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PART SPORTS AND HEALTH

PART B ENRICHMENT OF HEALTH EDUCATION

After World War , the School Education Law prescribed "the cultivation of habits necessary for a sound, safe and happy life and the harmonious development of mind and body" as one of the goals of school education. This law set, as an educational goal, the active promotion and maintenance of health, replacing the pre-war concept of school sanitation in which the conditions for learning were fulfilled merely through instruction about treatment and prevention of illness (with emphasis on infectious diseases) and injury. Under this new direction, policy was expanded for health education to include the areas of school health, school safety and school lunches. Furthermore, health education has met with great success in improving the physical fitness and health of students as well as the public's eating habits.

School health can be divided into the following activities: health education which aims to provide children with the necessary knowledge and abilities for healthy living through overall school activities including the subjects of "health" and "health and physical education" and special activities, and health care through sanitation improvements and medical checkups.

Furthermore, as described in the following, provisions regarding health education have been improved through successive revisions of the Courses of Study and health care has been improved and upgraded through the enactment of the School Health Law and through various policies and measures based on the 1972 Report of the Health and Physical Education Council.

The importance of one area of school health, health education, was indicated in the Outline of the 1947 Courses of Study (tentative plan), which was issued for the first time after the war. In this period, health education was taught as part of "physical education" classes. Later, in 1949, the course title "physical education" was changed to "health and physical education" at upper and lower secondary schools. The revised Outline of the Courses of Study (tentative plan) in 1951 set down a new way of teaching health education in elementary schools. "Rather than conducting health education only at a fixed time it is desirable to make use of all available opportunities and available activities including teaching the subject in class and extracurricular activities as well." The framework for the direction of health education was thus established for the decade of 1945-55. For a period after 1955, successive revisions were made in the Courses of Study for elementary and lower and upper secondary schools and increased efforts were made towards making the content relevant to social changes. Through a revision made in 1958, the area of "knowledge regarding health" within "physical education" classes in elementary schools was newly established and this clearly made a place for health studies. Also in that year the content of "health and physical education" classes was clearly separated between the "area of health" and the "area of physical education."

Later on, with revisions of the Courses of Study in 1977 and 1978, improvements were made stressing the following content at different school levels: for elementary schools, an understanding of safety and health issues in everyday life; for lower secondary schools, an understanding of fundamental health issues in daily life and for upper secondary schools, an understanding of health within the group and an integrated perception on health.

In 1989 the Courses of Study were revised towards improving the content of health education in elementary and lower and upper secondary schools in terms of mental health and the relationship between daily behavior and health. These revisions were made with reference to reports from the National Council on Educational Reform (April 1986) and the Curriculum Council (December 1987) which pointed to the necessity for school children to develop the proper attitudes and abilities to autonomously practice safe and healthy daily habits while coping with social changes.

After the war, according to the School Education Law, a place was established for health care within school educational activities. The Law prescribed that, "Each school shall, in order to maintain and promote the health of students, pupils or children as well as its personnel, conduct medical checkups and take other measures necessary for maintaining their health."

On the basis of this, physical examinations according to "Regulations on School Physical Examinations " were conducted together with infectious disease prevention according to" Regulations on School Infectious Disease Prevention" (regulations which had continued before the war). However, since these measures were insufficient for systematic school health care, a School Health Law was established in 1958. Through this law, the following measures were provided: maintenance and improvement of school sanitation, execution of medical checkups and health counseling, creating posts for school health technicians at prefectural boards of education, creation of the posts of school physician, dentist and pharmacist, establishment of school clinics, partial financial support from the national and local governments for carries out investigative research and related activities. Among the fruits of these efforts are manuals and handbooks for distribution to schools and other institutions such as "A Manual on Health Guidance for the Prevention of Smoking, Drinking and Drug Abuse" and "A Report on Programs for the Promotion of Sexual Guidance to Cope with AIDS and 'Other Problems."

In pre-war schools, school nurses were appointed to take charge of school sanitation, mainly dealing with infectious disease prevention. In 1941 nursing teachers "kundo" took the place of school nurses and they took on a more clearly defined educational role in child care. These nursing teachers "kundo" were the precursors to the present-day nursing teachers "yogo-kyoyu", a post established through the School Education Law of 1947. The role of the modern nursing teacher has become more and more important with the increasing necessity for health education.

The 1972 Report of the Health and Physical Education Council entitled Policy for Promoting and Maintaining Good Health Among Students clarified the duties of nursing teacher and pointed out the very important role which they have in health maintenance and promotion among students as follows: l) To precisely ascertain the condition of each child's health and school sanitation from a professional standpoint 2) to take charge of individual guidance for school children with physical or psychological problems such as those related to physical illness, emotional handicaps, physical strength or nutrition, etc. 3) to take charge of health promotional guidance for healthy children 4) to actively cooperate with the daily teaching activities of the general teaching staff.

Considering the importance of the role of nursing teachers, improvements were made regarding their employment and placement through the "Law Concerning Class Size and the Standards of Fixed Number of Educational Personnel in Public Compulsory Education Schools" (hereafter referred to as the "Compulsory Education Standards Law") and with the accomplishment of the fifth plan for the reduction of the fixed number of educational personnel in 1991, nearly all compulsory education schools employ nursing teachers. Also, nearly all public upper secondary schools employ nursing teachers as well.

After the war, positions were created for school physicians and dentists through revisions in the School Education Law Enforcement Regulations in 1953. As in the case of nursing teachers, their roles as active promoters of school children's health (in contrast to the pre-war role emphasizing school sanitation) were also clarified. Furthermore, one year later, in 1954 through revisions in the enforcement regulations of the same law, the position of school pharmacist was created.

