r e s e n t a t i v e o f C i t y H e a lt h D e p a r tm en t

7

2 5 .0

20

3 5 .6

8 . D i r e c t o r o f H e a lt h S e r v ic e

4

1 4 .2

7

1 2 .5

9 *. D i r e c t o r o f Home E c o n o m ic s

2

7 .1

2

3 .5

3.

S y s t e m s R e p o r te d - 2 8 R e p l i e s R e c e iv e d - 56

th a t tw e n ty -o n e

sy ste m s r e p o r te d h a v in g a h e a lt h

c o u n c il

t h a t s e t up t h e c u r r ic u lu m i n h e a l t h i n s t r u c t i o n . is

T h is

s e v e n t y - f iv e p e r c e n t o f t h e t w e n ty -e ig h t sy stem s

r e p o r te d .

F o r t y - s ix o f th o s e r e p ly in g ,

recom m ended t h i s p r o c e d u r e .

o r 8 2 .1 p e r c e n t,

T a b le XVI a l s o

sh o w s t h e

s c h o o l o f f i c i a l s m o st f r e q u e n t l y i n c l u d e d a s m em bers o f t h e H e a lt h C o u n c i l .

T h u s, i n I te m Two, C olum ns One a n d

Two, t w e n t y - o n e , o r 7 5 p e r c e n t o f t h e s y s t e m s r e p o r t e d , i n c l u d e d t h e D i r e c t o r o f H e a lt h I n s t r u c t i o n on t h e H e a lt h C o u n c il .

I n Colum ns T h ree a n d F o u r , t h i r t y - s i x ,

o r 6 4 . 3 p e r c e n t o f t h e r e p l i e s r e c e i v e d recom m end ed t h e p r a c tic e . The C u r r ic u lu m i s

So A r r a n g e d t h a t a t E a ch L e v e l S t u d e n t s

a r e G e t t i n g t h e H e a lt h I n f o r m a t i o n . A p p r e c i a t i o n , an d G u id a n c e t h a t W i l l E n a b le a n d C ause Them t o L iv e H e a lth fu lly . It is o f th e

n o t o n l y im p o r t a n t t h a t a l l t h o s e o f f i c i a l s

s y s t e m , who b y t r a i n i n g a n d a s s ig n m e n t h a v e a

c o n t r i b u t i o n t o m ak e, b e on t h e H e a lt h C o u n c il an d p a r ­ tic ip a te

i n m a k in g t h e c u r r ic u lu m , b u t i t

ta n t th a t t h is

c u r r ic u lu m

is

a l s o im p o r­

s h a ll e v e n tu a te in p o l i c i e s

a n d m e th o d s t h a t w i l l a t t a i n

t h e g o a l s o f a g o o d H e a lt h

P ro g r a m . T a b le X V II, p a g e 8 7 ,

su m m a r iz e s t h e r e t u r n s on

87 TABIE XVII AIMS OF THE CURRICULUM IN HEALTH INSTRUCTION

THE AIMS:

PRACTICE

RECOMMENDED

F req u en cy P er c e n t F requency P er c e n t ITEM 1.

COLUMNS - 1

2

3

4

S t u d e n t s a t E a ch L e v e l a r e G e t t i n g I n fo r m a ­ t i o n , A p p r e c ia tio n a n d G u id a n c e t h a t H e lp s Them L iv e H e a lth fu lly

21

7 5 .0

41

7 2 .9

2 . O th e r S u b j e c t s C o n t r i ­ b u t e N e e d e d I n fo r m a ­ tio n

21

7 5 .0

42

7 5 .0

3 . C ou rses fo r A ll S tu d e n t s a r e Gi ven f o r a t L e a s t Two S e m ester s in th e : ( a ) J u n io r H ig h S c h o o l 1 6 ( b ) S e n io r H ig h S c h o o l 2 2

5 7 .1 7 8 .6

31 44

5 5 .3 7 8 .5

S y s te m s R e p o r te d - 2 8 R e p l i e s R e c e iv e d - 56

88 t h e s e p o l i c i e s t h a t se e m e d b a s i c t o t h i s p u r p o s e i n t h e lite r a tu r e

s tu d ie d *

I n I te m O ne, o f t h i s

ta b le ,

tw e n ty -o n e , o r 75

p e r c e n t o f t h e s y s t e m s r e p o r t e d , make i t

th e ir p o lic y

to s e e t h a t s t u d e n t s a t ea ch l e v e l a r e a c q u ir in g th e a p p r e c ia tio n s o f h e a lth ,

and g e t t i n g th e in fo r m a tio n

an d g u id a n c e t h a t w i l l c a u s e them t o l i v e h e a l t h f u l l y * F o r t y - o n e , o r 7 2 . 9 p e r c e n t o f t h o s e who r e p l i e d , ap p roved t h is p o lic y *

(M e th o d s o f a r r i v i n g a t t h e s e

b a s i c n e e d s a r e shown i n T a b le XIX, p a g e 9 2 . ) I t e m s Two a n d T h r e e ,

T a b le X V II,

in d ic a te th a t

s c h o o l s w i t h good h e a l t h p r o g r a m s n o t o n l y h a v e c o u r s e s o f h e a l t h i n s t r u c t i o n b u t t h a t o t h e r s u b j e c t s make w h a t­ e v e r c o n tr ib u tio n th e stu d e n ts.

th e y can to

th e h e a lth in s t r u c t io n o f

I n t h e h i g h s c h o o l s e g m e n t,

a s shown i n

I te m 3 b , t w e n t y - t w o , o r 7 8 . 6 p e r c e n t o f t h e t w e n t y e i g h t s y s t e m s r e p o r t e d , h a v e s u c h c o u r s e s , an d a s show n in

t h e sam e I t e m ,

Colum ns T h r e e a n d F o u r , f o r t y - f o u r ,

o r 7 8 . 5 p e r c e n t o f t h o s e r e p l y i n g recom m end t h e p r a c ­ tic e . THE PERSONNEL AND PRACTICES OF HEALTH INSTRUCTION IN THE SCHOOL The C h il d n e e d s t o know a g r e a t d e a l a b o u t h e a l t h , and i t i s th e r e s p o n s ib i li t y o f th e s c h o o l to in s t r u c t h im . F or e x a m p le , h e n e e d s t o know how t o d e v e lo p g o o d h e a l t h f o r h i m s e l f , how t o a v o i d i l l n e s s a n d a c c i d e n t s ,

89 a n d how t o p r o t e c t t h e h e a l t h o f o t h e r s * S im ila r ly he m u st u n d e r s t a n d s u c h t h i n g s a s t h e d i f f e r e n c e b e tw e e n a n a d e q u a te a n d an i n a d e q u a t e d i e t , t h e e f f e c t o f d r u g s a n d s t i m u l a n t s , a n d t h e v a l u e s o f v a c c i n a t i o n a n d 1mm uni z a t i o n . 1 2 A*

C o u r s e s o f H e a lt h I n s t r u c t i o n

i n th e

S c h o o l.

T a b le X V I I I , p a g e 9 0 , r e v e a l s t h e p r a c t i c e i n t h i s r e g a r d i n tw o t h o u s a n d o n e h u n d r e d t w e n t y - t h r e e s c h o o l s r e p o r t e d t o h a v e g o o d h e a l t h p ro g ra m s*

In seven

h und red, o r 34*3 p e r c e n t o f th e s c h o o ls r e p o r te d , h e a lt h i n s t r u c t i o n w as r e q u i r e d o f a l l 71*4 p er cen t o f th o s e r e p ly in g ,

stu d e n ts.

F o r ty ,

or

recom m end ed t h i s p r a c t i c e .

The p r a c t i c e i n g r e a t e s t u s e a n d t h e o n e m o st g e n ­ e r a l ly approved i s

I te m Two, T a b le X V I I I , s p e c i f y i n g

c o u r s e s o f h e a l t h i n s t r u c t i o n o f tw o s e m e s t e r s i n b o t h J u n i o r a n d S e n io r H ig h S c h o o ls *

In t h i s Ite m ,

O ne a n d Two, s e v e n h u n d r e d n i n e t y - e i g h t , c e n t, u se th is p r a c tic e ,

and, in

C olum ns

o r 3 7 .6 p e r

Columns T h ree a n d F ou r,

f o r t y - t w o , o r 75 p e r c e n t o f th e r e p l i e s r e c e iv e d approve

it. I t is

w o r th n o t i n g t h a t among t h e s e s c h o o l s , I te m

F iv e , th e p r a c t ic e o f g iv in g h e a lth in s t r u c t io n on ce a w e e k , p r o b a b ly d u r in g a gym p e r i o d ,

i s n o t v ery g e n e r a l,

a n d h a d t h e a p p r o v a l o f o n l y o n e who r e p l i e d .

11H e a lt h i n

S c h o o ls ,w op * c i t . ,

p* 1 2 .

'90 TABLE X V III COURSES OP HEALTH INSTRUCTION IN THE SCHOOL

COURSES OF HEALTH INSTRUCTION:

PRACTICE

RECOMMENDED

F requency P er c e n t F requ en cy P er c e n t ITEM .

, .

COLUMNS - 1

2

3

4

1 . R e q u ir e d o f A l l S tu d e n t s

728

3 4 .5

40

7 1 .4

2 . Two S e m e s t e r s i n E a c h S egm en t

798

3 7 .6

42

7 5 .0

3 . One S e m e s t e r E ach Y ear

258

1 2 .2

7

1 2 .5

4 . E v e r y S e m e s te r

146

6 .9

6

1 0 .7

75

3 .5

1

1 .8

5* O nce a Week f o r S ix S e m este r s

S c h o o l s R e p o r te d - 2 1 2 3 R e p l i e s R e c e i v e d - 56

91 C o u r s e s i n H e a lt h C o n ta in U n i t s o f Work f o r A l l S tu ­ d e n t s B a se d on T h e ir N e e d s a s R e v e a le d by t h e H eal t h In v e n to r y * The f a c t o r s a n d p o l i c i e s t h a t g o v e r n t h e c o n t e n t o f th e c o u r se o f stu d y in h e a lt h in s t r u c t io n in w ith good h e a lt h program s i s

illu s tr a te d

a s show n In T a b le XIX, p a g e 9 2 .

s c h o o ls

in th e r e tu r n s

S i n c e t h i s q u e s t i o n w as

b a s e d on t h e t r e n d s a s d i s c o v e r e d I n t h e l i t e r a t u r e a n d in t e r v ie w s on t h e s u b j e c t , i t

sh o w s a c l o s e

c o r r e la tio n

b e tw e e n t h e t h i n k i n g a n d p r a c t i c e i n t h i s m a t t e r . p o l i c i e s and p r a c t i c e s o u t l i n e d i n a l l t h e

The

Ite m s in t h i s

T a b le h a d w id e s p r e a d u s e a n d v e r y s t r o n g s u p p o r t from t h o s e who a n s w e r e d t h e q u e s t i o n .

T h u s, I n Ite m T h r e e ,

T a b le XIX, t h e o n e h a v in g t h e g r e a t e r u s e a n d s u p p o r t , o n e th o u sa n d th r e e hu nd red and e ig h t y

s c h o o l s , o r 65 p e r

c e n t o f t h o s e r e p o r t e d , s t r e s s e d t h e d e v e lo p m e n t o f g o o d h e a lt h h a b it s and h a v in g s t u d e n t s h a v e n e e d e d c o r r e c t io n s m ad e.

F ifty -th r e e ,

o r 9 4 .6 p e r c e n t o f t h o s e r e p ly in g

recom m en d ed t h i s p o l i c y . C. I n s t r u c t i o n i n H e a l t h i s

G iv en D u r in g C o n f e r e n c e s , Home

V i s i t s , a n d H e a lt h I n s p e c t i o n s , by th e

O f f ic e r I n v o lv e d

i n E ach C a se . As i l l u s t r a t e d

i n T a b le XX, p a g e 9 3 , a l l r e p l i e s

I n d i c a t e t h a t n u r s e s an d o t h e r m em bers o f t h e h e a l t h

92 TABLE XIX CONTENT AND PROCEDURES IN COURSES OF HEALTH INSTRUCTION

IN COURSES OF HEALTH INSTRUCTION:

PRACTICE

RECOMMENDED

F requ en cy P e r c e n t F req u en cy P e r c e n t ITEM

COLUMNS -

1 , U n i t s o f Work B a s e d on t h e S tu d e n ts * N e e d D is c o v e r e d in th e H e a lth I n v e n to r y

1

2

3

4

124?

58*7

40

71*4

I n s p e c t i o n s and M e a su r e m e n ts B ecom e P a r t o f C la s s P ro­ ced ure

1381

65*1

45

8 0 .4

D e v e lo p m e n t o f Good H e a lt h H a b it s a n d S e c u r in g C o r r e c t i o n s S tr e sse d

1380

65*0

53

94*6

4 . I n te r p r e ta tio n o f P rogram an d I n fo r m a ­ t i o n a b o u t S tu d e n t N eed s i s B a s is fo r F a c t u a l I n f o r m a t io n

1352

63*7

45

8 0 .4

5 . C h e c k in g on P r o g r e s s a n d A r r a n g in g Con­ f e r e n c e s w ith D o c to r , e tc . , i s P art o f C l a s s R o u t in e

1191

5 6 .1

39

69*6

2.

3,

S c h o o l s R e p o r te d - 2 1 2 3 R e p l i e s R e c e i v e d - 56

93 TABLE XX HEALTH INSTRUCTION IN AUDITION TO THAT GIVEN IN CLASS

SPECIFIC HEALTH INSTRUCTION GIVEN DURING PRACTICE RECOMMENDED CONFERENCE BY: F requency P er c e n t F req u en cy P e r c e n t ITEM

COLUMNS - 1

2

3

4

1 . N u rses

1898

89* 4

56

1 0 0 .0

2 . P h y s i c a l E d u c a t io n T each ers

1820

8 5 .7

45

8 0 .4

3* C o u n s e lo r s

1676

7 8 .9

45

8 0 .4

4 . P h y s ic ia n s

1809

8 5 .2

47

8 4 .0

5* D e n t i s t s

1798

8 4 .7

46

8 2 .1

731

3 4 .4

23

4 0 .9

6* A d m i n i s t r a t o r s

S c h o o ls R e p o r ted - 2 1 2 3 R e p l i e s R e c e iv e d - 5 6

94 s e r v i c e d e p a r t m e n t s , and c o u n s e l i n g d e p a r tm e n ts g i v e , and are e x p e c te d to g iv e , h e a lth

in s t r u c t io n to

stu d e n ts

a s o c c a s i o n p e r m it s * I n t h i s T a b le , C olum ns One an d Two show t h a t i n o n e t h o u s a n d e i g h t h u n d r e d an d n i n e t y - e i g h t , c e n t o f th e s c h o o ls r e p o r te d ,

it

o r 8 9 ,4 p e r

i s th e p o lic y

fo r th e

n u r s e to i n s t r u c t in h e a lt h a s o p p o r tu n ity i s p r e se n te d * F ifty -s ix ,

o r 1 0 0 p e r c e n t o f t h o s e who r e p l i e d ,

r ec o m ­

m en ded t h i s p r a c t i c e * T h is T a b le sh ow s t h a t t h e p r a c t i c e s o u t l i n e d i n t h e I t e m s in

th is

T a b le h a d a v e r y w id e s p r e a d u s e i n

s c h o o ls w ith good h e a lt h p ro g ra m s and v e r y s t r o n g b a ck ­ i n g from t h e e d u c a t o r s who r e p l i e d to t h e q u e s t i o n , A l l S u b j e c t s i n t h e S c h o o l a r e E x p e c t e d t o Make W h a te v e r C o n t r i b u t i o n s P o s s i b l e t o H e a lt h I n s t r u c t i o n , The r e t u r n s t o t h i s q u e s t i o n show t h a t o n e th o u ­ sa n d fo u r h u n d red s e v e n t y ,

o r 6 9 .2 p e r c e n t o f t h e

s c h o o ls r e p o r te d u se d t h i s p r a c tic e * who r e p l i e d ,

O f th e f i f t y - s i x

fo r ty -o n e o r 7 5 .2 p e r c en t a d v o c a te d t h i s

p o lic y . I ll*

HEALTH GUIDANCE

H e a lt h g u id a n c e r e f e r s t o m e n t,

c o u n s e lin g ,

d is c ip lin e ,

su ch f a c t o r s a s en co u ra g e­

In te r e st,

d ir e c tio n

and h e l p

95 th a t k eep th e

s t u d e n t p r o g r e s s i n g to w a r d a n d a t t a i n i n g on

s c h e d u le g o a l s a n d g r o w th i n h e a l t h and h e a l t h b e h a v i o r . T r e n d s a n d P r a c t i c e s i n H e a lt h G u id a n ce a s R e v e a le d by t h e L i t e r a t u r e o n t h e P r o b le m . I t i s o f l i t t l e v a lu e y e a r a f t e r y e a r to d is c o v e r a n d t o a n n o u n c e t h a t W illia m h a s d e f e c t i v e v i s i o n — i f n o t h i n g i s d on e t o c o r r e c t i t . L i t t l e p r o g r e s s i s made i f t h e a d v a n t a g e s o f p r e v e n t i o n a r e d i s c u s s e d in t h e h e a l t h p rogram b u t n e i t h e r t h e s c h o o l n o r com m unity m ak es i t p o s s i b l e f o r t h e in d iv id u a l to p r a c t ic e w hat h a s b een a c ce p ted as d e s ir a b le . The p r o b le m i n h e a l t h g u id a n c e i s to r e c o g n i z e t h e c o o p e r a t iv e n a tu r e o f th e a c t i v i t y an d t o p r o v id e th r o u g h o r g a n i z a t i o n t h e m ean s o f b r i n g i n g hom e, s c h o o l a n d com­ m u n ity i n t o c l o s e r a n d b e t t e r r e l a t i o n s h i p f o r t h e e x ­ t e n s i o n an d im p r o v e m e n t o f t h e h e a l t h o f e a c h c h i l d . 1 3 The s c h o o l h a s t h e r e s p o n s i b i l i t y f o r a s s u r i n g t h a t p r o c e d u r e s recom m end ed by t h e s c h o o l m e d i c a l a d v i s e r a r e c a r r ie d o u t. T h is m e d ic a l f o l l o w - u p f r e q u e n t l y e n t a i l s e d u c a t i n g t h e p a r e n t s a s w e l l a s th e c h i l d i n t h e im ­ p o r t a n c e o f c a r r y i n g o u t t h e d o c to r * s a d v i c e . W ith t h e c o o r d in a te d e f f o r t o f a d m in is t r a t o r , m e d ic a l a d v is e r , n u r s e , a n d t e a c h e r , an d e v e n w i t h t h e b e s t c o o p e r a t i o n t h e f a m i l y c a n p r o v i d e , t h e s c h o o l may h a v e t o assum e t h e r e s p o n s i b i l i t y f o r a l l s e r v i c e s s h o r t o f m e d ic a l tr e a tm e n t. The s c h o o l a u t h o r i t y , w i t h t h e a s s i s t a n c e o f t h e c o u n t y , d i s t r i c t o r p a r i s h m e d i c a l s o c i e t y , may f i n d i t n e c e s s a r y t o recomm end t h e p r i v a t e d o c t o r o f h e a l t h a g e n c y , f i n d m ea n s o f f i n a n c i n g t h e v i s i t , make th e a p p o in t m e n t , a n d t r a n s p o r t t h e c h i l d t o a n d from t h e c lin ic . I t i s o b v i o u s l y u n so u n d t o u s e h e a l t h a d v i c e a l o n e , when d e f i n i t e d i s e a s e h a s b e e n fo u n d even i n t h e s o - c a l l e d " h e a l t h y . w1 4

1 0 " H e a lt h i n 14

I b id ., p .

