... . ...
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Florida's School Health Program
Prepared in Collaboration with
The Child Health Committee of the Florida
And Other Interested Agencies
FOR IMPROVEMENT OF SCHOOLS
Bulletin No. 4
Published Jointly by
STATE DEPARTMENT OF EDUCATION
STATE BOARD OF HEALTH
.. ; : .
3 737 Po q75
It is almost platitudinous to say that health is of fundamen-
tal importance to all society and to each individual in it, and
that all private and public agencies should work cooperatively
toward achieving that goal. Yet all too frequently the first iZ
not realized and the second is not done.
Our State should be particularly prideful that such cooper-
ation in developing a plan for the school health program has
been attained. Some features perhaps are not in agreement
with what any one individual might like and all phases will un-
doubtedly be improved as work under the plan progresses. The
significant factor is that we now have a plan upon which we
have agreed and that, knowing the extent of our responsibili-
ties as well as the places where we encroach upon the responsi-
bilities and work of others, we are all in a position to make our
utmost contribution to the program in the place where that con-
tribution will be most effective.
State Superintendent of Public Instruction
The ideas inculcated in this bulletin should be far reaching
in their effects for good in the State of Florida. It is through
education and cooperation that the worth-while things are ac-
The State Department of Education and the State Board of
Health, by joining hands with the Florida Medical Association
and other interested groups to work out a solution of the prob-
lems of Florida, will be of immeasureable value to the health,
welfare and happiness of the people of Florida.
A. B. McCREARY, M. D.
State Health Officer
PROCEDURES AND ACKNOWLEDGEMENTS
In order that all who are interested in an improved health
program for Florida schools might have an opportunity to as-
sist in planning that program, State Superintendent of Public
Instruction Colin English called a special two weeks' conference
beginning on August 14, 1939, for the purpose of developing the
program. A general invitation was issued to all, and a special
invitation was sent to the chairman of all organized groups
having a special interest in the program. The announcement
was made far enough in advance to allow study of special ma-
terials which were prepared in advance for the purpose of giv-
ing direction to the conference.
The response to the invitations indicated extreme interest
on the part of all, and a thoroughly representative group as-
sembled for the first two days of the conference. During this
time all aspects of the problem were discussed, and many sug-
gestions were made for inclusion in the written plans. Using
these suggestions as a background, a sub-committee continued
the work thus begun and put into definite written form the
principles established in the discussions. The actual time con-
sumed in this writing was nine days, and at the end of this
period the large group reassembled to discuss what had been
written and to make suggestions for changes. The product of
all these interchanges of ideas is this bulletin, which is the first
step in a concerted attempt to improve the health program in
It should be thoroughly understood that it is only the first
step. The plan must be translated into action, while it is being,
at the same time, continually improved. Supplementary bulle-
tins amplifying various aspects of the program, particularly
that dealing with health instruction, must be developed. With
a continuous united effort on a program which all understand,
however, great advancement will be made.
Acknowledgements are due to all who have had a part in
developing the plan or who may assist in its interpretation. To
those who participated in the conference and gave freely of
their time, energy, and ideas, special appreciation is due. Those
who were present for all or the greater part of the conference
were: Miss Fannie Shaw of the Georgia State Department of
Health and member of the Joint Committee on Health Prob-
lems in Education of the National Education Association and
the American Medical Association; Dr. G. F. Amyot, Adnminis-
trative Associate of the American Public Health Association;
Miss Ruth E. Henderson, Educational Assistant to the National
Director of American Junior Red Cross; Miss Alice Miller,
Lecturer, University of Texas; Dr. Garland Weidner, Assistant
City Health Officer of Atlanta, Georgia; Mrs. Elizabeth Bohnen-
berger, Director of Health Education, Florida State Board of
Health; Miss Katherine Montgomery, Director of Health and
Physical Education, and Miss Grace Fox, Instructor in Health
and Physical Education, Florida State College for Women; Dr.
E. Benton Salt, Director of Health and Physical Education,
University of Florida; Mr. B. K. Stevens, Instructor of Physical
Education, P. K. Yonge School; Mr. J. L. Graham, Director of
School Plant Planning Service, State Department of Education;
Mr. G. F. Catlett, Director of Engineering, Florida State Board
of Health; Mr. Joe Hall, Conference Director, Consultant in
Health and Physical Education, State Department of Education.
Those who participated during the first two and last days
of the conference were: Dr. A. B. McCreary, State Health Of-
ficer, Jacksonville; Dr. Colin English, State Superintendent of
Public Instruction; Dr. Luther W. Holloway, Representative of
the Florida Medical Ass'n.; Mrs. May Pynchon, Executive Sec-
retary of the Florida Tuberculosis and Health Ass'n.; Mrs. Inez
Nelson, R. N., President of the Florida State Nurses Associa-
tion; Mrs. Malcolm McClellan, President of the Florida Con-
gress of Parents and Teachers; Mr. John P. Ingle, Sr., Chairman
of the State-Wide Public Health Committee; Miss Sara Fergu-
son, Chairman of the Classroom Teachers Association; Mr.
Lafayette Golden, Secretary of the Florida High School Athle-
tic Association; Dr. J. C. Dickenson, Dr. John Norton Moore,
and Dr. J. Maxey Dell, Jr., Representatives of the Florida
Radiological bucic. Mr. J. S. Rickards, Executive Secretary
of the Florida Education Association; Mr. Nash Higgins, Direc-
tor of Health and Physical Education, University of Tampa;
Dr. Jay Pearson, Secretary, University of Miami; Mrs. J. Rals-
ton Wells, President of the Florida Federation of Women's
Clubs; Mr. M. W. Carothers, Director of Instruction, State De-
partment of Education; Dr. Lloyd N. Harlow, Director of the
Bureau of Dental Health and Representative of Florida Dental
Society; Dr. Dan N. Cone, Director of Epidemiology, State
Board of Health; Dr. F. V. Chappell, Director of Maternal and
Child Health, State Board of Health; Miss Ruth E. Mettinger,
R. N., Director of Public Health Nursing, State Board of Health;
Miss Jean Henderson, Director of Public Relations, State Board
of Health; Mrs. Gordon Ira, State Health Chairman of the Flor-
ida Federation of Women's Clubs; Mrs. R. C. Williamson, Chair-
man of the Alachua County Health Council; Mr. M. K. Adams,
Instructor in Health and Physical Education, University of Tam-
pa; Miss Ruth Moffatt, Instructor in Health and Physical Edu-
cation, University of Tampa; Dr., D. H. Turner, Field Director
Dental Department, State Board of Health; Miss Lalla Mary
Goggans, R. N., State Consultant for County Health Depart-
ments, State Board of Health; Dr. A. J. Logie, Director of Di-
vision of Tuberculosis Control, State Board of Health; Mr. Fred
Gehan, Chairman, Elementary Principals' Ass'n.; Mrs. Howard
Dial, Seventh Vice-President and Health Director of the Florida
Congress of Parents and Teachers; Miss Anna Mae Sikes,
Extension Nutritionist, Florida State College for Women; Mrs.
Dora Skipper, Member of the State Course of Study Committee,
Florida State College for Women; Dr. Ruth Connor, Acting
Supervisor of Home Economics Education, State Department
of Education; Miss Ella Faye Price, Secretary.
Special acknowledgement is given to the Florida Tubercu-
. losis and Health Association, whose financial, contributions
made the conference possible, and to Mr, James Edward Rog-
ers, Secretary of the National Society of Directors of Health
and Physical Education, who was of great assistance in devel-
oping the original idea and outline.
C. onferei-nce Director, Consultant in Health and Physical Educa-
.tion, State Department of Education.
TABLE OF CONTENTS
Foreword -------------------- iii
Part I-Basic Facts and Principles -------- -------- 9
Part II-Special Administrative Considerations 16
Part III-Healthful School Living -------- ------ 25
Part IV-Health Service ...-- .----- .. 38
Part V-Health Instruction -- --- ---.- -- ---- 48
Part VI-Suggestions for Evaluating the School Health
Program ...--------. - -- -------- 77
Part VII-Sources of Materials ------.---- 79
Appendix ----------------------------- 81
BASIC FACTS AND PRINCIPLES
A. Introductory Statement._ In recent years Health Education
has assumed a much broader significance than its original in-
terpretation implied. It now accepts responsibility for full
growth and development of the individual child. It embraces
all the activities directed toward the attainment and mainten-
ance of an optimum state of health from the pre-natal stage
through adulthood. It is known that one's state of health varies
in accordance with inheritance, immunity or susceptibility to
disease, home, school, and community environment, and daily
regimen of living.
/ It is helpful to think of health as a "quality of life" capable
of enrichment or deterioration./ The school is faced with the
responsibility of taking the child as he is at the age of six and
inculcating in him desirable health practices, giving such
knowledge as will rationalize everyday healthful living and cre-
ating favorable attitudes which will eventually lead the indivi-
dual to assume responsibility for the well-being of himself and
others-to make one self-directing in health activities which
will enrich, rather than deteriorate life. With the expansion
of the concept of the health program there appear today several
very definite underlying principles:
1. In every community many groups are interested in child health-
parents, private physicians, dentists, departments of public health,
voluntary health organizations, welfare and social agencies, teachers,
parent-teacher groups, women's clubs, other civic organizations, etc.
2. Health education is a sharing program. No single professional or
special group can claim a monopoly of interest or responsibility for the
health of the children of the state. Improved child health and im-
proved health conditions in the state will result, ndt from the pro-
gram of one group or one organization, but will come from the har-
monious planning and working together of all groups in Florida.
3. There is a decided trend toward breaking down the line of demarca-
tion between school health education and public health education.
Each is dependent upon the other. The school program is hampered
unless the public health program has functioned in its maternal and
child hygiene, dental and communicable disease -ntrol programs.
On the other hand, the success of the public health program is great.
ly augmented if the public school turns out pupils who are prepared,
10 FLORIDA'S SCHOOL HEALTH PROGRAM
through definite health education programs, to take their places of
leadership in home and community.
4. Health has been a primary objective of education for many years.
To realize this objective, Florida schools have a definite responsi-
bility in planning for the coordination of health experiences in the
home, school, and community in such a way as to influence favor-
ably habits, attitudes, and knowledge.
The purpose of this bulletin is (1) to set forth the respon-
sibility of the school for the improvement of the health of the
pupils and ultimately of health conditions in the state; (2) to
outline the scope of the school health program in order that
every school may advance in a balanced way toward the solution
of Florida's health problems; (3) to give guidance to teachers
in their methods of planning for daily school living, the im-
provement of health status of pupils, and more effective health
instruction programs; (4) to indicate the relation of health to
other subjects in the school curriculum and the needs for corre-
lation; and (5) to relate more adequately the school health pro-
gram to the health programs and health activities of other
groups or organizations.
B. Pertinent Facts About Florida's Health. There is disease
among Florida's people, a great deal of it. Some of the diseases
are those which affect people in every state. Some are here as
a result of the very things which otherwise make Florida an
especially good place in which to live. There is poverty in Flor-
ida and, while sickness may not be given the entire responsi-
bility, certainly we will never be free of poverty until a majori-
ty of our people are able to face the everyday necessity of work
with healthy bodies and healthy minds.
In 1937, 12,000 of Florida's people died from diseases or
conditions which are either wholly or partially preventable.
Many thousands more were ill from various preventable causes,
creating an economic burden on every county through their in-
ability to earn a living for themselves or their families.
Any program of health instruction in the school should be
planned on a basis of the definite needs as indicated. Listed
below are some of Florida's major health .problems:
Hookworm. According to a recent survey of 56 of Florida's 67 coun-
ties, an average of 34.8% of the rural white population is infested
FLORIDA'S SCHOOL HEALTH PROGRAM 11
with hookworm. In three counties 70% of the rural white population
is infested. This disease is particularly prevalent among school
Malaria. Estimates indicate there are over 100,000 cases of malaria
in Florida all the time. Over a five year period an average of 340
people died annually from malaria. Malaria does not kill as often
as it weakens and renders economically non-productive enormous
numbers of Floridians every year.
Syphilis and Gonorrhea. There is as much syphilis in Florida as in
other states which means that syphilis will affect one out of every
ten of the adult population. It is almost impossible to estimate the
economic loss due to this disease, so tremendous is the figure.
Syphilis can cause blindness, heart disease, insanity, miscarriages,
abortions, still births, joint conditions, and can assume the guise of
many other diseases.
Tuberculosis. In 1937, 966 persons died of tuberculosis in Florida.
It is estimated that there were at least 7,700 cases of this disease in
the state in that year, many of which were unknown or unrecognized.
Pneumonia. Contrary to common belief, pneumonia is very preval-
ent in Florida, and in 1937, 1,227 people died of it. For the years
1933-37, pneumonia was the fifth leading cause of death.
Infant Mortality. Over a five-year period, an average of 1,790 in-
fants in Florida died annually during the first year of life.
Maternal Mortality. For some years, according to population, more
Florida mothers died in child-birth than in any other state in the
union. At the present time Florida's maternal death rate is fifth
from highest among the 48 states. At least 40% of these lives
could have been saved by the application of known public health and
Diarrhea and Enteritis. In 1937, diarrhea and enteritis were respon-
sible for 280 deaths, of which 183 were children under two years of
age. These are also definitely preventable diseases.
Pellagra. This is a disease associated with inadequate and unbalanc-
ed diet, more commonly found among the indigent and low-income
groups, and accounted for 103 deaths in 1937.
Typhoid Fever. Although Florida has made progress in typhoid fever
control, there has been an average of 50 deaths in Florida from the
disease every year for the past five years.
Typhus Fever. There were 12 deaths and 107 reported cases of typhus
fever in Florida in 1937.
Each of these diseases and conditions is largely preventable
through the application of known public health and medical
12 FLORIDA'S SCHOOL HEALTH PROGRAM
principles. There are many other health problems requiring
consideration and study, such as care in the pre-natal and ma-
ternal periods, the infant and pre-school child, preventive den-
tistry, nutrition, milk and food supervision, sewage disposal
and housing. The study of such problems in Florida schools
will be of utmost importance in their eventual solution.
C. Point of View in Health Education. Health Education, to
be effective in providing for the growth and development of the
individual child, must be compatible with and must contribute
to the program of general education. Bonser states: "It is my
philosophy that the purpose of life, health and education are
one. The end and aim of all are growth and enrichment of hu-
The method in health, as in education, is learning through
experience. Interest plays a large part. The needs of children
form the basis for the curriculum. The school may be thought
of as a community in which children must have facilities to live
adequately during the school hours-individual lives, yet lives
which are harmoniously adjusted to the group with which they
associate. The curriculum is conceived, not in terms of subject-
matter only, but as experiences making up the life process-a
succession of experiences built around real situations and moti-
vated by the purposes of those being taught.
This point of view necessitates cooperative and careful
planning by school, home, and community. Only as the health
needs of children become evident to parents, school administra-
tors, and teachers and are related to all facilities in the com-
munity, will the school health program function as a primary
objective of education.
The teacher is the strategic person in the guidance of the
children in healthful living throughout school life and in the
maintenance of healthful conditions in the school environment.
It is essential that teachers exemplify healthful practices in
daily living. A broad knowledge of scientific facts underlying
personal and community health is imperative. In developing
a functional school program it is necessary for the teacher to
be thoroughly familiar with: (1) the health problems existing
in the school, in the homes, and in the community; and (2) the
FLORIDA'S SCHOOL HEALTH PROGRAM 13
health assets and facilities existing in the home, school and
community which may be used in solving the problems.
Problems of the type indicated in Section B are of particu-
lar significance. The Local and State Health Departments may
be of very special assistance to the teacher in acquainting him
with other health problems existing in the community and also
with the various health agencies and their services.
D. Laws Relating to School Health. All Laws concerning Flor-
ida's public schools are contained in "The Florida School Code."
Those laws dealing with school health have been compiled and
placed in the Appendix of this bulletin. An understanding of
these basic laws is essential for the development of a well
rounded health program.
E. Health Education Terminology. Terms used in this bulle-
tin are adopted from the report of the Committee on Termin-
ology of the Health Education Section of the American Physi-
cal Education Association which was prepared and accepted in
1935. These definitions not only promote clear thinking, but
also understanding of the scope of the program.
Health in the human organism is that condition that permits opti-
al functioning of the individual, enabling him to live most and to
serve best in personal and social relationships." The concept of
health needs enrichment. Too often health is commonly considered
to be merely the absence of disease.
"Health Education is the sum of all experiences which favorably in-
fluence habits, attitudes and knowledge relating to individual, com-
munity, and racial health." Health Education is not to be thought of
as a special course. It includes the many activities which make up
the total health program.
"School Health Education is that part of Health Education that
takes place in school or through efforts organized and conducted by
the school personnel." It is recognized that the child is educated in
health through all his experiences that in any way promote favor-
able changes in his habits, attitudes and knowledge relating to
health, but those identical with school life are definitely School
"Public Health Education is that part of Health Education that takes
place in home and community." This phase of Health Education oper-
ates largely through the efforts of health departments and various
14 FLORIDA'S 'SCHOOL HEALTH PROGRAM
unofficial agencies interested in promoting health among the people.
Public Health Education reaches children, as well as adults, and is,
therefore, one kind of experience relating to health.
"Healthful School Living is a term that designates thel provision of
a wholesome environment, the organization of a healthful school
day, and the establishment of such teacher-pupil relationships that
give a safe and sanitary school favorable to the best development
and living of pupils and teachers." Children learn through living
healthfully at school each day. The physical environment and the
social and emotional tone of the classroom are very important factors
in the Health Education Program.
"Health Service comprises all those procedures designed to deter-
mine the health status of the child, to enlist his cooperation in health
protection and maintenance, to inform parents of defects that may
be present, to prevent disease, and to correct remediable defects."
All school health services are included in the program primarily be-
cause of their educational value. Every service should be rendered
in a way that parents and children become self-directing in accepting
the responsibility for maintaining their own health.
"Health Instruction is that organization of learning experiences di.
rected toward the development of favorable health knowledge, atti-
tudes, and practices." Health Instruction is the function of the
classroom teacher in the elementary school and the teacher of health
in the secondary school. Health may be taught as a separate sub-
ject and enriched through correlation with other subjects. Always
Health Instruction seeks to integrate health knowledge with actual
living in home, school and community.
"Hygiene is the applied science of health; it provides the basic scien-
tific knowledge upon which desirable health practices are founded."
There are sever-al varieties of hygiene, such as personal, environmen-
tal, and mental hygiene.
"Sanitation is the application of scientific measures for improving or
controlling the healthfulness of the environment."
