The history of health education in NZ and a brief rundown on the curriculum
1. The History of Health Education in New Zealand
Around the time of the 1918 flu epidemic, the focii for health education were:
- hygiene
- exercise
- fresh air
- good food
This indicates the responsive and situated nature of health education in relation to the
social, economic and political context (Rice, G. cited in lecture, Sullivan). The notion
therefore, of what health education is, has evolved greatly over the last 100 years.
Something that came from yesteryear and was also strong in the 1960s and 70s, was the
political-economic perception of the medical and health-care professions (Colquhoun,
1992). Research in this area would focus on the perceived ‘virtuous’ nature of medical
professionals and the inequitable access to these professionals. This tied in to the idea of
healthism (Crawford, 1980 in Tasker, 2004). Here, the emphasis for health education lay
on the individual’s personal responsibility. But, if some individuals did not have access to
the services with which they were supposed to gain their health, how were they meant to
exercise this responsibility? The socio-ecological framework argued to provide a context
for the ‘science of the individual’ (Lawson, 1992).
During the 1980’s, the notion of health as a multi-dimensional construct emerged. This
was reflected in the 1985 revision of the New Zealand Health Education syllabus where
health was now referred to as ‘well-being’, the sum of mental, spiritual and physical
factors (Tasker, 2004:204). This was supported by the World Health Organisation’s
(WHO) Ottawa Charter, which recognised the link between environment and health,
acting as a catalyst for further curriculum development and thinking in New Zealand,
where the first Health and Physical Education curriculum document was drafted as a
separate curriculum area in 1995 and sent out for consultation early 1996 (Tasker, 2004).
This was an official curriculum document that supported and acknowledged Mäori
conceptualisations of health, which encompassed individual and community, a holistic
and relational view.
2. More recently, the Bangkok Charter, 2005 has raised the question of globalisation and its
relation to health – to what extent do we need to be concerned with the international
scene as we consider health and health education (cited in lecture, 2008)?
The Concepts
1. Hauora translates literally as the breath of life or well-being. There are many
models that represent and interpret the holistic and multidimensional nature of
Mäori conceptualisations of health, among which is Mason Durie’s whare
tapawhä (1998:69). This model represents health as consisting of four walls. If
one wall falls, then the house will no longer be ‘healthy’. Te taha hinengaro, or
the mental and emotional, depends on Te taha tinana, the physical, which in turn
depends on Te taha wairua, the spiritual (whether this is a religious sense or as a
connection to the environment) and these depend on Te taha whänau, or the social
- the family.
2. The socio-ecological framework has its basis in critical thinking. What are the
social, political, legislatory, environmental and tikanga-based factors that affect
hauora? What are the obstacles to well-being and how can they be removed or
overcome? This approach encourages active contribution to both personal well-
being and the well-being of others through critique of:
a. power and privilege
b. social structures
c. underlying motivations
d. conflicting interests (http://www.tki.org.nz/r/hpe/index_e.php)
3. The 1986 Ottawa charter acted as the catalyst for the Health Promotion
movement, which has a five pronged approach:
a. Good health policy
b. Up skilling individuals
c. Providing and/or realigning health services
d. Encouraging community action
e. Promoting a healthy environment.
3. 4. Attitudes and values functions on many levels: promoting “a positive and
responsible attitude” (NZC, 1999:34) to self; a respect for others; a care for
community and environment; and “a sense of social justice” (ibid.).
These concepts are interlinked and, together provide a multidimensional picture of the
potential for health education in New Zealand.
The extent of topics
The Health and Physical Education curriculum consists of four strands:
- Personal Health and Physical Development
- Movement Concepts and Motor Skills (specifically P.E.)
- Relationships with Other People
- Healthy Communities and Environments
The 1999 curriculum expands on these areas by specifying seven other topic areas, which
are:
• -Mental health
• Sexuality education
• Food and Nutrition
• Body Care and Physical Safety
• Physical Activity
• Sport Studies
• Outdoor Education
While the latter three topic areas could be seen as purely P.E. based, I argue that some
forms of outdoor education are health-based. For example, a survival unit delivered at
Newton Central when I was a kaiäwhina there taught the children the practical skills they
would need to keep themselves safe in the event of a natural disaster. There was a
problem-solving approach as the children figured out how to design and build a shelter;
how to catch, filter, purify and store water; how to gather, prepare and store food; how to
design and implement a hygienic sanitation system and how to make bedding from
naturally available resources.
4. Overall, these strands and topic areas give us an incredibly wide range of topics to choose
from. We could teach and learn anything in our classrooms, from: stereotyping and
discrimination; substance abuse – the what’s and why’s; suicide, death, grief and loss;
choices, opportunities and obstacles to healthy eating and healthy living; self-worth and
resilience. While some of these topics are perceived as hard topics of potential risk to
teachers as professionals, I believe that with open communication to families and the
wider community, none of these topics need to be left in the ‘too-hard’ basket. There has
to be a balance in the delivery of any of these topics. You cannot speak only the ‘bads’
when doing a unit on substance abuse. There are always reasons for using the substances.
There are always positives. Children know when you are being deliberately biased and I
know that when I was young, I would quickly move to do something if I was told I
wasn’t allowed to do it. Why not share the positives with the negatives and debate as a
class on which outweighs the other? Why not raise awareness so that when children get
given the choice they can make an informed decision? I believe that if this is explained
and justified to parents, then there can be more openness within the health curriculum. If
there are parents who choose to withdraw the class from these units, make sure there is
more ‘conventional’ related work for the students to work through and consider. If we
want to build the critical thinkers of tomorrow, then we need to be willing to take risks.