S c h o o ls ," 51.

o£.

c i t . . p . 27

96 The s t e p s w h ic h t h e s c h o o l s h o u ld t a k e t o a id

stu ­

d e n t s a r e o u t l i n e d b e lo w * . * * G arry on e x t e n s i v e e d u c a t i o n a l p r o g r a m s w i t h s t u d e n t s a n d p a r e n t s , r e g a r d i n g t h e im p o r t a n c e o f c o r ­ r e c t i o n s an d m ean s o f s e c u r i n g them* D i s c o v e r a n d u t i l i z e com m unity r e s o u r c e s f o r s e c u r i n g c o r r e c t i o n s f o r y o u t h s w h o se f a m i l i e s c a n n o t p r o v i d e n e c e s s a r y care* T h e se w o u ld i n c l u d e m e d i c a l an d d e n t a l s e r v i c e s a n d f i n a n c i a l su p p o r t* * * • P a r t i c i p a t e w ith th e h e a lt h a u t h o r i t i e s in i n g t h e c o m p le t io n o f im m u n iz a tio n s *

secu r­

• . « H elp e a c h s t u d e n t o r g a n i z e h i s tim e t o p r o v i d e f o r a b a l a n c e d program * E n c o u r a g e t h e w i s e u s e o f e x e r c i s e a n d w h o le so m e r e c r e a ­ t i o n th r o u g h s e e i n g t h a t o p p o r t u n i t i e s a r e p r o v i d e d w it h in th e s c h o o l day f o r su c h a c t i v i t i e s * P r o v i d e tim e d u r i n g t h e s c h o o l d a y f o r r e s t a n d r e l a x a tio n .1 5

F o llo w - u p h e a l t h p r o b le m s u s u a l l v i n v o l v e s one o r m ore o f t h e f o l l o w i n g p r o c e d u r e s : ( a ; M e d ic a l, s u r g i c a l , o r d e n t a l t r e a t m e n t a s r e q u i r e d f o r d e f e c t s su c h a s d e ­ c a y ed t e e t h and p o o r v is io n ; (b ) p r o v is io n o f h e a lt h n e c e s s i t i e s , s u c h a s f o o d , c l o t h i n g , o r im p r o v e d home c a re and s u p e r v is io n ; ( c ) ch an ges in su ch r o u tin e s o f l i v i n g a s c h o ic e o f d i e t s , c a r e o f v i s i o n , h o u rs o f s l e e p , an d a c t i v i t y ; (d ) p rogram a d j u s t m e n t s , i n c l u d i n g p r o v is io n fo r lip - r e a d in g in s t r u c t io n , sp eech c o r r e c ­ t i o n , m o d ifie d p h y s i c a l e d u c a tio n p ro g ra m s, o r a s h o r te n ­ e d s c h o o l d a y * 16 The p r im a r y o b j e c t i v e s o f t h e h e a l t h s e r v i c e a n d g u id a n c e p rogram i n t h e s c h o o l a r e t o d e t e r m in e t h e h e a lt h s t a t u s o f th e p u p il, to e n l i s t h i s c o o p e r a tio n

-t

C

P hy s i c a l F i t n e s s V i c t o r y C orps P a m p h le t N o* 3 , op* c i t * , pp. 1 -3 . ,

1 6 I b i d * , p* 9 0 .

97 In p r o t e c t i n g a n d m a i n t a i n i n g h i s h e a l t h , t o in fo r m p a r e n t s o f t h e f i n d i n g s o f t h e h e a l t h e x a m in a t io n , t o p r e v e n t d i s e a s e , a n d t o work to w a r d t h e c o r r e c t i o n o f r e m e d ia b le d e f e c t s . To a c c o m p l i s h t h i s e f f e c t i v e l y , t h e a r e a o f h e a l t h s e r v i c e s h o u ld s t r i v e t o i n c l u d e : . . . M eth o d s o f u t i l i z i n g t h e f i n d i n g s o f t h e e x ­ a m in a t io n i n a l l p h a s e s o f t h e a c a d e m ic p r o g r a m . (E m p h a s is on c l a s s i f i c a t i o n o f p u p i l s a s w e l l a s on m a te r ia l fo r c la s s d i s c u s s i o n .) . . . N o t if ic a t io n o f p a r e n ts o f th e p o s i t i v e and n e g a tiv e r e s u lt s o f th e h e a lth a p p r a is a l. (A f r i e n d ­ l y , human a p p r o a c h s h o u l d b e u s e d . Com m unity r e ­ s o u r c e s f o r r e f e r r a l s h o u ld b e a v a i l a b l e . ) P rop er c o u n s e lin g o f p u p ils , a s w e ll a s p a r e n ts , r e ­ g a r d in g t h e m e n ta l, s o c i a l , and p h y s i c a l w e l l - b e i n g o f th e stu d e n ts . . . . C o n ta c ts w ith c l i n i c s and o u t s id e a g e n c ie s w h e r e c o r r e c t i o n o f d d f e c t s can be made a y a i l a b l e t o c h i l d r e n w h o se f a m i l i e s a r e f i n a n c i a l l y u n a b le t o p r o v id e p r iv a t e c a r e . A s y s te m a tic fo llo w -u p o f d i f f i c u l t i e s t h e h e a l t h e x a m in a t io n .

r e v e a le d by

A p rogram o f h e a l t h o b s e r v a t i o n by t h e c la s s r o o m tea c h e rs. ( T e a c h e r s n e e d i n - s e r v i c e t r a i n i n g in t h i s a r e a . )1 7 The R o le o f t h e T e a c h e r i n H e a lt h G u id a n ce A l l t e a c h e r s s h o u ld b e a b l e t o g i v e so u n d a d v i c e a b o u t t h e common a f f a i r s o f d a i l y h e a l t h f u l l i v i n g . The r u l e s o f h y g ie n e s h o u ld b e known a n d p r a c t i c e d b y e v e r y te a c h e r . When a q u e s t i o n c a l l i n g f o r m ore e x t e n d e d o r t e c h n i c a l k n o w le d g e i s p r e s e n t e d , sh e s h o u l d know w h er e t o g e t t h e r e q u i r e d i n f o r m a t i o n o r t o whom t h e s t u d e n t s h o u ld b e r e f e r r e d .18

^ L lo y d E. W e b s te r , 11P l a n n i n g f o r H e a lt h an d P h y s i c a l F i t n e s s , ” C a l i f o r n i a J o u r n a l o f S e c o n d a r y E d u c a t i o n , V o l. 2 0 , N o. 1 , J a n u a r y , 1 9 4 5 . 18

T e a c h e r s 1 G u id e I n H e a l t h E d u c a t io n , C a l i f o r n i a S t a t e D e p a r tm e n t o f E d u c a t io n , A u g u s t , 1 9 4 7 , p . 1 6 .

98 A Summary o f t h e P r o c e d u r e s G e n e r a l l y C o n s id e r e d I m p o r t a n t t o H e a lt h G u id a n c e a s E x p r e s s e d I n Much o f th e L i t e r a t u r e R ead I s G iv e n H e r e w it h ; (1 )

S tu d y t h e n e e d s o f e a c h s t u d e n t an d s e t up p r o p e r g o a l s f o r him i n r e f e r e n c e t o h i s h e a l t h , a n d s e t up w i t h t h e s t u d e n t , t e a c h e r , c o u n s e l o r and p a r e n t s p r o c e d u r e s a n d r e q u ir e m e n t s n e c e s s a r y t o r e a c h t h e s e g o a ls .

( 2 ) N o t i f y p a r e n t o r g u a r d ia n o f c h i l d a b o u t a n y h e a l t h c o n d i t i o n s t h a t n e e d t h e a t t e n t i o n o f t h e home o r o f th e fa m ily p h y s ic ia n .

(3) A r ra n g e i n d i v i d u a l c o n f e r e n c e s f o r s t u d e n t s and p a r e n ts w ith n u r s e s , c o u n s e lo r s , d o c t o r s , d e n t i s t s , a s o c c a s i o n dem ands u n t i l a l l h e a l t h r e q u ir e m e n t s a r e m e t. ( 4 ) A d ju s t t h e p ro g ra m o f e a c h s t u d e n t so t h a t i t i s c o m p a ta b le w i t h h i s h e a l t h n e e d s a n d p r o t e c t s a n d p r o m o te s h i s h e a l t h . ( 5 ) T r a in t h e s c h o o l s t a f f t o u s e a l l c o n t a c t s w i t h s t u d e n t s t o i n s t r u c t th em a n d t o c r e a t e i n them a n i n t e r e s t an d d e s i r e t o p o s s e s s e x c e l l e n t h e a l t h . ( 6 ) P r e s e n t s u i t a b l e r e c o g n i t i o n t o s t u d e n t s when t h e y have a t t a i n e d c e r t a in sta n d a r d s i n th e v a r io u s f ie ld s o f h e a lth . ( 7 ) A r ra n g e f o r t h e im m u n iz a tio n o f a l l s t u d e n t s a s recom m ended b y h e a l t h a u t h o r i t i e s . ( 8 ) Know a n d u t i l i z e com m u nity r e s o u r c e s f o r s e c u r i n g c o r r e c t i o n s f o r s t u d e n t s w h o se f a m i l i e s c a n n o t p r o ­ v i d e th em . (9 )

(1 0 )

C r e a te s c h o o l - w i d e i n t e r e s t i n i n d i v i d u a l , s c h o o l a n d com m unity h e a l t h p r o b le m s b y m ean s o f l e c t u r e s , d e m o n s t r a t i o n s , b u l l e t i n s , a s s e m b l i e s , m o tio n p i c ­ tu r e s and c o n te s ts * C o o p e r a te w i t h a l l o u t - o f - s c h o o l a g e n c i e s i n d e -

99 v e l o p i n g a h i g h s t a n d a r d o f com m u nity h e a l t h . 19 R e t u r n s from t h e Q u e s t i o n n a i r e R e l a t i v e t o H e a lth G u id a n c e .

A ssu m in g t h a t t r a i n e d p e r s o n n e l a n d f a c i l i t i e s

a r e a d e q u a t e f o r a g o o d h e a l t h p ro g ra m i n t h e

s c h o o l, and

t h a t a c o m p le t e i n v e n t o r y o f t h e h e a l t h s t a t u s o f a l l t h e c h ild r e n

i s on h a n d ,

i t w i l l be n e c e ssa r y to

d e v i s e m e th o d s

t o make i n t e l l i g e n t a n d e f f e c t i v e u s e o f them i n o r d e r t o a tta in

th e g o a ls o f t h e h e a lth program .

f a l l in to

T h e s e m e th o d s w i l l

t h e f i e l d o f g u id a n c e a n d i n s t r u c t i o n .

The r e ­

t u r n s from t h i s p a r t o f th e Q u e s t i o n n a ir e r e v e a l t h e p e r ­ s o n n e l a n d p r a c t i c e s i n r e g a r d t o h e a l t h g u id a n c e i n u s e

in

s c h o o ls w it h good h e a lt h p rogram s. THE PERSONNEL AND PRACTICES OF HEALTH GUIDANCE IN THE SYSTEM A* The O f f i c e r R e s p o n s i b l e f o r H e a lt h G u id a n ce i n th e I n th e l i t e r a t u r e and in

read in

S y s te m .

c o n n e c t i o n w it h t h i s

stu d y

in t e r v ie w s h e ld w ith t h e v a r io u s a u t h o r i t i e s on th e

h e a l t h p r o g r a m , h e a l t h g u id a n c e w as c o n s i d e r e d a v e r y im ­ p o r ta n t fu n c tio n .

19

I t w as t h e p u r p o s e o f t h i s p a r t o f t h e

" H e a lt h i n S c h o o l s , ” o p . c i t . , p p . 2 5 - 5 7 . M a rio n B row n, HThe H e a lt h Program i n th e U n i v e r s i t y H igh S c h o o l , 11 o £ . c i t . , p p . 1 - 1 6 . MThe C om m ission on E d u c a t i o n ,” o p . c i t . , p p . 7 - 8 . “ P h y s i c a l F i t n e s s , " V i c t o r y C orp s S e r i e s , P a m p h le t N o. 3 , p p . 1 , 1 9 , 1 4 , 1 8 , 3 0 , 3 9 .

lao in v e s tig a tio n to

d is c o v e r j u s t w hat o f f i c i a l in th e

h e a l t h p rogram s h o u ld be r e s p o n s i b l e t o

se e th a t t h is

f u n c t i o n w as p r o p e r l y c a r r i e d o u t . The r e t u r n s a s shown i n T a b le XXI, p a g e 1 0 1 , f a v o r p l a c i n g t h i s r e s p o n s i b i l i t y w i t h t h e o f f i c e r who h a s c h a r g e o f t h e h e a l t h p rogram f o r t h e s y s t e m .

T h u s, a s

show n i n Ite m O ne, C olum ns One a n d Two, f o u r t e e n , o r 5 0 p e r c e n t o f th e tw e n ty -e ig h t sy ste m s r e p o r te d , t h is p r a c tic e . s ix ,

em p loy

O f t h e i n d i v i d u a l s who r e p l i e d ,

t ? /e n t y -

o r 4 6 . 4 p e r c e n t recom m end t h i s p r a c t i c e a s show n i n

C olum ns T h re e a n d F o u r . T a b le X X II, p a g e 1 0 2 , o ffic ia ls

th a t a r e g e n e r a lly

illu s tr a te s

th e ty p e o f

e m p lo y e d t o a s s i s t i n

f u n c t i o n o f h e a l t h g u id a n c e i n t h e s y s t e m .

th e

I te m O ne,

T a b le X X II, i n d i c a t e s t h a t t h e s c h o o l c o u n s e l o r s a r e a s s ig n e d th e r e s p o n s ib i li t y

f o r c o n s i d e r i n g the

h e a lth

f a c t o r i n r e g a r d t o t h e c h i l d a n d c o o p e r a t e i n th e p r o ­ gram .

T h u s, r e a d i n g from l e f t

C olum ns One and Two, e i g h t e e n ,

t o r i g h t i n I te m O n e, o r 6 4 .2 p e r c e n t o f t h e

tw e n t y - e ig h t sy ste m s r e p o r te d , u se d t h is

p r a c tic e .

C olum ns T h re e a n d F o u r , I te m O n e, show t h a t t h i r t y - s i x , o r 6 4 . 3 p e r c e n t o f t h o s e who r e p l i e d a p p r o v e d t h e p r a c ­ tic e . I t e m s Two a n d T h ree show t h a t n e a r l y h a l f o f a l l s y s t e m s r e p o r t e d e m p lo y e d p s y c h i a t r i s t s a n d p s y c h o l o g i s t s

101 TABLE XXI THE OFFICER FOR THE HEALTH GUIDANCE PROGRAM IN THE SYSTEM

TITLE & STATUS:

PRACTICE

RECOMMENDED

F requ en cy P e r c e n t F req u en cy P er c e n t ITEM 1. 2. 3.

COLUMNS - 1

The O f f i c e r i n C h arge o f t h e H e a lt h P rogram

2

3

4

14

5 0 .0

26

4 6 .4

The D i r e c t o r o f H e a lth S e r v ic e

9

3 2 .1

16

28*5

The D i r e c t o r o f t h e G u id a n c e D e p a r tm e n t

5

1 7 .9

8

1 4 .3

1

3 .6

1

1 .8

4 . D i r e c t o r o f H e a lt h a n d P h y s i c a l E d u c a t io n S y s te m s R e p o r t e d - 2 8 R e p l i e s R e c e i v e d - 56

102 TABLE XXII ASSISTANTS TO THE OFFICER OF HEALTH GUIDANCE

TITLE OR STATUS:

PRACTICE

RECOMMENDED

F req u en cy P er c en t F requ en cy P er c e n t ITEM

COLUMNS - 1

2

3

4

C o u n s e lo r s

18

6 4 .2

36

6 4 .3

2 . P s y c h ia tr is ts

14

5 0 .0

23

4 1 .1

3 . P s y c h o lo g is ts ^

13

4 6 .4

23

4 1 .1

9

3 2 .1

21

3 7 .5

1.

4 . M e n ta l H y g i e n i s t s

S y s te m s R e p o r te d - 2 8 R e p l i e s R e c e i v e d - 56

103 to a s s i s t in th e h e a lt h program . Eh

The S e r v i c e o f G u id a n c e E x p e r t s i s A s s i g n e d t o t h e I n d iv id u a l S c h o o l a s H eeded, S e v e n te e n sy ste m s o r 60*7 p e r c e n t o f th o s e r e ­ p o r t i n g on t h i s q u e s t i o n w ere a b l e t o e x t e n d h e a l t h g u id a n c e e x p e r t s t o i n d i v i d u a l s c h o o l s a s n eed ed * an sw ers to

t h i s q u e s t i o n w e r e p r o b a b ly made a f t e r

The con­

s i d e r a t i o n o f t h e tw o p r e v i o u s q u e s t i o n s a n d h a v e r e f e r ­ e n c e t o t h e t y p e o f g u id a x fce a n d g u id a n c e e x p e r t s r e p r e ­ s e n t e d by t h e p r o f e s s i o n a l p e o p l e c o n s i d e r e d i n them — th a t i s , have to

c o u n s e lo r s , p s y c h i a t r i s t s and p s y c h o lo g is t s t h a t do w i t h a c a d e m ic an d m e n ta l a s p e c t s o f g u id a n c e .