F. Scope of The School Health Program. This broad interpre-
tation has implications which are significant to every phase of
the child's life. The chart here given is designed to picture all
the aspects of the school program. The meanings of the terms
used and the way in which various parts of the program are
carried out are indicated in other parts of the bulletin.
SCOPE OF SCHOOL HEALTH EDUCATION PROGRAM
I. HEALTHFUL SCHOOL LIVING
A Condition of School Environment
2. Site adequate size-free from
2. Building hygienically construct-
ed-equipped with regard to
3. Special provision for play, lunch
4. Maintenance of sanitary school
grounds and building.
R. Organization of a Healthful School
2. Safe and comfortable transpor-
2. Length of school day and
3. Mental and physical work al-
4. Supervised study at school-
minimum home study.
C. Pupil-Teacher Relationship.
1. Social and emotional tone of
2. Avoidance of strain, noise, and
3. Provision for success and a-
voidance of failure.
4. Provision for individual differ-
5. Wholesome personality 6f tea-
chers contribute to healthful
II. HEALTH SERVICE
A. Coordination and Utilization of
School Facilities with Local
Health Service-health education
B. The Prevention and Control of
1. Through daily observation by
2. Through daily observation by
3. Through immunization.
C. Health Examination.
1. Psychological preparation by
2. Testing sight and hearing by
3. Invitation of parents.
4. Preparation of record cards.
D. Special Health Examination.
Major athletics, re-examinations
school personnel, transfer students
E. Correction of Defects.
1. Health Officer conference with
2. Home visits by public health
3. Health instructions based on
findings of examination.
4. Use of community resources.
III. HEALTH INSTRUCTION
A. Purpose and Philosophy.
Hea'th-a way of living, develop-
ing whole child. Positive approach
based on needs and interests of
B. Principles of Gradation.
1. Grades 1-3 emphasizes practices
based upon daily experiences of
children and using health read-
2. Grades 4-6 emphasize reasons
for health habits, skills and at-
titudes-introduce health texts.
3. Grades 7-8 emphasize adjust-
ment to school situations.
Grades 9-10 living in communi-
ty; grades 11-12 preparing for
C. Areas of Subject Matter
Personal hygiene, nutrition, clo-
thing, stimulants and narcotics,
sleep and rest, exercise and play,
mental hygiene, body structure
and function, social relations, en-
vironmental sanitation, health ser-
vices, communicable disease, safe-
ty and first aid.
D. Methods of Instruction
1. Based on problems of pupils.
2. Teaching aids-correlations.
A. Part II Makes Special Suggestions. Part II of this bulletin
contains suggestions which may not logically be included in
other parts and also indicates how the ideas developed in other
parts may best be utilized. Its purpose is to eliminate any gaps
in the suggested plan for the school health program which may
be caused by the plan of organization and to coordinate the
B. Health Is a Problem of the Entire Community. All who un-
derstand the full significance of health are in complete agree-
ment that the school health program is only a relatively small
part of the total community health problem and that the
school program must assume only its proportionate share of to-
tal health considerations which must be concerned with society
as a whole, as well as with the individual from conception to
death. Important as immunization of school children is, for ex-
ample, infant and pre-school immunization are far more im-
portant. Likewise, many other health procedures ordinarily as-
sume greater significance for the pre-natal, infant, and pre-
school child than for the school child himself.
The school as an agency for community development, there-
fore, will wish to give its assistance first, to providing for a
total community health program, and second, to establishing
its proper relationship as a part of that total program. One
important step in the development of the community health
program is the establishment of full-time local health units in
the fifty Florida counties which do not now have such units.
The 1939 study' made by the American Public Health Associa-
tion recommends that "where full-time local health service is
not now established, the endeavor of the educational authori-
ties be concentrated, in cooperation with health authorities on
the establishment of full-time local health units." This public
agency will be able to meet the needs of school health service
(See Part IV) which are the responsibility of public agencies
and to bridge the gap between unrecognized need of medical
FLORIDA'S SCHOOL HEALTH PROGRAM 17
attention on the part of the individual and the help which the
private physician and the dentist may give to him. With these
health units established the greatest responsibility of the school,
insofar as professional health service is concerned, will be to
make it possible for this agency to function effectively in the
school program. This will not, however, minimize the impor-
tance of those aspects of health service which are school re-
sponsibilities, regardless of the way in which professional
health service iP ,endered.
Health units which are established will not fulfill the pur-
pose for which they are created unless trained and capable
personnel are employed. The school should lend its influence
to insistence that this be done. The school and the health
unit should constantly keep in mind the idea that one of the
chief objects of the work of the health unit is to assist in de-
veloping an interest in and an understanding of the health
benefits which may be obtained from a capable family physi-
The principles stated in this section apply to both dental
and medical services. When operating under State Board of
Health regulations both are most desirable. For full information
on procedures to be followed in establishing local health units
and on the services which they can render, write to the State
Board of Health, Jacksonville, Florida.
C. The Breadth of the School Health Program Is Designed to
Meet Child Needs. The school health program deals with all
aspects of the school life of the individual. (See Part 1, Section
F). The ways in which these needs of the child that are a
part of Healthful School Living may be met are indicated in
Part III. Those which are a part of Health Service are given
in Part IV. For Health Instruction, however, it is logical to
include in Part V only principles dealing with the teaching of
health. In the elementary schools these principles adequately
describe the organization of the program. The organization
of the program for health instruction in secondary schools and
colleges, however, must be given special attention.
D. Special Attention Must Be Given to the Organization of the
18 FLORIDA'S SCHOOL HEALTH PROGRAM
Secondary School Program For Health Teaching. "Some edu-
cators feel that health instruction in secondary schools can be
presented entirely through the integration of health material
'with science courses, with home economics, with physical edu-
cation and other subjects of the curriculum. It is the consen-
sus of many, however, that such presentations have not proved
satisfactory because of the divided responsibility, because many
important topics may be omitted with this type of arrangement
and because at times teachers have been asked to teach health
materiall when inadequately prepared for such work."2
E. Four Plans of Organization of the Secondary School Pro-
gram Are Suggested. In Florida some plan for direct health
teaching should be provided. The most satisfactory plan seems
possible in schools which are organized on the core basis. Health
Being one of the needs of all children becomes a logical part
of the teaching in that core. Schools organized on a subject
matter basis will need special periods for health teaching.
'The most highly recommended plan for this is the daily
teaching of health for one full semester in each of the sev-
enth, ninth and eleventh grades, or in the eighth, tenth,
and twelfth grades. A third plan, just as effective but
more difficult of administration, is the teaching of health
for nine weeks during each year from the seventh through
the twelfth grades. A fourth plan, which has not proven satis-
factory and which is recommended as a last choice, is health
,teaching for one period each week throughout the school life
of the child. The equivalent of one credit toward graduation
.should be granted for any of these four plans.
The assignment of special periods on alternate years for
'health teaching does not mean that health practices and health
teaching should not be continuous processes. Health is a res-
ponsibility of all teachers at all times. As indicated in
Part V, all teachers should include in their pre-plans specific
-provisions for making their contribution to health teaching.
It is also emphasized in Part III that all teachers are at all
times responsible for healthful school living. This teaching
and practicing of healthful living are continuous parts of the
health program. The special period assigned for health
FLORIDA'S SCHOOL HEALTH PROGRAM 19
teaching makes it possible to eliminate any gaps that may exist
in the total instructional program and to give emphasis to those
phases of the health program which need emphasis.
F. Health Teaching in College is Important. There is need for
the inclusion of health instruction as a part of the regular
college program for all students. Courses which are offered
for this purpose will naturally deal with problems which are
of special interest to students of college age. If the general
training provided by the college program is adequate, one reg-
ular course of a full semester's duration should be sufficient
to fulfil this need.
In addition to this regular course provided for all stu-
dents, those individuals who plan to enter the teaching pro-
fession will need training in school health problems on the
school level where they expect to teach. A full course of one
semester should also be satisfactory for this. Those who plan
to specialize in health education either as teachers or super-
visors will need additional training in this field.
G. Recognition of Responsibilities and Proper Training of Per-
sonnel are Essential.
The School Administrator: The school administrator is
responsible for planning all phases of the school program so
that the school may make the greatest possible contribution
to health. He is also responsible for 'supervising to the extent
that all plans are fully carried out. This responsibility includes
the relationship of the school to public health agencies, as
well as all details of the program within the school. The points
which should receive attention are clearly indicated in this
bulletin. The administrator will find it helpful to utilize indi-
viduals and committees from his faculty in meeting these re-
sponsibilities. The training of the administrator should be at
least equivalent to that indicated in section "F" of this chap-
The Classroom Teacher: A general principle to be observed
by the classroom teacher is that she should assume the respon-
sibility for all phases of the school health program which
are a definite part of the entire county health program, except
20 FLORIDA'S SCHOOL HEALTH PROGRAM
those which are strictly professional. The training necessary
for this is indicated in section F of this chapter.
The survey, of the American Public Health Association
states: "The teacher should play a definite part in the school
health program and should be trained and encouraged to un-
dertake health services, such as rendering first aid, teaching
first aid, the testing of eyesight and hearing, and the obser-
vation of children for signs of communicable disease and
other conditions affecting health. The teacher should also
be sufficiently interested in the health of the pupils to study
their health records and to present to the health authorities
any problems which may be related to health."3
Health Teachers and Health Supervisors: In addition to
the health training which all teachers have the health teacher
and health supervisor should have a college major in the field
of health education. The duties of this teacher and supervisor
will be, not only to teach the special health subjects in the
curriculum, but also to assist the administrator in organizing
and coordinating the total school health program.
The Health Officer From the Local Health Unit: "A
full-time, thoroughly trained, and otherwise well-qualified
health officer can assist in organizing school health services
and take an active part in physical examination of children"
. .'. He together .. "with hvs modern health organization . .
the public health nurse and sanitarians . can assist in com-
municable disease control, environmental sanitation, and the
supervision of the health of the children."4
The Public Health Nurse from the Local Health Unit:
"The public health nurse is not a certified teacher and should
not be expected to teach in the schools, nor should she spend
too much of her time in the schools. She is the important
link between the school, the home and the community. It is
a waste of tax payers' money and an imposition on an already
over-crowded health service to require public health nurses to
remain in the schools waiting to give first aid. It may be
necessary for public health nurses to instruct teachers in first
aid who, in turn, should teach this as a subject to the pupils,
FLORIDA'S SCHOOL HEALTH PROGRAM 21
utilizing the opportunities of rendering first aid as a demon-
stration. To conduct independent school health nursing ser-
vice is not in conformity with modern public health thought
. health conditions of school children reflect the con-
ditions of the home and community as a whole. A school child
with bad teeth, with hookworm, who is malnourished, or who
shows other defects and health deficiencies, is merely a sam-
ple from a home where these conditions are likely to exist in
some or all of the other children."6
It is the duty of the public health nurse to act as health
councilor in all situations of this kind. In maintaining this re-
lationship and advising the parents regarding corrections of
conditions in the home and in giving professional guidance to
teachers, she will find her chief work.
The Sanitary Officer from the Local Health Unit: The
sanitary officer provided in all local health units is trained
in the principles and practices of environmental sanitation. Like
the nurse, he is not a teacher and should not be expected to
teach. He should be used for advice and consultation with the
teacher in regard to school sanitation and essential rules of
conduct necessary to be observed by pupils for proper use of
sanitary facilities. He should also act as consultant and ad-
visor to janitors and other school employees entrusted with
the operation and maintenance of the school plant.
The Work of Other Personnel is Extremely Important.
Janitors, bus drivers, school secretaries, lunch room directors,
and other school personnel occupy a most important place in
the complete health program. Special health training of the
type most suitable for their respective work should be pro-
vided and required. Since the employment of these individuals
is almost entirely subject to regulation of county boards of
public instruction, these boards should assume the initiative
in establishing health training and other requirements for
Personnel Now In Service Also Need Training. All per-
sonnel, regardless of position, who are now working in the
22 FLORIDA'S SCHOOL HEALTH PROGRAM
schools and who have not had adequate training in. school
health work should make plans to secure such training as
soon as possible. Principals, county superintendents and
county boards should offer encouragement to that end.
A Careful Study of the Bulletin Will Indicate Specific
Duties. The first five parts of this bulletin point out those
things which should be included in every School Health Pro-
gram. It is probable that the actual plan and assignment of
specific responsibilities will vary somewhat with every com-
munity in the State. The matter of chief importance is for
every school to make a careful analysis of what its program
should include and to develop for its own situation a plan
which adequately covers all points.
Parts I through V will help in the analysis of needs and
the development of a plan; Part VI will help in the evaluation
of that plan; and Part VII will help in securing materials and
assistance in conducting the program.
H. Horne, School and Community Cooperation are Essential.
The planning and functioning of the school health program
depend upon the coordination of all health facilities in the
home, school and community and the cooperative efforts of
all available health personnel.
The various factors contributing to growth and develop-
ment are so closely related that it is impossible to think of
Classification of pre-na' al, infant, pre-school and school
child are merely conN mnint terminology. Obviously 's the
same -hild moving imperceptibly, to himself at least, -irough
those -arious stages. The child's life is a continuous proce ,s
and cannot be divided into isolated compartments. Likewise,
the child is not divided into compartments to receive the ser-
vices which various organizations might give to him. The
child needs an integrated Health Program, regardless of
whether the elements come from one or a dozen different
sources. It is essential, therefore, that all agencies and indi-
viduals functioning in the health program have the same con-
cepts and understandings of that program.
FLORIDA'S SCHOOL HEALTH PROGRAM 23,
Parents, of course have the greatest interest in seeing
their children grow into strong men and women. They have
first responsibility in furnishing a home, food, clothing, medi-
cal care and for habit formation. They do not always know
the health needs of children, nor are they always financially
able to provide essential needs, but fundamentally they are in-
terested and need the help of professionally trained personnel,
such as doctors and dentists who are interested in preventing
disease and correcting defects of children.
The Department of Public Health and Local Health Units
are interested in providing for children communicable disease
control measures, pure food and water, sewage disposal and
other environmental safe-guards.
Voluntary health organizations, community welfare and
other social agencies are interested in child health activities
because they see the relationship between good health and
one's ability to live fully. They know that sickness and pov-
erty go hand in hand.
Teachers are interested in the well-being of their pupils
because health contributes largely to learning. They accept
the responsibility for providing a healthful place to live in
school, for developing habits, attitudes, and knowledge which
prepare children to assume responsibility for their own health.
Civic clubs, women's clubs, and parent-teacher groups are
interested in and contribute definitely to programs for im-
proving the health of children. Any services which they un-
dertake should be developed with the idee that they will be-
come a part of the work of official a., e ies as soon as the
community realizes the i eed. Special contributions which they
make will result in the most practical good if they are made
directly to an official agency or if the service rendered is un-
der the guidance of the official agency.
Progressive groups of this kind welcome opportunity to
participate in a program of improved community health and
are anxious to be utilized in this endeavor. Those who are
charged with the responsibility for the health program are
remiss in their duties if they fail to acquaint these organiza-
24 FLORIDA'S SCHOOL HEALTH PROGRAM
tions with the most effective ways in which they can contri-
bute to the program.
1. "The Health Situation in Florida," Report of the American Public
Health Association, 1939. p. 54.
2. Joint Report on Suggested School Policies by the American Medical
Association and National Education Association.
3. "The Health Situation in Florida" Report of the American Public
Health Association, 1939, p. 53.
4. Ibid., pp. 52-53.
5. Ibid., p. 53.
6. Ibid., p. 52.
HEALTHFUL SCHOOL LIVING
A. Healthful School Environment. The ideals of every person
are influenced by lawns, trees and beautiful buildings. The
public school plant is the people's investment for the future.
It, therefore, should be made an example for home improve-
ment. It should be developed so that it will be artistic and
In the school children, we have represented a part of
every home and the communicable diseases occurring in those
homes. The construction of the school building, insofar as
environmental sanitation has to do with the transmission of
disease is, therefore, of utmost importance from the stand-
point of public health.
Before acquiring school site property, the county board should
determine the location of elementary, junior high, and senior high
schools for the county, as prescribed in Chapter IX, Article 2,
Section 916 and 917 of the Florida School Code. Each school site
should contain a minimum of two acres for a one teacher school.
At least one acre should be added to this minimum size of the site
for every fifty pupils enrolled in the school after the first fifty
pupils, and until the enrollment reaches five hundred pupils.
Each site should be well drained, reasonably free from mud,
and the soil adapted to landscaping as well as to playground pur-
poses. Insofar as practicable, the school site should not adjoin
the right of way of any railway, or any through highway, and
should not be adjacent to any factory or other property from
which noises, odors, or other disturbances would be likely to inter-
fere with the school program.
The site should be accessible from every direction and to all
parts of the area to be served. Attention should be given to any
special services for which provision has been made in the build-
ing, and which may be intended for those living beyond the limits
of the local attendance area.
Sites should be located with due regard to traffic, the avail-
ability of bus lines, paved roads, as developed at the time of the
selection, as well as the possibility of future traffic programs. It
is important from a public health standpoint in selecting a site
FLORIDA'S SCHOOL HEALTH PROGRAM
that localities be avoided where the drainage is such that disease
carrying mosquitoes would be a problem, or in the vicinity of slum
sections or where the surrounding sanitation is below the best
standards existing in the community. Where a public sewerage
system is not available, the site should be selected with a view
to the proper disposal of waste materials from the school building.
Insofar as possible in erecting one story schools, materials
should be used which are available and adaptable to that particu-
lar section. In the erection of school buildings of two stories, fire
resistive; materials should be used in the construction of stairways
and halls. Due regard should be given to the size of corridors, and
stairways should be provided in conformity with the recommenda-
tions of the National Board of Fire Underwriters. Buildings of
three or more stories should be entirely fire proof in order to pre-
vent the danger of panics. In buildings already erected of two or
more stories, well constructed fire escapes should be provided where
the 'number of stairways does not meet the standards as prescribed
by the National Board of Fire Underwriters.
The principals, teachers, and janitors should, in conformance
with state laws and regulations, at the beginning of each school
year agree on rules which should govern the drills, and these drills
should take place at least once a month at a different period of the
day in each case.
