**2. The intersection between health and education**

Let us start with, what we owe children and youth and the commitment they should expect from the educational system. The intersection of health and education, profoundly impacts well-being and quality of life. Research has shown this powerful connection, that education leads to improved health [5–7]. A gain in personal control and an increase in agency are two outcomes of education that positively impact personal health [8]. Education, both a process and a product occur in formal and informal (outside the school) settings provides children and youth with the knowledge, skills, and capacity to be healthy and productive as young people and in adulthood [9].

Children and youth, throughout the world should expect a commitment to their overall health and well-being and learning success through a comprehensive and coordinated approach. Two frameworks, that provide this approach are the United States (US) Centers for Disease Control and Prevention's Whole School, Whole Community, Whole Child Framework (WSCC) [10]. The other is the World Health Organization's (WHO) Health Promoting Schools (HPS) [11]. Frameworks create a context for the work that allows for site specific application based on the needs of the school community.

The WSCC framework puts the student at the center and the school and community surround and support the students. This model is built on the role the community has in supporting the school, the link between health and academic success, and the need for evidence-based school policies and practices [10]. The framework centers around the five tenets of the Whole Child: healthy, safe, engaged, supported, and challenged. Schools play a critical role in supporting healthy behaviors in school children. It is easier to establish good health practices in children than to try to change unhealthy behaviors in adulthood [5]. The 10 components of the WSCC model are found in **Table 1** and they mirror the HPS efforts outlined by the WHO [10, 11]. The WHO introduced the concept of a health-promoting school, a whole school approach, over 25 years ago, and the principles are based on eight global standards, which are also found in **Table 1**. These principles posit that for educational systems to be truly

*Perspective Chapter: Strengthening and Empowering Professional Health Educators' Capacity… DOI: http://dx.doi.org/10.5772/intechopen.108980*


#### **Table 1.**

*A comparison of the US CDC whole school, whole community, whole child framework, and the WHO health promoting schools.*

successful, they must commit to supporting and promoting the health and well-being of everyone linked to our schools including students, teachers, administrators, staff, and the community. In addition, there are bidirectional influences that impact health and well-being. For example, schools that have safe, supportive, and predictable environments are likely places where students report strong connections to staff and report that there are adults in the building who care about them.

In both the US and globally, the relationship between health and learning outcomes is being recognized more and more [11–13]. This became even more evident during the COVID-19 pandemic [14, 15]. Millions of children and youth shifted to online learning if they had the technology, and many were isolated from social, education, and supportive services and systems located in the schools. School closures, reliance on remote learning, learning loss, inequalities in educational systems, and mental health issues are examples of the impact the pandemic had on students' health and learning [16]. Healthy students are better learners and building capacity in schools for healthy living,

learning, and working benefits everyone. The COVID-19 pandemic revitalized the importance and commitment to the linkages between education and health including unmet mental health needs and limited or no access to services.

Let us explore the similarities between the US CDC WSCC model, and the WHO HP model. Both approaches include collaboration across many sectors and levels. Key school, public health, government, and community stakeholders and leaders at the local, state, and national levels work together to coordinate policies, operations, and practices that champion health and learning outcomes for all students [10, 11]. The aim of both models is cohesive and collaborative efforts that are strategically planned and implemented between health, government, and educational sectors, and engage community stakeholders in the process. What does this mean? There is better coordination and access to services for students and their families, opportunity to address social determinants of health, more efforts to build students' health knowledge and skills and an inclusive learning environment, and a commitment to working together to improve and support student health and well-being. Both models provide guidance for implementing and sustaining this approach. In **Table 1**, you will notice, some of the similarities and differences. The HPS approach separates out three standards on government and school policies and school governance and leadership, which are woven through the WSCC model and are found in each of the 10 components [10, 11]. Each component of the whole child is distinct yet interconnected. If a school is challenging and does not feel safe and supportive, every child will not be able to reach their full potential. Schools that provide safe and supportive environments without challenging curricula will risk perpetuating a bias of low expectations.

Research on the impact of HPS and the WSCC models reveal improvements in health and learning outcomes [12, 17–20]. Findings reported included improved measures of depression, bullying, violence, sexual health knowledge and beliefs around gender equity for secondary students, and school and social connectedness decreased risky healthy behaviors including drug use and had a positive impact on mental health [17, 18]. Incorporating the WSCC model had led to changes in several US states' health education practices and policies where student health is more at the center of the education system, there is more support from policymakers and administrators, and community health organizations collaborate with the educational system better [20]. Finally, both modules are built on increasing health literacy skills in students and the larger community. Advancing health literacy skills increase the capacity for making health-related decisions and actions for oneself and others [21].
