{"id":4121,"date":"1948-09-01T01:00:00","date_gmt":"1948-09-01T01:00:00","guid":{"rendered":"https:\/\/www.rbc.com\/en\/about-us\/history\/letter\/september-1948-vol-29-no-9-school-childrens-health\/"},"modified":"1948-09-01T01:00:00","modified_gmt":"1948-09-01T01:00:00","slug":"september-1948-vol-29-no-9-school-childrens-health","status":"publish","type":"rbc_letter","link":"https:\/\/www.rbc.com\/en\/about-us\/history\/letter\/september-1948-vol-29-no-9-school-childrens-health\/","title":{"rendered":"September 1948 &#8211; Vol. 29, No. 9 &#8211; School Children&#8217;s Health"},"content":{"rendered":"<div id=\"layout-column-main\">\n<p class=\"boldtext\">Because it is generally recognized that                     ill-health is largely the result of mistakes which could                     have been avoided had there been fuller knowledge and greater                     care, this article is designed to look into the place of health                     education and practice in the school. It is at the school                     that for the first time every child&#8217;s health can be assessed,                     and deficiencies corrected. There, if anywhere, is our golden                     opportunity for constructive work in building a healthy Canada.                   <\/p>\n<p> The only limitations on health progress in any age are the                     bounds set by the growth of scientific knowledge, the willingness                     of those in authority to introduce advanced ideas, and the                     readiness of people to pay the cost &#8211; a price which is low                     relative to the resulting good. <\/p>\n<p> Persons with vision will aim at much more than the prevention                     of this or that disorder of childhood. It is no longer satisfactory                     merely to detect measles, chickenpox, mumps and other &#8220;children&#8217;s                     diseases&#8221; and isolate the victims. The new idea implies the                     promotion of bodily and mental vigour, strength and alertness,                     a target worthy of our best attention. <\/p>\n<h3>We Have New Standards<\/h3>\n<p> Children born around the beginning of this century had prospect                     of an average length of life of only 49\ufffd years; babies born                     in 1947 may look for an average life of 66\ufffd years. <\/p>\n<p> Life has become safer for children, but it is hardly correct                     to refer to the death rate in this and that disease as having                     &#8220;dropped&#8221; or &#8220;declined.&#8221; It was pushed down under the feet                     of advancing science, the outstanding victories achieved by                     medical research men, and the active co-operation of                     parents and schools. <\/p>\n<p> Our improved standards of living, too, have taken as their                     chief beneficiary the infant and the child. This year&#8217;s baby                     will have more baths in his first twelve months than Frederick                     the Great had in all his life. If the baby grows up into an                     admirer of Chippendale furniture he will be horrified, equipped                     as he is with a three-piece bathroom, to learn that the                     great Master seldom was called upon to design a wash-stand.                     Today, we have abandoned the 19th Century&#8217;s mystical absorption                     with &#8220;Survival of the fittest,&#8221; and we are trying to do something                     about the unfitness of some survivors. <\/p>\n<p> There are, of course, fussbudgets who make this a point                     of argument. They suggest that the saving in infant life has                     preserved the unfit, and somehow suggest that this is a bad                     thing. But they are not right. In addition to the reduction                     in mortality there has been a great advance in protective                     measures which save children from diseases likely to prove                     injurious in later years. <\/p>\n<p> Progress has been made, but our achievements and practice                     fall far short of our ideals and knowledge. Dr. Griffith Binning,                     Medical Director of Schools in Saskatoon, wrote an article                     in the <em>Canadian Journal of Public Health<\/em>, reporting                     on a comparison of Saskatoon children with army volunteers                     on the basis of the Pulhems test. Whereas only 41.8 per cent                     of the army candidates graded &#8220;A&#8221;, there were 82.5 per cent                     of Saskatoon children in this class. Dr. Binning makes this                     striking statement: &#8220;A physical standard for children should                     be evolved, since in their case the present Army standard                     is too low an objective to be satisfactory.&#8221; <\/p>\n<p> What we need today is a gripping sense of the possibilities                     of healthful living, and to get away from dependence for satisfaction                     upon the reduction of death rates. Lowness of mortality, and                     even absence of disease, are not satisfactory standards for                     this age. <\/p>\n<h3>The C. E. A. Survey<\/h3>\n<p> As part of the constructive activity of the Canadian Education                     Association and the Canadian Public Health Association, there                     was set up in the summer of 1945 a National Committee for                     School Health Research provided with financial assistance                     by the Canadian Life Insurance Officers Association. <\/p>\n<p> Data have been gathered from 26,101 elementary schools,                     about 90 per cent of all in Canada, and 8,000 secondary school                     classrooms, about 70 per cent of the total. The conditions                     covered in the two