S i n c e o t h e r m em bers o f t h e h e a l t h s t a f f p l a y a m a jo r r o l e in h e a lt h g u id a n c e , a s i l l u s t r a t e d T a b le IX , p a g e 6 6 , i n

i n one i n s t a n c e i n

th e c a se o f th e n u rse i t

app ears

t h a t t h i s p r a c t i c e o f a s s i g n i n g g u id a n c e p e r s o n n e l t o s c h o o ls a s n eed ed i s a p r a c t ic e o f a l l

s y s t e m s h a v in g

good h e a lt h p rogram s. G. C a s e s H e e d in g S p e c i a l F a c i l i t i e s A re S e r v e d i n C e n t r a l L o c a tio n s . The l i t e r a t u r e

s t u d i e d se e m e d t o f a v o r t h i s p r a c t i c e

and t h e r e t u r n s on t h i s q u e s t io n

sh o w ed s t r o n g s u p p o r t

fo r i t .

E ig h te e n , o r 64*3 p e r c e n t o f t h e sy ste m s r e p ly ­

in g to

t h i s q u e s t io n , r e p o r te d t h a t th e y u s e d th e p r a c t ic e ,

104 and t h ir t y - f o u r ,

o r 60*7 p e r c e n t o f t h e

fifty -s ix

a u t h o r i t i e s who r e p l i e d recom m ended i t . PERSONNEL AND PRACTICES OP HEALTH GUIDANCE IN THE SCHOOL Many s y s t e m s a r e p r e p a r e d t o o f f e r t h e i n d i v i d u a l s c h o o l a l l t h e s e r v i c e s n e c e s s a r y t o h a v e an e f f e c t i v e h e a l t h p ro g ra m ,

b u t i n many s c h o o l s t h e m e th o d s u s e d do n o t

make f u l l u s e o f th e m .

An ex a m p le o f t h i s i s

th e p r a c tic e

o f m a k in g q u i t e a t h o r o u g h p h y s i c a l i n s p e c t i o n , t h e r e s u l t s o f w h ic h a r e f i l e d w i t h ' t h e s t u d e n t 1 s r e c o r d , w h ic h l i t t l e

is

don e.

but about

T h is p a r t o f t h e s t u d y sh ow s t h e

p r a c t i c e s u s e d i n many s c h o o l s w i t h g o o d h e a l t h p r o g r a m s t o m ake t h e program e f f e c t i v e

th r o u g h p r o p e r g u i d a n c e .

The r e t u r n s o f q u e s t i o n s A,

B, a n d C o f t h e Q u e s t i o n ­

n a i r e a r e shown I n T a b le X X III , p a g e 1 0 5 . o u tlin e d in

The p r a c t i c e s

t h e s e t h r e e q u e s t i o n s w e re c o n s i d e r e d im p o r t a n t

i n t h e l i t e r a t u r e s t u d i e d a n d w e r e fo u n d to b e s t r o n g l y f a v o r e d a s i n d i c a t e d b o t h b y p r a c t i c e a n d by o p i n i o n . Ite m T h ree, in

th is

ta b le ,

is

s i g n i f i c a n t in

i n t r o d u c e s a d y n a m ic a p p r o a c h t o h e a l t h i n s t r u c t i o n . i m p l i c a t i o n i n t h i s Ite m i s

th a t in s tr u c tio n

is

e x p e r i e n c e s t h a t a r e im p o r t a n t a n d p e r s o n a l t o

th a t i t The

b u i l t around each s tu d e n t,

a n d a r e t h e r e f o r e m ore i n t e r e s t i n g a n d m e a n in g f u l t o h im . E i g h t y - s e v e n an d t h r e e - t e n t h s p e r c e n t o f th e

s c h o o ls r e -

105 TABLE X X III PRACTICE OF HEALTH GUIDANCE IN THE SCHOOL

PERSONS & FUNCTIONS PRACTICE RECOMMENDED IN HEALTH GUIDANCE: F requency P e r cen t F requency P er c e n t ITEM

COLUMNS - I

2

( ’’A11 ) 1 . A l l T e a c h e r s Have t h e H e a lt h R e c o r d s o f th e S tu d e n ts in T h e ir C l a s s e s a n d G iv e A s s ig n m e n t s i n K e e p in g w i t h T h e ir H e a lt h H eed s* 8 4 1 ( HB,f ) 2 .

C o u n s e lo r s and A dm ini s t r a t o r s a d ju st th e School P rogram a n d t h e P rogram o f t h e I n d i v i d u a l S tu ­ d e n t s w i t h th e H e a lt h N e e d s o f t h e G roup a n d t h e I n d i v i d u a l i n M ind. 1 5 4 2

(«C« ) 3 . T he T e a c h e r o f H e a lt h I n s t r u c t i o n G iv e s I n t e n s i v e G u id a n ce I n t h e F o r m a tio n o f H e a lt h H a b i t s a n d i n H e lp in g S t u d e n t s S e c u r e N e e d e d C or­ r e c tio n s .

S c h o o ls R e p o r te d - 2 1 2 3 R e p l i e s R e c e i v e d - 56

1853

56*6

3

4

59

69*6

7 2 .6

55

9 8 .2

8 7 .3

55

9 8 .2

106 p o r te d ,

o r o n e th o u sa n d e ig h t hu n d red and f i f t y - t h r e e ,

shown i n I te m T h r e e , and f i f t y - f i v e , and F ou r,

as

C olum ns One a n d Two, u s e t h i s p r a c t i c e ,

or 98. 2 p er c e n t,

a s shown i n

Colum ns T h r e e

o f t h o s e r e p l y i n g recom m end i t .

A. N u r s e s , D o c t o r s , D e n t i s t s a n d O th e r H e a lt h S e r v i c e P e r s o n ­ n e l Grive G u id a n c e . The t e c h n i q u e s i n v e s t i g a t e d i n

th e ite m s o f t h i s

q u e s t i o n r e c e i v e d a lm o s t 1 0 0 p e r c e n t a p p r o v a l a s i n d i c a t e d , b o t h b y u s e a n d o p i n i o n , a n d a s show n i n T a b le XXIV, p a g e 107.

T h u s, i n I t e m O ne, Colum ns One an d Two show t h a t o n e

t h o u s a n d n i n e h u n d r e d a n d t w e l v e , o r 9 0 .1 p e r c e n t o f t h e s c h o o l s r e p o r t e d , n o t i f y t h e p a r e n t s o f c h i l d r e n w h o se h e a lth

c o n d itio n n e e d s a t t e n t io n .

Of th e

fifty -s ix

educa­

tio n

a n d h e a l t h a u t h o r i t i e s who a n s w e r e d t h e q u e s t i o n ,

a ll,

o r 1 0 0 p e r c e n t , a s show n i n

Colum ns T h r e e a n d F o u r ,

a p p r o v e d th e p r a c t i c e . The H e a l t h G fuidance Program i s

D i s c u s s e d a n d E m p h a siz e d

F r e q u e n t ly a t T e a c h e r s * M e e t in g s i n O rd er t o

S e c u r e M axi­

mum U n d e r s t a n d in g a n d C o o p e r a tio n on t h e P a r t o f T e a c h e r s . One o f t h e f a c t o r s s t r e s s e d i n th e l i t e r a t u r e s t u d ie d , and in th e in t e r v ie w s r e l a t i v e

t o t h e p r o b le m ,

w as t h e n e c e s s i t y o f a t h o r o u g h u n d e r s t a n d in g o f t h e h e a l t h program on t h e p a r t o f t h e e n t i r e and w hat p a r t ea ch p la y e d in i t .

sc h o o l p e r s o n n e l,

107 TABLE XXIV GUIDANCE TECHNIQUES IN THE SCHOOL

NURSES, DOCTORS, DENTISTS PRACTICE AND OTHER GUIDANCE PERSONNEL:

RECOMMENDED

F requ en cy P er c e n t F req u en cy P e r c e n t ITEM

COLUMNS -

1

2

3

4

1 . N o tify P a r e n ts o f H e a lt h C o n d it io n T h a t N eed s A tte n tio n

1912

9 0 .1

56

1 0 0 .0

2 . Make C o n t a c t s w i t h C h ild a n d P a r e n t s U n t il N eed ed C o r re c ­ t i o n s a r e O b t a in e d

1811

8 5 .3

56

1 0 0 .0

3 . H e lp S t u d e n t s Make C o n ta c t w ith P h y s i­ c ia n s o r C lin ic s a s N ecessa ry

1892

8 9 .1

56

1 0 0 .0

4 . O u t l i n e C o n v a le s c e n t . P rogram f o r C h ild r e n R e t u r n in g a f t e r I lln e s s

1839

8 6 .2

56

1 0 0 .0

S c h o o ls R e p o r ted - 2 1 2 3 R e p lie s R e c e iv e d - 56

108 The r e t u r n s o n t h i s q u e s t i o n show t h a t t h i r t e e n hundred and f i f t e e n ,

o r 61*9 p e r c e n t o f t h e s c h o o ls r e ­

p o r t e d made u s e o f t h e t e a c h e r s * e m p h a s iz e t h e h e a l t h program *

m e e tin g s to

F o r ty -fo u r ,

e x p la in and

o r 76*6 per

c e n t , recom m end ed t h a t t h i s b e done* C h a p te r summary*

The summary f o r t h i s

b a s e d on t h e r e t u r n s from t h e q u e s t i o n n a i r e * th e q u e s tio n n a ir e i s

ch a p te r i s The o u t l i n e o f

fo llo w e d and th e p r a c ti ce in

each in ­

s t a n c e t h a t w as u s e d b y t h e l a r g e s t num ber o f s y s t e m s o r s c h o o ls c o n s id e r e d to h a v e good h e a lt h program s i s The f i n d i n g s i n t h e l i t e r a t u r e m e n d a tio n s made i n

g iv e n .

on t h e s u b j e c t and t h e r ec o m ­

th e r e tu r n s are in s u b s t a n t ia l agreem ent

w ith th e p r a c t ic e s c ite d * HEALTH SERVICE IN THE CITY SCHOOL HEALTH PROGRAM P a r t I*

The c i t y

A* The o f f i c e r sy stem is

sy ste m . f o r th e h e a lth

s e r v i c e p ro g ra m i n t h e

s h o u l d b e t h e D i r e c t o r o f H e a lt h S e r v i c e .

He

g e n e r a lly a d o c to r o f m e d ic in e .

B. He c o o r d i n a t e s t h e h e a l t h

s e r v i c e p ro g ra m o f t h e

sy ste m w it h o u t - o f - s c h o o l h e a lt h a g e n c ie s * C* He s e e s t h a t t h e e n v ir o n m e n t i n

th e s c h o o ls i s

su c h

t h a t t h e h e a l t h o f s t u d e n t s a n d t e a c h e r s i s p r o m o te d and c o n serv ed .

109 D. He h a s w h a t s o e v e r a s s i s t a n t s , n u r s e s , tis ts

d o c to rs,

den­

a n d d e n t a l h y g i e n i s t s , m e n ta l h y g i e n i s t s ,

d ie t ic ia n s , and f a c i l i t i e s n e c e ssa r y to

carry out

an e f f e c t i v e p r o g ra m .

'i

E.

The m o s t common n u r s e p u p i l r a t i o w as fo u n d t o b e one n u rse to

P art I I . A.

ea ch one th o u sa n d p u p i l s .

H e a lt h s e r v i c e p e r s o n n e l a n d p r a c t i c e

in th e s c h o o l.

C o m p r e h e n siv e p h y s i c a l e x a m i n a t io n s by s c h o o l d o c t o r s an d d e n t i s t s a r e g iv e n t o a l l e n tr a n c e to

th e sy ste m , 2 .

stu d e n ts:

on e n tr a n c e to

m e n t, 3 . b e f o r e e a c h s p o r t s e a s o n , 4 . B. P s y c h i a t r i c s e r v i c e i s

1.

on

each s e g ­

a s needed.

a v a ila b le a s needed.

C. I m m u n iz a tio n an d v a c c i n a t i o n a r e r e q u i r e d o f a l l s tu d e n ts and p e r s o n n e l. D. S e l e c t i o n o f t e a c h e r s a n d t e a c h i n g c o n d i t i o n s a r e s u c h t h a t p u p i l a n d t e a c h e r r e a c t i o n s p r o m o te g o o d m e n ta l and s o c i a l h e a lt h .

(O ne h u n d r e d p e r c e n t

d e s ir e d b u t n o t g e n e r a lly a t t a i n e d .) E.

S p e c ia l f a c i l i t i e s

th a t a r e g e n e r a lly fu r n is h e d fo r

t h e p r o m o tio n o f h e a l t h a r e : tie s ,

h o t w a te r ,

1 . h a n d w a s h in g f a c i l i ­

so a p a n d p a p e r t o w e l s ; 2 . a c a f e ­

t e r i a , w e l l b a la n c e d m e a l s , a n d am ple tim e f o r e a t i n g ; and 3 .

room s f o r s p e c i a l gym.

110 HEALTH INSTRUCTION IN THE CITY SCHOOL SYSTEM P art I .

The c i t y

sy ste m *

A. The o f f i c e r r e s p o n s i b l e t h e s y s te m

fo r h e a lth in s tr u c tio n

in

s h o u ld b e t h e D i r e c t o r o f H e a lt h I n s t r u c ­

tio n * B* A l l o f h i s t i m e s h o u ld b e a s s i g n e d t o t h i s * f u n c t io n * C* The c u r r ic u lu m i n h e a l t h i n s t r u c t i o n i s

th e r e s u lt

o f a c o o p e r a t iv e e n t e r p r is e on th e p a r t o f t h i s D S re cto r w ith th e h e a lt h

c o u n c i l f o r t h e s y s te m an d

t h e c u r r ic u lu m d e p a r tm e n t. th e

sy stem i s

The H e a lt h C o u n c il f o r

g e n e r a l l y co m p o sed o f t h i s D i r e c t o r o r

c h a ir m a n , t h e s u p e r i n t e n d e n t , t h e a s s o c i a t e s i n t h e h e a l t h p rogram an d t h e d i r e c t o r s o f t h e c u r r ic u lu m , hom em ak in g, s c i e n c e a n d g u id a n c e d e p a r tm e n ts a n d f r e q u e n t l y a r e p r e s e n t a t i v e from t h e

c it y h e a lth

d e p a r tm en t* D. A t e a e h l e v e l s t u d e n t s g e t t h e i n f o r m a t i o n , m o t iv a ­ t i o n , a n d g u id a n c e t h a t e n a b l e s a n d c a u s e s them t o liv e h e a lth fu lly . P art I I .

The p e r s o n n e l a n d p r a c t i c e s o f h e a l t h in

th e

in s tr u c tio n

s c h o o l.

A . T h e r e a r e cou rses o f h e a l t h i n s t r u c t i o n i n th e o f a t l e a s t tw o s e m e s t e r s i n a l l stu d e n ts.

sch ool

e a c h se g m e n t r e q u i r e d o f

Ill B . C o u r s e s o f h e a l t h i n s t r u c t i o n a r e b a s e d on t h e n e e d s o f s tu d e n ts d is c o v e r e d a s a r e s u lt o f p h y s ic a l ex­ a m in a t io n s a n d h e a l t h k n o w le d g e t e s t s .

P h y s ic a l e x ­

a m i n a t i o n s , d e v e lo p m e n t o f g o o d h e a l t h h a b i t s , in g o f needed c o r r e c tio n s ,

c h e c k in g on p r o g r e s s ,

a r r a n g e m e n ts f o r c o n f e r e n c e s w i t h d o c t o r s , a l l p art o f th e C. I n s t r u c t io n

secu r­ and

e tc * , are

c la s s r o u tin e .

in h e a lt h i s

g iv e n by a l l h e a lt h p e r so n ­

n e l d u r in g c o n f e r e n c e s , home v i s i t s

and h e a lth in ­

s p e c tio n s * D. A l l s u b j e c t s in th e sc h o o l g iv e to

th e ir

stu d e n ts

w h a tev e r i n s t r u c t i o n in h e a lt h i s p o s s i b l e . HEALTH GUIDANCE IN THE CITY SCHOOL P art I .

The c i t y s y s t e m .

A. The o f f i c e r r e s p o n s i b l e sy stem i s B.

f o r h e a l t h g u id a n c e i n t h e

t h e o f f i c e r i n c h a r g e o f the

h e a lt h program .

The o f f i c i a l s who a s s i s t i n h e a l t h g u id a n c e a r e a s s o c i a t e s i n th e h e a lt h program , c o u n s e lo r s , p s y c h ia ­ t r i s t s and p s y c h o l o g is t s .

C. The s e r v i c e o f g u id a n c e e x p e r t s i s

a s s ig n e d to th e

sch o o l as needed. D. C a s e s n e e d i n g s p e c i a l f a c i l i t i e s lo c a tio n s .

a re serv ed in

c e n tr a l

112 P a r t II*

P erso n n el and p r a c tic e s

i n h e a l t h g u id a n c e i n

th e

s c h o o l* A. A l l t e a c h e r s h a v e th e h e a l t h r e c o r d s o f t h e s t u d e n t s in

t h e i r c l a s s e s a n d g i v e a s s ig n m e n t s i n k e e p i n g w i t h

t h e ir h e a lth n e e d s.

(A lm o s t o n e h u n d r e d p e r c e n t d e ­

s ir e d b u t a t t a in e d i n o n ly 3 6 .6 p e r c e n t o f s c h o o ls r e p o r t e d .) B.

C o u n s e lo r s a n d a d m i n i s t r a t o r s a d j u s t t h e s c h o o l p r o ­ gram a n d t h e p ro g ra m o f i n d i v i d u a l s t u d e n t s i n e a c h c a s e w i t h t h e h e a l t h n e e d s i n m in d .