Fire extinguishers should be provided in schools according to
.the. provisions of the School Code, and the operation of an extin-
guisher should be demonstrated at the beginning of school terms as
part of the fire drill instruction. All exit doors should be hung so
as to swing out and should be provided with hardware which may
be opened by pressure from the inside at all times.
a. Heating and Ventilation
The condition of school room air, particularly its temperature,
has a direct bearing upon the incidence f certain disease es. There
must be a circulation of a:r, and for thu classroom the temperature
of this air should not bo less than 68 degrees or more than 72 de-
grees. The most suitable method of ventilation under Florida con-
ditions is the window inlet ceiling exhaust system. Windows should
be of such a type that at least 50% of their area may be opened at
one time. Standard classrooms should be provided with two win-
dow deflectors to protect pupils from currents of cold air.
For small schools where central heating plants are not feasible
the jacketed stove furnishes the best means of providing heat and
ventilation. This consists ,of a, stpve, that is enclosed in a metal
FLORIDA'S SCHOOL HEALTH PROGRAM 27
cylinder opened at the top and bottom. A fresh air duct runs from
the outside of the building and is terminated beneath the jacket.
Cold air is drawn up between the jacket and stove, is warmed, and
is discharged above to go out into the room. Some of the room
air which has become cold and fallen to floor level is also drawn
into the jacket and rewarmed. Air change is insured by means of
an exhaust duct with an opening at floor level. The exhaust duct
connects with the chimney, or better still encloses the chimney. The
chimney keeps the temperature of the exhausted air sufficiently high
so that a good upward draft is insured. Dampers should be pro-
vided in both the inlet and exhaust ducts so that the amount of air
entering the school can be regulated. For a schoolroom 22' x 30'
with a ceiling of 12' the jacketed stove used should have a fire pot
diameter of at least 18" at the low end of the stove door.
,b. Water Supply
The drinking water used in schools is of the very greatest im-
portance from the standpoint of public health. Where the public
water supply is available, schools must always connect with this.
There should be no other source of supply available to the children.
The safety of public water supply is insured and no concern need
be given to the quality of this. It is where no public water supply
is available that a most important problem presents itself in school
sanitation. If it is necessary to develop a private water supply for
the school, it should be from a drilled well, sunk so that the water is
derived from deep seated sources and surface and ground water
preventedd from entrance into the well. Such wells should be con-
structed in accordance with the regulations of the State Board of
Health. School water supplied not from public sources should have
periodic bacteriological laboratory examinations to check on the
safety of it. This examination may be made by application to the
local health officer, or if there is no local health officer, to the
State Board of Health. In connection with the distribution of wa-
ter, the use of common drinking cups is unlawful and most daner-
ous as disease may be spread in this way. Where inning water is
available in the school, sanitary drinking fountains should b in-
stalled as the preferable procedure. Disposable paper cups ma. be
used as a substitute.
c. Sewerage Disposal
The most satisfactory method of disposing of school. sewage
wastes is by connection with a municipal sewerage system, and such
connection should always be made where it is possible to make it
Where there is no municipal system, special facilities must be
arranged. A septic tank must be provided for water flush toilet
systems. Except in case of very large schools, the septic tank ef-
28 FLORIDA'S SCHOOL HEALTH PROGRAM
fluent can be disposed of by a tile pipe drainage field laid in trench-
es of crushed stone or cinders. The difficulty is in getting septic
tanks properly designed and adequate in capacity and in getting
sufficient drain tile properly installed. For this reason, such instal-
lations cease to function in a short time, and sewage bubbles up
from the ground and stands on the surface. This makes a very
dangerous condition. The specifications given in State Board of
Health Bulletin "Sewage Disposal for the Home" may be used for
the small school, not exceeding 200 pupils. It also explains the
fundamental principles involved.
For larger schools the State Board of Health will send a repre-
sentative for investigation and will furnish specific plans for any
In very small rural schools, where water under pressure is not
available it will be necessary to construct a sanitary privy. The
State Board of Health Bulletin "The Sanitary Pit Privy" covers
specifications for privy sanitation very completely. Special designs
for larger multiple privies to meet the need of schools can be fur-
Where a privy must be used, it is most important that it be so
constructed that excreta will not contaminate the soil, will not be
accessible to animals, that it be absolutely fly-tight, and that it be
vented so as not to produce odors.
d. Toilet Rooms
Wherever possible, indoor flush toilets should be provided for
public schools. At least one toilet room for each sex should be re-
quired on each floor, and entrances to them should be well separat-
ed. They should be easily accessible from play grounds and class-
rooms. Wherever possible, cross ventilation should be provided in
these rooms, and as many of them as possible located on sides which
will receive direct sunlight some time during the day. The floors
of toilet rooms should be of some non-absorbent material; tile should
be used whenever possible. The walls should be of a material which
will enable the custodian to take soap and water and wash them at
least as high as six feet from the floor. The toilet room should be
provided with a drain, and the floor shaped so that the custodian
may take a hose and flush the toilet floor. Toilet rooms should
not be located in basements and should be provided with 20% win.
dow glazing as compared with the floor area. Toilets should be so
located and screened that the inside is not visible from a corridor
when pupils are passing in and out of the room. Doors should be
provided for toilet stalls which will stand open when not in use.
FLORIDA'S SCHOOL HEALTH PROGRAM 29
Toilet fixtures should be provided as follows:
Boys' Toilet Seats 3ne for each 15 boys
Boys' Urinals One for each 25 boys
Girls' Toilet Seats One for each 15 girls
Boys' Toilet Seats One for each 20 boys
Boys' Urinals One for each 33 boys
Girls' Toilet Seats One f, ach 20 girls
For primary children, the height of the toilet s( .juld not be
over 10"; for the elementary school children, the i .6 should be
12"; and for high school children 14". Separate toilet rooms are de-
sirable features for the kindergarten and primary children. Pedestal
type urinals are highly satisfactory for use in the public schools and
urinal troughs should not be used.
Handwashing facilities are very essential in any school. There
should be one lavatory for every fifty pupils and at least two for
each school. Ample soap and paper towel facilities and mirrors are
also essential. Lavatories for elementary grades should not be over
25" in height and not over 30" for high school children.
The natural and artificial lighting of classrooms plays an im-
portant part in the health of school children. The great use of the
eyes in school work demands that illumination be adequate at all
times. Most school hygienists, doctors and illumination engineers
have agreed that about ten-foot candles of illumination are adequate
for most school purposes. A classroom of approximately 20'x30'x12'
can be naturally lighted if the glazing in the room amounts to 20
per cent of the floor area, and the glazing is properly placed. The
windows should be within six inches of the ceiling, placed on one side
of the room so that light is received over the pupils' left shoulder,
and should be approximately 42" above the floor. The preferred
fenestration is east and west. Such a facing enables a classroom
to receive the benefit of the sun's rays during a part of the day, and
from experiments it has been proved that such facing of the win-
dows has the least amount of desk interference from the sun during
the course of the school day. If movable seats are used, care should
be exercised to see that no pupil faces the light for an extended
Shades are necessary to control the light which varies during
the day. The double-hung shade hung in the middle of the window
enables the teacher to lower or raise shades readily, and in this
manner she can effectively control desk interference from the sun-
shine. They should be of enough density to avoid glare on work-
FLORIDA'S SCHOOL HEALTH PROGRAM
ing surfaces. Care should be taken to see that objects outside of
the school such as trees and tall buildings do not affect the amount
of light in the building. The interior finish of the classroom ma-
terially affects the illumination. It is necessary that a paint sche-
dule be worked out carefully. As a usual thing, walls of buff, or
light green with the ceilings white, or very light cream, and dadoes
of darker color, as a dark tan, have coefficients of reflection which
will help to control the light so that there will be no glare. Ceilings
should be painted with a material which ,gives 75 to 80 per cent
reflection, upper walls about 50 to 60 per cent, and dadoes, not
more than 30 per cent.
Artificial lighting is essential not only for night work but to
insure sufficient illumination during winter months. Lighting units
should be placed to eliminate shadows. As a rule, six outlets about
18" from the ceiling with semi-indirect equipment will light a class-
room satisfactorily. It is necessary to keep in mind that fixtures
should be cleaned at regular intervals, and the classroom painted
at regular intervals or the number of foot candles or light furn-
ished will vary considerably.
f. Special Health Rooms
A lunch room is essential to every public school. It should be
located where it can receive a maximum of sunlight and air and at
the same time must be easily accessible to all. It should be so lo-
cated as to eliminate the spread of cooking odors. About ten square
feet should be provided per pupil exclusive of service space. A
hiomelike appearance should be sought and, every effort should be
utilized in securing a minimum amount of noise. The lunch counter
should be of sufficient length to serve rapidly. The facilities pro-
vided will depend on the financial ability of the community and on
the size of the school. For large schools, the following items should
be provided: counter, steam table, ice cream packer, bread and sand-
wich table, tray and silver rack, cashier stand., cocoa urn, milk and
cream cooler, water cooler, guide rail or partitions, dish trucks, soil-
ed dish trays, kitchen, storage space and main dining room. Bat-
tleship linoleum affords an excellent floor surface. Tables should
be provided that can be washed and should be about 74" long and
In the larger schools, comfortable rest rooms should, be pro-
vided for the teaching staff.
Every community should be interested in good health standards
and, ih order to make the highest accomplishments possible, it sh,:Ild
provide every available health facility. The health clinic should be
located adjacent to the administration unit and should be provided
with artificial and natural lighting, nurses' room, medical clinic,
FLORIDA'S SCHOOL HEALTH PROGRAM 31
and waiting room. All of these facilities, of course, will not be a-
vailable in every school plant, but as many of them as possible
should be provided in the medium and large size schools and these
facilities should be available at accessible centers to all public school
children in the county school system.
From a health standpoint, the most important single piece of
school furniture is the school seat. Seats may be classified in three
general classes. The fixed seat and desk is most commonly used,
but is probably the least desirable. Movable seats are excellent for
modern teaching techniques, but may be as injurious to the chil-
dren's posture as the fixed type. The table and chair arrangement
for primary grades offers a very nice working situation and is be-
ing used more extensively in the higher grades- Seats should be
about seven feet from the front wall and extend to within three feet
of the rear wall and should have aisles .of about 20" next to the
windows and three feet wide next to the inside classroom wall.
In general, movable furnishings are more desirable than fixed
ones in the school room, because with such furniture the room may
be used as a play room, or the chairs may readily be removed and
made accessible in other areas. Some of the common faults of
school seating are: Seats are too high and deep for the pupils; desks
are too close or too far away from the pupils; desks and seats
though adjustable are not often adjusted to pupil's needs. Some
standards for seating are: The seat is too high if there is pressure
on the thighs and the feet are resting on the floor, and too deep if
it does not permit the pupil to sit back in the seat.
Practically all standards can be met by use of the adjustable
seat. Interest and, skill, however, are necessary to secure the pro-
per adjustments. The following sizes of desks are recommended by
Dr. H. E. Bennett in his book, "School Posture and Seating."'.
Grade 6 5 4 3 2 1
I 90% 10%
II 50 50
III 25 50 25%
IV 35 40 10%
V 10 40 25
V7 40 50
VII 25 50 25%
VIII 10 40 50
High School 25 40 35%
32 FLORIDA'S SCHOOL HEALTH PROGRAM
3. Maintenance of a Sanitary Environment
Custodian Services. The duties of the custodian should be to
keep the building clean and sanitary. He should do all sweeping
washing, dusting, cleaning rooms, and watering grass. When necess-
ary he should keep the grounds in good condition and do other cus-
todial work as specified from time to time. Administrators should
set up work schedules to be performed by the custodian, determine
standards of service, and the volurne of work which a custodian
should be given. A complete list of the duties and activities of the
custodial staff should be outlined and the teachers and, custodians
should have copies of these duties that they may effetively cooperate
with one another in the discharge of their duties.
If a person has ideals of appreciation of cleanliness, and to this
is added the ability to impart these characteristics to others, this
combination of qualities will manifest itself in clean, well kept, com-
fortable, sanitary school buildings. Well kept, sanitary buildings
require more man power than one in which little work is done and
which is allowed to remain dirty and insanitary. The time has
come when the responsibility for a sanitary school building cannot
be entrusted to ignorant, untrained personnel. House keeping no
longer means the wielding of a corn broom and a feather duster
and slopping soap suds on dirty floors. Intelligence in the proper
direction is necessary if the building is to be sanitary. A custodian
needs to possess traits which would tend to classify him as a para-
gon. He should be economical with supplies and utilities and should
be a good sanitarian. He must keep the school building, fixtures,
furniture and equipment in such a state of cleanliness as to avoid
illness among the children housed in the building.
Administrators must not expect custodians to do the impossible-
They must see that they are properly provided with good equip-
ment, and must furnish proper directions for maintenance of the
school plant. The following is a suggested list of the, frequency
of the cleaning operations that should be performed by the custo-
dian in a school building.
Class rooms and other rooms Daily
Corridors and Stairs Twice Daily
Under Radiators Weekly
Walls and Ceiling 3 Times Yr.
Wall Pictures and Window Shades 3 Times Yr.
Radiator Tops Weekly
Between Radiator Sections Yearly
FLORIDA'S SCHOOL HEALTH PROGRAM 33
Scrubbing and Mopping:
Classrooms 3 Times Yr.
Rest Rooms 3 Times Yr.
Corridors 3 Times Yr.
Domestic Science Rooms Weekly
Offices and Kindergartens Weekly
Furniture and Woodwork 3 Times Yr.
Windows (outside) 3 Times Yr.
Windows (inside) Weekly
Inside Door Glass Twice Weekly
Cupboard Glass Twice Weekly
Toilet-room Floors Twice Daily
Toilet Bowls Daily
Removal of Sawdust and Shavings Daily
Removal of Garbage Daily
Hand Rails and Doorknobs Daily
B. Organization of a Healthful School Day. The responsibility
of the school for the health of the child begins when the school
bus picks him up in the morning. This hour of leaving for
school should not be early enough to interfere with a whole-
some warm breakfast. The bus should not be overcrowded,
and pupils with communicable disease should not be allowed to
enter the bus. The bus driver should be selected on the basis
of good moral character, good vision, and hearing; he should
be able-bodied, free from communicable disease, mentally alert,
and not a user of alcoholic beverages or narcotics. The condi-
tion of the bus should insure a safe and comfortable ride to
Pupils who arrive at school early or are obliged to wait
for a late bus should be comfortably sheltered and supervised
by members of the teaching staff.
The length of the school day is definitely specified in
school laws given in the appendix of this bulletin. A- is shown
there, the length of the school day varies to meet the needs of
children at different stages of physiological and ph::chological
34 FLORJDA'S SCHOOL HEALTH PROGRAM
development, and should be organized to prevent undue fati-
gue. A balance between work and play and rest should be
maintained. The daily schedule should allow time for recess,
relaxation and play, and lunch periods. Care should be taken
that curricular or extra-curricular activities be assigned ac-
cording to the strength and energy of pupils. Regular physi-
cal education periods should be observed in accordance with
plans indicated in the State Course of Study in Physical Edu-
,cation. The activities at this time should be so planned and
,organized that every child has a desire and an opportunity for
safe, vigorous and educational play suited to his age and phy-
Definite and adequate time should be allotted to the lunch
period. This plan will vary according to the situation. A
longer period will be required when pupils go home to lunch.
A school lunch room where hot, nutritious food is prepared
and served under the supervision of the school authorities is
essential for the health of the pupils. Special provision should
be made for those children who bring their lunches from home
to eat healthfully at school. The school lunch room is a labo-
ratory where children learn what to eat and how to eat. No
carbonated drinks, tea or coffee should be served in the school
lunch room. No candy should be served or sold in the school
or on the school premises. The school has the same responsi-
bility to educate appetites as minds.
Rest and relaxation periods should be interspersed in
the daily schedule when the pupils need relief from sustained
-effort. Windows should be opened and pupils allowed to par-
ticipate in relaxation activities chosen according to their im-
mediate needs. Change of work results in relaxation and
avoidance of strain. Social activities which serve to amuse and
relieve monotony are desirable.
In order that a maximum amount of work may be done
with the accumulation of a minimum amount of fatigue, it is
recommended that school subjects requiring close mental work
should alternate, when possible, with subjects requiring motor
FLORIDA'S SCHOOL HEALTH PROGRAM 35
There is a definite trend today to spend more time on
assignment and preparation of lessons and less time on formal
recitations. Guidance of children in establishing effective
study techniques requires supervised study periods.
No home work should be assigned in the elementary grades.
A limited amount, and such work as can be accomplished with
satisfaction at home, may be assigned in the secondary grad-
es. The danger of cumulative fatigue, interference with sleep
and play, eye strain, etc., from heavy home assignments has
been recognized as a menace to health. Suggestions regarding
budgeting time and effective home study may encourage high
school students to improve or make the best possible use of
study conditions in the home.
A minimum amount of after-school activities should be
planned by the school. Evening school activities should be
rare and so planned that there will be no interference with
sleep. It is recognized today that parents and children need
more family association. Home duties and responsibilities
are desirable and educationally worth-while for children.
C. Pupil-Teacher Relationship. If the school accepts the res-
ponsibility for the development of the whole child, the class-
room environment in which he lives must be conducive to his
physical, mental, social and emotional growth. Wrong habits
and improper emotional reactions formed early in school life
condition present and future achievement. Environment in-
cludes more than the physical plant and sanitary features of the
school building. It goes further than arranging a daily sche-
dule. The social and emotional tone of the classroom provide
atmosphere for mental, social and emotional as well as physical
well-being. The classroom experience should be so guided as
to eliminate fears in children and to develop in them self-con-
fidence, self-respect, and self-direction. Fear is frequently
responsible for numerous types of abnormal behavior, such as
jealousy, types of delinquency, lying and cheating.
Success and failure establish certain attitudes in children
that largely determine future success. Continual failure leads
to despair, continual success without effort to over-confidence.
36 FLORIDA'S SCHOOL HEALTH PROGRAM
The teacher should plan for experiences which give opportuni-
ties in which every child may experience genuine success rea-
sonably often. Likewise she should plan work which will chal-
lenge the ability of brighter students to the level of their abi-
lity. Knowledge of success favors learning. The mental ef-
fect of failure tends to destroy self-confidence. The well-in-
formed teacher will be able to plan for the personality develop-
ment of all her pupils.
Classroom discipline promotes or retards personality deve-
lopment. It should be remembered that faulty vision, defec-
tive hearing, imperfect elimination, lack of nourishing food,
illness, insanitary surroundings and unfavorable conditions at
home affect the behavior of children. Punishment that fails
to recognize all such factors violates all principles of child de-
velopment. Corporal punishment, depriving the child of neces-
sary recreation, standing in the corner, using fear or sarcasm
as a motive for actions are methods of discipline which often
result in personality problems of a very serious and long
standing nature. Harsh discipline measures undoubtedly pro-
duce a non-cooperative attitude in children. On the other hand
indulgence and lack of control often develop an anti-social out-
look. Between these extremes, an understanding teacher work-
ing with her class may set up standards of behavior which lead
to self-direction and control in maintaining acceptable group
and individual behavior.