Key Competencies
The five key competencies identified in the New Zealand curriculum were informed by
international research to find out the essential skills required by people to be active and
successful members of their communities. Rychen and Salganik argue that these
competencies must be:
• universally relevant
• holistic
• authentic and demonstratable (2003, in Boyd & Watson,
2006:2).
The key competencies that are in the New Zealand curriculum include:
• thinking and moving
5. • using language, symbols and text
• managing self in...
• relat[ion] to others
• participating and contributing (italics indicate my changes from the original)
They are the result of dialogue between Ministry staff, researchers and practitioners.
They are more than just skills and attitudes, but function in an integrated way across all
areas of learning (Hipkins, Boyd & Joyce, 2005:5). There is much debate about each of
the above and, in fact, about exactly what a competency is or should be defined as. I
believe that key to integrating the above into the health curriculum is your interpretation
of the competencies. I agree with those who debate the separation of thinking and
moving. The two are inseparable. I would also combine the third and fourth, as to me, the
concept of self is the result of relating to others. I experienced the introduction of the
proposed draft curriculum into the classroom by Whaea Tamsin, who explored the
contents with the children and then debated what they had just explored. What was
important? What was not so important? Had anything important been left out? The class
then drafted feedback sharing their thoughts with the Ministry of Education. I believe this
is an example of all of the key competencies in action. When incorporating the
competencies into the health curriculum, we need to acknowledge the link between
thought and action – the movement from using language, symbols and text, thinking
about it, relating to others as you think about it and then participating and contributing as
you move to take action. Another example: AIDS awareness. To take action, the children
could participate and contribute as part of online communities, such as
www.takingitglobal.org and share their learning in a forum, communicate it through film
or collaborate with an international group to find avenues for taking action.
Values
“Kind of obscure, it’s got a lot of vague things, values and things like that”, was a teacher
comment from Sullivan’s research into perceptions of health education (2003:142).
Values are inherently subjective. While the values are outlined in the curriculum
document, and teachers and schools are told that these ‘deeply held beliefs’ are ‘to be
6. encouraged, modelled and explored’ (NZC, 2007:10), who is to say how these values are
interpreted in relation to the health curriculum? How are they to be modelled in the
classroom and what does it mean to be curious? When one teacher encourages children to
ask questions and the next sends children to the principal’s office for questioning, how
are we to ensure that there is some form of constancy? At face value, these values that
should be integrated across all curriculum areas are commendable, consisting of:
- excellence
- innovation, inquiry and curiosity
- diversity
- equity
- community and participation
- ecological sustainability
- integrity
- respect
But what does it mean to teach the valuing of diversity? Census 2001 records close to
700,000 New Zealanders born overseas, with a range of languages spoken in this country
that covers the globe (www.statistics.govt.nz). I believe that language is a vehicle for
culture and a tool for empowerment. Therefore, I should encourage my class to teach
each other parts of their respective languages and complement this with the integration of
te reo Mäori within a range of health topics. An example: teaching each other ways to
communicate ‘no’, ‘stop’ or ‘I am feeling uncomfortable’ as part of a Keeping Ourselves
Safe unit. I should also encourage ESOL or NESB students to use their native tongue for
communication as they become familiar with English. But is this enough? What else does
it mean? Possibly the only way for successful planning and implementation around the
curriculum values, lies in the concept of the reflective practitioner. Through reflection,
thought and deliberation, I can come to grips with exactly what the values mean to me
and this will hopefully result in a depth of delivery. And, as the curriculum document
suggests, dialogue will help in the process of articulating exactly what these values mean
to me in the classroom, to the students I work with, to the school I work within and to the
wider community.
7. References
Boyd, S. and Watson, V. (2006). Shifting the frame: Exploring integration of the Key
Competencies at six Normal Schools. NZCER: Wellington.
Durie, M. (1998). Tirohanga Mäori: Mäori health perspectives. In Whaiora: Mäori health
development. 2nd ed. Auckland, NZ: Oxford University Press (p. 66-80).
Hipkins, R., Boyd, S. & Joyce, C. (2005). Documenting learning of the key
competencies: What are the issues? A discussion paper. NZCER: Wellington.
http://www.stats.govt.nz/tables/2001-census-cultural-diversity-tables.htm Cultural
Diversity Tables. Retrieved 17/08/2008.
http://www.tki.org.nz/r/hpe/index_e.php TKI Health and Physical Education Online
Community. Retrieved 20/08/2008.
Lawson, H. (1992). Toward a socioecological conception of health. Quest ; v.44, no.1,
1992 (p. 105-121)
Ministry of Education. (n.d.). The Socio-ecological Perspective and Health Promotion in
Health and Physical Education in the New Zealand Curriculum (pp 8-10).
Ministry of Education. (2007). The New Zealand Curriculum: for English-medium
teaching and learning in years 1-13. Wellington: Learning Media
Ministry of Education. (1998). Health and Physical Education in the New Zealand
Curriculum. Wellington: Learning Media
Sullivan, R. (2008). Health Education lecture series. Session 1 and session 4 cited.
Sullivan, R. (2003). You wonder if it’s all worthwhile. In B. Ross and L. Burrows (Eds).
It takes two feet : teaching physical education and health in Aotearoa New
Zealand Palmerston North, N.Z. : Dunmore Press (p. 138-149)
Tasker, G. (2004). Health education: contributing to a just society through curriculum
change. In A. O’Neill, J. Clark and R. Openshaw (Eds). Reshaping culture,
knowledge and learning: policy and content in the New Zealand curriculum
framework. Palmerston North, N.Z: Dunmore Press (p. 203-223).