C. T e a c h e r s o f h e a l t h i n s t r u c t i o n g u id e s t u d e n t s i n t h e f o r m a t io n o f h e a l t h h a b i t s an d h e l p them s e c u r e n eed ed c o r r e c tio n s . B. N u r s e s ,

d o c t o r s , d e n t i s t s and o th e r h e a lt h s e r v ic e

p e r s o n n e l n o t i f y p a r e n t s o f c h i l d r e n who h a v e h e a l t h c o n d i t i o n s t h a t n e e d a t t e n t i o n , make c o n t a c t w i t h p a r e n t a n d c h i l d u n t i l n e e d e d c o r r e c t i o n s a r e m ade, h e lp

s t u d e n t s make c o n t a c t s w i t h p h y s i c i a n s o r

c l i n i c s , and o u t lin e r e n r e tu r n in g to

c o n v a le s c e n t program s fo r c h i ld ­

sch ool a f t e r i lln e s s .

E . The h e a l t h g u id a n c e p rogram i s

d i s c u s s e d a n d empha­

s i z e d f r e q u e n t ly a t t e a c h e r s 1 m e e tin g s i n o r d e r to s e c u r e maximum u n d e r s t a n d in g an d c o o p e r a t i o n on t h e p a rt o f tea c h e rs.

CHAPTER V SUMMARY IMPLICATIONS AND CONCLUSIONS T he p r o b le m * The p u r p o s e o f t h e i n v e s t i g a t i o n was t o d i s c o v e r t h e p r a c t i c e s i n r e g a r d t o t h e p e r s o n n e l u s e d and m e th o d s i n v o l v e d i n th e a d m i n i s t r a t i o n a n d c o o r d i n a t i o n o f h e a lth

i n s t r u c t i o n , h e a lt h g u id a n c e , and h e a lt h

s e r v ic e in

s c h o o l s w i t h g o o d h e a l t h program s* The a im s o f t h e h e a l t h p ro gram * a im s t o g e t t h e b e s t p o s s i b l e

The h e a l t h p rogra m

r e s u lt s fo r th e stu d e n ts in

t h e c o n s e r v a t i o n o f g r o w th p o t e n t i a l i t i e s , p h y s ic a l d e f e c ts , liv in g ,

th e c o r r e c tio n o f

th e e s ta b lis h m e n t o f h a b it s o f h e a lt h f u l

and a c q u i s i t i o n a n d a p p r e c i a t i o n o f k n o w le d g e s t h a t

w i l l c a u s e them t o l i v e h e a l t h f u l l y i n s c h o o l a n d p o s t s c h o o l d ays and to

c r e a t e h e a l t h f u l c o m m u n it ie s .

P rocedure*

I n “i n t e r v i e w s w i t h t e a c h e r s , p r i n c i p a l s ,

s u p e r in te n d e n ts , and a u t h o r i t i e s on th e s c h o o l h e a lt h program , t h e f o l l o w i n g q u e s t i o n s w e re d i s c u s s e d . 1.

What i n y o u r o p i n i o n a r e th e m o st im p o r t a n t f a c t o r s i n s e c u r i n g a g o o d h e a l t h p rogram i n t h e c i t y s c h o o l s y s te m ?

2* Whom do you c o n s i d e r t o b e o u t s t a n d i n g a u t h o r i t i e s i n r e g a r d t o t h e s c h o o l h e a l t h p rogram ? 3 . What a r e som e o f t h e q u e s t i o n s be in c lu d e d in a q u e s t io n n a ir e gram i n t h e c i t y s y s te m ?

t h a t y o u t h i n k s h o u ld a b o u t th e h e a lth p ro ­

114 4 . What l i t e r a t u r e do y o u c o n s i d e r o f o u t s t a n d i n g v a lu e i n r e l a t i o n t o t h i s p r o b le m ? 5.

Do you know o f a n y s c h o o l s o r s c h o o l s y s t e m s t h a t h a v e g o o d h e a l t h p r o g r a m s?

A l e t t e r o f I n q u i r y w as s e n t t o t h e a u t h o r i t i e s reco m ­ m ended i n t h e i n t e r v i e w s a s w e l l a s t o a num ber o f o t h e r o u t ­ s ta n d in g e d u c a to r s and sc h o o l h e a lth

a u th o r itie s .

The p u r ­

p o s e o f t h e i n q u i r y w as to s e c u r e t h e o p i n i o n s o f t h e s e e d u c a t o r s on c e r t a i n im p o r ta n t c o n s i d e r a t i o n s i n r e g a r d t o t h e p r o b le m a n d t o s e c u r e from them l i s t s

o f s c h o o l s and

sc h o o l sy ste m s t h a t had o u t s t a n d in g program s i n h e a lth w e l l a s t h e p r o p e r s c h o o l a u t h o r i t y w i t h whom t o

as

corresp o n d

in each in s ta n c e . F o r t y - t h r e e r e p l i e s w ere r e c e i v e d from t h e i n q u i r y and i t w as t o t h e s c h o o l o r s c h o o l sy s te m

recom m end ed i n th e se

r e p l i e s t h a t a la r g e p e r c e n ta g e o f th e q u e s t io n n a ir e s w ere se n t. The l i t e r a t u r e s t u d i e d c o m p r is e d t h a t recom m ended i n th e in te r v ie w s ,

t h e r e p o r t s o f n u m er o u s c o n v e n t i o n s and m e e t ­

i n g s , u n p u b lis h e d t h e s e s and r e s e a r c h p a p e r s , p r o f e s s i o n a l books and r e p o r t s d e a lin g w ith th e s u b j e c t . The q u e s t i o n n a i r e w as d e s i g n e d t o a s c e r t a i n t h e m e th o d s and p e r so n n e l u se d in

t h e a d m i n i s t r a t i o n and c o o r d i n a t i o n o f

t h e h e a l t h p rogram i n

s c h o o ls o r s c h o o l sy stem s th a t have

o u t s t a n d in g h e a lt h program s and w as s e n t to t h e s c h o o l sy ste m s t h a t w ere t h u s d e s i g n a t e d i n t h e r e t u r n s from t h e I n q u i r y ,

115 s u g g e s te d i n in t e r v ie w s o r i n r e l a t e d l i t e r a t u r e , and t o s t a t e a n d c i t y s u p e r v i s o r s o f t h e h e a l t h p ro g ra m a n d t o o th e r e d u c a to rs. F i f t y - s i x r e p l i e s r e p r e s e n tin g tw e n ty -e ig h t c i t y sy stem s,

6 6 5 J u n io r a n d s e n i o r h i g h a n d 1 , 4 5 4 e le m e n ta r y

s c h o o ls w ith a p o p u la tio n o f 1 ,5 2 6 ,0 4 2

c h i l d r e n w ere r e ­

c e iv e d , I.

SUMMARY

S p e c i f i c F i n d i n g s , The f o l l o w i n g summary i s b a s e d on t h e p r a c t i c e s and t r e n d s fo u n d i n tio n n a ir e s ,

th e in q u ir y ,

on t h e s u b j e c t *

t h e r e t u r n s from th e q u e s ­

th e in t e r v ie w s and i n l i t e r a t u r e

I n e a c h i n s t a n c e t h e p r a c t i c e i n m o st

g e n e r a l u s e an d m o s t g e n e r a l l y recom m en d ed i s

d e s c r ib e d *

I n many c a s e s t h e r e w e r e a l t e r n a t e

c h o ic e s o f p r a c t ic e s th a t

w ere u s e d and had s t r o n g a p p r o v a l.

T h e se a l t e r n a t e c h o i c e s

a r e t o b e fo u n d i n t h e m dln b od y o f t h i s

stu d y .

The summary

fo llo w s th e o u tlin e

u s e d i n t h e q u e s t i o n n a i r e an d p r e s e n t s

a c o m p o s it e p a t t e r n

f o r a h e a l t h p ro g ra m .

The p e r s o n n e l a n d a d m i n i s t r a t l o n o f t h e h e a l t h p rogram in th e

c ity

sy ste m *

The r e s p o n s i b i l i t y

f o r t h e a d m in is tr a ­

t i o n a n d c o o r d i n a t i o n o f t h e h e a l t h program i n th e c i t y sy stem i s

a s s ig n e d to an a s s i s t a n t

d i r e c t o r who h a s a u t h o r i t y t o i s s u e

s u p e r in te n d e n t o r t o a d ir e c t iv e s and se e th a t

116 t h e p o l i c i e s a d o p t e d by th e

s y s te m a r e c a r r i e d o u t e f f i c i ­

e n tly . T h is p o l i c y a p p l i e s w h e th e r o r n o t t h e own h e a l t h

s t a f f th r o u g h o u t o r i s

s y s te m h a s i t s

depend en t fo r i t s

f e s s i o n a l s e r v i c e s o n a c i t y o r c o u n ty h e a l t h

pro­

d e p a r tm e n t*

The tim e a l l o w e d t h i s o f f i c e r f o r t h e a d m i n i s t r a t i o n a n d c o o r d i n a t i o n o f th e h e a l t h p ro g ra m d e p e n d s on two f a c ­ to rs*

The f i r s t o n e b e in g t h e num ber o f f u n c t i o n s i n t h e

t o t a l p ro g ra m o f e d u c a t i o n , a s s i g n e d t o t h e h e a l t h p rogram * The o t h e r f a c t o r i s

th e s i z e o f th e

common p r a c t i c e , u s e d i n

s y s t e m s w it h

a s s ig n in g th e fu n c tio n s o f h e a lt h tio n ,

sy ste m *

Where t h e

good p r o g r a m s , o f

s e r v ic e ,

h e a lth

a n d p h y s i c a l e d u c a t i o n and r e c r e a t i o n ,

i n s t a n c e s g u id a n c e a n d w e l f a r e t o

and in

some

th e h e a l t h program i s

u s e d , a l l o f t h i s o f f i c e r 1 s t im e i s t h e p rogram i n

in s tr u c ­

g e n e r a lly a llo w e d fo r

s y s t e m s w ith a s t u d e n t p o p u l a t i o n o f 2 0 , 0 0 0

o r m o re. T h is o f f i c e r :

1 . Works w i t h t h e c u r r ic u lu m d e p a r t -

m en t a n d o t h e r ' d i r e c t o r s i n th e

sy ste m to s e e t h a t a l l h e a lt h

o f f e r i n g s a n d p r a c t i c e s i n o t h e r f i e l d s a r e made t o

c o n tr i­

b u t e t o t h e a im s o f t h e h e a l t h p rogram an d t o a v o i d n e e d l e s s o v e r l a p p i n g ; 2* C o o r d in a t e s t h e

s c h o o l p ro g ra m i n h e a l t h

w ith o u t o u t - o f - s c h o o l h e a lt h a g e n c ie s ;

3 . A c t s a s ch a irm a n

f o r t h e h e a l t h c o u n c i l fo r - t h e s y s t e m

in t h e o v e r a l l p l a n ­

n in g o f th e h e a lt h program .

_

117 The p e r s o n n e l a n d a d m i n i s t r a t l o n o f t h e h e a l t h p r o ftram i n t h e i n d i v i d u a l s c h o o l s p e r s o n w h o se r e s p o n s i b i l i t y i t

In each s c h o o l th e r e i s one is

t o a d m i n i s t e r a n d c o o r d in ­

a t e t h e h e a l t h p ro g ra m i n t h e s c h o o l . ch a irm a n o f t h e h e a l t h

T h is p e r s o n i s t h e

c o u n c i l f o r t h e s c h o o l a n d c o o r d in ­

a t e s th e p la n s and p o l i c i e s o f t h i s

c o u n c i l w i t h t h e p ro g ra m

s e t up by t h e s y s t e m . The p e r s o n s e l e c t e d f o r t h i s a s s ig n m e n t

i s g e n e r a lly

c h o s e n from t h e p e r s o n n e l o f t h e s c h o o l o n t h e b a s i s o f q u a lific a tio n ,

i n t e r e s t i n t h e p ro g ra m a n d p e r s o n a l i t y r e ­

g a r d le s s o f d ep a r tm e n ta l a f f i l i a t i o n . g e n e r a l ly g iv e n to

t h is p erso n i s

The s t a t u s d e p e n d in g on t h e s i z e

th a t o f h e a lth o f th e

e q u iv a le n t o f th a t o f c o u n c illo r , a s s is t a n t p r in c ip a l. w ill a ls o to

m o st c o o r d in a to r .

s c h o o l s h o u ld b e th e

h e a d o f d e p a r tm e n t o r

The tim e a l l o w e d f o r t h e a s s ig n m e n t

v a r y w i t h t h e s i z e o f t h e s c h o o l from o n e p e r i o d

f u l l tim e .

s tr a tiv e

The t i t l e

For in s t a n c e ,

s u p e r v is io n to

f u n c t i o n s a s s i g n e d f o r a d m in i­

th e h e a lth

s ta tu s o f a s s is t a n t p r in c ip a l,

c o o r d i n a t o r , w ilh

th e

on f u l l t im e i n a l a r g e h i g h

s c h o o l , m ig h t w e l l b e t h o s e o f h e a l t h i n s t r u c t i o n , p h y s i c a l e d u c a tio n , a t h l e t i c s , h e a lth

s e r v ic e ,

a n d th e

c o o r d in a tio n

o f t h e h e a l t h c o n t r i b u t i o n s made b y t h e s e a n d o t h e r d e p a r t ­ m ent s . The h e a l t h c o u n c i l o r s t a f f f o r t h e c o m p o se d o f t h e h e a l t h

sch o o l i s

g e n e r a lly

c o o r d i n a t o r c h a ir m a n , n u r s e s , p r i n c i p a l ,

118 sc h o o l d o c to r and d e n t is t ,

te a c h e r s o f h e a lth

e d u c a tio n ,

h e a d s o f d e p a r tm e n ts i n p h y s i c a l e d u c a t i o n , home m ak in g and s c ie n c e ,

c o u n s e llo r s ,

a tte n d a n c e o f f i c e r and h ead c a r e ta k e r .

C o o r d in a t in g t h e h e a l t h p rogram i n t h e

c it y sy stem *

C o o r d in a t io n o f t h e h e a l t h p rogram i n t h e s y s te m s u l t o f c e r t a in f a c t o r s and p o l i c i e s . ta n t o f th e se i s

is

th e r e ­

Among t h e m o st im p o r ­

e f f i c i e n t a d m i n i s t r a t i o n on t h e p a r t o f a

t r a i n e d a d m i n i s t r a t o r w i t h s u f f i c i e n t a u t h o r i t y and tim e t o in itia te

a n d p u t i n t o o p e r a t i o n a g o o d h e a l t h program *

T h ere I s on t h e s t a f f o f t h i s a d m i n i s t r a t i v e o f f i c e r e n o u g h a s s i s t a n t s i n a l l c a t e g o r i e s t o s u p e r v i s e an d d i r e c t t h e f u n c t i o n s o f t h e p rogram t h r o u g h o u t t h e sy ste m * T h er e a r e p l a n n i n g c o n f e r e n c e s a t w h ic h a l l t h e

de­

p a r t m e n t s o f t h e e d u c a t i o n a l p ro g ra m a r e r e p r e s e n t e d t o s e e th a t a l l th e o f f e r in g s in th e a r e a o f h e a lth a re a v a ila b le to

every

c h ild ,

to

e lim in a t e n e e d le s s o v e r la p p in g and to

a r r i v e a t a common u n d e r s t a n d in g o f t h e t o t a l h e a l t h p rogram a n d how e a c h s u b j e c t r e i n f o r c e s t h e o t h e r s .

The p e r s o n n e l

o f t h e s e c o n f e r e n c e s a r e g e n e r a l l y d e s i g n a t e d a s th e H e a lt h C o u n c il f o r t h e s y s te m s e n t a t i v e from t h e c i t y

a n d i n c l u d e In i t s num ber a r e p r e ­ H e a lth D e p a r tm e n t.

C o o r d in a t in g t h e h e a l t h p rogram i n t h e o f th e e s s e n t i a l f a c t o r s in th e

s c h o o l*

Some

c o o r d in a tin g p r o c e s s o f a

g o o d h e a l t h p rogram i n a s c h o o l f o l l o w .

119 1.

T h er e i s

some p e r s o n

a u th o r ity to th e h e a lth 2.

T h ere i s a ll

in th e

s c h o o l w it h

tim e and

c o o r d in a t e t h e v a r io u s f u n c t i o n s o f

program .

a h e a l t h c o u n c i l o n w h ic h a r e r e p r e s e n t e d

s u b j e c t s th a t have a c o n tr ib u tio n

m in is tr a tiv e o f f i c e r s ,

t o m ake, a d ­

c o u n c illo r s and c a r e ta k e r s to

p l a n t h e h e a l t h p rogram a n d t o c o o r d i n a t e i t a l l o ffe r in g s

so t h a t

c o n tr ib u te to t h e a c c e p te d g o a ls o f

th e s c h o o l in r e s p e c t to h e a lt h . 3 . A l l th e v a r io u s h e a lt h f a c t o r s in r e g a r d to e a c h s t u d e n t a r e a s s e m b le d i n o n e p l a c e i n t h e s c h o o l f o r th e 4.

c o n v e n i e n t u s e o f t e a c h e r s and h e a l t h p e r s o n n e l .

E v e ry t e a c h e r i s

a w are o f t h e h e a l t h p rogram i n t h a t

s c h o o l and c o o p e r a t in g in

it

to th e g r e a t e s t e x te n t

p o s s ib le * H e a lt h s e r v i c e p e r s o n n e l a n d p r a c t i c e s i n t h e s y s t e m . The d i r e c t o r o r s u p e r v i s o r o f h e a l t h is

a d o c to r o f m e d ic in e .

o f t h e p rogram a n d i s He i s

He i s

s e r v ic e fo r th e

sy ste m

on t h e s t a f f o f t h e D i r e c t o r

i n th e h e a lth c o u n c il f o r th e sy stem .

a llo w e d f u l l tim e . He i s r e s p o n s i b l e 1.

to s e e

The e n v ir o n m e n t i n

th a t:

th e s c h o o ls i s

h e a lt h o f s tu d e n ts and te a c h e r s i s con served .

su c h t h a t t h e p r o m o te d an d

120 2.