reports already published show an average                     across the country. and there are wide differences between                     provinces, Most of the material in this article, applying                     to Canadian schools, is drawn from the committee&#8217;s reports,                     but the comment and interpretation are our own. <\/p>\n<h3>Teaching Health in School<\/h3>\n<p> Health instruction is a positive duty of the teacher. It                     cannot be left to occasional talks by the school physician                     or advice from a physical training instructor. <\/p>\n<p> The aims of health education should be practical: (1) to                     bring about correct bodily development through physical activities                     such as games, corrective exercises and dances; (2) to make                     the physical constitution stronger through development of                     sanitary and health habits; (3) to detect, and thus take the                     first steps toward preventing or stopping physical upsets                     such as are caused by dental defects, eye, heart and stomach                     disturbances. <\/p>\n<p> Explanations for health habits should be given. It is no                     longer sufficient to say &#8220;Do this&#8221; and &#8220;Don&#8217;t do that.&#8221; Even                     children in elementary classes look for the why and wherefore.                     The child should be led to believe that his best health habits                     are his normal health habits, and anything less is unworthy.                   <\/p>\n<p> Health education should be spread through the whole curriculum,                     instead of being tacked on as an appendix to a course in physiology                     and hygiene. One of the dullest books we know is one on hygiene,                     which teaches about physiology instead of telling how the                     functioning of the human organism enters into providing the                     abundant energy we need if we are to do the things we want                     to do. <\/p>\n<h3>Physical Examinations<\/h3>\n<p> It is said by qualified authorities that school health service                     should place its main emphasis on positive action rather than                     upon the construction of charts and tabulations. At the same                     time, the tabulation arising out of regular medical examination                     is needed to find out what defects are threatened. These records                     frequently reveal changes in health factors which enable problems                     to be tackled in time to prevent lasting trouble. <\/p>\n<p> One of the latest devices is the Wetzel Grid, referred to                     in the <em>Annual Report <\/em>of the Child and Maternal Health                     Division of the Department of National Health and Welfare.                     This chart, which helps to evaluate the physical status and                     growth of children from birth to the age of eighteen years,                     was distributed to authorities throughout Canada. It was being                     used, according to the 1947 report, in the study of some 6,000                     children in British Columbia, and Saskatoon was co-operating                     in a study of emotional factors which may influence growth,                     a preliminary report on which appeared in this spring&#8217;s issue                     of <em>Health<\/em>. <\/p>\n<p> It is pointed out, very properly, that neither the Wetzel                     Grid nor any other contrivance is designed to try to fit every                     child into a preconceived &#8220;ideal&#8221; weight, height and degree                     of development. There are many differences between children,                     due to race, family habits, and conditions of living. The                     test is: does the child progress? If records of physical examinations                     show a halted or stumbling progress, then the child cannot                     be looked upon as a satisfactory example of good health. <\/p>\n<p> It will appear very sensible to the business man, accustomed                     as he is to the use of flow charts and other devices to keep                     business moving smoothly, that there should be a continuous                     record kept of every child s health progress. This might start                     in pre-natal days, and continue with the family doctor                     until school age, then be handed over to the school health                     authorities. At graduation, the record should be available                     for the employer&#8217;s physician, and should then follow the subject                     to whatever doctor he chooses as his personal adviser. <\/p>\n<h3>Prevention of Disease<\/h3>\n<p> It is a good thing to cure illness, and great skill is shown                     in treatment of those smitten by disease, but it is better                     and shows more wisdom to prevent illness. <\/p>\n<p> The policy of tuberculin tests for school children is steadily                     gaining favour, and travelling clinics bring the campaign                     for early detection of tuberculosis within reach of a substantial                     proportion of the school population and the young adult group.                     Means of protection against diphtheria and whooping cough,                     available to the public free of charge, have done marvellous                     things in prevention of these diseases. Smallpox has ceased                     to be a serious menace in communities where vaccination is                     required. The incidence of goitre among Prairie children was                     radically reduced by the administration of iodine in various                     forms. <\/p>\n<p> Typical of the work being done in this field is that of                     the National Immunization Division of the Health League of                     Canada, whose Sixth National Immunization Week was scheduled                     this year from September 12 to 18. A truly remarkable reduction                     in both number of cases and deaths is recorded by the Division.                   <\/p>\n<h3>Dental Health<\/h3>\n<p> The condition of the teeth of our children is still shockingly                     bad, said an article in the <em>Statistical Bulletin <\/em>of                     the Metropolitan Life Insurance Company, a publication which                     reports monthly on health matters in the United States and                     Canada. &#8220;Surveys show that more than 95 per cent of the children                     reaching 15 have already experienced some decay in their permanent                     teeth.&#8221; An inspection in Montreal in 1946 showed that some                     73 per cent of the children examined had dental defects. <\/p>\n<p> Dental decay is largely the result of defective nutrition.                     Dr. Alan Brown of the Hospital for Sick Children, Toronto,                     said in a radio address: &#8221; If children are fed meals that                     contain sufficient milk, fruit, vegetables, eggs and meat,                     and if they are given a daily dose of fish liver oil during                     the eight colder months of the year, they will have much less                     dental decay.&#8221; From the age of three onward, he warned, children                     should have their teeth checked every six months. Cleaning                     is important, too. It is surely less significant that children                     should be taught at school how many teeth they have, and their                     names, than that they should learn to brush them daily and                     eat the proper foods to build and preserve them. <\/p>\n<h3>Nutrition<\/h3>\n<p> At the beginning of this century much was made of the theory                     that the prevalence of undernutrition was primarily, if not                     wholly, an evidence of insufficient food due to widespread                     poverty. It is now known that malnutrition may be prevalent                     in the homes of the wealthy as well as among the poor, as                     a result of faulty selection of food, insufficient rest, and                     the aftermath of general infections or other causes. <\/p>\n<p> The truth is that even when a community has advanced to                     the point where it has a <em>wide <\/em>choice of foods, there                     is nothing to prevent its people from eating the wrong <em>kind                     <\/em>of food. <\/p>\n<p> In every survey conducted in Canada it has been found that                     one child in three could be expected to benefit by eating                     a better diet. <\/p>\n<p> The school lunch should be mentioned as one agency which                     is operating as a health influence in many schools. The mere                     provision of one suitable meal a day results in nutritional                     betterment of many children, and when this is accompanied                     by an educational programme the results are more outstanding.                   <\/p>\n<p> Eating places in the school afford a wonderful opportunity                     for instruction in good nutrition and development of good                     eating habits. By relieving mothers of some of their work,                     to the ultimate benefit of the children, school lunches may                     prove to be a substantial contribution to better family life.                   <\/p>\n<h3>Physical Training<\/h3>\n<p> The purpose of physical training is to promote a strong                     body in which all the muscles, because in daily use, perform                     their functions properly, giving necessary support to the                     vital organs. <\/p>\n<p> More than exercise is involved. Knowledge must be given                     of respiration, circulation, glandular action, rest and diet.                     When the &#8220;why&#8221; is explained, the pupil will better understand                     the demand made that athletes must be temperate in their way                     of living as well as submissive to training. <\/p>\n<p> In a report of the Quebec Protestant Education Survey over                     the signature of W. A. F. Hepburn, physical education was                     carried into even the one-room school, where the floor                     is taken up with nailed-down desks and an immovable stove.                     These features, plus the fact that pupils range in age from                     five or six to fifteen, present obstacles which might seem                     impossible to surmount. But this committee made suggestions,                     and if it has found a way of providing indoor physical training                     under such circumstances there is no excuse for any school                     anywhere to fail. <\/p>\n<p> The committee emphasized the undesirability of stressing                     the kind of competition which results from inter-school                     leagues. It is all right in its place, but the training of                     a few selected athletes should never be done at the expense                     of the majority of the pupils. <\/p>\n<h3>Mental Health<\/h3>\n<p> The subject of mental health merits treatment in a separate                     article, but its mention here is necessary because in many                     respects it is part and parcel of physical health. Many more                     children relieve their emotional tensions by getting sick                     than do so by becoming behaviour problems. <\/p>\n<p> It is not sufficiently realized that mental achievement                     tests will show a marked drop in the presence of emotional                     