The rush and tension of modern life are being felt even
in the classroom. Over-crowded programs and faulty work
habits lead to unplanned and purposeless living. Fatigue and
strain may be observed in the average group of pupils. Rest-
lessness is often mistaken for surplus energy and children are
permitted, if not forced, to extend themselves beyond their
ability. The understanding teacher plans for democratic ex-
periences based on the interests and abilities of her group.
Working together on mutually interesting problems often
takes care of unruly behavior and makes possible wholesome,
stimulating effort of the entire group. Even the non-coopera-
tive child is susceptible to group approval.
Children are no more alike in mental ability than in phy-
FLORIDA'S SCHOOL HEALTH PROGRAM 37
sical appearance. They vary in strength, endurance, resis-
tance to disease, likes and dislikes, visual and auditory accuity,
intelligence, memory power, educability. The well-trained teach-
er will understand this and plan her classroom experiences
according to the principles of individual differences. Only
through such a procedure can the health of children be ade-
Informal instruction adjusts itself well to the principle of
individual differences. One child excels in one line of work,
another can make an equally satisfying contribution in an-
other activity. A low I. Q. does not always indicate failure,
nor does a high I. Q. insure success. When tasks are assign-
ed on the basis of interest and ability rather than the next
chapter, children will begin to live and learn functionally at
Parents often hold pupils to a standard of high grades a-
bove their ability. The teacher grades rigidly and children
frequently cheat or become emotionally upset in facing such
situations. Rewards, honor rolls, and prizes for achievement
and attendance may give satisfaction to a few outstanding
children but many more suffer as a result of such faulty
The teacher is the key person in the health program in
the classroom. She should personify health in personal ap-
pearance and daily living. Children are her imitators. They
reflect her enthusiasm, her health practices, her voice, her
philosophy of living as well as her neatness of appearance.
Her responsibility is great. She largely molds the lives of
1. Bennet, H. E.; School Postures and Seating. Ginn and Co., Atlanta,
A. Introductory Statement. The school health service is
initiated and provided in order to improve and maintain
the child's health and happiness. Moreover, this health ser-
vice must be utilized as educational demonstration material
and should be the joint effort of both educational and health
authorities with a distinct realization of mutual responsibili-
ties. Effective planning by both school and health officials
should do much to prevent any break in daily school routine
and to anticipate misunderstandings. In fact, all phases of
health service provided in the school and in the community
should be for the purpose of demonstration, and the teaching
should conform to the same principles demonstrated by the
service. The object of health service is not only to per-
form a needed service but to impress on the child the necessity
of forming certain habits and attitudes that he can retain
throughout life to protect health. There must be real under-
standing and sincere cooperation between the personnel of
both services. The health department should not be asked to
perform services in the schools that should be undertaken by
the educational personnel. The weighing and measuring of
children, testing of hearing and sight, the rendering of first
aid, morning observation and any other routine needs should
be possible of accomplishment by any capable teacher. These
activities should be used as demonstrations to supplement the
teaching of health in the schools.
B. The Prevention and Control of Communicable Disease
in the School. Children are compelled by law to attend school;
therefore, it is imperative that school and health authorities
jointly insure a healthy school environment. Communicable
disease-that is, disease which can be spread from one person
to another-must be brought into the schools before it can be
transmitted to other scho-' children. This necessitates the
FLORIDA'S SCHOOL HEALTH PROGRAM 39
establishment of safeguards to prevent entrance in the school
of persons suffering from communicable disease. School pre-
ventive services include-
1. Daily observation of the child at home by the parents before he
leaves for school in the morning. This implies that detailed sug-
gestions must be given to the parents by the school and the health
department to assist them with the morning observation. It is
obvious that a child showing any symptoms of the common cold-
that is, sneezing, coughing, running nose, flushed face, or a head-
ache-should be kept at home. A child who has been apparently
perfectly normal and suddenly develops a headache, ach ill, a vom-
iting spell, or any other signs of illness should not be permitted to
go to school. Average daily attendance should not require at-
tendance to the extent of neglecting the health of the child.
2. Daily health observation by the teacher in the school. As a further
safeguard, every teacher should be familiar with the signs and
symptoms of the common communicable diseases and should observe
carefully every child before the morning class work begins. The
schools should have a thermometer available, and the teachers should
know the technique of reading the thermometer and sterilizing it
between uses. When in doubt, it is always advisable to take the
temperature of a pupil, and any increase over 99 degrees Fahren-
heit should be assumed to be abnormal. The teacher who is respon-
sible for play-ground supervision should be on the alert each morn-
ing to observe any child who appears ill and exclude or isolate the
child immediately, before hel has come into contact with the children
in the classroom.
a. Isolation of Sick Pupils. All children who are thought by the teach-
er to be sick should be isolated-that is, placed apart from all
other children until arrangements can be made for sending them
home. The teacher with consent of the principal should immedi-
ately get in touch with the parents, who are responsible for taking
charge of the sick child, It is unwise for the teacher to take the
responsibility of calling the family physician unless she has definite
authority from the parents. The teacher should render any neces-
sary first aid and if possible should get in touch with the local
fulltime health unit to report findings and to receive instructions
that might aid her in removing the sick child from the school.
b. Transportation. Provision should be made in every school for the
transportation of sick children to their homes. The first attempt
should be to have the parents take the resporchility. hut if this
is impossible some other arrangement must be made. A transpor-
tation committee of the P. T. A., or some other local organization
40 FLORIDA'S SCHOOL HEALTH PROGRAM
might be utilized. The school bus should be used only as a last
resort. Health department personnel should not be expected to
take the child home or to the physician unless all other means have
been exhausted. However, it is essential that the health unit be
informed by the school immediately of the action taken.
c. Knowledge of the Presence of Communicable Disease in the Area.
Every teacher should know of the presence of communicable disease
i. the area, and should familiarize herself with the signs and symp-
t n i of these diseases to assist her in the morning observations of
the children. The information should be provided by the local
d. Av' idarie of Infection. There are many opportunities in the schools
for the prevention of the spread of infections from undetected early
cases or from carriers of communicable disease. The teacher should
study health habits in the school as they relate to the spread of
communicable disease. Not only is it necessary for the teacher to
establish the practice of prevention in the school, but she must incor-
pr,' te it into teaching. As an example, there may be good hand
washing facilities in the school, but if these are not used properly
by the pupils, they are of no value. The following points will aid
in preventing the spread of infection:
(1) Frequent hand washing-particularly before meals and after using
the toilet. A child should be taught to keep his fingers and other
objects out of his mouth and nose. There should be an abundance
of hot water, soap, and individual paper towels. In small schools
some facilities can be provided by using a little imagination and
(2) The proper use of clean handkerchiefs. Every child should have a
clean handkerchief and be taught to cover his mouth and nose to
protect other children when it is necessary to cough or sneeze.
(3) Sanitary drinking fountains or individual cups. The common drink-
ing cup or dipper went out of use many years ago and the custom
should not be revived. Where sanitary drinking fountains are
not available, individual disposable drinking cups should be utilized.
(4) A communicable disease chart is provided by the State Board of
-Health and can be obtained through the local health unit. The chart
should be placed on the wall of every classroom at a height suit-
able for the use' of both teachers and pupils. It should be frequent-
ly studied and immediately referred to .whenever communicable
disease is present in the community.
(5) Re-admission after illness from communicable disease. All chil-
dren who have been absent from school due to a communicable dis-
ease should not be re-admitted without a certificate from the full-
time health officer andlor family physician stating that the child
FLORIDA'S SCHOOL HEALTH PROGRAM 41
is non-infectious and physically fit to return to school.
(6) Cleanliness of the school. Attention should be paid to the cleanli-
ness of the school at all times, but particularly when there are any
communicable diseases among school children. Soap and water,
properly utilized are the generally recognized means of removing
micro-organisms which may have been deposited by cases or carriers
on desks and other school equipment.
3. Immunization. Immunity refers to the state of a human body in
relation to its protection against certain diseases. Many years ago
through observation and research it was found that after an attack
of some of the common diseases persons developed some internal
protection against a further development or attack of the disease.
This is immunity and applies in the case of measles, scarlet fever,
chicken pox, small pox and others of the communicable diseases.
Immunizati.o0 given by the physician will protect against speci-
fic diseases. This may be in the form of vaccination, as for small-
pox, or innoculation, such as toxoid for diphtheria. Immunization
should be given as early in life as possible. In the case of diph-
theria every child should be immunized during the latter part of
the first year of life and evidence of immunity or a second immu-
nization should be provided just before the child enters school. The
Schick Test should be done three to six months after each attempt-
ed immunization and thereafter at appropriate intervals during the
period of greatest susceptibility.
With an adequate local full-time health service and the cooper-
ation of practicing physicians, the' ideal is to expect all children
to be immunized some years before reaching school age. Neverthe-
less, where health departments have not been established for a suf-
ficient length of time and the service has not been made available
from the family physician, it will be necessary to provide facilities
for immunization of school children. The chi'd should be prepared
for this procedure by adequate teaching and, the procedure utilized
as an opportunity for demonstration with the idea of stimulating
the child's thinking and attitudes and a desire to be reimmunized
when necessary. Immunization is available for: diphtheria, small-
pox, whooping cough, typhoid fever, and a limited immunization
for measles in the presence of an epidemic. It should, be the objec-
tive of every teacher to determine whether pupils have been pro-
tected against diphtheria, small pox and in certain areas and at cer-
tain times, against whooping cough and typhoid fever. Smallpox
vaccination should be repeated at least seven ye after the origin-
al vaccination andlor more frequently if the disease i- prevaint in
C. Health Examination or Physical Examination. The
42 FLORIDA'S SCHOOL HEALTH PROGRAM
object of a health examination is to ascertain the status of the
health of the school child and the presence or absence of de-
fects. Defects may not only interfere with the physical and
mental development of the child, but may also definitely in-
fluence the school life and learning processes. Physically or
mentally defective children are difficult to teach. A child with
a heart disease may be harmed by engaging in the more
strenuous activities of the physical education program or by
taking part in certain athletics unsuited to his condition. The
control of communicable disease deals with the school as a
whole, while health examination is for the benefit of the in-
dividual child. Every child should be examined at least annu-
ally by the family physician. In the case of those children
who have not had the advantage of adequate medical care by
family physicians it has been found necessary to provide school
health examinations to stimulate a desire on the part of the
child and the parent for this service, and, at the same time,
to demonstrate the necessity of frequent examinations as a
safe-guard to health. It is imperative that health officials or
those responsible for conducting health examinations give suf-
ficient time to the examination to create a proper experience
for the child.
1. Preliminary Procedure for Health Examinations
a. Preparation of the child. The child should be prepared by the
the teacher to desire the examination and realize its importance.
b. Invitation to Parents. Not only the child benefits from the exami-
nation, but the parents should be present to discuss the findings
-with the physician.
c. Weighing and Measuring. The child should be weghed and measur-
ed before examination is to take place, as -well as at periodic inter-
vals, and this procedure should be used as a teaching experience. It
must be noted that weight and measurement are not sufficient criteria
on which to base the nutritional status of the child, but must be uti-
lized with other factors, which include the health examination and
the build and stature of the parents. The important feature of
weighiirg and measuring is to show progressive normal increases in
weight and growth. A satisfactory method of demonstrating this to
the child is to have him keep an individual growth graph. Stand-
FLORIDA'S SCHOOL HEALTH PROGRAM 43
ard weight is no longer considered a measure of health and devia-
tions should not be emphasized by the teacher or parents. This is
a matter for the health authorities or the family physician.
d. Testing Sight and Hearing. This is a simple procedure and can
be learned by the teacher, providing her again with an opportunity
of demonstration. Advice and help in this and other technical mat-
ters should be obtained from the local full-time health unit. De-
tails of technique and chart may also th obtained from the fulltime
local health unit.
e. Clinic Rooms. Proper clinic rooms should, be available in every
school. Privacy should be insured for the examination of children.
Under no circumstances should children have clothing removed in
the presence of other children and this applies to children of the
same sex, as well as to those of opposite sexes.
f. Appointments for Parents. Definite appointments should be made
and kept for examining each pupil or all pupils in a family. The
parents shouldd be asked to come to the school at this time and the
examination should proceed as closely as possible to the appoint-
ment schedule. It is advisable to arrange the examination of all
children in one family who are attending the school, so that the
parent will have to make only one trip to the school. When ap-
pointments have once been made, it is imperative that the examin-
ing physician, the public health nurse, and the child be ready on
2. Information Needed by Physician (Health Record Card)
a. Previous history of the child and the family
b. Record of illnesses, particularly communicable diseases
d. Results of previous examinations
e. Observations by teacher to be recorded on the Health Record
(1) Academic Progress (3) Health Habits and Attitudes
(2) Social Behavior (4) Mannerisms and Abnormalities.
f. Observations by the parents which should be recorded by the
teacher, public health nurse, or the physician. These should not
be made in the presence of the child.
3. Periodic examination of pupils must be distinguished from exami-
nation for special or specific purposes. The periodic examination
should be made at the time of entering school and at least every
three years during the school life. It should be made by a capable
and well qualified physician who should be sufficiently interested
44 FLORIDA'S SCHOOL HEALTH PROGRAM
to take time to utilize the examination as a demonstration for the
pupil, the parent, and the teacher. The examination should be a
definite aid, not only to the physical well-being of the pupil, but
to assist in the child's utilization of the available educational faci-
The local full-time unit in Florida is the agency which should
organize and be responsible for the physical examination of school
children. A definite record form should be used. Copies of this
form may be obtained from the local full-time health unit. To be
of any value the record form must be carefully filled in at the time
of the examination by the physician or under instructions of the
physician by the public health nurse. That part referring to the
child's school life should be completed by the teacher. If records
are not properly and continuously kept, they are of little use and a
waste of time and energy. A copy of the record should be kept
in the school after the physician or nurse has discussed the health
of each child with the teacher. A copy of the record should be
kept in the full-time health unit to be used by the public health
nurse for follow-up home visits. Any further entries made on
either copy should be transferred to the other.
4. Other Examinations
a. Examination should be made of all students taking part in ma-
jor athletics at the beginning of the practice season of each major
sport, this examination to be made by the team physician in co-
operation with the full-time local health unit.
b. At least annual reexaminations should be made of every child in
whom major defects are found, to ascertain from time to time the
progress ,of the child.
c. Summer round-up examinations have been made because of the
lack of adequate facilities for periodic examination during the
pre-school period of the child's life. As mentioned before, many
preventable defects develop during the pre-natal, infant, and pre-
school periods. Obviously the periodic examinations made dur-
in these periods should aid in bringing to the school a child in
better physical and mental condition. Where adequate' pre-natal,
infant, and pre-school services are available there should be no
need of the summer round-up. Where these are not available
it is advisable to examine early in the spring those pupils who
intend to enter school for the first time in the fall. Thus any
defects found may be corrected before school opens.
d. Transfer students. All transfer students should be examined up-
on entrance unless there is an accompanying record of a recent
adequate examination in the former school. Health records should
be transferred when the pupil changes schools.
FLORIDA'S SCHOOL HEALTH PROGRAM 45
e. Personnel examination. All school personnel, including teachers,
clerks, janitors, bus-drivers, cafeteria workers and others who
are in any way in contact with the school children, should be
thoroughly examined at least annually. Such examination should
include an x-ray plate of the chest and blood test for syphilis and
other special examinations which may be deemed necessary joint-
ly by the State Department of Education and, State Board of
Health. A special record form should be kept for each member
of the personnel. The examination may be performed by private
physicians, provided they follow the agreed procedure of exami-
nation and will use the official record forms. Records of per-
sonnel examinations should be confidential, filed in the health
department, and available only to the school authorities when
teachers and others have failed or refused to comply with in-
structions and are endangering the health of the pupils. On the
completion of the examination the teacher should be given a
certificate by the health unit showing the completion of the ex-
amination and the filing of the forms with the full-time health
unit. This certificate should be tendered to the school authorities
by the teacher.
D. Correction of Defects. Periodic health examinations are
of little value unless the defects found are corrected. It is
the parents' responsibility to arrange for the adequate treat-
ment of the child. Where the parents are unable to pay for
this service other facilities should be sought, but' utilized only
with the consent of the parents. To facilitate in the correc-
tion of defects it is necessary that:
1. The parents be present at the examination. A form detailing the
defects in readily understandable terms should be presented to the
parents at the termination of the examination. When the parents
are not present this form should be taken home by the public health
nuTse and carefully explained.
2. Home visits should be made by the public health nurse to advise
the parents and to assist them in obtaining corrections.
3. For those unable' to pay, the resources of the community should be
carefully studied by the health authorities to assist in providing
for the correction of defects.
4. In utilizing findings of physical examinations as an aid in health
instruction, the defects of individual children should not be re-
ferred to in the classroom or to the pupils when others are present.
E. First Aid.
It is expected that schools will do everything possible to prevent ac-
cidents in school buildings and grounds, through elimination of dan-
46 FLORIDA'S SCHOOL HEALTH PROGRAM
gerous or imperfect equipment, through alert supervision and other
safety procedures, and through safety education. However, there
will be some emergencies in spite of all precautions.
In cases of accidents or sudden illness, first aid for ordinary inju-
ries is the responsibility of the teacher. The ideal is that every
teacher should be adequately prepared through the Red Cross Stand-
ard Course in First Aid. Classes for such training can usually be
arranged through the local RPed, Cross Chapter. If this is not feas-
ible, communicate with the Red Cross National Headquarters, Wash-
ington, D. C., asking how to get in touch with the nearest autho-
If not all teachers in a school can have such training, at least one
should be so prepared.
It is desirable to have a first aid cabinet or kit in every room; the
minimum should be at least one in every school, in a place acces-
sible to all.
There should be a clinic or rest room, ,or in one-room schools a first
aid corner of a cloakroom, where emergency cases can be treated.
Every school bus should be equipped with a first aid kit and bus
drivers should be trained in first aid treatment. Wherever a Red
Cross Highway First Aid sign is displayed, trained personnel is
3. Limitations of Treatment
A teacher trained in first aid will know what should not be done,
as well as what should be done. In cases of sickness, a teacher
should not give internal medicines except under a doctor's direction.
4. Accident Record Form
An account of the accident should be written on an accident record
form. In cases of accidents which may prove serious, the names and
addresses of witnesses and a signed statement as to what they
observed should be taken at the time of the accident.