N eed ed m e d ic a l s e r v i c e s ,

im m u n iz a tio n a n d o t h e r

p r e v e n t a t iv e m e a su r e s, m e n ta l h e a lt h

s e r v ic e ,

c o m p r e h e n s iv e p h y s i c a l e x a m in a t io n s an d d i e t e t i c n e e d s a r e e x te n d e d c o n tin u o u s ly to a l l c h ild r e n . He h a s w h a t e v e r a s s i s t a n t s a n d f a c i l i t i e s n e c e s s a r y t o c a r r y o u t an e f f e c t i v e p r o g r a m . n u r s e f o r e a c h 1 ,0 0 0 p u p i l s i n t h e

T h ere i s

a t l e a s t on e

sy stem .

H e a lt h s e r v i c e , p e r s o n n e l a n d p r a c t i c e s i n t h e s c h o o l . The H e a lt h C o o r d in a t o r

i s r e s p o n s ib le

h e a l t h s e r v i c e p rogram i n t h e fa c ilita te s

s c h o o l.

t h e work o f th e n u r s e s ,

o th e r a s s is t a n t s in

th e h e a lth

He c o o r d i n a t e s a n d

d o c to r s,

d e n t i s t s and

s e r v i c e d e p a r tm e n t .

H e a lt h s e r v i c e s n e e d e d i n 1.

t o a d m i n i s t e r th e

th e s c h o o l a r e :

C o m p r e h e n siv e p h y s i c a l e x a m in a t io n s b y d o c t o r s a n d d e n t i s t s a r e g i v e n on e n t r a n c e t o t h e s y s t e m , on e n t r a n c e t o

e a c h s e g m e n t, b e f o r e e a c h s e a s o n

o f s p o r t o r o th e r str e n u o u s a c t i v i t y

a n d on r e ­

tu r n t o s c h o o l a f t e r i l l n e s s . 2 . P s y c h ia t r ic o r p s y c h o lo g ic a l s e r v ic e s . 3 . I m m u n iz a tio n ,

v a c c i n a t i o n and o t h e r p r e v e n t a t i v e

m easur es* S p e c i a l f a c i l i t i e s n e e d e d f o r th e p r o m o tio n o f h e a l t h . 1.

S u p e r v is e d r e s t room s w i t h o n e c o t p e r p e a k gym l o a d o f 2 0 g i r l s a n d o n e c o t p e r p e a k gym l o a d o f 50 b o y s .

121 2 . A d e q u a te h a n d w a s h in g f a c i l i t i e s

in c lu d in g h o t

w a te r , so a p and p ap er t o w e ls . 3 . P l e a s a n t a n d c o m f o r t a b le c a f e t e r i a a n d lu n c h a r e a s p r o v i d e d , w i t h tim e a l l o w e d f o r u n h u r r ie d e a t i n g a n d b a la n c e d m e a l p r o v i d e d a t l o w e s t p o s s ib le p r ic e s . 4* O r t h o p e d ic gym s p r o v i d e d f o r s t u d e n t s who n e e d s p e c i a l o r m o d ifie d program s in p h y s ic a l a c t i v i t y . 5 . C e n t r a l l o c a t i o n s w h er e s t u d e n t s n e e d i n g s p e c i a l fa c ilitie s

may b e c a r e d f o r .

H e a lt h i n s t r u c t i o n , p e r s o n n e l a n d p r a c t i c e s i n t h e sy stem . s y s te m

The o f f i c e r r e s p o n s i b l e f o r h e a l t h i n s t r u c t i o n

in

i s a d i r e c t o r o r s u p e r v i s o r a n d d e v o t e s f u l l t im e t o

t h i s a s s ig n m e n t .

He i s a member o f t h e h e a l t h

P r a c tic e s or p o lic ie s

c o u n c il.

fo u n d t o b e e s s e n t i a l t o a g o o d

i n s t r u c t i o n a l p ro g ra m f o l l o w . 1* The c u r r ic u lu m i n h e a l t h

in s tr u c tio n i s th e r e s u lt

o f a c o o p e r a t iv e e n t e r p r is e o f th e h e a lt h c o u n c il c o m p o sed o f t h e f o l l o w i n g o f f i c i a l s :

th e d ir e c to r

o f th e h e a lt h program , t h e d i r e c t o r s or su p e r ­ v is o r s o f h e a lth in s t r u c t io n , e d u c a tio n , h e a lt h s e r v ic e ,

home e c o n o m ic s ,

a n d a r e p r e s e n t a t i v e from th e m e n t,

d i r e c t o r s o f th e

S u p e r in te n d e n t.

c u r r ic u lu m , p h y s i c a l s c ie n c e

c i t y h e a lth d e p a r t­

v a r i o u s s e g m e n t s a n d th e

122 2* The c u r r ic u lu m

is

so a r r a n g e d t h a t a t ea ch l e v e l

s tu d e n ts a r e g e t t i n g th e in fo r m a tio n , a p p r e c ia ­ t i o n s an d g u id a n c e t h a t w i l l e n a b le a n d c a u s e them t o l i v e

h e a lth fu lly .

3 . O th e r s u b j e c t s c o n t r i b u t e n e e d e d i n f o r m a t i o n . '

\

The p e r s o n n e l an d p r a c t i c e s o f h e a l t h th e s c h o o l.

The h e a l t h c o o r d i n a t o r i s

I n s tr u c tio n

in

r e s p o n s ib le to ad­

m in is t e r and c o o r d in a te h e a lt h I n s t r u c t io n

i n th e

s c h o o l.

P r a c t i c e s fo u n d t o b e e s s e n t i a l t o a g o o d p rogram o f h e a lth in s t r u c t io n

in t h e s c h o o l f o l l o w .

1 . T h er e a r e c o u r s e s o f h e a l t h i n s t r u c t i o n s c h o o l r e q u ir e d o f a l l s tu d e n t s .

in th e

T h e se c o u r s e s

a r e g i v e n t h e e q u i v a l e n t o f tw o s e m e s t e r s i n e a c h s e g m e n t.

H e a lt h i s

ta u g h t a s a se p a r a te s u b je c t

f i v e d a y s a w eek an d t h e p u p i l l o a d , m a t e r i a l s , an d f a c i l i t i e s 2.

a re c o m p a r a b le to any o th e r s u b j e c t .

The f o l l o w i n g p r o c e d u r e s , a im s a n d p o l i c i e s a r e b a s ic to a good c o u r se in h e a lth a.

The c o n t e n t o f t h e c o u r s e i s

I n s tr u c tio n . b a s e d on t h e n e e d s

o f t h e s t u d e n t s a s d e t e r m in e d b y a h e a l t h k n o w le d g e t e s t ,

th e h e a lt h in v e n to r y and a

su rvey o f h e a lth h a b it s . b . P h y s i c a l i n s p e c t i o n , m ea su rem en t an d c h e c k in g on p r o g r e s s i s p a r t o f t h e c l a s s p r o c e d u r e .

123 c.

The d e v e lo p m e n t o f g o o d h e a l t h h a b i t s ,

th e

s e c u r in g o f n eed ed c o r r e c t io n s and a rra n g e­ m e n ts f o r c o n f e r e n c e s w it h d o c t o r s ,

d e n tis ts

and o th e r h e a lt h p e r s o n n e l i s p a r t o f th e c la s s r o u tin e . d . The f a c t u a l I n f o r m a t io n i n

th e c o u r se i s

n e e d e d to m o tiv a te and e x p la in

th a t

th e a c t i v i t i e s

a n d a im s o f t h e c o u r s e an d t o d e v e lo p t h e d e ­ s i r e d k n o w le d g e s a n d a p p r e c i a t i o n s . 3 . In fo rm a l in s t r u c t io n in h e a lth i s c o n fe r e n c e s,

home v i s i t s ,

in s p e c t io n s and t r e a t ­

m e n ts b y a l l h e a l t h p e r s o n n e l . o f t h e h e a l t h program r e a l i z e m ain f u n c t i o n s i s

g iv e n d u r in g

A ll th e p e r so n n e l th a t one o f th e ir

to te a c h .

H e a lt h G u id a n c e , p e r s o n n e l a n d p r a c t i c e s i n sy stem .

The o f f i c e r r e s p o n s i b l e

t h e s y s te m

is

th e c i t y

f o r t h e h e a l t h g u id a n c e i n

th e D ir e c t o r o f th e h e a lt h program .

The s e r v i c e s o f p s y c h i a t r i s t s , p s y c h o l o g i s t s and o t h e r g u id a n c e e x p e r t s a r e a s s i g n e d t o t h e v a r i o u s s c h o o l s a s needed. P e r s o n n e l a n d p r a c t i c e s o f h e a l t h g u id a n c e i n t h e s c h o o l.

P e r s o n s a n d t h e i r f u n c t i o n s i n h e a l t h g u id a n c e . The t e c h n i q u e s u s e d to g e t s t u d e n t s t o

co m p ly w i t h

t h e r e q u ir e m e n t s s e t u p f o r them i n r e g a r d t o d e s i r a b l e

124 h e a lt h , c o n d u c t ,

s e c u r i n g n e e d e d c o r r e c t i o n s and t r e a t m e n t

a n d t h e a p p l i c a t i o n o f k n o w le d g e a c q u i r e d a r e t h e b u s i n e s s o f g u id a n c e . A ll te a c h e r s have th e h e a lt h r e c o r d s o f s tu d e n ts in t h e i r c l a s s e s a n d g i v e a s s ig n m e n t s i n k e e p in g w i t h t h e i r n eed s. C o u n s e lo r s a n d a d m i n i s t r a t o r s a d j u s t t h e

sch ool p ro­

gram a n d t h e p r o g r a m s o f t h e i n d i v i d u a l s t u d e n t w i t h t h e h e a l t h n e e d s o f t h e g ro u p an d t h e i n d i v i d u a l i n m in d . The t e a c h e r o f h e a l t h i n s t r u c t i o n g i v e s g u id a n c e i n th e fo r m a tio n o f h e a lt h h a b it s an d i n h e lp in g s t u d e n t s s e c u r e n eed ed c o r r e c tio n s and tr e a tm e n t. N u rses,

d o c to rs,

p e r s o n n e l s h o u ld :

d e n t i s t and o th e r h e a lt h s e r v ic e

n o t i f y p a r e n t s o f c h i l d r e n who h a v e

h e a lth c o n d itio n s th a t n eed a tte n tio n ;

make c o n t a c t w i t h

c h ild and p a r e n ts u n t i l n eed ed c o r r e c tio n s o r tr e a tm e n ts a r e o b t a i n e d ; h e l p s t u d e n t s make c o n t a c t w i t h p h y s i c i a n s o r c l i n i c s a s n e c e s s a r y and o u t l i n e c h ild r e n r e t u r n in g to

c o n v a l e s c e n t p rogram f o r

sch ool a fte r i lln e s s .

The h e a l t h g u id a n c e p rogram i s

d is c u s s e d fr e q u e n tly

a t t e a c h e r s ’ m e e t i n g s i n o r d e r t o s e c u r e maximum u n d e r s t a n d ­ in g and c o o p e r a tio n . G en eral f in d in g s . w e r e im p o r t a n t i n

F in d in g s o f a g e n e r a l n a t u r e t h a t

e s t a b l i s h i n g t h e v a lu e o f t h e i n v e s t i g a -

125 tio n j H e a l t h w as fo u n d t o b e im p o r t a n t t o t h e p r o g r e s s i n s c h o o l o f t h e s t u d e n t a n d t o t h e p r o p e r d e v e lo p m e n t o f h i s m en ta l and p h y s ic a l r e s o u r c e s * 1 I t w a s fo u n d t h a t t h e th e s c h o o l to

com m u nity a n d t h e

s ta te e x p e c ts

c o n s e r v e a n d p r o m o te t h e h e a l t h o f t h e

c h i l d w h ile he i s

in

s c h o o l a n d t o t e a c h him t h e know­

l e d g e s a n d a p p r e c i a t i o n s t h a t w i l l c a u s e him t o l i v e h e a l t h f u l l y i n p o s t s c h o o l d a y s* The h e a l t h o f s c h o o l c h i l d r e n

is

f a r b e lo w w h at i s

c o n s i d e r e d b y a u t h o r i t i e s a s a r e a s o n a b l e e x p e c ta tio n * * * A b o u t s e v e n t y - f i v e p e r c e n t o f a l l a b s e n c e from sch o o l i s

th e r e s u lt o f i l l n e s s .

A b se n c e from s c h o o l

r a n g e s from 4 * 1 t o 5*8 p e r c e n t o f t h e s c h o o l p o p u la ­ tio n . 3 A b s e n c e from s c h o o l a n d r e p e t i t i o n o f c o u r s e s a n d g r a d e s on th e p a r t o f c h ild r e n a s a r e s u l t o f i l l n e s s r e p r e s e n t s a c o n s id e r a b le f i n a n c i a l l o s s t o th e d is tr ic t* 4

C f* a n t e , pp* 1 2 f f . ^ SX* a n t e , p p .

I4 ff.

3 C f. a n t e , p p . 1 7 f . C f- a n t e , p p . 1 8 f .

sch o o l

126 I t w as fo u n d t h a t t h e h e a l t h

s ta tu s o f sc h o o l c h ild ­

r e n w as g r e a t l y im p r o v e d on t h e i n s t a l l a t i o n

o f a good

h e a l t h p ro g ra m i n t h e s c h o o l . ^ IX .

IMPLICATIONS

T h e r e I s one i m p l i c a t i o n b r o u g h t o u t i n g a t i o n t h a t s h o u ld b e c o n s i d e r e d b e c a u s e i t

th e i n v e s t i ­

h a s a b e a r in g

on t h e f i n a n c i n g o f t h e h e a l t h p rogram I n a c i t y

sch ool

sy ste m . I t w as fo u n d t h a t t h e a v e r a g e a b s e n c e from s c h o o l a s a r e s u l t o f i l l n e s s r a n g e s from 4 . 1 e n r o llm e n t.

I lln e s s i s

to 5 .8 p e r c e n t o f th e

t h e c a u s e o f a lm o s t 7 5 p e r c e n t o f

a l l a b s e n c e from s c h o o l.* *

A sy ste m ,

th e re fo re ,

4 .1 to 5 .8 p e r c e n t o f i t s

Incom e when t h e c h i l d r e n a r e

a b s e n t a n d do n o t r e c e i v e f u l l b e n e f i t from i t . w h e r e in c o m e i s

In s t a t e s

r e c e i v e d from t h e s t a t e o n t h e b a s i s o f

a v e r a g e d a i l y a t t e n d a n c e , A .D .A ., th e s t a t e i s

s p e n d s from

r e d u c e d by from 4 . 1

I f th e a v era g e ab sen ce i s w ith a t e n m ill i o n

t h e am ount r e c e i v e d from to 5 . 8 p e r c e n t . 7 4 . 1 p e r c e n t i n a s y s te m

d o l l a r b u d g e t , $ 4 1 0 ,0 0 0 i s

s p e n t when t h e

c h i l d r e n a r e a b s e n t a n d do n o t r e c e i v e t h e b e n e f i t from i t .

5 C £. a n t e , p p . 1 9 f f . 6 C f. a n t e , p p . 1 7 f f . ^ C f. a n t e , p p .

1 8 ff.

127 The am ount t h u s s p e n t i f t h e a v e r a g e a b s e n c e i s is

5 .8 p er c en t

# 5 8 0 ,0 0 0 . The in co m e from t h e s t a t e a t n i n e t y d o l l a r s p e r A .D .A .

i n a s y s t e m w i t h an e n r o llm e n t o f 3 0 ,0 0 0 w o u ld b e # 2 ,7 0 0 ,0 0 0 * I f t h e a v e r a g e a b s e n c e a s a r e s u l t o f i l l n e s s w as 4 . 1 p e r c e n t t h e am ount r e c e i v e d from t h e s t a t e w o u ld b e # 1 1 0 ,7 0 0 le s s .

I f t h e a b s e n c e w ere 5 .8 p e r c e n t , i t

w o u ld b e

# 1 5 6 ,0 0 0 l e s s . A dded to t h e a b o v e l o s s e s i n

e ith e r

c a s e w o u ld b e

t h e am ount s p e n t a s a r e s u l t o f g r a d e arid c o u r s e r e p e t i t i o n c a u s e d by a b s e n c e s a s a r e s u l t o f i l l n e s s . th e r e fo r e ,

t h a t th e

I t is

a p p a r e n t,

lo s s to a sch o o l d is t r ic t as a r e s u lt

o f a b sen ce c a u se d by i l l n e s s i s

c o n s id e r a b le .

I f t h e a v e r a g e a b s e n c e c o u ld be r e d u c e d 1 . 7 p e r c e n t , t h a t f o r ex a m p le i s

from 5*8 p e r c e n t t o

s a v in g s in t h e sy stem w ith a te n m i ll i o n be # 1 7 5 ,0 0 0 .

In t h e

s y s te m w it h t h e

4 .5 p er c e n t,

th e

d o l l a r b u d g e t w o u ld

e n r o llm e n t o f 3 0 ,0 0 0

t h e in c o m e from t h e s t a t e w o u ld b e i n c r e a s e d b y # 4 5 ,0 0 0 . The r e p e t i t i o n o f c o u r s e s a n d g r a d e s w o u ld p r o b a b ly d e c r e a s e in l i k e p r o p o r tio n ,

th e r e b y e f f e c t i n g a f u r th e r s a v in g s .

I t w as fo u n d t h a t t h e h e a l t h s t a t u s o f s t u d e n t s sh o w ed a m ark ed im p r o v em e n t on t h e i n s t a l l a t i o n g o o d h e a l t h p ro g ra m .®

8 cf.

PP» 19

tt.

of a

What t h e p e r c e n t a g e o f im p ro v em en t

128 w a s , h o w e v e r , w as n o t d e te r m in e d ;

b u t i n v ie w o f t h e f i n d ­

i n g s o n e t o two p e r c e n t im p r o v em e n t i n a t t e n d a n c e a s a r e s u l t o f t h i s im p r o v e d h e a l t h se em e d l i k e

a m o d e st e x ­

p e c ta tio n . The i m p l i c a t i o n s ,

th e r e fo r e , are th a t a good h e a lth

p ro g ra m w i l l s a v e m oney f o r t h e s y s t e m , p r o b a b ly m ore t h a n en o u g h t o p a y f o r i t s e l f . 9 III.

