Can European school health move beyond its ABC? By Clive Needle - EuroHealthnet's Advocacy and Policy Director

14 October 2013

The 4th European conference of the Health Promoting Schools (HPS) movement has been successfully completed in Odense, Denmark. You can see a video link of the highlights via the new WHO Europe site.

The event website contains a wealth of information including videos of all presentations.

There were many impressive features. It was reported that over 30,000 schools in more than 40 countries are now part of the movement, which is a major achievement. The Minister for Education for Denmark Christine Antorini made a powerful keynote speech and contributed to the national conference held in association with the European event. Many national coordinating bodies took part in the event to report progress, including EuroHealthNet member agencies from Scotland, Netherlands and elsewhere.

The European schools health network SHE is organised from the CBO collaborating centre in the Netherlands by Goof Buijs and colleagues, backed by EU co-funding (here):

Academic experts, including from the hosts at the University of South Denmark, presented on latest findings and concepts.  The growing evidence base is underpinned by the excellent HBSC longitudinal study series (available here).

WHO EURO is a strong supporter as part of its Healthy Europe 2020 strategic approach.

The conference will produce a full report and associated materials including information about the state of the art in practices and innovative approaches. One output still in discussion online among participants will be a Conference Statement, reflecting the situation, aims and needs of the movement and its component parts, hence its working title of An ABC for health promoting schools. As the event moderator, I learnt much and enjoyed the event. I was sometimes inspired by speakers, and the parallel group of young students from Danish schools who linked with counterparts in Lithuania and Macedonia made a robust, intelligent and fun contribution, providing voices for the future. I hope the Statement, on which draft I worked throughout with the Organising Committee and Rapporteur, will prove a useful tool for work at many levels in future.

It is with that constructive approach in mind that I offer five brief observations, as a supporter and future contributor to the Advisory body of SHE:

  1. It is an outstanding achievement by many people incredibly hard working in health, education and governance sectors to take the concept so far since it was first established: this was just the 4th such conference after initial events in Athens, Egmond and Vilnius. Many have contributed as volunteer workers. As WHO division director Gauden Galea noted, one challenge now is to make this process systematic rather than voluntary, with full support from policy to practice. That may be hard in tough economic times; a strong approach will be needed.
  2. Much of the evidence presented was on an academic or research basis. Several presenters called for more multidisciplinary, holistic approaches. As in other aspects or settings for health promotion, I feel a need is to improve links with other sectors. That work for health in all practices and policies is more easily said than done, as we have seen within the global health promotion conference process earlier in 2013 at Helsinki, for example, or via the EuroHealthNet Crossing Bridges project on methodologies across sectors.
  3. An example of that is with movements around children at home. I did not hear mention of thinking around an EU Recommendation for its states on child poverty reduction. The conference theme was Equity, Education and Health. It is great that equity is at the heart of HPS, and it is clearly practiced. But just as health promoters generally can improve links with social inclusion, gender, anti-discrimination and other related specialisms, I feel that clear strategic objectives towards that will be helpful. We have structured the Odense Statement draft to help that, for example by identifying a wider range of target audiences. I would have expected to hear more about community links with social care structures, for example.
  4. While HPS is well connected with WHO processes, and also has EU funding support, sometimes it feels a little distant. I was surprised that so few in the audience knew of latest work on social determinants of health, which were well presented by Professor Allan Dyson. Many of the recommendations of the Marmot reports feature early child development, or the school as a major factor in tackling the causes of the causes of ill-health. I would see HPS practitioners as being front line advocates of approaches of social determinants of wellbeing approaches. Clearly many are immensely committed and country approaches will necessarily vary, but again I would hope to see an integrated development in the next phase.
  5. Finally, it was striking that mental health was a prominent subject, just as it is becoming on EU and WHO agendas. Young people raised it repeatedly, regarding action on bullying, stigmas and other psycho-social factors as more important than physical activities. Professor Margaret Barry was among leading presenters who emphasised research in the field; others spoke powerfully about mindfulness, belonging, empowerment and cultures. Stresses and needs of teachers, families and parents were highlighted. I have long regretted that mental health is seen as being a separate strand of public health, with different governance. That often leads to mutual misunderstandings. It felt in Odense that mental health and wellbeing will be central to the hearts and minds approach of HPS as it teaches its future ABC lessons.

EuroHealthNet Policy and Advocacy Director Clive Needle moderated the Odense HPS Conference by invitation.