stresses. The child&#8217;s I. Q. may appear to be lower than it                     really is. Because of worries, which may be of home origin,                     he may stay a second year in the same grade, without teacher,                     parent or child realizing that the cause is illness. <\/p>\n<p> Ideally, the child would be properly diagnosed, even at                     considerable expense. Among the treatments used should be                     rest from mental and physical stress. Instead of this, unfortunately,                     a child mentally sick because of his emotional problems is                     likely to be loaded with pressures from home and school. In                     an effort to push him ahead he may be given extra home work                     and special lessons. Is it any wonder that the child so often                     protests against the mental upset by developing body illness                     or relapsing into the more comfortable dream world of mental                     disease? <\/p>\n<p> Our schools cannot disregard this emotional side of the                     child&#8217;s life in favour of concentration on his intellectual                     development, any more than they can ignore the physical health                     side. Intellectual fitness, physical well-being and mental                     health are so interdependent that the wholeness of an individual                     cannot be achieved if any one is neglected. <\/p>\n<p> While the home is necessarily the most important factor                     in mental hygiene, the school and the community have their                     responsibilities, particularly in the early unbiased detection                     of abnormalities which, if neglected in childhood, develop                     into personality maladjustments of adult life. <\/p>\n<p> Twenty years ago it was pointed out in an article in the                     <em>Annals <\/em>of the American Academy of Political and Social                     Science: &#8220;If the youngster was fairly born, with a good prospect,                     and if now, at the age of seven he is developing tantrums,                     or if at 16 he has become delinquent, or if at 19 he has developed                     a neurosis, or if at 25 he has developed a psychosis not of                     an accidental type, or an organic type, then, not having been                     born with these defects, where did he get them? If it were                     the measles we would ask, &#8216;whom has he been with?&#8217; It is a                     good question to ask here; and the answer is &#8211; mostly with                     his parents and teachers.&#8221; <\/p>\n<p> The National Committee tackles this problem head-on,                     and presents this report: &#8220;Mental health problems will be                     reduced to a secondary position if we strive for: (a) smaller                     classes with teachers better trained in at least the elementary                     principles and techniques of mental health; (b) a release                     from the &#8216;lock-step&#8217; system of education in which we                     attempt to have forty-odd children of widely varying                     abilities all learn the same things at the same rate of progress;                     (c) the satisfying of the basic psychological needs of the                     child; (d) better liaison between school and home; (e) education                     of the parents in the rearing of children.&#8221; <\/p>\n<h3>Training for Teachers<\/h3>\n<p> While the school has accepted the duty of education in health                     as one of its responsibilities, there remains some degree                     of confusion both as to objective and means. This should be                     resolved by consultation and agreement on the highest levels,                     followed by proper and adequate training of those who will                     administer the school health programme. <\/p>\n<p> Student teachers-in-training should acquire a                     thorough understanding of what is meant by positive health                     education and of its techniques. Teachers who are already                     in positions should be given in-service training. <\/p>\n<p> Dr. Binning urges establishment in universities of a Chair                     of School Medicine as a means to assuring that school medical                     work shall be in the best possible hands and shall be conscientiously                     performed. In Great Britain the Central Advisory Council for                     Education recommended in 1947 that all medical officers entering                     the service should be required to hold special qualification                     in children&#8217;s medicine, and that the school health service                     should be made to provide a satisfactory career for a medical                     officer. <\/p>\n<h3>School Environment<\/h3>\n<p> As well as having fully qualified medical practitioners                     and specially trained teachers, the schools need a certain                     healthful environment. This includes attention to location,                     construction, size, ventilation, heating, lighting, acoustics,                     seating, adequacy of lavatories and handwashing facilities,                     physical training space with lockers and showers, health service                     rooms and health libraries. All these, said an article in                     <em>Canada&#8217;s Health and Welfare<\/em>, are necessary for adequate                     health training. <\/p>\n<p> Too often, in schools which emphasize health instruction,                     health practices do not keep pace with the lessons. Pupils                     cannot be expected to build and practise the health habits                     which are taught when conditions are the opposite of the teaching.                     &#8220;It would be ridiculous to think of functional health teaching                     in many schools where sanitary conditions are actually a menace                     to health,&#8221; said the National Committee report. <\/p>\n<p> In some provinces as high as 12 per cent of the secondary                     schools do not provide even a hand basin for washing; in six                     provinces at least 20 per cent have no soap and paper towels;                     only 28.5 per cent have the water supply tested periodically;                     only 43 per cent of secondary school classrooms have artificial                     lighting giving the minimum required intensity; the proportion                     of one-room schools with inadequate natural lighting                     ranges up to 43.5 per cent; and in most provinces more than                     80 per cent of these schools have no artificial illumination                     of any kind; in one province all one-room schools have                     only outdoor toilet facilities and over all provinces the                     proportion is 71.4 per cent; in many schools drinking water                     is in an open pail, with a dipper for drinking, and slops                     go back into the pail. <\/p>\n<p> In one province 100 per cent of the schools have first aid                     kits, but only 15 per cent of them test their drinking water                     supply annually. <\/p>\n<p> These and hundreds of other facts regarding the environment                     in schools are given in the National Committee report, published                     in <em>Canadian Education<\/em>, Volume II, Number 2, 1947,                     and Volume III, Number 2, 1948. There is, on this evidence,                     more room for improvement than most people thought possible                     in an enlightened age, and the Committee makes constructive                     suggestions arising out of its findings. <\/p>\n<h3>A Combined Operation<\/h3>\n<p> It is evident that the health of children calls for a combined                     operation in which school and home and community participate.                     In a very real sense, the limits of school health are the                     boundaries of the community, not the fence around the school                     yard. <\/p>\n<p> Health education begins with pre-natal education and                     care, and continues with the sanitation of the community,                     the home hygiene of the pre-school child, the training                     of the adolescent in school, and the graduation of the student                     with sound knowledge upon which to base his own treatment                     of his own children. This is not a programme to be floated                     upon sentimental propaganda in fits and starts, but one to                     be laid out on a basis of facts found by trained investigators                     and carried out by technically qualified personnel. <\/p>\n<p> There is needed, obviously, a new effort to win close co-operation                     between teachers, members of the school health service, and                     parents. The best kind of youngsters cannot be raised by guess                     and by hearsay. Good will and good intentions cannot be substituted                     for expert skill and knowledge. Some of the required knowledge                     can be had for the asking, either by talking with the school                     medical authorities or by writing to the provincial board                     of health for up-to-date booklets, which are freely                     available. <\/p>\n<h3>The Penalty of Neglect<\/h3>\n<p> The penalty of neglect of health in childhood is very heavy.                     As Horace Mann said: &#8220;All through the life of a feeble-bodied                     man, his path is lined with memory&#8217;s gravestones which mark                     the spots where noble enterprises perished for lack of physical                     vigour to embody them in deeds.&#8221; <\/p>\n<p> Those who take office on school boards have a special responsibility                     to appreciate their opportunity to improve the health of coming                     generations, and to that end to provide all practicable facilities                     for teaching and practising health in the schools of today.                   <\/p>\n<p> There are problems of personnel and equipment and funds,                     but these should not be allowed to baffle people of good will                     and good sense. The objective is well worth striving for.                   <\/p>\n<p> A good start, but merely a start, has been made. Only unremitting                     effort, intelligently directed by those responsible, supported                     by the resources of the community, can adequately fulfil the                     obligation. <\/p>\n<\/p><\/div>\n","protected":false},"author":0,"featured_media":0,"template":"","categories":[1],"rbc_letter_theme":[],"rbc_letter_year":[28],"class_list":["post-4121","rbc_letter","type-rbc_letter","status-publish","hentry","category-uncategorized","rbc_letter_year-28"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>September 1948 - Vol. 29, No. 9 - School Children&#039;s Health - RBC<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.rbc.com\/en\/about-us\/history\/letter\/september-1948-vol-29-no-9-school-childrens-health\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"September 1948 - Vol. 29, No. 9 - School Children&#039;s Health - RBC\" \/>\n<meta property=\"og:description\" content=\"Because it is generally recognized that ill-health is largely the result of mistakes which could have been avoided had there been fuller knowledge and greater care, this article is designed to look into the place of health education and practice in the school. 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