CONCLUSIONS

Among t h e many c o n c l u s i o n s t h a t m ig h t b e drawn a s a r e s u l t o f t h i s i n v e s t i g a t i o n a fe w o f t h e m o st I m p o r ta n t on es fo llo w . T he l o c a l com m u nity a n d t h e

s t a t e e x p e c t th e s c h o o l

t o p r o t e c t a n d p r o m o te t h e h e a l t h o f s t u d e n t s a n d t o im p a r t t o them t h e k n o w le d g e s , h a b i t s ,

and a p p r e c ia t io n t h a t w i l l

c a u s e th em t o l i v e h e a l t h f u l l y w h i l e t h e y a r e i n in p o st

s c h o o l and

sch o o l d ays. I t w as fo u n d i n

t h is I n v e s tig a tio n

th a t a h e a lth p ro­

gram p r o p e r l y a d m i n i s t e r e d a n d u s i n g e f f i c i e n t m e th o d s i n d is c h a r g in g th e f u n c t io n s o f h e a lth s e r v ic e , h e a lth in s t r u c ­ tio n ,

a n d h e a l t h g u id a n c e im p r o v e d t h e p h y s i c a l an d m e n ta l

h e a lth o f s tu d e n ts ,

and a c c e le r a t e d t h e i r p r o g r e s s and s u e -

9 C f. p p . 2 2 f f .

129 c e s s i n t h e i r s t u d i e s , 10 A b s e n c e from s c h o o l a n d r e p e a t e d g r a d e s a n d c o u r s e s , as a r e s u lt o f illn e s s , good h e a lt h p rogram s.

w ere g r e a t l y r e d u c e d i n

s c h o o ls w ith

The s a v i n g s t h u s e f f e c t e d w o u ld p a y

f o r t h e h e a l t h p rogram ; o r i n

a n y e v e n t w o u ld p a y t h e d i f ­

f e r e n c e b e tw e e n a g o o d p rogram a n d a p o o r o n e , 1 1 The p e r s o n n e l ,

p r a c tic e s , and f a c i l i t i e s

th a t are

n e c e s s a r y f o r a n e f f i c i e n t a n d e f f e c t i v e h e a l t h program h a v e b e e n w o r k e d o u t a n d may b e o b t a i n e d from some o f t h e c o n s i d e r a b l e num ber o f s c h o o l s y s t e m s t h a t h a v e g o o d h e a l t h p r o g r a m s ,12 T h ere a r e g e n e r a lly en ough t r a in e d p e o p le in a sy ste m to

s t a r t a g o o d h e a l t h p r o g ra m .

d i r e c t o r o f t h e program .

T h is may n o t a p p ly t o

th e

S i n c e h e m u st h a v e b o t h t r a i n i n g

i n t h e f i e l d o f h e a l t h a n d m u st be a go o d a d m i n i s t r a t o r , s u c h a d i r e c t o r may h a v e t o b e s o u g h t o u t s i d e o f t h e s y s t e m . The k e y f a c t o r s i n a g o o d h e a l t h program a r e a t r a i n ­ ed a d m in is tr a to r in

c h a r g e o f t h e program w i t h s u f f i c i e n t

a u th o r ity to is s u e and carry ou t d ir e c t io n s ,

th e a c t i v e

i n t e r e s t an d b a c k in g o f t h e s u p e r i n t e n d e n t f o r an d t h e a c t i v e i n t e r e s t an d b a c k in g s c h o o l.

^

O f. a n t e , p p .

1 9 ff.

^

QL* a n t e , p p . 2 2 f f .

1 2 °£* P o s t * PP* 1 6 0 f f .

th e sy ste m ,

o f th e p r i n c i p a l i n

th e

130 I n v ie w o f t h e a b o v e c o n s i d e r a t i o n s i t w o u ld seem t h a t th e sy stem o r t h e s c h o o l, charge i t s o f th e

d u ty t o

th e

if It

is

to p r o p e r ly d i s ­

stu d o a t and m eet th e e x p e c t a t io n s

com m unity i n t h i s r e s p e c t , h a s no a l t e r n a t i v e b u t

t o i n s t a l l an d m a i n t a i n t h e p e r s o n n e l , p r a c t i c e s an d f a c i l i ­ t i e s n e c e s s a r y to p r o v id e a good h e a lt h program .

BIBLIOGRAPHY

132 A.

BOOKS

G o f f i n , J o h n L. C . , M.D. , ” H e a lth E d u c a t io n P rogram f o r E le m e n ta r y a n d S e c o n d a r y S c h o o l s , ” S c h o o l P u b l i c a t i o n No* 3 3 0 * L os A n g e le s C it y S c h o o l s , 1940* 49 p p . H ard y, M a rth a C rum pton, a n d C a r o ly n H. H o e f e r , H e a lth y G row th: A S tu d y o f t h e I n f l u e n c e s o f H e a lt h E d u c a tio n o n t h e G row th a n d D e v e lo p m e n t o f S c h o o l -C h ild r e n * C h ic a g o : U n i v e r s i t y o f C h leagp P r e s s , 1 9 3 6 . Hoyman, Howard S . , H e a lt h G u id e U n i t s f o r O regon T e a c h e r s * Ann A r b o r : E dw ards B r o t h e r s , I n c * , 1 9 4 6 . 357 p p . K e e n e , C h a r le s H. , M *D ., The P h y s i c a l W e lf a r e o f t h e S c h o o l C h ild . New Y o rk : The R i v e r s i d e P r e s s , 1 9 2 9 . P p . 1 5 1 168. K e l l e y , D anieL J . , a n d E f f i e P . K n o w lto n , A P r a c t i c a b l e S c h o o l H e a lt h P rogram B in g h a m p to n , New Y o r k * New Y ork : M e t r o p o l i t a n L i f e I n s u r a n c e Company P r e s s , R e v i s e d , 1934. 36 pp . L a P o r te , W illia m R a lp h , The P h y s i c a l E d u c a t io n C u r r ic u lu m . L os A n g e le s : The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a P r in ., 1942. 95 pp. M o elh lm a n , A r th u r B . , S c h o o l A d m i n i s t r a t i o n . C am b rid ge, M a ssa c h u se tts: The R i v e r s i d e P r e s s , 1 9 4 0 . N a sh , J . B . , T e a c h a b le M om ents. Com pany, 1 9 3 8 .

New Y ork :

A.

S. B arnard

’’P h y s i c a l F i t n e s s T h rou gh H e a lt h E d u c a tio n f o r t h e V i c t o r y C o r p s ,11 V i c t o r y C orps S e r v i c e P a m p h le t Number 3 . W a s h in g to n . D* C. , R e p o r t o f The C o m m ittee on War Time H e a l t h E d u c a t io n For H ig h S c h o o l s . U. S. O f f i c e o f E d u c a t io n . S c h o o l H ealth. P r o g r a m , T h e. W h ite H ou se C o n f e r e n c e o n C h ild H e a lt h a n d P r o t e c t i o n , S e c t i o n 3 . C o m m ittee on th e S c h o o l C h ild . New Y ork: The C e n tu r y Company, 1 9 3 2 . S e l e c t i v e S e r v i c e a s t h e T id e o f War T u r n s. U. S . G overnm ent P r i n t i n g O f f i c e , 1 9 4 5 .

W a sh in g to n :

T erm an, L. M*, G e n e t i c S t u d i e s o f G e n iu s . P a lo A l t o : S ta n ­ fo r d U n iv e r s ity P r e s s , 1 9 2 5 . Volum e I , C h a p te r s V I I - V I I I .

133 Ward, T. D . ,. a n d U. S . P o w e l l , H e a lt h S u p e r v i s i o n a n d M ed i­ c a l I n s p e c t i o n o f S c h o o ls * New Y o r k : W. B . Sanndon Company, 1927* Pp. 2 6 0 -2 6 1 . W i l l i a m s , J e s s e e F e i r i n g , H e a lt h a n d P h y s i c a l E d u c a tio n f o r P u b lic S c h o o l A d m ln ls tr a to r s . New Y ork : T eachers C o lle g e ^ C o lu m b ia U n i v e r s i t y , 1 9 3 0 . W in slo w , D. E . A . , T he S c h o o l H e a lt h P rogram . M c G r a w -H ill Book Company, 1 9 3 8 . B.

New Y ork:

PERIODICAL ARTICLES

A b e m a tle y , R u th , a n d E l s o S c h n e i d e r , " H e a lt h An E s s e n t i a l F r e e d o m ,11 N . E . A# J o u r n a l , Volum e 3 7 , Num ber 7 , 450-452* A u g u st, 1 9 l8 . Brow n, M a r io n , 11 The H e a lt h P rogram i n U n i v e r s i t y H ig h S c h o o l , ” U n l v e r s i t y H ig h S c h o o l J o u r n a l , Volume 1 7 , Number 1 , p . 6 4 , O cto b er , 1 9 3 8 . The U n i v e r s i t y o f C a l i f o r n i a H ig h S c h o o l , G rove S t . a t 5 7 t h , O a k la n d , C a l i f o r n i a . C o n ra d , V e. L. , 11H e a lt h E d u c a t i o n ,” M ind an d B o d y . 4 2 - 4 9 O c to b e r , 1 9 3 5 . G a r d n e r , Thomas A . , ”P r o p e r D e n t a l C are f o r t h e C h ild P a t i e n t , ” J o u r n a l o f ' The A m e r ic a n D e n t a l A s s o c i a t i o n , D ecem b er, 1 9 3 0 . ” How The F i r s t M i l l i o n D r a f t e d Men M ea su red Up P h y s i c a l l y , ” C u r r e n t O p in io n , L X X III, J u ly - D e c e m b e r , 1 9 1 9 . L a n d r e th , V ern e S . , ” C o o r d in a t io n o f Community H e a lth E d uca­ t i o n , ” C a l i f o r n i a J o u r n a l o f S e c o n d a r y E d u c a t io n , V o l. 2 0 , N o. 1 : 3 0 -3 4 , Janu ary, 1945. W oodward, L u th e r E . , S o c i a l C a s e , "Work i n R e l a t i o n t o S e l e c ­ t i v e S e r v i c e a n d t h e R e j e c t e e , " M e n ta l H y g ie n e , J u l y , 1 9 4 3 . C.

PUBLICATIONS OF LEARNED ORGANIZATIONS

B l a i r , W ils o n N . , " B u i l d i n g a n d P r e s e r v i n g Sou nd T e e t h , ” N a t i o n a l D e f e n s e M onograph, H. 3 . O f f i c e o f The County S u p e r i n t e n d e n t , L os A n g e l e s , C a l i f o r n i a , 1 9 4 1 . 9 pp.

134 C a r d e r , Howard R . , "D on1! L e t L i t t l e T h in g s B ecom e B i g , ” The H e a lt h N ew s, L os A n g e l e s C it y S c h o o l s , O c to b e r , 1939. P . 4. C o l l i n s , S elw y n D. , ”A C om p arison o f A b se n c e from S c h o o l On A c c o u n t o f S i c k n e s s a n d From C a u se s O th e r Than S i c k n e s s Among B o y s a n d G i r l s , ” R e p r in t N o. 7 9 5 . U. S. P r in t in g O f f ic e , 1 9 2 2 . 4 pp. __________ 11I n c i d e n c e o f S i c k n e s s Among W h ite S c h o o l C h ild r e n i n H a g e r sto w n , M .D. R e p r in t N o. 9 9 3 P u b l i c H e a lth R e p o r ts. G overnm ent P r i n t i n g O f f i c e , W a s h in g to n , D. C ., F eb ru ary 2 7 , 1 9 2 5 . 14 p p . ” S c h o o l A b s e n c e o f B oys a n d G i r l s , ” P u b l i c H e a lt h R e p o r t , R e p r in t N o. 7 9 3 . G overnm ent P r i n t i n g O f f i c e , W a s h in g to n , D. C. , O c to b e r 2 7 , 1 9 2 2 . 4 pp. _______ , 11 S i c k n e s s Among S c h o o l C h i l d r e n ,” R e p r in t N o. U. S . G overnm ent P r i n t i n g O f f i c e , 1 9 2 1 . 10 pp.

674.

F o r s y t h e , D r. W arren F . , a n d M ab le E. R u gen , ” A H e a lt h Know­ l e d g e T e s t , ” R e s e a r c h Q u a r t e r ly The A m e r ic a n A s s o c i a t i o n f o r H e a l t h , P . E . , a n d R e c r e a t i o n , May 1 9 3 5 . P. 105. F r e n c h , W i l l , ” A l l Y o u th N eed To D e v e lo p a n d M a in t a in Good H e a lt h a n d P h y s i c a l F i t n e s s , ” The B u l l e t i n o f N a t i o n a l A s s o c i a t i o n o f S e c o n d a r y S c h o o l P r i n c i p a l s . V o l. 3 1 , Num ber 1 4 5 . 1 2 0 1 S i x t e e n t h S t . N. W. , W a sh in g to n 6 , D. C ., M arch, 1 9 4 7 . Pp. 2 6 - 3 6 . F u l l e r , D r. J o h n D . , 11H e a lt h E d u c a t io n i n th e P u b l i c S c h o o l s , ” N ew s L e t t e r Number 2 6 o f The C a l i f o r n i a A s s o c i a t i o n For H e a l t h , P h y s i c a l E d u c a t io n , a n d R e c r e a t i o n . S a c r a m e n to , C a l i f o r n i a , M arch , 1 9 4 4 . G o f f i n , J o h n L. C ., e d i t o r , ” H e a l t h E d u c a tio n T o d a y ,” Hand­ b o ok S u g g e s t i o n s S c h o o l P u b l i c a t i o n N o. 3 1 0 . L os A n ge­ l e s C ity S c h o o ls .

t H e a lt h N ew s, V o l. I l l , N o. 1 3 . S c h o o l D i s t r i c t , O c to b e r , 1 9 3 9 .

The L os

A n g e le s C i t y

______, H e a lt h N e w s. V o l . I l l , N o . 1 4 . S c h o o l D i s t r i c t , D ecem b er, 1 9 3 9 .

The L o s

A n g e le s C it y

_______ , H e a lt h N e w s, V o l. I l l , N o . 1 5 . S ch o o l D i s t r i c t , F eb ru ary, 1 9 40.

The L os

A n g e le s C it y

135 ” H ard W ork in g F a c i l i t i e s i n S c h o o l s , ” M onograph N o* 3 . A r e p o r t o f a s u r v e y o f t h e f a c i l i t i e s fo u n d i n 4 0 0 s c h o o ls lo c a te d in 29 s ta te s * M e tr o p o lita n L if e I n ­ s u r a n c e Company, 1 9 2 8 . 13 pp. ” H e a lt h E d u c a t i o n ,” R e p o r t o f t h e J o i n t C o m m ittee on H e a lt h P r o b le m s i n Ed u c a t i o n , o f t h e N a t i o n a l E d u c a t io n A s s o c i a t i o n a n d A m erica n M e d ic a l A s s o c i a t i o n , W a s h in g to n , D. C ., 1 9 4 1 . P. 15. ” H e a lt h N e e d s o f S c h o o l Age Y o u t h ,” The Bu l l e t i n o f The N a tio n a l A s s o c ia tio n o f S econ d ary S ch o o l P r in c ip a ls , V o l. 3 0 , N o. 1 3 8 . 1 2 0 1 S i x t e e n t h S t r e e t N . W ., W ash in g­ t o n , D* C ., A p r i l , 1 9 4 6 . Pp. 5 0 -6 7 . ” H e a l t h R e co m m en d a tio n s I n The S c h o o l s , ” N ews L e t t e r N o. 1 5 . The C a l i f o r n i a A s s o c i a t i o n f o r H e a lt h , P h y s i c a l E d u ca ­ t io n and R e c r e a tio n . S a c r a m e n to , C a l i f o r n i a , N ovem b er, 1940. ” H e a lt h S e r v i c e s f o r phe S c h o o l- A g e C h ild i n O r e g o n ,” P ub­ l i c a t i o n o f The O regon S t a t e J o i n t C om m ittee For H e a lt h a n d P h y s i c a l F i t n e s s , V o l . 1 , N o. 1 . S a le m , O re g o n : S t a t e P r i n t i n g D e p a r tm e n t, 1 9 4 4 . 28 pp. H ilb y , S . Lyman, “ R eco m m en d a tio n s f o r th e P h y s i c a l E d u c a t io n a n d H e a lt h P rogram i n t h e P o s t w a r C u r r ic u lu m ,” The B u l­ l e t i n o f th e N a t i o n a l A s s o c i a t i o n o f S e c o n d a r y S c h o o l P r i n c i p a l s , V o l. 2 9 , Number 1 2 9 . 1201 S ix te e n th S t r e e t N . W ., W a sh in g to n , D. C . , M arch , 1 9 4 5 . P. 62. H o y t, 0 . M ., D i r e c t o r , “ P e r c e n t a g e o f C a s e s o f I l l n e s s , T r u a n cy and I l l e g a l A b s e n c e s I n R e l a t i o n To A l l C a s e s H a n d le d i n J u n i o r a n d S e n io r H igh S c h o o l s , ” R e p o r t o f t h e A t t e n d a n c e a n d Em ploym ent S e c t i o n . L os A n g e le s C it y S c h o o l s . _______ , “ S tu d y o f C a u s e s o f A b s e n c e F or Week E n d in g F eb ru ­ a r y 1 5 , 1 9 3 5 i n 2 8 E le m e n ta r y S c h o o l s , ” R e p o r t o f t h e A t t e n d a n c e an d Emplo y m e n t o f M in o r s S e c t i o n . Los A n g e le s C i t y S c h o o l s . H ubbard, F ran k W ., “ H e a lt h I n S c h o o l s , ” T w e n t ie t h Y e a r b o o k o f The A m e rlca n A s s o c i a t i o n o f S c h o o l A d m i n i s t r a t o r s . W a s h in g to n , D. C . : 1 2 0 1 S i x t e e n t h S t r e e t , N. W ., 1 9 4 2 . 544 pp.