5. Educational Aspects
The need of administering first aid provides a learning situation,
which should be utilized later in class discussion as to how the ac-
cident happened, how it can be prevented next time, how it was
taken care of. Treatment to prevent infection can be! related to
general science and the health education period. Treatment for
shock, bleeding, broken bones, etc., can be related to study of struc-
ture and functions of the body.
Making equipment for an emergency room or corner may be a shop,
an industrial arts, and home economics problem.
FLORIDA'S SCHOOL HEALTH PROGRAM
6. Notifying Parents
As soon as, possible after an accident or the onset of sickness, the
school should notify the parents, turning over to them the respon-
sibility of deciding on further treatment and the arrangements for
getting the pupil home.
7. Disposition of Pupil
Before or after first aid treatment, a pupil who needs to be re-
moved from school should be kept quiet and away from a crowd,
until a doctor, an ambulance, or the parents reach the school. Or-
dinarily the pupil should not be sent home alone or accompanied
only by another pupil.
F. Provision for Handicapped Children. As handicapped
children come under the compulsory school act, it is the duty
of the school authorities to provide adequate facilities for their
instruction. Except in larger cities this stage of education is
sadly neglected in most areas. It should be quite feasible to
develop special facilities in a county or combination of coun-
ties for teaching of children suffering from various defects.
The following broad groups of defects lend themselves to
remedial and scholastic improvement by the development of
1. Orthopedic Defects 5. Heart Defects
2. Visual Defects 6. Neurological Defects
3. Speech Defects 7. Certain Mental Defects
4. Hearing Defects
This is specialized instruction and requires specialized
The home economics classes, the cafeteria and school
lunch provide additional opportunities for influencing nutri-
G. Cooperation. Only by the closest cooperation between the
school authorities, the teacher, the physicians and the local
full-time health unit, can an adequate school health service be
conducted. Each must have an understanding of the other's
program, problems, and facilities, and the school health pro-
gram should be jointly planned by the school and health ser-
A. Purpose and Philosophy. As expressed in the White House
Conference on Child Health And Welfare, the goal of health
education is the daily conduct on the part of the individual
which is in accord with our present knowledge of healthful liv-
ing in all of its aspects-physical, mental, emotional, social.
Since health is a way of living, as well as a subject to be
taught, instruction should be developed from, and should
improve the quality of, the life experiences of the child.
It therefore deals with practical everyday situations and
with sound, functional materials. These are approached from
the positive, rather than the negative viewpoint, all leads be-
ing taken from problems known to be vital to the interests of
the child and in accord with his needs and desires. Such in-
struction should result in the child's improvement in those
habits, attitudes, and knowledge essential to healthful, joy-
ous, and satisfying experiences adequate in meeting the de-
mands of life.
B. Principles of Gradation. In grades one through three
there should be little or no direct teaching of health, but em-
phasis should be placed almost entirely on the everyday living
experiences of the child with the idea of helping the child to
establish proper health and attitudes.
In grades four through six, if the teaching method is
through the large unit or integrated plan, care should be exer-
cised to see that health is a part of this plan. If definite sub-
ject matter lines are drawn, however, a daily period for teach-
ing health should be provided. A graded program for this
period should be developed by the teacher. Emphasis should
be placed not only upon habit formation and a development of
FLORIDA'S SCHOOL HEALTH PROGRAM 49
skills, but also upon the how and why of these habits and
A good plan of approach for teaching in the seventh and
eighth grades is through a study of the problems involved in
the student's personal adjustment to the school environment;
in the ninth and tenth grades through consideration of the
student's relationship to the community; in the eleventh and
twelfth grades through a study of human relationships and so-
cial problems including the structure and function of the
human body as it relates to these and to economic efficiency.
All approaches should be through a consideration of the basic
sciences in which our knowledge of health and disease has becn
built. "The instruction concerning disease should be limited
to information which laymen need, and care should be taken to
present it in such a way that pupils will not feel that they can
diagnose and treat their own sicknesses."I
Health Educat:cn courses provided for those who are
training to be teachers should deal with school health prob-
lems and should give emphasis to health approaches at the
secondary level, rather than at the adult level.
C. Areas of Health Subject Matter. The following outline,
which is not intended to be all inclusive, indicates important
health subject matter areas that should be drawn upon in de-
veloping health unrit, both in Health Instruction classes and
in other subjects correlated with health. It will not be possible,
of course, to teach all of this in special health classes. T5Ie
suggestions are intended to indicate possible health teaching
which may be inclu-led in oth-r cla ses as well as those specific-
ally devoted to health teaching.
In each area iL e1 cent al that the teacher of health have
a knowledge of the fundamental scientific facts and an under-
standing of the local health problems involved. She should
also be able to guide the student in experiences that stimulate
his interest in the problems, develop a scientific attitude in
dealing with the situations, acquire initiative and indep-end-
ence in drawing his own conclusions, and retain a desirable
50 FLORIDA'S SCHOOL HEALTH PROGRAM
attitude concerning his personal responsibility for the solu-
tion of each health problem-personal, school, home, commu-
1. Personal Hygiene-Medical and health examination records are
one index to personal needs
a. Attractive Personal Appearance
(1) Care of the body (cleanliness and beauty); clothes-com-
fort, beauty, appropriateness, style, seasonal variations;
skin-complexion (acne), cosmetics; hair-care, health, be-
comingness; nails-cleaniliness, manicuring; teeth-dental
hygiene, corrections, care; posture and feet-defects, cause,
prevention, shoes; perspiration and body odors-remedy.
(2) Hygiene of the eyes, ears, nose, mouth
(3) Other health habits: food selection-overweight and un-
derweight; enjoying sunshine and fresh air-sunburn
dangers; sleep, rest, relaxation, recreation; bathing-
change of clothing after exercise; elimination of wastes;
temperance-in exercise, in eating, in drinking, in emo-
tional stimulation; avoiding the use of tobacco, alcohol,
b. Heredity and Eugenics
c. Relation of Industry and Occupations to Personal Health
d. Responsibility of Individuals for the Health of Others: use
of handkerchief to prevent spread of infection; avoiding con-
tacts that spread diseases; isolation and immunization; im-
proving home, school and community conditions for personal
a. Food: sources; habits of people in other lands; food values-
vitamins, calories, other properties; diets and menus for dif-
ferent ages and ,occupations; fads and fallacies in food fan.
cies; propaganda-relative costs and actual values; selection
and purchase of foods--seasonal variations; preparation of
foods for various occasions-picnics, parties, daily meals;
preservation-storage, handling, shipping, prevention of con-
tamination and spoiling of foods; legal protection-Pure Food
and Drug Acts, Government inspection of meat, milk, fruits,
b.. Relations of Foods to Human Energy: digestion and assimi-
lation; quality of foods and energy values
FLORIDA'S SCHOOL HEALTH PROGRAM 51
c. Food Deficiency Diseases: pellagra, scurvy, beri-beri, rickets
a. History: United States and other countries, customs-styles
b. Adequacy, appropriateness and comfort for various seasons,
activities, and social occasions
c. Beauty and becomingness, design in construction of clothes
as influencing mental and emotional health
4. Stimulants and Narcotics
a. Nature and effects: alcohol-percent in beverages; tobacco-
cigarettes, cigars, pipes, chewing, snuff; tea and coffee;
drugs-cocaine, opium, morphine, heroin, hasheesh
b. Propaganda: fraudulent and exaggerated claims made for
beverages, for tobacco
c. Economic consideration of such habits
5. Sleep and Rest
a. Modern life: strains, tensions, nervous breakdowns
b. Value of rest and relaxation
c. How to relax
d. Importance of sleep to health, variations in needs of the chil-
dren on different age levels
e. Leisure and relaxation-recreation suited to individual's needs
for mental or physical rest
6. Exercise and Play
a. Relation to proper development of body's structure and func-
b. Daily needs-amount and type of activities for different indi-
c. Activities for physically handicapped children
d. Equalization in competition, a factor in health
e. Dangers of excessive competition in athletics-"burning up"
athletes and play for play's sake, minimized victory and
f. Recreational facilities in the community-adequate, safe, sani-
tary, control, value in the community
52 FLORIDA'S SCHOOL HEALTH PROGRAM
7. Mental Hygiene
a. Personal Problems
(1) Need for developing such qualities as self assurance, in-
dependence, leadership and fellowship, ability to suc-
cessfully assume responsibilities to accomplish something
satisfying to self-ability to face reality, a sense of pro-
portion, honesty, frankness, a sense of humor
(2) Feeling of security: economic security-how to make a
living; budgeting allowance, choosing a healthful voca-
tion, keeping normally safe and well; leisure for con-
(3) Development of a satisfactory philosophy of life
(4) Self control: redirection of destructive emotions-worry,
fear, hate, jealousy
_-(5) Developing constructive emotions: cheerfulness, courage,
love, sympathy and tolerance
'46) Stimulation and satisfaction of curiosity: exploring new
ideas and fields of knowledge
(7) Hobbies: satisfying desire to collect and to acquire, also
to construct things with the hands
(8) Improving aesthetic appreciations: beauty in creative
arts, music (singing and playing) and their contribu-
tions to mental and emotional health
b. Social Problems-relation of individual to the group
(1) Widen responsibilities, interests and experiences in the
(2) Healthful living in the home-improving family relation-
(3) Personal friendship and neighborliness
(4) Constructive channels for "hero worship"
(5) Satisfactory relations with opposite sex and with those
of same age and sex
(6) Selecting one's mate
(7) Social ethics, and special etiquette in dating and danc-
(8) Joy in play, work and rest
FLORIDA'S SCHOOL HEALTH PROGRAM
8. Body Structure and Function
a. Building healthful, useful bodies: growth and development-
different characteristics on each age level; individual and
b. The body's processes-their inter-relations and their inter-
dependence-the body as a whole and its important life func-
tions: skeletal system; muscles; nerves; circulation; respi-
ration; digestion; special senses-eyes, ears, nose, mouth;
endocrine system; excretory system; heat regulation in the
body; reproductive system; the voice-structure of organs,
use of voice
c. Body mechanics-laws of equilibrium, force, momentum, lev-
erage, chemical processes in digestion and metabolism and
muscle activity; posture-cause and remedies of defects; care
of the feet-causes and remedies of defects
d. Handicaps to normal functions: inherited defects; prenatal
deformities; acquired handicaps-disease (pathogenic and aller-
gic), accidents, drugs and alcohol
e. The hygiene and care of the body-its structure and function
9. Social Relationship in Health
a. Historical: man's progress in health care through the ages;
history of preventive medicine
b. Individual's responsibility for improving health in the home
and family relations: the family physician and dentists;
family health; child welfare and maternal care; home nurs-
c. School and community health: local health service-nature
and cost; hospitals and clinics; special problems in town and
in rural areas; inter-relationship for organized groups
d. State and National health services: agencies-governmental
service; private services-The American Junior Red Cross,
the Tuberculosis and Health Association, laws for improving
e. Vital statistics as guides to health instruction
10. Environmental Sanitation
a. The relation of science to progress in sanitation
b. Effects of environment on individual's health-physical, men-
54 FLORIDA'S SCHOOL HEALTH PROGRAM
c. Home, school and community problems; water supply quality,
source, use, protection from pollution; food supply-milk, pas-
teurization, meats and their sources and care; fruits and
their preservation; food adulterations and poisoning; storage
preservation, transportation, contamination; drainage; dis-
posal of wastes-sewage, pit privies, garbage; insect and ani-
mal control-flies, mosquitoes, roaches, rats, rabbits, dogs,
cows; diseases carried by humans-typhoid, malaria, typhus,
undulant fever, tularemia, rabies; public eating places, stores,
comfort stations; recreational areas-parks, beaches, pools,
dance halls, picnic grounds, game areas; legal protection
d. Housing-Private and Public
(1) History from cave man to the present day
(2) Types of homes-camps, rural homes, city homes, apart-
(3) Public buildings-libraries, schools, stores, movie thea-
ters, hospitals, recreation halls, government buildings
(4) Factors in health, selection of the site; building needs-
ventilation, lighting, plumbing, heating, fire protection
and other safety measures; interior furnishings-comfort,
beauty, cost and durability, sanitation and upkeep; meth-
ods employed in upkeep-cleaning appliances and methods,
11. Choice and Use of Health Services
a. The family physician
0. Local services-hospitals, druggists, public nurses
c. Voluntary organizations-nature and functions: Tuberculosis
and Health Association: American Red Cross
d. Government agencies-nature ard- functions: city health func-
tions; child care, food and drugs, anitation, preventable dis-
ease, hospitals, clinics, laboratories, records and public health,
water supply, housing, police, education, recreation. State
Board of Health and Local Health Units; National agencies
U. S. Public Health Service (Department of Interior); Bureau
of Education (Department of Interior); Children's Bureau
(Department of Labor); Department of Agriculture; Bureau
of Census (Department of Commerce)
12. Communicable Diseases-nature, cause, control, prevention
a. Bacteria carriers: insects, animals, water, milk, humans
b. Florida's problem: Malaria, hookworm, tuberculosis, pellagra,
FLORIDA'S SCHOOL HEALTH PROGRAM 55
rickets, pneumonia, colds, influenza, typhoid, diphtheria,
scarlet fever, smallpox, whooping cough, mumps, diarrhea,
syphilis, gonorrhea, poliomyelitis, typhus, undulant fever
13. Safety and First Aid
a. Safety in the home
b. Safety in transportation: pedestrians, drivers and vehicles
c. Safety in recreation: playgrounds, athletics, recreation halls,
parks and outing areas, swimming and water safety
d. Safety in the school: pupil certification in first aid and life
saving; teacher certification in first aid and life saving
e. Occupational safety
f. First aid
D. Methods of Instruction
1. There is no one best method for health instruction. Factors
determining methods are:
a. The child-his nature, background, needs, interests
b. The situation-type, location, time limit
c. The specific outcomes desired-habits, knowledge, scientific
2. All methods to be effective must consider:
a. Emphasis upon the positive (joy, beauty, effectiveness of
health) rather than the negative (fear and morbid attitudes
toward ill health)
b. Individual differences in needs, abilities, capacities, interests
c. Cooperation of home and community as essential in the school
health instruction program
d. The importance of example in health teaching
e. Daily vital experience -s in the child's life as the best starting
point for any health unit
f. Practice rather than knowledge stressed-every pupil being
given opportunity to contribute something in the health unit
g. Suggested pupil activities:
(1) Surveys: community health histories; prevailing condi-
tions in school and community
(2) Campaigns: dissemination of information-posture, clean-
(3) Reading: scientific facts as background in problem solv-
FLORIDA'S SCHOOL HEALTH PROGRAM
(4) Writing and speaking: outline of procedures of problem
solving; reports of findings; articles for publicity;
themes; short talks before the public
(5) Committee work: examining and trying to solve existing
problems in health
(6) Conferences: study of health problems-with school faculty
and other children, with specialists (doctors, health of-
ficers, nurses), with community leaders (civic, industrial,
(7) Discussions: class; round table; panel
(8) Recreational activities: school and community-recess and
athletics, hikes, picnics, cther outings and excursions,
parties and special celebrations, sports days, study of
public amusement (nature, control, adequacy)
(9) Dramatization: plays, pageants
(10) The school lunch room activities
(11) The school health examination and other health services
(12) Handicrafts: scrap books, slides, posters, bulletins, graphs
(13) Community service: Junicr Safety Patrol; Junior Red
Cross (First aid, life saving, and home and farm acci-
3. Typical methods of instruction
a. Indirect teaching as found mostly on the primary school level
b. Direct instruction for imparting knowledge
c. Problem method of health instruction and integration.
The approach: On each grade level through the elementary
and secondary schools the approach is through the vital ex-
periences of the child. The content of the instruction is based
on the child's background of knowledge and capacities, and
proceeds from his immediate needs and interests. Great care
should be taken to relate closely instruction to all experiences
whether they occur in the home or at school. In each lesson
every child should be given some opportunity to contribute
according to his individual abilities. While some basic prob-
lems may occur on several grade levels, each unit will be dis-
tinctly different since the groups dealing with the problem
vary in background, interests and needs. For example, the
primary child's problems in food habits differs greatly from
the study of nutrition in the last year of high school.
References: Pupil references found in parentheses under each
problem on the elementary level refer to the bibliography in
the section on Teaching Aids.
(1) Primary Grades--Grades 1, 2, 3
(a) Health problems which arise whbn getting ready for
FLORIDA'S SCHOOL HEALTH PROGRAM 57
Rising in time to attend to all duties
Cleanliness-body, clothes, hair. nails, teeth
Well-being-free from signs of colds, or general dis-
Pupil references: 1, 5, 6, 7, 8, 10, 11, 12,
18, 19, 25, 26, 27, 37, 39, 43
(b) Health problems which arise when going to school:
Safety practices as a passenger in automobile, bus,
Safety in walking to and from school
Self-direction in using time before going into school-
Pupil references: 1, 5, 6, 7, 8, 10, 11, 12,
13, 17, 18, 19, 25, 26, 31, 39, 43
(c) Health problems which arise while living in the
Safety in using tools
Healthy emotions-happiness, takes responsibility,
bears disappointment bravely, self-confidence, friend-
ly attitude, shares tools and materials
Protection-eyes, ears, nose, posture, colds and other
Putting things in mouth-thumb, nail biting, pencils
Pupil references: 5, 6, 7, 8, 10, 11, 12, 13,
16, 17, 18, 20, 25, 26, 27, 31, 32, 39, 43
(d) Health problems which arise during the recess period
Mid morning lunch-between meals foods, no sharing
Use of drinking fountains
Play, exercise and fresh air
Safety in playing areas
Pupil references: 1, 5, 6, 7, 8, 10, 11, 12,
13, 16, 17, 18, 20, 25, 26, 27, 31, 32, 39, 43
(e) Health problems which arise during the noon hour:
Lunch room problems
Choice of foods
58 FLORIDA'S SCHOOL HEALTH PROGRAM
Pupil references: 5, 6, 7, 8, 10, 11, 12, 13,
17, 18, 19, 20, 25, 26, 27, 32, 37, 39, 43
(f) Health problems which arise during after school
Safety at home-indoors and out-of-doors
Temperance and strenuous exercise
Pupil references: 1, 5, 6, 7, 8, 10, 11, 12,
13, 16, 17, 18, 20, 25, 26, 27, 31, 32, 43
(g) Health problems which arise when getting ready
Hour of retiring
Routine duties in making ready for bed
Pupil references: 1, 1, 7, 8, 10, 11, 16, 19,
21, 26, 43
(2) Intermediate Grades-Grade 4
(a) The problem of growth
Food, rest and exercise
Self-direction in guarding weight
Growth and heredity
Tobacco and drugs
Pupil references: 2, 14, 16, 20, 21, 27, 28, 33
(b) The problem of health practices and why they are
Refer to habits listed on the primary level. As these
problems occur give more detailed information as to
why these habits are desirable. Make use of basic
scientific facts for source material. Develop favor-
able attitudes toward healthful living.