136 ” I m p r o v in g th e H e a lt h P rogram o f t h e O hio U n i v e r s i t y S c h o o l , 11 E d u c a t io n a l R e s e a r c h B u l l e t i n , H e a lt h Com­ m i t t e e o f t h e F a c u l t y o f U n i v e r s i t y S c h o o l , O hio S t a t e U n i v e r s i t y , S e p te m b e r , 1 9 4 3 . K i c k l i g h t e r , M a t e r ia P . , 9 S le e p a n d R e s t , ” O f f i c e o f t h e C ou n ty S u p e r in t e n d e n t o f S c h o o l s , L os A n g e l e s C o u n ty , H. 4 , D ecem b er, 1 9 4 1 . P. 11. K in n e y , P a u l , nWho S h o u ld T each H e a lt h E d u c a t io n P r o g r a m s ,11 N ew s L e t t e r N o. 2 6 .' The C a l i f o r n i a A s s o c i a t i o n f o r H e a lth ," ' P h y s ic a l E d u c a tio n a n d R e c r e a t i o n . S a c r a m e n to , C a l i f o r n i a , M arch, 1 9 4 4 . L a n d r e t h , V ern e S . , e t a l . , ,1 T e a c h e r ’ s G uide I n H e a lt h Edu­ c a t i o n f o r S e c o n d a r y S c h o o l s , ” C a l i f o r n i a Community H e a lt h E d u c a t io n P r o j e c t , C a l i f o r n i a S t a t e D ep a rtm en t o f E d u c a t io n . S a c r a m e n to , C a l i f o r n i a , A u g u s t , 1 9 4 7 . I l l pp. L e o n a r d , J . P a u l , P r o f e s s o r , e d i t o r , 9 P la n n i n g For A m erican Y o u t h ,” N a t i o n a l A s s o e l a t i o n o f S e c o n d a r y S c h o o l P r i n c i ­ p a ls . C o p y r ig h t , W a s h in g to n , D. C . , 1 9 4 4 . 63 p p . L o y , D a v id T . , a n d M. W. H urband, ” A H e a lth K n o w led g e Su r­ v e y ," R e s e a r c h Q u a r t e r ly t h e A m e rica n As s o e l a t i o n o f H e a l t h . P h y s i c a l E d u c a tio n a n d R e c r e a t i o n , May, 1 9 3 9 . P. 53. M o ss, B e r n i c e , an d W. H* O r ia n , "The P u b l i c S c h o o l P rogram i n H e a l t h , P h y s i c a l E d u c a tio n and R e c r e a t i o n , ” B u l l e t i n The U ta h S t a t e D e p a r tm en t o f E d u c a t io n a n d The C a l i f o r n i a S t a t e D ep a rtm en t o f E d u c a t io n , S a c r a m e n to , C a l i f o r n i a . 18 pp. O h n im u s, A r th u r A . , e d i t o r , " E d u c a t io n ,” C o n s t i t u t i o n o f t h e S ta te o f C a lifo r n ia . S a c r a m e n to , C a l i f o r n i a : S ta te P r in tin g O ffic e , 1944. Pp. 7 6 -8 3 . ” O reg o n M anual f o r t h e U se o f The S c h o o l H e a lt h R e c o r d C a r d ,” O reg o n S t a t e J o i n t C om m ittee f o r H e a lt h a n d P h y s i c a l F i t n e s s , Volum e 1 , N o. &. S a le m , O re g o n , R e v i s e d , 1 9 4 4 . P . &8. ” P h y s i c a l F i t n e s s , ” R e p o r t o f The C om m ission o n The E d u c a t io n o f The Young C i t i z e n , Long B e a c h . The Long B e a c h C it y S c h o o ls , 1 9 4 4 . Pp. 1 6 -3 8 .

137 R e g u l a t i o n s R e l a t i v e t o The T e a c h in g o f H e a lt h I n The S t a t e o f C a lifo r n ia . The E d u c a t i o n a l Code o f C a l i f o r n i a , S e c t i o n s 8 2 5 2 - 8 3 5 4 , 1 0 1 1 6 - 1 0 1 2 8 , 1 0 3 0 2 , an d 1 6 4 0 1 - 1 6 4 8 6 . S a c r a m e n to , C a l i f o r n i a , 1 9 4 1 . “ S c h o o l H e a lt h P o l i c i e s , 1’ R e p o r t o f t h e N a t i o n a l C om m ittee on S c h o o l H e a lt h P o l i c i e s . A m erica n M e d ic a l A s s o c i a t i o n , O c to b e r , 1 9 4 5 . 45 p p . ’’ The S c h o o l H e a lt h P rogram an d th e S c h o o l C h il d . The T e a c h ­ e r s ’ R o l e , ” H e a lt h B u l l e t i n f o r T e a c h e r s , M e t r o p o l i t a n L i f e I n s u r a n c e Company, Volum e X I I I , N o. 4 , D ecem b er, 1941. ’’ The S c h o o l H e a lt h P rogram a n d t h e S c h o o l C h i l d , 1* H e a lt h B u l l e t i n f o r T e a c h e r s , M e t r o p o l i t a n L i f e I n s u r a n c e Com­ p a n y , Volum e X I I I , N o. 5 , J a n u a r y , 1 9 4 2 . Pp. 1 7 -2 0 . ” The S c h o o l H e a lt h P rogram and th e Hom e,” H e a lt h B u l l e t i n f o r T e a c h e r s , V olum e X T II, N o. 6 . M e t r o p o l it a n L i f e I n s u r a n c e Com pany, F e b r u a r y , 1942* Pp. 2 1 -2 4 . S c o t t , W a lt e r , ’’ H e a lt h E d u c a t i o n ,” R e p o r t s S e n io r H igh Women a n d S e n io r H ig h Men. Long B e a c h C i t y S c h o o l s , L ong B e a c h , F e b r u a r y 2 4 , 1 9 4 4 . 4 pp. S u n d w e ll, J o h n S . D r ., ” A S c h o o l H e a lt h S tu d y o f N ew to n , M a s s a c h u s e t t s , ” M onograph N o. 5 , M e t r o p o l i t a n L i f e I n su ra n c e Company P r e s s . New Y o rk , New Y o rk . 85 pp. “T e a c h e r ’ s G u id e I n H e a lt h E d u c a t i o n ,” B u l l e t i n . S t a t e De­ p a r tm e n t o f E d u c a t io n . S a c r a m e n to , C a l i f o r n i a , A u g u s t, 1947. P. 16. Van H agen , W i n i f r e d , e d i t o r , ’’ S p e c i a l A c t i v i t i e s i n P h y s i c a l E d u c a t io n f o r H ig h S c h o o l a n d A d u lt G r o u p s ,” B u l l e t i n D e p a r tm e n t o f E d u c a t io n . S a c r a m e n to , 1 9 3 5 . 97 p p . W h ite H ouse C o n f e r e n c e , A d d r e s s o r a n d A b s t r a c t s o f C om m ittee R e p o r ts. New Y o rk : The C e n tu r y Company. P p. 2 3 2 - 3 4 . W i ll i a m s , J e s s i e F e i r i n g , “B a s i c R e q u ir e m e n ts f o r a Sound P rogram i n H e a lt h E d u c a t i o n ,“ P r o c e e d i n g s o f t h e N a t i o n ­ a l War an d P e a c e F i t n e s s C o n f e r e n c e * A m e rica n A s s o c i a ­ t i o n o f H e a l t h , P h y s i c a l E d u c a t io n a n d R e c r e a t i o n . New ' Y ork, 1 9 4 4 . “ The Y e a r s P r o g r e s s In H e a lth ," H e a lt h B u l l e t i n F or T e a c h e r s , M e t r o p o l i t a n L i f e I n s u r a n c e Company. N o. 5 1 , May, 1 9 3 4 . 4 pp.

138 D.

UNPUBLISHED MATERIALS

B e r r y , "A S tu d y o f The T e a c h in g o f H e a l t h f u l L iv in g a s a S u b j e c t I n The L os A n g e le s C i t y S c h o o l S e c t i o n s . 11 Un­ p u b l i s h e d M a ster* s T h e s i s , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s . B u r l e y , M ike G ., ” The O r g a n iz a t io n o f H e a lt h E d u c a tio n i n S e n i o r H ig h S c h o o l s . ” U n p u b lis h e d M a s t e r ’ s T h e s i s , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 3 6 . C l i n e , R ic h a r d M ., ” An A d eq u a te H e a lt h P rogram W ith E c o n o ­ m y .” U n p u b lis h e d r e s e a r c h , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 3 5 . P. 13. ” The C o r r e l a t i o n o f H e a lt h a n d I n t e l l i g e n c e . ” A Term p a p e r s u b m i t t e d t o t h e S c h o o l o f E d u c a t io n , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , Los A n g e l e s , 1 9 3 9 . P. 15. _______ , ” A D e s c r i p t i o n a n d E v a l u a t i o n E d u c a t io n a n d G -uidance C a l l e d The s e a r c h i n P h y s i c a l E d u c a tio n 2 9 0 , S o u t h e r n C a l i f o r n i a , Los A n g e l e s ,

O f A P la n o f H e a lt h L og o f H e a l t h . ** R e - ‘ The U n i v e r s i t y o f June, 1 9 32. 61 p p .

” H e a lt h E d u c a tio n an d The R e c o n s t r u c t i o n o f Our T im e s .” A Term p a p e r p r e s e n t e d t o t h e S c h o o l o f E d u ca­ t i o n , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , J u ly , 1933. P . 14. D on ah u e, H arry E d g e b e r t , ”An A n a l y s i s o f The U n d e r ly in g C a u s e s o f Non A t t e n d a n c e .” U n p u b lis h e d M aster* s T h e s i s , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 3 3 . r^Dumn, W. K ., ” A S u r v e y o f O p in io n o f A d m in i s t r a t o r s C o n ce rn ­ i n g P h y s i c a l E d u c a t io n i n t h e S e c o n d a r y S c h o o l s o f C a l i ­ f o r n i a . ” U n p u b lis h e d M a s te r * s T h e s i s , The U n i v e r s i t y o f S o u t h e r n C a l i f o r n i a , L os A n g e l e s , 1 9 3 5 . Pp. 4 9 -7 0 . E v a n s, M y r t le M ay, ” The C ause o f Non A t t e n d a n c e I n An E l e ­ m e n ta r y S c h o o l . ” U n p u b lis h e d M a s t e r ’ s T h e s i s , The U n i­ v e r s i t y o f S o u t h e r n C a l i f o r n i a , L os A n g e l e s , 1 9 4 2 . H o l l i s t e r , M a r g a r e t A l t h e a , ” An O b j e c t i v e E v a l u a t i o n o f The H e a lt h I n s t r u c t i o n P rogram s In L o s A n g e le s C ounty S e c o n ­ d a r y S c h o o l s . ” U n p u b lis h e d M a s t e r ’ s T h e s i s , The U n i­ v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 4 3 .

139 M i l l e r , E u n ic e L o r in g , 11A S u r v e y a n d E v a l u a t i o n o f the H e a lt h S e r v i c e P rogram o f t h e D a l l a s C i t y S c h o o ls U n p u b lis h e d M a s t e r 1s T h e s i s , The U n i v e r s i t y o f S o u th e r n C a lif o r n ia , L os A n g e le s , 1 9 4 0 . L i n d h o r s t , G e n e v ie v e , HAn A n a l y s i s o f P r o c e d u r e s U s e d I n D e n t a l C o r r e c t i o n I n E le m e n ta r y S c h o o ls .* ’ U n p u b lis h e d M a ster* s T h e s i s , T he U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 4 4 . S i e m e r in g , L a u r e n c e , ” A S u rv e y o f C u r r e n t T r e n d s In H e a lt h I n s t r u c t i o n I n S e l e c t e d H igh S c h o o ls I n The U n it e d S t a t e s . ” U n p u b lis h e d M a s t e r f s T h e s i s , The U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , L os A n g e l e s , 1 9 4 4 . E.

NEWSPAPERS

F u h t e r , J o s e p h W. , C h a im a n o f The N a t i o n a l G ra n g e, P r o c e e d ­ i n g s , N a t i o n a l G ran ge C o n v e n t io n . A s s o c ia te d P r e ss P is p a t c h , C h ic a g o , F e b r u a r y 7 , 1 9 4 8 . P r o c e e d i n g , The A m e r ic a n D e n t a l A s s o c i a t i o n C o n v e n tio n . A s s o c i a t e d p r e s s R e p o r t , C l e v e l a n d , O h io . S ep tem b er 1 2 . 1941.

APPENDIX A.

141 INQUIRY ON The A d m i n i s t r a t i o n , C o o r d in a t io n an d A d m i n i s t r a t i v e P e r s o n n e l o f t h e H e a lt h P rogram . F or t h e p u r p o s e o f t h i s i n v e s t i g a t i o n t h e h e a l t h p rogram r e f e r s t o a l l f a c t o r s i n t h e s c h o o l t h a t i n f l u e n c e t h e h e a l t h o f t h e c h ild * I.

L i s t o u t s t a n d i n g p r o g r a m s o f h e a l t h w it h w h ic h y o u may b e a c q u a i n t e d a s f o l l o w s : 1*

S c h o o l s y s t e m s o r s y s t e m a n d p e r s o n s w it h whom to co rresp o n d .

2* S c h o o l o r s c h o o l s a n d p e r s o n s w i t h whom to resp on d .

II*

cor­

What f a c t o r do y o u c o n s i d e r p a r t i c u l a r l y im p o r t a n t in d e te r m in in g t h e s u c c e s s o f a s c h o o l h e a lt h p r o ­ gram?

142 III*

S h o u ld t h e r e b e a f u l l tim e a d m i n i s t r a t o r r e s p o n s i b l e f o r t h e h e a l t h p rogram i n t h e c i t y s y s te m ? Y es _ _ _ _ _

No___________

Comment ________________________________________________________

IV .

The o f f i c e r i n t h e s y s te m r e s p o n s i b l e f o r th e a d m in i­ s t r a t i o n a n d c o o r d i n a t i o n o f t h e h e a l t h p rogram .s h o u ld h a v e t h e s t a t u s o f : (C h eck t h e o n e y o u c o n ­ s id e r b e st) A s s is t a n t s u p e r in te n d e n t

( ________ )

A D ir e c to r

( ________)

An a s s o c i a t e i n t h e h e a l t h s e r v i c e d e p a r tm e n t I n t h e g u id a n c e d e p a r tm e n t I n t h e c u r r ic u lu m d e p a r tm e n t Or i n th e d e p a r tm e n t o f h e a l t h , p h y s i c a l e d u c a t io n a n d r e c r e a t i o n Comment

V.

F or th e o v e r a l l s u p e r v i s i o n o f t h e h e a l t h p rogram i n ­ c l u d i n g h e a l t h s e r v i c e , h e a l t h g u id a n c e and h e a l t h i n ­ s t r u c t i o n i n t h e s y s te m do y o u f a v o r ? 1.

A d o c t o r o f m e d ic in e ____________ _______________________

2 . An e d u c a t o r w i t h s u i t a b l e b a c k g r o u n d f o r h e a l t h adm i n i s t r a t i o n Comment

VI*

I n each, s c h o o l s h o u ld one p e r s o n b e r e s p o n s i b l e f o r c o o r d i n a t i n g a n d s u p e r v i s i n g t h e h e a l t h program ? Y e s _________

No

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P le a s e f i l l

i n Name, fitle ,

I n s titu tio n , S iz e o f I n s t i t u t i o n , A d d ress, M ore c o m p r e h e n s iv e comment o n a n y it e m w i l l b e w e lc o m e . P l e a s e p u t on t h e b a c k o f t h i s q u e s t i o n n a i r e *

144 L e t t e r o f T r a n s m is s a l f o r th e I n q u i r y

D ecem b er 2 6 , 1 9 4 5

Y ou r i n t e r e s t i n h e a l t h e d u c a t i o n h a s l e d me t o s o l i c i t y o u r c o o p e r a t i o n i n an i n v e s t i g a t i o n c o n n e c t e d w i t h t h e h e a l t h p rogram i n c e r t a i n c i t y s c h o o l s o r c i t y s c h o o l s y s te m s * The p u r p o s e o f t h e i n v e s t i g a t i o n i s t o a s c e r t a i n t h e m e th o d s u s e d i n t h e a d m i n i s t r a t i o n a n d c o o r d i n a t i o n o f o u t s t a n d i n g h e a l t h p ro g ra m s* The ty p e o f a d m i n i s t r a t i v e p e r ­ s o n n e l e m p lo y e d i n s u c h p r o g r a m s i s a l s o t o b e i n c l u d e d i n t h e s tu d y * I t w i l l b e o f g r e a t h e lp a n d w i l l b e a p p r e c i a t e d i f y o u w i l l f i l l o u t t h e e n c l o s e d i n q u i r y b la n k . Q u e s t i o n n a i r e s , p e r t a i n i n g t o t h e a b o v e p r o b le m , w i l l be s e n t to p e r so n s d e s ig n a te d in you r r e p ly . I f y o u w o u ld l i k e a summary o f t h e f i n d i n g s o f t h i s stu d y p le a s e ch eck h ere ( )* T h ere i s a sta m p e d , ad ­ d r e s s e d e n v e lo p e f o r y o u r c o n v e n i e n c e . T h a n k in g y o u i n a d v a n c e f o r t h i s f a v o r , I am Y o u rs s i n c e r e l y ,

R ic h a r d M. C lin e

145 The Nam es a n d S t a t u s o f T h o se E d u c a to r s Who R e p l i e s t o t h e I n q u i r y A p p l e q u i s t , H. A; , S u p e r v i s o r o f P h y s i c a l E d u c a tio n S a c r a m e n to C i t y U n i f i e d S c h o o l D i s t r i c t , S c h o o l A d m in is t r a ­ t i o n B u ild in g 1 2 0 0 2 1 s t S t r e e t , S a c r a m e n to , C a l i f o r n i a A r n e t t , G-lenn W. , S t a t e D i r e c t o r o f H e a lt h , P h y s i c a l E d u ca­ t io n and R e c r e a tio n S t a t e B o a r d o f E d u c a t io n , S t a t e C a p i t o l B u i l d i n g S a l t L ake C i t y , U ta h B a u e r , W* W ., M. D . , D i r e c t o r , B u r e a u o f H e a lt h E d u c a tio n A m e r ic a n M e d ic a l A s s o c i a t i o n , 1 2 5 ,0 0 0 d o c t o r s 5 3 5 N o r th D e a rb o rn S t r e e t , C h ic a g o 1 0 , I l l i n o i s B lu m e, C la r e n c e E . , S p e c i a l A s s ig n m e n t ( P r i n c i p a l a t C e n t r a l H ig h S c h o o l , S e p t . E d u c a t io n M in n e a p o l i s , M in n e s o ta

1 9 4 6 ),

B oard o f

B row n, W a lte r H ., M. D . , Dean o f S c h o o l o f P u b l i c H e a lth U n iv e r s ity o f C a lifo r n ia B e r k e le y , C a lif o r n ia B u r k e , J o h n C ., A s s i s t a n t D i r e c t o r ( H e a lt h S e r v i c e S e c t i o n ) L os A n g e l e s C it y S c h o o ls 8 1 0 Chamber o f Commerce B u i l d i n g , L os A n g e le s 1 5 , C a l i f o r n i a Cobb, L o u is e S . , A s s o c i a t e S p o n s o r o f P h y s i c a l E d u c a tio n U n i v e r s i t y o f C a l i f o r n i a , B e r k e l e y , 1 0 ,0 0 0 B e r k e le y , C a lif o r n ia C r is p , K a t h a r in e B . , T e a c h e r o f B i o l o g y ( r e t i r e d J u n e , 1 9 4 5 ) E a s t H ig h S c h o o l , D e n v e r , C o lo r a d o , 2 4 0 0 1 2 7 6 E m erson S t r e e t , D en v er 3 , C o lo r a d o D e a n e , M a rth a B . , A c t i n g C h airm an , D e p a r tm en t o f P h y s i c a l E d u c a tio n U n i v e r s i t y o f C a l i f o r n i a , Los A n g e l e s , a p p r o x im a t e ly 7 ,0 0 0 e n r o ll m e n t 4 0 5 H i l g a r d A v e n u e , L o s A n g e le s 2 4 , C a l i f o r n i a E x to n , B e s s , C o n s u lt a n t i n H e a l t h E d u c a t io n N a t i o n a l E d u c a t io n A s s o c i a t i o n , A .A .H .P .E .R . W a sh in g to n 6 , D. C.

146 E n g l i s h , M ild r e d , D i r e c t o r , L a b o r a to r y S c h o o l, G> S. C.W. G e o r g ia S t a t e C o l l e g e f o r Women, 450 i n Lab S c h o o l; 1 2 0 0 i n c o lle g e B o x 4 5 0 , M i l l e d g e v i l l e , G e o r g ia F i r e s t o n e , H e le n M ., H e a lt h E d u c a to r B a ld w in P u b l i c S c h o o l s , 4 0 0 0 ( a p p r o x i m a t e l y ) B a ld w in , Long I s l a n d , New York F r e n c h , W i l l , P r o f e s s o r o f E d u c a tio n T e a c h e r s .C o l l e g e , C olu m b ia U n i v e r s i t y New Y ork 2 7 , New Y ork G o f f i n , Joh n L . C*, M. D «, S u p e r v i s o r o f H e a lt h E d u c a tio n L os A n g e l e s C it y S c h o o ls 8 0 6 Chamber o f Commerce B u i l d i n g , L o s A n g e l e s , C a l i f o r n i a G o ld b e r g e r , D r. I . H«, A c t in g D i r e c t o r o f H e a lt h E d u c a t io n B o a r d o f E d u c a t io n , C it y o f New Y o r k , 9 0 0 ,0 0 0 p u p i l s 1 1 0 L i v i n g s t o n S t r e e t , B r o o k ly n 2 , New Y ork G r o u t, R u th E . , A s s o c i a t e P r o f e s s o r , E d u c a tio n and P u b l i c H e a lt h U n i v e r s i t y o f M in n e s o t a , M in n e a p o l i s , 1 6 ,0 0 0 s t u d e n t s M in n e a p o l i s , M in n e s o t a H anna, L avone A ., G e n e r a l S u p e r v is o r Long B ea ch P u b l i c S c h o o ls L ong B e a c h , C a l i f o r n i a K e e ly , D a n ie l J . , F o r m e r ly S u p e r in t e n d e n t o f S c h o o ls B in g h a m to n P u b l i c S c h o o l s , 1 4 ,0 0 0 c h i l d r e n B in g h a m to n , New Y ork K e n t, R osem ary M*, M ary P e m b e r to n N o u r s e F e l lo w i n P u b l i c H e a lt h U n i v e r s i t y o f N o r th C a r o lin a , C h a p el H i l l , N o r th C a r o lin a F o r m e r ly H e a lth . C o n s u l t a n t , W in s to n -S a le m C it y P u b l i c S c h o o l s H e a lt h E d u c a tio n C o o r d in a t o r , M o r r is , T e n n e s s e e K in n e y , P a u l B . , M. D *, C h ie f P h y s i c i a n P a s a d e n a C it y S c h o o l s , 2 0 ,0 0 0 e n r o llm e n t 1501 E a st V i l l a S t r e e t , P asad en a 4 , C a lif o r n ia L a n d r e th , V ern e S . , D i v i s i o n o f P h y s i c a l a n d H e a lt h E d u c a t io n S a c r a m e n to , C a l i f o r n i a

147 L a S a l l e , D o r o th y , D r . , V i s i t i n g P r o f e s s o r i n S c h o o l o f Edu­ c a t i o n a n d S u p e r v i s o r o f Women1 s P h y s i c a l E d u c a tio n U n i v e r s i t y o f M ic h ig a n , 1 1 ,0 0 0 s t u d e n t s Ann A r b o r , M ic h ig a n L a P o r te , W. R . , C h a irm a n , D e p a r tm e n t o f P h y s i c a l E d u c a tio n U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , 1 0 ,0 0 0 s t u d e n t s L os A n g e le s 7 , C a lif o r n ia M e th e r n y , E le a n o r , P r o f e s s o r P h y s i c a l E d u c a t io n U n i v e r s i t y o f S o u th e r n C a l i f o r n i a , 1 1 ,0 0 0 L o s A n g e le s 7 , C a l i f o r n i a M i l l e r , Ben W ., E x e c u t i v e S e c r e t a r y T r e a s u r e r A m e rica n A s s o c i a t i o n f o r H e a l t h , P h y s i c a l E d u c a t io n and R e c r e a tio n 1 2 0 1 1 6 t h S t r e e t , W a sh in g to n 6 , D* C. M o s s , B e r n i c e , S t a t e D e p a r tm en t o f P u b l i c I n s t r u c t i o n S a l t Lake C i t y , U ta h N a s h , J a y B . , P r o f e s s o r o f E d u c a t io n C hairm an D ep a r tm en t o f P h y s i c a l E d u c a tio n a n d H e a lt h New Y ork U n i v e r s i t y N e l s o n , C e c y l, P r o j e c t S u p e r v i s o r S t a t e D e p a r tm e n t o f E d u c a tio n F resn o S t a t e C o lle g e , F r e sn o , C a lif o r n ia O b e r t e u f f e r , D . , Chairm an o f M en*s D i v i s i o n P r o f e s s o r o f P h y s i c a l E d u c a t io n , O h io S t a t e U n i v e r s i t y Colum bus 1 0 , O hio R u g e n , M abel E * , P r o f e s s o r o f H e a lt h a n d P h y s i c a l E d u c a tio n U n i v e r s i t y o f M ic h ig a n Ann A r b o r , M ic h ig a n Sharm an, J a c k s o n R. , A d m in i s t r a t o r o f D e p a r tm e n t o f P h y s i c a l and H e a lt h E d u c a t io n , U n i v e r s i t y o f A lab am a, 5 0 0 0 U n i v e r s i t y , A labam a S c o t t , W a lte r L. , S u p e r in t e n d e n t P h y s i c a l E d u c a tio n Long B e a c h P u b l i c S c h o o ls 7 1 5 L o c u s t A v en u e, L on g B e a c h , C a l i f o r n i a S e l l e r y , C. M o r le y , M. D*, D i r e c t o r , H e a lt h S e r v i c e S e c t i o n L os A n g e le s C it y S c h o o l s , 4 0 9 s c h o o l s ( i n c l u d e s 2 4 e v e n in g a n d a d u l t s c h o o l s ) , a v e r a g e e n r o ll m e n t 3 2 0 ,2 5 2 , t o t a l t e a c h i n g s t a f f 1 0 ,2 5 2 8 1 0 Cham ber o f Commerce B u i l d i n g , Los A n g e le s 1 5 , C a l i f o r n i a

148 S t a f f o r d , P rank S . , C o n s u lt a n t i n H e a lt h a n d P h y s i c a l Edu­ c a tio n U n it e d S t a t e s O f f i c e o f E d u c a tio n W a sh in g to n 2 5 , D. C* E s p e n s c h a d i, A nna, A s s o c i a t e P r o f e s s o r P h y s i c a l E d u c a tio n U n i v e r s i t y o f C a l i f o r n i a , 8 ,0 0 0 s t u d e n t s B e r k e le y , C a lif o r n ia S t e p h e n s o n , F l o r e n c e , C hairm an P h y s i c a l E d u c a tio n D e p a r t­ m ent f o r Women San F r a n c i s c o S t a t e C o l l e g e , 1 1 0 2 e n r o l l e d 1 2 4 B u ch a n a n , San F r a n c is c o 2 , C a l i f o r n i a S t o k , H e r b e r t R . , A s s o c i a t e S u p e r in t e n d e n t i n C h arge o f I n d i v i d u a l G -uidan ce, O a k la n d P u b l i c S c h o o l s , 4 7 ,0 0 0 s c h o o l p o p u la tio n 1 0 2 5 S e c o n d A v e n u e , O a k la n d , C a l i f o r n i a S t r a n g , R u th , P r o f e s s o r o f E d u c a tio n T e a c h e r s C o l l e g e , C olu m b ia U n i v e r s i t y New Y ork 2 7 , New Y ork T h o r p e , D r, L o u is P . , U n i v e r s i t y o f S o u th e r n C a l i f o r n i a Los A n g e l e s , C a l i f o r n i a T r i e b , C a r l T *, A s s o c i a t e P r o f e s s o r P h y s i c a l E d u c a tio n O c c id e n ta l C o lle g e , 8 0 0 -9 0 0 L os A n g e l e s , C a l i f o r n i a W e b ste r , L lo y d E , , D i r e c t o r o f H e a lt h and P h y s i c a l E d u c a tio n Los A n g e l e s C ou n ty S c h o o ls L os A n g e l e s , C a l i f o r n i a W i ll i a m s , J e s s e F e i r i n g , E m e r it u s P r o f e s s o r C olu m b ia U n i v e r s i t y New Y o r k , New Y ork W ils o n , C h a r le s C , , P r o f e s s o r o f H e a lt h a n d P h y s i c a l E d u c a t io n T e a c h e r s C o l l e g e , C olu m b ia U n i v e r s i t y New Y o r k , New York

APPENDIX B .

150 Q u e s t i o n n a i r e C o n c e r n in g t h e A d m i n i s t r a t i o n and t h e C o o r d in a t io n o f t h e S c h o o l H e a lt h Program I n s tr u c tio n s : C heck t h o s e p r a c t i c e s t h a t a p p ly i n t h a t s y s t e m o r s c h o o l* P la c e a p lu s s ig n a f t e r th o s e p r a c ­ t i c e s o f w h ic h y o u a p p ro v e* W r ite s u g g e s t i o n s o r com­ m e n ts on t h e b a c k o f t h i s i n q u ir y * P l e a s e g la n c e o v e r t h i s q u e s t io n n a ir e b e fo r e you r e a c t to th e sta te m en ts# I#

The a d m i n i s t r a t i o n a n d c o o r d i n a t i o n o f t h e h e a l t h p r o ­ gram i n t h e c i t y sy stem * A. The a d m i n i s t r a t i v e o f f i c e r f o r t h e h e a l t h p rogram i n t h e s y s te m i s : 1* An A s s i s t a n t S u p e r in t e n d e n t ( ________ ) 2 . D i r e c t o r o f H e a lt h P rogram {________,) 5# O th e r ____ ________ ___________ B. O f 1. 2. 3* 4.

h i s t im e h e d e v o t e s t o A ll T w o - t h ir d s O n e -h a lf O n e -th ir d

t h i s a s s ig n m e n t : ( _______ ( ( _______ (

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C* A l l t h e f u n c t i o n s o f t h e h e a l t h program a r e c o o r d i n a t e d t h r o u g h h i s o f f i c e . ______________________________ ( _______ ) D* He h a s t h e f o l l o w i n g a s s i s t a n t s o r a s s o c i a t e s , a d ir e c t o r o r a s u p e r v is o r o f : 1* P h y s i c a l E d u c a tio n a n d r e c r e a t i o n ________ ( _______ ) 2 . H e a lt h S e r v i c e ( _______ ) 3* H e a lt h I n s t r u c t i o n 4 . O th e r ______________ _____ II.

)

The a d m i n i s t r a t i o n an d c o o r d i n a t i o n o f t h e h e a l t h p r o ­ gram i n t h a t s c h o o l . A* T h e r e i s a h e a l t h c o o r d i n a t o r i n sta tu s o f: 1 . V ic e P r i n c i p a l 2 . A s s is t a n t P r in c ip a l 3 . O th e r __ _________________________

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B* He c o o r d i n a t e s t h e s c h o o l h e a l t h p rogram w it h o u t - o f s c h o o l h e a l t h a g e n c i e s an d p ro g ra m s* ( )

151 C. A l l s c h o o l p e r s o n n e l c o o p e r a t e s w i t h nh e a l t h c o ­ o r d i n a t o r ” i n c o o r d i n a t i n g a l l o f t h e f u n c t i o n s an d f a c t o r s i n t h e h e a l t h p rogram o f t h e s c h o o l . ( ________) P.

The s c h o o l h e a l t h c o u n c i l o r s t a f f i s com p osed o f t h e f o l l o w i n g m em bers: 1 . The p r i n c i p a l ( _______) 2 . H e a lt h c o o r d i n a t o r ( _______ ) 5 . N u r se ( 4 . C o u n s e lo r ( 5 . A t te n d a n c e o f f i c e r ( 6 . C h airaian , P h y s i c a l E d u c a t io n D e p a r tm e n t ( 7 . S c h o o l D o c to r ( 8 . School D e n tis t ( 9 . T e a c h e r s o f H e a lt h I n s t r u c t i o n ( 1 0 . Homemaking t e a c h e r ( 1 1 . O r t h o p e d ic t e a c h e r ( 1 2 . O th e r

E . A t e s t i n g p rogram d e s i g i e d t o e v a l u a t e o u tc o m e s , p r a c t i c e s , p r o c e d u r e s , a n d t h e h e a l t h s t a t u s o f th e stu d e n ts i s in u s e . ( _________) 1 . H e a lt h k n o w le d g e t e s t s a r e g i v e n a l l s t u d e n t s t o g u id e i n d e v e lo p in g c o u r s e s o f s t u d y . ( _ _ _ ) 2 . H e a lt h p r a c t i c e s o f a l l s t u d e n t s a r e s u r v e y e d t o d i s c o v e r n e e d s f o r g u id a n c e a n d in s tr u c tio n * ( _______ _ ) 3 . H e a lt h r e c o r d s a r e so a r r a n g e d t h a t t h e h e a l t h s t a t u s o f t h e s t u d e n t s c a n be a s c e r t a i n e d a t any tim e . ( _ _______ ) 4 . A c o m p r e h e n s iv e a n d c u m u la t iv e h e a l t h r e c o r d i s k ep t f o r each s tu d e n t. ( ________ ) 5 . A d e q u a te c l e r i c a l h e l p i s a v a i l a b l e to f a c i l i ­ t a t e a l l f u n c t i o n s o f t h e h e a l t h p r o g ra m . ( ________) Q u e s t i o n n a i r e o n H e a lt h S e r v i c e i n t h e C i t y S c h o o l S y stem H e a lt h s e r v i c e r e f e r s t o t h o s e s e r v i c e s r e n d e r e d "to s t u ­ d e n ts by s c h o o l o f f i c e r s and a g e n c ie s d e s ig n e d to p r o t e c t and c o n se r v e h e a lth . I n s tr u c tio n s : I.

P l e a s e r e a d i n s t r u c t i o n s on p a g e o n e .

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B* He c o o r d i n a t e s t h e h e a l t h program o f t h e s c h o o l s w i t h o u t - o f - s c h o o l h e a l t h a g e n c ie s * ( ________ ) C. He s e e s t h a t t h e e n v ir o n m e n t a l c o n d i t i o n s i n a l l s c h o o l s a r e s u c h t h a t t h e h e a l t h o f s t u d e n t s and t e a c h e r s i s p r o m o te d a n d c o n s e r v e d , ( _______ ) D. He h a s a s s i s t a n t s w h o se a c t i v i t i e s h e c o o r d i n a t e s , a s fo llo w s ; 1 , D e n ta l and d e n ta l h y g i e n i s t s in s p e c t o r s ( 2 , M e d ic a l a n d H e a lt h i n s p e c t o r s ( 3, M e n ta l h y g i e n i s t s ( _______ 4 , D ie tic ia n ( _______ . 5 , One n u r s e t o e a c h 500 s t u d e n t s ( ________ 1 .0 0 0 s t u d e n t s ( _______ 1 .5 0 0 s t u d e n t s ( ________ 2 .0 0 0 s t u d e n ts ( _______ 2 .5 0 0 s t u d e n t s ( _______ II.

H e a lt h s e r v i c e p e r s o n n e l an d p r a c t i c e s i n t h e s c h o o l. A. C o m p r e h e n siv e p h y s i c a l e x a m in a t io n s b y s c h o o l d o c t o r s a n d d e n t i s t s a r e made o f a l l s t u d e n t s : 1. P re -sch o o l * ( ) 2 , On e n t r a n c e t o s y s te m '_(________ ) 3m E ach y e a r ( ______ _) 4 , On e n t e r i n g e a c h se g m e n t ( _____ 5 , B e fo r e each s p o r t se a so n ( _______ ) 6 , As n e e d e d ( ) 7 , On r e t u r n t o s c h o o l a f t e r s e r i o u s illn e s s