Pupil references: 2, 8, 14, 21, 28, 33, 38, 40
(c) Problems which deal with the individual's responsi-
bility to the home, school and community; Quaran-
tine and immunization
Safety-home, school, alcohol as one cause of acci-
dents, recklessness and foolhardiness, bicycle safe-
ty, hitchhiking, picnicking, first aid
Keeping community attractive and clean
Pupil references: 2, 3, 14, 20, 21, 22, 28,
33, 38, 40, 43,
(3) Intermediatd Grades-Grade 5
FLORIDA'S SCHOOL HEALTH PROGRAM 59
(a) Problems which deal with growing up
Things that help you grow: food, exercise, sunshine,
sleep, cleanliness, elimination of body wastes, good
habits of living
Things that interfere with growth: lack of proper
foods, alcohol, tobacco, chronic sources of infection,
accidents and disease
Pupil references: 3, 9, 11, 21, 29, 30, 34, 41
(b) Problems which deal with the child's responsibility
for his own health
Care of the body
Prevention of disease
Knowledge of how germs are spread and ways of
preventing their spread
Avoidance of personal injury: care of eyes, ears, nose
Avoidance of habit-forming substances
Pupil references: 3, 8, 9, 15, 21, 22, 23, 29, 34, 38
(c) Problems which deal with personal appearance
Care of clothing
Selection of clothing
Happy, friendly attitude
Pupil references: 3, 15, 21, 29, 34, 41
(4) Intermediate Grades-Grade 6
(a) Problems which arise with the desire to belong to
and receive recognition in a group
Strong bodies for work and play: food and the power
to work and play; elimination, skin, lungs, kidneys,
intestines; development of good muscle tone, exer-
cise and the circulatory system; exercise and the
respiratory system; exercise and digestion; exercise
and clothing; temperance in c& 'rcises; effects of to-
bacco and alcohol on resistant,, to disease; protec-
tion of eyes and ears in work and play; safety and
first aid in work and play.
Personal appearance: nails, hair, teeth, eyes, posture,
Pupil references: 4, 9, 15, 23, 24, 30, 41
(b) The problems of health and comfort indoors
Regulation of body temperature
60 FLORIDA'S SCHOOL HEALTH PROGRAM
Misconceptions regarding alcohol and body heat
Freedom from pests-insects and animals
Pupil references: 4, 9, 15, 21, 22, 24, 30, 41
(c) Problems which arise in self-direction of daily ac-
Wise choice of foods-menu planning
Preservation of foods
Recreation for family and self
Distribution of home responsibilities
Prevention of communicable diseases and other ill-
Pupil references: 4, 9, 15, 21, 23, 24, 30, 35, 41
(d) Problems which arise in working with others in the
home, in the school, in the community
Healthful home conditions-prevention of accidents
Healthful school conditions-prevention of accidents
Healthful community conditions: ways of safeguard-
ing food and water supply; disposal of wastes; con-
trol of insects, animals and human carriers of disease
Pupil references: 4, 9, 15, 23, 24, 30, 41, 43
(e) Probldms which arise pertaining to outings and ex-
Picnic menu planning and food protection
Safe water supply
Safety in "adventuring"
Water safety and life saving
Safe camping and picnic grounds
Safety in travel-motor, bicycle, on foot
Pupil references: 4, 9, 15, 22, 35, 43
(5) Junior High School Problems
(a) Adjusting to the school situation
Self-direction in selecting courses, in joining organi-
Developing new interests
Understanding the school purposes
Learning to study: methods of study; getirg
time; evaluating what is real (truth and propaganda)
Pupil Reference: 43
(b) Growing into adolescence
FLORIDA'S SCHOOL HEALTH PROGRAM 61
Mental, emotional, physical adjustments
Caring for personal appearance
Acquiring habits and skills essential to success in
(c) Personality development
Choosing and making friends of own sex and of op-
Personal assets and liabilities
Mental and emotional control
Happy social relationships: courtesy in dating,
Importance of health habits: food, rest, exercise and
(d) Living healthfully (including safety and first aid)
In the home-family relationships
In the school-living healthfully
In the community-civic and social health and safe-
ty, choice of health service
Pupil Reference: 43
(e) Choosing a vocation
Requirements of desired vocations
Pupil Reference: 43
(f) Enjoying avocations
Recognizing needs for leisure activities
Abilities and limitations in recreational activities
(g) Problems of a consumer
Determining one's needs
(h) Keeping health-self and others
Protecting others from contagion
Maintaining mental health
Abstaining from harmful drugs and narcotics-to-
bacco, alcohol, marihuana
Pupil Reference: 43
(6) Senior High School Problems
(a) Preparing for a vocation
Gaining apprentice experiences
Fitting oneself for the position
Fapil Reference: 1
(b) Making a home
Choosing a mate
Making needed adjustments-personal, economic, re-
62 FLORIDA'S SCHOOL HEALTH PROGRAM
Budgets and finances-food, clothing, shelter, recrea-
Building or renting
Essential-comforts and conveniences
Beauty and art in the home
Family life-rearing children
Recreation and leisure in the home
(c) Community Responsibilities
Social relations for health-Public Welfare, Public
Safety and first aid
Pupil Reference: 1
(d) Living in Florida-special Florida health problems
Climate-health and disease
Natural resources for health
Health factors in tourist trade
Special health problems existing in Florida (See
Part I, Section D)
Water safety and life saving
Pupil Reference: 1
(e) Living in a democracy
Self-respect-gained through independent thinking,
self-direction, constructive leisure, satisfactory home
and community relations
Private rights and public authority-the individual's
responsibilities for the' group (and vice versa in
Democratic methods of dealing with health problems
Pupil Reference: 1
4. The teacher's part in employing successful methods for health
a. As organizer
(1) Planning class activities
(2) Delegating responsibilities on the basis of a thorough
knowledge of the child's capacities and interests
(3) Motivating interests-special programs
(4) Utilizing all community resources
(5) Securing home, school and community cooperation
Teacher Reference: 1
b. As guide
(1) Counselling and supervising pupils in their activities for
the health units
FLORIDA'S SCHOOL HEALTH PROGRAM 63
(2) Leading pupils into self-direction and independent think-
(3) Supplying helpful source materials: texts; reference
for pupils findings; moving pictures and stories; radio
programs; steroptican slides
(4) Testing and evaluating results of pupil experiences as
a means of improving health instruction
Teacher Reference: 1
c. As coordinator
(1) Being familiar with health units given by other teachers
(2) Recognizing omissions in the child's health experiences
(3) Focusing all child experiences upon improving his health
(4) Keeping each member of the school informed as to all
health teaching being given the children
Teacher Reference: 1
d. As first aider-Red Cross Certification
Teacher Reference: 1
E. Teaching Aids. In all grades the teacher will find it help-
ful to secure recent materials, such as text books, health read-
ers, and visual aids. Some of the sources of these are indicated
in Part VII. In planning for the adoption of state textbooks
the course of study committee should strive to get as broad a
distribution of materials as possible. Operating under the
present law, this means that there should be a different text
for each grade in the school.
In grades one through three adoption should be of the
reader or story type of book. In grades four through six com-
bination stories and subject matter books are desirable. In
the upper six grades an attempt should be made to secure
books providing a wide range of source materials. It should
be possible for the student in any one grade to have access to
the books adopted for all grades. The teacher will probably
wish to make references to all books.
(Part VII gives a list of sources of aids and materials for
health. Aids listed below are of special value for health in-
struction in the different age levels.)
1. Elementary School Source Material
a. Pupil references
(1) Burkard, William E.; Chambers, Raymond L.; Maroney, Fre-
drick W.: Health Stories and Practices, Lyons and Carnahan,
N. Y., 1936.
64 FLORIDA'S SCHOOL HEALTH PROGRAM
(2) Burkard, William E.; Chambers, Raymond L.; Maroney,
Frederick W.: Health By Doing, Lyons and Carnahan, N. Y.,
(3) Burkard, William E.; Chambers, Raymond L.; Maroney,
Frederick W.: Building for Health, Lyons and Carnahan.
N. Y., 1936.
(4) Burkard, William E.; Chambers, Raymond L.; Maroney,
Frederick W.: The Body and Health. Lyons and Carnahan,
N. Y. 1936
(5) Towse, Anna B.; Gray, William S.: Health Stories. Bk. 1
Scott, Foresman and Co., N. Y. 1939
(6) Towse, Anna B.; Matthews, Florence E.; Gray, William S.:
Health Stories. Bk. J. Scott Forseman and Co., N. Y., 1935.
(7) Towse, Anna B.; Matthews, Florence E.; Gray, William S.:
Health Stories, Bk. 3. Scott Forseman, and Co., N. Y. 1935
(8) Charters, W. W.; Smiley, Dean F.; Strang, Ruth M.: Keeping
Healthy. The MacMillan Co., 1935
(9) Charters, W. W.; Smiley, Dean F.; Strang Ruth M.: The
Body's Needs. The MacMillan Co.. 1939
(10) Charters, W. W.; Smiley, Dean F.; Strang, Ruth M.: From
Morning Till Night. The MacMillan Co., 1936
(11) Charters, W. W.; Smiley, Dean F.; Strang, Ruth M.: Happy
Days. The MacMillan Co., 1936
(12) Andress, J. Mace; Goldberger, I. H.; Dolch, Marguerite P.:
Growing Big and Strong. Ginn and Co., N. Y. 1939
(13) Wood, Thomas D.; Phelan, Annette M.; Lerringo, Marion 0.:
Now We Are Growing. Thomas Nelson and Sons, 1939
(14) Wood, Thomas D.; Phelan, Annette M.; Lerrigo, Marion 0.:
Many Ways of Living. Thomas Nelson and Sons, 1937
(15) Wood, Thomas D.; Phelan, Annette M.; Lerrigo, Marion;
Lamkin, Nina B.; Rice, Thurman B.: Keeping Fit. Thomas
Nelson and Sons, 1935.
(16) Hahn, Mary L., Let's Grow. Charles E. Merrill Co., N. Y.
(17) Whaley, Dorothy Nell, and Knudson, Charles W.: The Land of
Happy Days. Doubleday, Doran and Co., Inc. N. Y. 1938
(18) Whaley, Dorothy Nell and Knudsen, Charles W.: A Holiday
With Betty And Jack. Doubleday, Doran and Co., Inc. N. Y.
(19) Brownell, Clifford Lee; Ireland, Allen Gilbert; Siegl, May
Hollis: Friendly Living. Rand McNally and Co., N. Y. 1937
(20) Brownell, Clifford Lee; Ireland, Allen Gilbert; Siegl, May
Hollis: Happy Living. Rand McNally and Co., N. Y. 1937
(21) Brownell, Clifford Lee; Ireland, Allen Gilbert; Biles, Helen
Fisher: Everyday Living. Rand McNally and Co., N. Y. 1935.
(22) Brownell, Clifford Lee; Ireland, Allen Gilbert; Biles, Helen
FLORIDA'S SCHOOL HEALTH PROGRAM 65-
Fisher: Helpful Living. Rand McNally and Co., N. Y. 193&5
(23) Brownell, Clifford Lee; Ireland, Allen Gilbert; Towne, Char-
les Franklin: Science in Living. Rand McNally and Co., N.
(24) Brownell, Clifford Lee; Ireland, Allen Gilbert; Towne, Charles
Franklin: Progress in Living. Rand McNally & Co., N. Y.
(25) Andress, J. Mace; Goldberger, I. H.; Dolch, Marguerite P.:
Spick and Span. Ginn and Co., N. Y. 1939
(26) Andress, J. Mace; Goldberger, I. H.; Dolch, Marguerite P~-
The Health Parade. Ginn and Co., N. Y. 1939
(27) Andress, J. Mace; Goldberger, I. H.; Dolch, Marguerite P.;
Growing Big and Strong. Ginn and Co., N. Y. 1939
(28) Andress, J. Mace; Goldberger, I. H.; Jenkins, Elizabeth B.:
Safety Every Day. Ginn and Co., N. Y. 1939
(29) Andress, J. Mace, Goldberger, I. H.; Hallock, Grace T.: Doing
Your Best For Health. Ginn and Co., 1939
(30) Andress. J. Mace; Goldberger I. H.; Hallock, Grace T.: Build-
ing Good Health. Ginn and Co., N. Y. 1939
(31) Buckley, Horace Mann; White, Margaret L.; Adams, Alice B.;
Silvernale, Leslie R.: In Storm and Sunshine. American
Book Co., N. Y. 1938
(32) Buckley, Horace Mann; White, Margaret L.; Adams, Alice B.;
Silvernale, Leslie R.: Happy Times. American Book Co., N.
(33) Buckley, Horace Mann; White, Margaret L.; Adams, Alice B.;
Silvernale, Leslie R.: Here and There. American Book Co.,
N. Y. 1938
(34) Buckley, Horace Mann; White, Margaret L.; Adams, Alice B.;
Silvernale, Leslie R.: In Town and Country. American Book-
Co., N. Y. 1938
(35) Buckley, Horace Mann; White), Margaret L.; Adams, Alice B;-
Silvernale, Leslie R.: Around the Year. American Book Co.,
N. Y. 1938
(36) Frasier, George Willard, and Dolman, Helen: Sunshine and
Rain. The L. W. Singer Co., Chicago, 1938
(37) Bryce, Catherine: The Safe-Way Club. Thomas Nelson and-
Sons, N. Y. 1938
(38) Frasier, George Willard; Dolman, Helen; Van Noy, Kathryne&
Through the Year. The L. W. Singer Co., Chicago, 1937
(39) Fowlkes, John Guy; Jackson, Lora Z.; Jackson, Arnold S.:
Healthy Bodies. John C. Winston Co., Phila. 1936
A6 FLORIDA'S SCHOOL HEALTH PROGRAM
(40) Fowlkes, John Guy; Jackson, Lora Z.; Jackson, Arnold S.:
Healthy Growing. John C. Winston Co., Phila. 1930.
(41) Fowlkes, John Guy; Jackson, Lora Z.; Jackson, Arnold S.:
Keeping Well. John C. Winston Co., Phila. 1936
(42) Fowlkes, John Guy; Jackson, Lora Z.; Jackson, Arnold S.:
Healthy Living. John C. Winston Co., Phila., 1913.
'43) The Junior Red Cross News and The American Junior Red
Cross Program of Activities; Washington, D. C.
2. Secondary School Source Material
a. For pupil references-books and pamphlets.
(1) The Junior Red Cross Journal, Washington, D. C.
(2) Andress, Aldinger and Goldberger-Health Essentials. At-
lanta, Ginn and Co., 1928.
4(3) Andress and Brown: Science and the Way to Health. Atlanta,
Ginn and Co., 1929.
(4) Andress and Evans: Health and Good Citizenship. rev. ed.
Ginn and Co., 1933.
(5) Andress and Goldberger: Broadcasting Health._ Ginn and Co.,
(6) Bauer, W. W.: Health Questions Answered, 2nd. Bobbs-Mer-
rill Co., 1934.
(7) Bauer, W. W.: Health Questions Answered, 2nd. Bobbs-Mer-
rill Co., 1937
,(8) Bauer, W. W. and Teschner, P. A.: Your Health. Pupil's
Workbook and Guide. Johnson Pub. Co., Atlanta, 1937, 1938.
(9) Bridges, M. A.: Food and Beverage Analysis. Lea and Febi-
ger, Phila. 1935.
(10) Broadhurst, Jean: Health Horizons._ Silver Burdett and Co.,
N. Y. 1931
,(11) Brownell, Ireland and Towne: Progress in Living. Rand Mc-
((12) Burkard, Chambers, and.Maroney: Personal and Public Health.
Lyons and Carnahan, Atlanta.
((13) Burkard, Chambers and Maroney: Health and Human Welfare
Lyons and Carnahan, Atlanta, 1937.
'(14) Charters, Smiley and Strang: Adventures in Health. MacMil-
lan Co., N. Y. 1938.
(15) Charters. Smiley and Strang: Health Through Science. The
MacMillan Co. 1936.
'(16) Clendening, Logan: Behind the Doctor. Alfred A. Knopf, N.
(17) Clendening. Logan: The Human Body. Alfred A. Knopf, N. Y.
(18) Cobb, W. F.: Health for Body and Mind. D. Appleton-Cen-
FLORIDA'S SCHOOL HEALTH PROGRAM 67
tury Co., N. Y. 1936.
(19) Cockefair, E. A. and Cockefair, A. M.: Health and Achievement.
Ginn and Co.. Atlanta, 1936.
(20) Committee on the function of Science in General Education,
Science in General Education. D. Appleton Century Co., N. Y.
(21) Crisp, Katherine B.: Be Healthy. J. B. Lippincott Company,
(22) Crisp, Katherine B.: Growing Into Maturity (Contains infor-
mation for sex education). J. P. Lippincott Company, Phila-
(23) DeKruif, Paul: Microbe Hunters. (Dollar Edition) Harcourt,
Brace and Co., N. Y.
(24) DeKruif, Paul: Hunger Fighters. (Dollar Edition) Harcourt,
Brace and Co., N. Y.
(25) DeKruif, Paul: Man Against Death. (Dollar Edition) Harcourt,
Brace and Co., N. Y.
(26) Emerson, C. P.; and Bethel, G. H.: Living at Our Best. Book
II. Bobbs-Merrill Co., 1934.
,(27) Fishbein, Morris: Shattering Health Superstitions. Liveright
Pub. Corp., N. Y. 1930.
(28) Fitzgerald, J. A.; Hoffman, C. A.; Bayson, J. R.: Drive and
Live. Johnson Pub. Co., Richmond, Va., 1937.
(29) Gregg, F. M.; and Rowell, H. F.: Health Studies. World Book
Co., N. Y. 1932. (A series of books.)
(30) Hanna, Paul, and Research Staff: Youth Serves the Commun-
ity. D. Appleton Century Co., N. Y. 1936.
(31) Harkness and Fort: Youth Studies Alcohol. Benjamin H.
Sanborn Co., N. Y., 1937.
(32) Holt, L. E.: Care and Feeding of Children. D. Appleton-Cen-
tury Co., N. Y. 1934.
*,(33) Lyman and Hill: Literature and Living, Book I. Scribner and
(34) Pardee, H. E.: What You Should Know About Heart Disease.
Lea and Febiger, Phila., 1935.
(35) Saver, Louis: Nursery Guide. C. V. Mosby Co., St. Louis,
(36) Smiley, D. F.; and Gould, A. G.: Community Health. The
MacMillan Co., N. Y., 1935.
(37) Strain, Francis B.: Being Born. D. Appleton-Century Co., N.
(38) Tobey, J. A.: Cancer: What Everyone Should Know About It.
Alfred A. Knofp, N. Y. 1932.
(39) Turner, C. E.: Personal and Community Health. C. V. Mosby,
St. Louis, Mo.
(40) Turner, C. E.: Physiology and Health. C. V. Mosby Co.,
St. Louis, Mo.
68 FLORIDA'S SCHOOL HEALTH PROGRAM
(41) Turner and Collins: Community Health. D. C. Heath and Co.,
(42) Wheat, F. M.: and Fitzpatrick. E. T.: Everyday Problems in
Health. Atlanta, American Book Co., 1935
(43) Woods, Hutchinson: The New Handbook of Health. Houghton-
b. For Teacher References
(1) American National Red Cross: Life Saving and Water Safety,
Swimming and Diving, Home Hygiene and Care of the Sick:
First Aid: P. Blakiston's Son and Co., Inc., Philadelphia, 1937.
(2) American Public Health Association (1939 Survey) The Health
Situation in Florida. State Board of Health. Jacksonville, Flor-
(3) Bauer, W. W.: Health, Hygiene and Hooey. Bobs-Merrill Co.,
(4) Bauer, W. W. and Hull, T. G.: Health Education of the Public.
W. B. Saunders Co., Philadelphia, 1937.
(5) Chadwick, Mary: Adolescent Girlhood. The John Day Co.,
N. Y. 1938.
(6) Chenoweth and Selkirk: School Health Problems. F. S. Crofts
and Co., 1937.
(7) Conrad, H. L. and Mcister, J. F.: Teaching Procedures in H/ealth
Education. W. B. Saunders Co., Philadelphia. 1938.
(8) Diehl, H. S. and Shepard, C. E.: The Hjealth of the College Stu-
dents. American Council on Education, Washington, D. C.
(9) Donnelly, G. L.: Alcohol and the Habit Forming Drugs. N. C.,
Alfred Williams and Co., 1936.
(10) Deaver, G. G.: Fundamentals of Physical Examination. Phila-
delphia, W. B. Saunders Company, 1939.
(11) Dull, Charles E.: Safety First and Last. Henry Holt and Co.,
N. Y. 1938.
(12) Education Policies Commission: Social Services and the Schools
Washington, D. C., N. E. A., 1939.
(13) Ehlers, V. M. and Steel, E. W.: Municipal and Rural Sanitation.
McGraw-Hill Book Company, 1937.
(14) Floherty, J. J.: Youth at the Wheel. J. B. Lippincott Co. Phil-
(15) Lippitt, L. C.:Hygiene and Home Nursing. World Book Com-
pany, New York, 1934.
FLORIDA'S SCHOOL HEALTH PROGRAM 69
(16) Lloyd, Deaver and Eastwood: Safety in Athletics. W. B. Saun-
ders Company, Philadelphia. 1938.
(17) Logie, Arthur J.: Tuberculosis Survey in Florida. State Board
of Health Jacksonville, Florida. 1939. Reprinted from The
American Review of Tuberculosis.
(18) Mustard, H. S.: Rural Health Practice. Commonwealth Fund.
(19) Nash, J. B.: Teachable Moments. A. S. Barnes and Company,
New York. 1938.
(20) Spaulding, F. T.: High School and Life. The Regents Inquiry,
McGraw-Hill Co., New York. 1938.
(21) Strain, Frances B.: New Patterns in Sex Teaching. The Normal
Sex Interests Of Children and Their Guidance from Infancy
to Adolescence. D. Appleton-Century Company, New York. 1932.
(22) Thorn, Douglas A.: Normal Youth and its Everyday Prob-
lems. D. Appleton-Century Company, New York. 1932.
(23) Turner, C. E.: Principles of Health Education. D. C. Heath
Co., Atlanta. Revised. 1938.
(24) Whitney, Albert W.: Man and the Motor Car. National Con-
servation Bureau, New York. 1937.
(25) Williams, F. E.: Adolescence. Farrar and Rinehart, Inc., New
(26) Williams, J. F.: Healthful Living. Revised. The MacMillan Co.,
(27) Williams, F. F. and Shaw, F. B.: Methods and Materials of
Health Education. Thomas Nelson and Sons, New York, 1938.
(28) Winslow, C. E. Q.: The School Health Program. The Regents
Inquiry. McGraw-Hill Book Co., New York. 1938.
(29) Wood and Lorrigo: Health Behavior. Public School Publish-
ing Co. Bloomington, Illinois. 1928.
Note: Pamphlets, charts, slides, moving pictures and other aids are
available from sources listed in Part VII.
F. Contributions of Other Teachers and Subjects
Health is a responsibility of every member of the school
system. Instruction in each subject matter area should be given
by that teacher best equipped to deal with the problems invol-
ved. Artificial correlations should never be made with any sub-
ject. The following suggestions are given as indications of some
health areas best treated in other subjects. It is essential that
the health instructor be familiar with the treatment given each
health problem by other teachers so that he may (1) not overlap
but coordinate, (2) prevent omissions of important topics, (3)
70 FLORIDA'S SCHOOL HEALTH PROGRAM
provide for those students who do not elect the subjects in
which certain health problems are studied.
a. Relation of plants to human welfare
b. Animals and human health
c. Soil in relation to health
d. Safety on the farm
2. Arts and Handicrafts
a. Beauty and its relations to emotional health
b. The creative factor in mental health hobbies for health
c. Special contributions to health units: making posters, pup-
pets, charts, pictorial graphs
3. Biological Sciences-biology, physiology, zoology, bacteriology
a. Insects' relation to human health
b. Animals and health of man
c. Animal's behavior and man's
d. Bacteria-friends and foes to health
e. Control of pathogenic organisms
The human body as a whole-the interdependence and interre-
relations of its parts. (This involves anatomy and phys-
iology as related to the health of the organism.)
g. Special health problems-scientific facts known:
(1) Effects of alcohol and narcotics on body structure, on
(2) Relation of rest, exercise, emotional status, diet, to body
structure and function
(3) Heredity and eugenics in health
4 h. Pseudo-science-superstitions, fallacies and misconceptions re-
i. The scientific attitude
4. English-literature, composition, and dramatics
a. Readers in health for children of each grade level (See bib-
liography under Teaching Aids)
5. Library readings dealing with health
a. Plays, pageants, and dramatics involving human experien-
ces in the field of health
b. Composition-written and spoken.
(1) Reports of findings in the study of health problems
(2) Articles for publication in school or local paper
(3) Talks on health topics-classroom, assembly, parent-
6. Home Economics
a. Nutrition-all phases relating to health
FLORIDA'S SCHOOL HEALTH PROGRAM 71
b. Clothing and textiles in relation to health-physical, men-
c. Home and family problems
(1) Family relationships
(2) Building and furnishing the home, also upkeep
(3) Infant and maternal care
d. Community improvement in health-special subjects
(1) Publication of low cost healthful mc-nus
(2) Standards for home making
a. Finances, measurements, proportions
(1) Budgeting: food, clothing, shelter, recreation
(2) Building and furnishings-private and public
(3) Costs of heating-school, home
b. Problems in the economics of-
(1) Farming: Florida's products
(2) Public sanitation
(3) Disease control, medical care
c. Elementary statistics-
(1) Public facts interpreted-health conditions in the coun-
try and in Florida-incidence, range, tabulations, corre-
(2) Treatment of findings in health problems studied-
surveys, vital statistics
(3) Making individual growth charts and graphs showing
7. Physical Education
a. Relation of health to physical skills
b. Mental health and physical education
c. Training for athletics
d. Health examinations safeguarding health
e. Shifting activities to physical limitations
f. Alcohol and narcotics-handicaps to physical achievement
g. Safety and first aid in physical education
h. Activities for constructive leisure-for personal and social
8. Physical Sciences physics, chemistry
a. Energy-mechanical and human in relation to health
b. Problems of lighting and ventilating rooms
c. Body mechanics in health
(1) Laws of equilibrium
72 FLORIDA'S SCHOOL HEALTH PROGRAM
d. The chemistry of foods, digestion, and exercise
(2) Metabolism, muscle activity in health
e. The scientific attitude
9. Social Sciences-civics, geography, history, economics, sociology
a. Problems in public health
(1) Government responsibility for health
(2) Conservation of human resources
(3) The problems of the consumer
(4) Recreation and social problems in health
(5) Standards of living and health
(6) Industrial and occupational health problems
(7) Racial problems in health
(8) Infant mortality
(9) Care of the handicapped
(10) Disease control
(11) Social security and health
(12) Democratic principles in methods of solving public
b. Natural resources in Florida and the United States-health
assets and liabilities
c. Health problems in trade and international intercourse
d. Interdependence of the individual and group in health; de-
pendence ot health upon social organizations and relationships
e. Science and technology and health
f. Personal problems of the individual in society
(1) Social ethics-with same age, sex, opposite sex, with
(2) Etiquette-dating, dancing, eating
(3) Choosing a vocation
(4) Planning for a home
4.. Evaluation of Health Instruction. Evaluation is never an
end in itself but a useful means of improving health in-
1. All procedures are based upon desired outcome3-hence the first
step in evaluating is to state the objectives of health instruc-
Health instruction should:
a. Develop those social impulses that make for successful men-
tal and social health: leadership and fellowship, cooperation,
mass participation, successful assuming of responsibilities,
FLORIDA'S SCHOOL HEALTH PROGRAM 73
initiative, dependability, democratic principles of group behav-
cb. Give all pupils an awareness of health problems-personal
,c. Impart knowledge of scientific facts that give an adequate
understanding of the areas in which health problems occur
d. Stimulate an abiding interest in the solution of health prob-
e. Develop an attitude that insures capable, satisfactory behav-
ior in dealing with all health situations, personal and com-
2. Methods vary for evaluating results of health information accord-
ing to the situation studied. As far as possible these should be
objective, but for certain outcomes there are no objective meth-
ods of evaluating available
The following methods have been found to be useful in evalu-
ating health instruction:
a. Observation and recording of changes in pupil behavior-as
,/evidences of social development, of health awareness, of in-
terests and of attitudes
(1) Brief anecdotal statements of significance
(2) Planned interviews recorded
(3) Questionnaires answered-by pupils, parents, teachers.
(4) Pupils' diaries of reading and other activities
(5) A study of pupils' creative products-
(a) Recorded problem-findings and conclusions
(b) Themes on health topics
(d) Handicrafts in the health field
(e) Time budgets
(f) Growth charts
A(6) A study of pupils' plans for college and for a career
(7) Staff reports on pupils.
(8) Case studies
(9) Pupils' behavior recorded under each objective
b. Tests on knowledge of scientific facts
(1) Gates, Strang Health Knowledge Tests-Forms for each
.grade level (Secu'ed from Teachers College, Columbia,
University, New York City.)
(2) Speer-Smith Tests for grades 3-8 (Secured from the
Acorn Publishing Co., Rockville, L. I., N. Y.)
(3) Wood-Lerrigo Scales of Health Behavior (Wood and
Lerrigo-"Health Behavior," Public School Publishing
Company, Bloomington, Illinois.)
74 FLORIDA'S SCHOOL HEALTH PROGRAM
(4) Dr. E. Benton Salt's Health Information, Test Health
Superstitions-Fallacies and Misconceptions in Health
(Secured from Dr. E. Benton Salt, University of Flor-
ida, Gainesville, Florida.)
(5) Rugen and Forsythe Health Knowledge' Tests for Senior
High Schools (Secured from the University of Mich-
igan, Ann Arbor, Michigan.)
c. Skill tests and growth charts as indices of improved person-
d. Improved environmental conditions as evidences of function-
ing health instruction
H. Source Materials Must Be Developed. The suggestions in-
cluded under Health Instruction will be valuable to the
teacher in clarifying her thinking in regard to the teaching
possibilities in the health field, and the principles established
will help her in understanding what is correct procedure.
It is at once apparent that the teacher must do a great deal
of work in further analyzing the teaching possibilities in the
subject matter areas before a good instructional program is
possible. To assist the teacher with this difficult undertaking,
source materials should be developed in each of the subject
matter areas of the health fields from which selection may be
made to meet special needs.
A publication of the Progressive Education Association
"Science in General Education" gives a plan for the develop-
ment of source units which seems most effective. "Some schools
in attempting a reorganization of the program are finding it
desirable to construct source units which are intended to give
aid to the teacher in becoming oriented in unfamiliar fields
and in the cooperative planning of learning experiences. This
is particularly necessary in situations (1) where a number of
teachers in various areas work together in planning a program
which unifies many hitherto relatively unrelated fields, or
(2) where the material is scattered and consequently difficult
to secure. Such units are not intended to serve directly as
guides to the organization of classroom teaching but rather
as resources upon which the teacher, planning with his pupils,
may draw in providing for suitable learning experiences."2
FLORIDA'S SCHOOL HEALTH PROGRAM 75
In developing these source units the plan suggested for
Florida is the preparation of units related to special health
problems of areas of health subject matter using the following
1. Importance of the problem area
2. Suggested Approaches
3. Suggested Objectives
4. Suggested Activities
5. Suggested Evaluations
6. Suggested Materials
"Science in General Education" further amplifies the idea
of source units. "As the name 'source unit' indicates, this unit
is intended to be used by the teacher purely as a source from
which he may select whatever is appropriate to his purposes,
supplementing the selected materials as he sees fit. What ma-
terials are selected and how they are organized for classroom
use will depend upon the needs and interests of the particular
group of students with whom the teacher is working. He may
draw upon the source unit again in an entirely different way
when dealing with children of another age and background."3
Since many of the problems in the subject matter areas of
health education are of national scope it seems wise to sug-
gest that many of these source units be prepared with the
idea of nationwide use by a group of especially well qualified
individuals. When this is done it will still be necessary for
each state and local community to select from the suggested
sources the ideas pertinent to local conditions. Since such
units do not exist at the present time, Florida should make
some provision for beginning this work and helping teach-
ers to make the most effective use of those source units de-
In order to develop some of these source units and in
order to help teachers in adjusting them to their local situa-
tions a workshop will be conducted at the Florida State Col-
lege for Women during the first summer session of 1940. All
useable materials which are available in the United States will
be assembled and adequate competent leadership will be pro-
76 FLORIDA'S SCHOOL HEALTH PROGRAM
vided to direct the activities of the workshop.
Six hours credit will be allowed for the work. Students who
are in this workshop should not plan to take other courses.
In order that some idea may be obtained of the amount of
facilities and leadership to be provided, those who plan to par-
ticipate should write the Director of Health and Physical Ed-
ucation, Florida State College for Women, Tallahassee, Flor-
ida. All who are interested in working out their programs in
Health Education should attend. Certainly all Health Educa-
tion teachers should attend. Others particularly interested, es-
pecially administrators, will find the Workshop most useful.
Further information pertaining to the details of this workshop
will be given at a later date.
Many graduate students are searching for these prob-
lems. It is highly recommended that some of these students
whose training and ability make them particularly suited for
this work, use as thesis projects the development of source
units in one or more of the subject matter areas of Health
Education. If work of this kind is accumulated and made
available for teacher adaptation and use, the program for
health instruction will necessarily be continuously improved.
1. Joint Report on Suggested School Policies by the American Medical
Association and the National Education Association.
2. Science in the General Curriculum, Commission on Secondary School
Curriculum, Progressive Education Association, D. Appleton Century
Co., N. Y., 1937, p. 450.
3. Ibid., p. 626.
SUGGESTIONS FOR EVALUATING THE
SCHOOL HEALTH EDUCATION
In evaluating the School Health Education Program, it
should be remembered that there are three types of outcomes
to be expected: A. Improvement of Health Status of the Chil-
ren; B. Improvement in the Environment in which the children
live; and C. Educational Outcomes which measure progress in
terms of favorable health practices, attitudes and knowledge re-
lating to personal, community, and racial health.
Evaluation procedures may be of subjective and objective
types. Both are accepted by health authorities. It is helpful to
use some methods of evaluating the program in order that
progress may be measured and to determine emphasis for fur-
ther work. The following brief suggestions are offered:
A. Improvement of Health Status of the Children. (Records
should be protected over a period of years).
1. The number and per cent of children free from physical de-
2. The number and per cent of physical defects corrected during
the school year.
3. The number of immunizations given and per cent of children
immunized during the year.
4. The number of children absent because of illness. The num-
ber of days lost from school because of illness (For analysis
of cause of illness.)
5. Number of children showing satisfactory growth during the
year (As shown by growth charts).
6. Number of children showing improvement in nutritional status
during the year (As determined by physician).
B. Improvement in the Environment in Which Children Live
1. Adjustments made in lighting, heating, ventilation, seating.
2. More adequate toilet, drinking and handwashing facilities
3. Enlarged and improved playgrounds.
78 FLORIDA'S SCHOOL HEALTH PROGRAM
4. Improvements made in lunch room, rest room, and clinic room
5. Adequate first aid facilities furnished.
6. Specific safety precautions takldn.
7. Improved methods of cleaning adopted.
8. The use of safe water and safe milk in the school is insured.
C. Educational Outcomes in Terms of Habits, Attitudes and
Knowledges. It is difficult to measure habits and attitudes. The
subjective method of observation will necessarily have to be
employed here. The observing teacher may unmistakably see
improvement in the health practices and attitudes of his group.
Suggested methods for observing improvement in health hab-
1. Inspection each morning for improvement in personal ap-
2. Occasional observation of health practices in everyday situ-
ations at school, as (1) the number of pupils choosing bal-
anced lunches; (2) the number of pupils observing good sit-
;ing, walking or standing postures; (3) the number of chil-
dren voluntarily washing hands before eating lunches; (4) the
number of pupils removing wraps on arrival at school. Other
similar practices may be observed.
3. Health-habit questionnaires may be used occasionally to de-
termine the health behavior of pupils both at home and
4. Interview may be held with parents to check on cooperation
in health-habit improvement in the home.
5. Questionnaires may also be' sent to parents to ascertain
changes made in health practices.
There are no widely used tests for the evaluation of health
education as it relates to improving attitudes. Some suggest-
1. Improved attitude toward the nurse, doctor, dentist, and the
2. Interest toward and efforts made to correct defects
3. Enthusiasm shown for health education activities
4. Cooperation in maintaining healthful environment in the
FLORIDA'S SCHOOL HEALTH PROGRAM 79
5. Consideration for health of group as shown by willingness
to remain at home when there is danger of spreading disease
6. Interest in public health activities in the community
Health Knowledge may be measured in much the same way
as other school subjects. Standard tests are suggested in the
Health Instruction Section. Objective tests probably serve their
best function when the classroom teacher is able to make them
to meet a specific situation as at the end of a particular unit
SOURCES OF MATERIALS
A. Criteria for Selection of Material
1. Is it scientifically sound?
2. Is it educationally sound in its approach and presen-
3. Is the vocabulary and subject matter wtihin the
range of the child's ability and interest?
4. Does it give a knowledge of the situation that will
bring an understanding of the problems involved?
5. Is it suited to the purpose for which it is used?
6. Is it unbiased-i. e. does it favor or promote one pro-
7. To what degree will it influence the child's behav-
8. What attitudes will be developed through the sub-
9. Does it develop a sense of proportion and an under-
standing of the area in which there is limited knowl-
edge to the extent that overconfidence results?
10. Is arrangement simple, attractive and legible as to
type and paper ?
B. Score List. Each of the organizations listed has helpful
material on health subjects for distribution. Much of it
is free and the remainder may be purchased for a nom-
inal sum. If purchased in quantity the price lowers con-
siderably. The material offered is in the form of bulle-
tins, pamphlets, charts, posters, films and slides. Pos-
ters should be used only as suggestive guides for the ac-
FLORIDA'S SCHOOL HEALTH PROGRAM 81-
tual making of posters by the children.
Teachers are urged to use discretion in allowing chil-
dren to write state and national organizations for materi-
als. The teacher's request or that of the principal or
county superintendent for a specified number of copies
will receive more prompt attention than will a pupil re-
quest. When several children write from one grade to
the same office it is urged that they be instructed to
give the name and address of the teacher so that all
material may be sent in one package to her.
State Department of Education,
Florida State Board of Health
Bay County Health Department
Panama City, Florida
Broward County Health Dept.,
Ft. Lauderdale, Fla.
Duval County Health Department
Escambia County Health Debt.,
Franklin-Gulf County Health Dept.,
Gadsden County Health Dept.,
Highlands County Health Dept.,
Hillsborough County Health Dept.,
Jackson County Health Department
Monroe County Health Dept.,
Key West, Fla.
Orange County Health Department
Pinellas County Health Dept.,
Wakulla County Health Dept.,
Tampa City Health Department
Miami City Health Department
Jacksonville City Health Dept.,
Florida Tuberculosis and Health
Ass'n., Jacksonville, Fla.
State Department of Agriculture
Woman's Field Army for Control
of Cancer, Mrs. J. Ralston Wells,
Chairman, Daytona Beach, Fla.
State Board of Public Welfare
Home Demonstration Service
Florida Safety Council
General Extension Division.
Children's Bureau, U. S. Dept. of
Labor, Washington, D. C.
Bureau of Home Ec., U. S. Dept.
of Agri., Washington, D. C..
FLORIDA'S SCHOOL HEALTH PROGRAM
U. S. Office of Education
Washington, D. C.
U. S. Public Health Service
Washington, D. C.
U. S. Government Printing Office
Washington, D. C.
Consumers Council, U. S. Dept. of
Agriculture, Washington, D. C.
American Medical Ass'n., 535 Dear-
born St., Chicago, Ill.
American Dental Ass'n., 212 E. Su-
perior St., Chicago, Ill.
American National Red Cross
Washington, D. C.
American Public Health Assn., 50
W. 50th St., New York City.
American Social Hygiene Ass'n.
50 W. 50th St., New York City.
American Society for Hard of
Hearing, 1537 35th St., N. W.,
Washington, D. C.
National Committee for Mental
Hygiene, New York City.
National Society for Prevention of
Blindness. 50 W. 50th St., New
American Heart Association and
American Society for Control of
Cancer, 350 Madison Ave., New
Maternity Center Ass'n., 1 E. 57th
St., New York City.
Child'Study Ass'n. of America, 221
W. 57th St., New York City.
National Congress of Parents and
Teachers, Washington, D. C.
. Nat. Com. on Ed. by Radio, 1 Mad-
ison Ave., New York City.
LAWS RELATING TO SCHOOL HEALTH
The following sections from the Florida School Code are
those pertinent to the health of the school child, the teacher,
and other personnel, and the school environment. (Chapter
19355, Acts of Florida, 1939. For complete code see Florida
School Code, Acts of Florida, 1939.)
Chapter I. Section 118.
(18) SCHOOL DAY.-A school day for any group of pupils is
that portion of the day in which school is actually in session
and shall comprise not less than five net hours, and not less
than six hours including intermissions for all grades above the
third; not less than four net hours for the first three grades;
and not less than three net hours in kindergarten and nursery
school grades; Provided that the minimum length of the school
day herein specified may be decreased not to exceed one net
hour under regulations of the State Board.
Chapter IV. Section 422.
It shall be the duty of the County Board, after consider-
ing recommendations submitted by the County Superintendent
to exercise the following general powers:
(e) PROVIDE FOR4 EDUCATION OF SPECIAL GROUPS.-To
provide, insofar as practicable, for special facilities for classes for
backward, defective, truant, or incorrigible children of school age
and for children with unusual ability, and to provide facilities in the
way of day, part-time, or night schools or classes for adolescents
and adults, including illiterates and groups needing Americaniza-
tion and, when desirable and practicable, to provide for the educa-
tion of children below the first grade level in nursery school or
(f) HEALTH EXAMINATIONS AND TREATMENTS.-To pro-
vide for all children of school age in the county to have periodical
physical and dental examinations and, insofar as practicable, t) ar-
range and cooperate with other organizations for the prompt treat-
84 FLORIDA'S SCHOOL HEALTH PROGRAM
ment of all pupils who are in need of remedial and preventive treat-
ment: Provided that except in emergencies pupils may be given
remedial or preventive treatment only on written consent of the
(10) TRANSPORTATION OF PUPILS.-To make provision
for the transportation of pupils to the public schools or school
activities they are required to attend: . and to adopt the
necessary rules and regulations to insure safety, economy, and
efficiency in the operation of all buses, as prescribed in Chap-
ter VIII of the School Code.
(11) SCHOOL PLANT.-To approve plans, after considering
any recommendations which may have been submitted by the
trustees of the districts concerned, for locating, planning, con-
structing, sanitating, insuring, maintaining, protecting, and
condemning school property as prescribed in Chapter IX of the
School Code and as follows:
(b) SITES, BUILDINGS, AND EQUIPMENT.-To select and pur-
chase school sites, playgrounds, and recreational areas located at
centers at which schools are to be constructed and of adequate size
to meet the needs of pupils to be accommodated: Provided that the
trustees of any district shall have authority to refuse, on the grounds
of excessive cost or improper location . to expand existing sites;
. to insure that all plans and specifications for buildings provide
adequately for the safety and well-being of pupils . .
(c) MAINTENANCE AND UPKEEP OF SCHOOL PLANT.-To
provide adequately for the proper maintenance and upkeep of school
plants, so that children may attend school without sanitary or phy-
sical hazards and to provide for the necessary heat, lights, water,
power and other supplies and utilities necessary for the operation
of the schools.
(e) CONDEMNATION OF BUILDINGS.-To condemn and prohibit
the use for public school purposes of any building which can be
shown for sanitary or other reasons to be no longer suitable for
such use, and when any building is condemned by any State or
other government agency, as authorized in Chapter IX of the School
Code, to see that it is no longer used for school purposes.
Chapter IV. Section 433.
It shall be the duty of the County Superintendent to ex-
ercise all powers and perform all duties listed below: Provided
that in so doing he shall advise and counsel the County Board:
FLORIDA'S SCHOOL HEALTH PROGRAM 85
(8) CHILD WELFARE.-To recommend plans to the Coun-
ty Board for the proper accounting for all children of school
age, for the attendance and control of pupils at school, for the
proper attention to health, safety, and other matters which
will best promote the welfare of children in the following
fields, as prescribed in Chapter VI of the School Code:
(15) COOPERATION WITH OTHER AGENCIES.-To rec-
ommend plans for cooperating with and on the basis of ap-
proved plans to cooperate with Federal, State, County and
municipal agencies in the enforcement of laws and regulations
pertaining to vocational education, vocational rehabilitation,
physical restoration of children and adults, health of pupils,
school attendance, child welfare, and other matters relating to
Chapter V. Section 540.
SICK LEAVE.-Any member of the instructional staff
employed in the public schools of the State who is unable to
perform his duty in the school because of illness or because of
illness or death of father, mother, brother, sister, husband,
wife, or child, and consequently has to be absent from his work
shall be granted leave of absence for sickness by the County
Superintendent, or by someone designated in writing by him
to do so.
(1) EXTENT OF LEAVE.-Each member of the in-
structional staff shall be entitled to not more than five days
of sick leave during any one year: Provided that such leave
shall be taken only when necessary because of sickness as
herein prescribed. Such sick leave shall be cumulative from
year to year: Provided that not more than twenty school days'
sick leave, including sick leave for the current year and ac-
cumulated sick leave for previous years, may be claimed in any
one year: and provided that unused sick leave credit for any
year may not be claimed later than the end o' the third year
thereafter: and Provided, further, that at least half of this
cumulative leave must be established within the same county
86 FLORIDA'S SCHOOL HEALTH PROGRAM
Chapter VI. Section 603.
EVIDENCE OF DATE OF BIRTH TO BE REQUIRED.-
Before admitting a child to the first grade, the principal shall
require evidence that the child has attained the age at which
he should be admitted in accordance with the provisions of
Section 601 of the School Code. The County Superintendent
or attendance assistant may require evidence of the age of any
child whom he believes to be within the limits of compulsory
attendance as provided for in this Article . .
Chapter VI. Section 606.
(1) PHYSICAL AND MENTAL DISABILITY.-Child-
ren whose physical or mental condition is such as to prevent
or render inadvisable their attendance at school or application
to study: Provided that before issuing a certificate for physi-
cal or mental disability, the County Superintendent shall re-
quire the submission of a statement from the county health
officer, if a licensed physician, in counties having such an
officer, and in other counties from a licensed practicing phy-
sician designated by the County Board, certifying that the
child is physically or mentally incapacitated for school attend-
ance: Provided, further, that children who are handicapped
by blindness as to be unable to make satisfactory progress
in the public schools shall attend the Florida State School for
the Deaf and the Blind or some other institution within or
without the State in which equivalent instruction is offered,
the rating of such instruction to be determined by the State
Superintendent under regulations prescribed by the State Board
and Provided, further, that if an) child is so seriously crippl-
ed as to make impossible or inadvisable his or her attendance
at a regular public school, the County Superintendent shall at-
tempt to make arrangements for such child to attend a pub-
lic or other school for crippled children.
Chapter VI. Section 629.
PHYSICAL AND MENTAL EXAMINATION.-The State
Board of Education and the State Board of Health shall joint-
ly prescribe uniform forms, rules and regulations, and, through
FLORIDA'S SCHOOL HEALTH PROGRAM 87
their executive officers, shall arrange for the examination at
appropriate intervals of each child attending the public schools
of the State for the purpose of discovering, reporting and pro-
moting treatment of mental and physical defects that require
medical or surgical treatment for the proper development of
Chapter VI. Section 630.
MEDICAL EXAMINATION OF SCHOOL CHILDREN
UNDER SUPERVISION OF STATE BOARD OF HEALTH.
-Subject to these rules and regulations the State Board of
Health shall have supervision over all matters pertaining to
the medical examination of school children in Florida, with
such duties and powers as are prescribed by law pertaining to
public health, and all school children shall be examined as 1o
their physical condition at appropriate intervals. Any work
done by health authorities in schools shall be arranged with
the school authorities.
Chapter VI. Section 631.
COUNTY BOARDS AND HEALTH AUTHORITIES TO
COOPERATE.-County Boards of Public Instruction and
county health authorities shall cooperate in providing and ar-
ranging for periodic medical examinations of all school child-
ren under regulations of the State Board of Health . .
Chapter VI. Section 632.
COUNTY HEALTHi UNITS: COOPERATION WITH.--
In counties in which county health units have been provided
and are in active operation, it shall be the duty of the County
Board and the County Superintendent to cooperate with said
units in all matters having to do with the health and welfare
of school children: Provided that if the periodic medical in-
spection of school children is a part of the program of a county
health unit such medical inspection shall be considered as
meeting the requirements for a medical inspection as set forth
in this Article.
88 FLORIDA'S SCHOOL HEALTH PROGRAM
Chapter VI. Section 633.
CHILD ILL AT SCHOOL.-If a child becomes ill while at
school it shall be the duty of the teacher or principal to segre-
gate such child from other children until such time as he can
be removed to his home.
Chapter VI. Section 634.
PROCEDURE DURING EPIDEMICS.-In case of an epi-
demic of a communicable disease among the pupils of a school,
it shall be the duty of the County Superintendent to observe
such measures as are advisable by the full-time county health
officer who shall act in accordance with rules and regulations
prescribed by the State Board of Health. In case there is no
full-time county health officer, it shall be the duty of the
County Superintendent to act on the advice of a physician
designated by the County Board, which physician shall act in
accordance with rules and regulations prescribed by the State
Board of Health regarding control of communicable diseases.
Chapter VI. Section 635.
ADMITTANCE OF CHILD AFTER ILLNESS WITH
COMMUNICABLE DISEASE.-A school child who has been
ill of a communicable disease shall in no case be allowed to
return to school except upon the written permission of the
full-time county health officer or other reputable physician li-
censed to practice in the State of Florida.
Chapter VI. Section 636.
SANITATION OF SCHOOLS: STATE REGULATIONS.
-The State Board of Education and the State Board of Health
shall jointly adopt and promulgate all needful rules and regu-
lations having to do with sanitation of school buildings,
grounds, shops, cafeterias, toilets, school buses, laboratories,
rest rooms, first aid rooms, and all rooms or places in which
pupils congregate in pursuit of the school duties or activities.
Chapter VI. Section 637.
DUTIES OF COUNTY BOARDS WITH REFERENCE TO
SANITATION.-It shall be the duty of the County Board to
FLORIDA'S SCHOOL HEALTH PROGRAM 89
see that all State rules and regulations having to do with sani-
tation of the schools under their control are enforced: Pro-
vided that additional rules and regulations not in conflict with
the State rules and regulations may be adopted by the County
Board and enforced through the County Superintendent.
Chapter VIII. Section 802.
SAFETY AND HEALTH OF PUPILS.-Maximum regard
for safety and adequate protection of health shall be primary
requirements which must be observed by County Boards in
routing buses, appointing drivers, and providing and operating
Chapter VIII. Section 805.
EXAMINING PHYSICIANS.-Each County Board shall
designate a physician or physicians to examine and report the
physical condition of bus drivers and driver applicants in ac-
cordance with regulations of the State Board and procedure
prescribed by the State Superintendent.
Chapter IX. Section 906.
(2) CONDEMNATION BY STATE DEPARTMENT OR
STATE BOARD OF HEALTH.-An inspection of any school
property may be made by the State Department or by the
State Board of Health, either of which may order the property
to be withdrawn from school use until undesirable conditions
are corrected: Provided that the State Board of Health shall
notify the State Superintendent of any such action taken by
Chapter IX. Section 913.
FIRE PRECAUTION.-It shall be the duty of a principal
or teacher in charge of a school to see that all teachers, jani-
tors, and any and all school employees under his direction
take proper precautions in handling or storing of waste papers
kerosene lamps, oiled dusting cloths, and any and all inflam-
able articles and to endeavor to see that pupils exercise all
necessary precautions. All closets, cabinets, attics, basements,
storage spaces, and any places within or under the building
90 FLORIDA'S SCHOOL HEALTH PROGRAM
where supplies are kept or where waste paper or other ma-
terials may accumulate shall be regularly checked by the prin-
cipal and County Superintendent and any improper conditions
shall be remedied.
Chapter IX. Section 914.
FIRE DRILLS.-The State Superintendent shall formu-
late and prescribe regulations and instructions for fire drills
for all the public schools of the State of Florida, and each
principal or teacher in charge of each such school shall be
provided with a copy of such regulations and instructions and
it shall be the duty of such person to see that fire drills for
his school are held at least twice each semester and that all
teachers and pupils of the school are properly instructed re-
garding such regulations and instructions.
Chapter IX. Section 920.
SITE MUST BE ADEQUATE.-Each new site selected
shall be adequate in size to meet the needs of the school to be
served. As far as practicable, any present sites which are not
adequate shall be increased to conform to minimum standards
for new sites. Each school site shall contain a minimum of
two acres for a one-teacher school. At least one acre shall
be added to this minimum size of the site for each fifty pupils
enrolled in the school after the first fifty pupils and until the
enrollment reaches five hundred pupils: Provided that this
requirement may be waived in the discretion of the State
Superintendent under regulations of the State Board when any
County Board files evidence showing that a school site of that
size is impracticable in any given situation.
Chapter IX. Section 921.
OTHER MINIMUM STANDARDS TO BE MET.-It shall
be the responsibility of the County Superintendent to recom-
mend to the County Board for purchase and of the County
Board to purchase school sites in accordance with the provis-
ions of Chapter 4 of the School Code which meet standards
prescribed below and such supplementary standards as may
be prescribed by the State Board to promote the educational
FLORIDA'S SCHOOL HEALTH PROGRAM 91
interests of the children. Each site shall be well drained,
reasonably free of mud, and the soil shall be adapted to land-
scaping as well as to playground purposes. Insofar as prac-
ticable, the school site shall not adjoin a right of way of any
railroad or any through highway and shall not be adjacent
to any factory or other property from which noise, odors, or
other disturbances would be likely to interfere with the school
Chapter IX. Section 934.
NEW BUILDINGS MUST MEET MINIMUM STAND-
ARDS.-In order to provide for the sanitary, safe, and eco-
nomical construction and maintenance of public school plants,
toilets and physical equipment, and in order to promote the
physical welfare and safety of the school children of the State
any building hereafter constructed for public school purposes
in any county in this state shall meet all minimum standards
prescribed jointly by the State Board of Education and the
State Board of Health as herein provided. It shall be the re-
sponsibility of the State Board of Education and of the State
Board of Health to prescribe jointly necessary minimum stand-
ards relating to the sanitation of school buildings and the pro-
tection of public health as affected by the school plant.