Later, in 1958 with the enactment of the School Health Law, the positions of school physician, school dentist and school pharmacist were stipulated by law. Standards for the professional duties of each respective position were set down in the enforcement regulations of the same law.

Also in order to secure the placement of school physicians, dentists and pharmacists, efforts have been made since 1960 to improve their salaries through local allocation taxes.

School safety encompasses two parts, the first is safety education conducted through overall school activities including safety taught through special activities, classes of all types and moral education, i.e., children gaining an understanding of the essential matters of safety, applying them in their daily lives and thus developing the abilities to behave in a safe manner. The other part of school safety involves safety management, i.e., managing facilities and equipment, carrying out safety inspections, etc., in order to provide a safe environment for students.

In regard to safety education, the 1947 Course of Study for School Physical Education brought safety into the school curriculum. Lower elementary grades were taught "disease prevention" and "injury prevention" and upper elementary grades and lower secondary grades were taught "nursing (including disinfecting procedures) and first aid."

In the case of traffic safety, with a dramatic rise in traffic accidents in 1955, a circular from the permanent Vice-Minister of Education entitled "On the Prevention of Traffic Accidents" pressed all schools to give thorough instruction in traffic safety education and since then, similar official circulars were repeatedly issued. In the following years the Ministry created three handbooks promoting improvements in safety in daily life and traffic safety guidance entitled "Handbook for Traffic Safety Guidance" in 1967, "Handbook for Safety Guidance for Elementary Schools" in 1972 and "Handbook for Safety Guidance for Lower Secondary Schools" in 1975. In other developments the Japan School Safety Association (a special legal corporation, now merged into the National Stadium and School Health Center of Japan) has been publishing the journal "School Safety" since 1964. Its other publications include a collection of case studies of disasters, which was started in 1973. These activities have encouraged the spread of school safety throughout the country.

Safety management includes the important functions of the everyday safety inspection of buildings and equipment. In 1978, revisions were made in the School Health Law that provided measures for hazard prevention such as necessary repairs to buildings and equipment and the planning and execution of safety inspections.

Since pre-war times, schools have customarily provided emergency first aid and care in the cases of illness and injury at school. After this initial treatment the parents or guardians of the children were expected to take care of medical costs in almost all cases. After the war however, the continuing occurrence of accidents and disasters on school grounds involving groups of children aroused public concern towards providing relief for the victims of such occurrences. Under these circumstances, efforts were made in all of the nation's prefectures for creating organizations to provide assistance for victims regardless of intention or fault on the part of the person(s) responsible for an accident or disaster that occurred under school jurisdiction. Such measures aimed at keeping school education running smoothly. Also, in order to better manage a relief system, a nationwide movement developed for the government to create a school safety association. Thus, amidst this background, the Japan School Safety Association Law was enacted in 1959 followed by the establishment of the Japan School Safety Association in 1960 as a special legal corporation (this was later absorbed into the National Stadium and School Health Center of Japan). This same association began a Mutual Aid System for Disasters and Accidents, a mutual aid system financed through premiums purchased by the children's parents or guardians, by the school establishing bodies and with financial assistance for benefit funds from the national government. After the establishment of this system, a series of reforms were carried out regarding the standard level of benefits. Notably, in 1977, an increasing number of school accident related lawsuits arose which tended to discourage active school educational activities. In addition there was a strong demand from the school side that reforms be made in the standard level of benefits. Amidst this background, a subcommittee for reviewing ways of enriching the school accident benefit system, called the "Subcommittee on School Accidents" was formed within the House of Representatives' Committee on Education, Science and Culture. With reference to the goals of the Subcommittee's report, in March 1978, the Japan School Safety Association Law was revised and the Mutual Aid System for Disasters and Accidents underwent drastic reforms. Among these reforms were: large-scale increases in death and disability benefits (death benefits from 3 to 12 million yen and the highest level of disability benefits from 4 to 15 million yen) introduction of government assistance for benefit payments and a newly created special contract to cover the liability of school establishing bodies for death and disability. Moreover, in recent years, further efforts have been made to improve death and disability benefits.

The post-war school lunch program was institutionalized with the enactment of a School Lunch Law in 1954. With articles stipulating: the goals of the school lunch program, share of financial responsibility, government support, etc., it clarified national policy regarding the spread and enrichment of school lunch programs. In the following years, in answer to growing public demand for expanding actual school lunch programs, partial revisions were made in the School Lunch Law in 1956 to provide school lunches at lower secondary schools as well. In addition, a "Law Concerning School Meals at Upper Secondary Schools Having Evening Courses" followed by a "Law Concerning School Lunches at Kindergarten and Upper Secondary Departments of Schools for the Blind, Deaf and Otherwise Handicapped" were enacted. Also, in 1954, "Standards for the Provision of School Lunches" were established. This set down guidelines related to the actual preparation of school lunches, i.e.., regarding facilities, equipment, nutritional content of foodstuffs, etc.

Moreover, in order to cope with the increasing number of institutions offering school lunches, improvements were made in the function of the school lunch materials supply organization, the Japan School Lunch Association (established in 1950 as a legal corporation) due to the growing necessity of smoothly, and efficiently managing the supply of foodstuffs and materials to schools. In 1955 the "Japan School Lunch Association Law" was enacted, creating the Japan School Lunch Association as a special legal corporation (later incorporated into the National Stadium and School Health Center of Japan), thus helping to promote the effectiveness of carrying out a school lunch program.

Through the improvements gained from these laws, the following policies were promoted: financial assistance for school lunch facilities and equipment, financial support for the cost of lunches for needy school children, improvements in the supply system for school lunch foodstuffs and full financing of the post of school nutritionists by prefectural governments. The effect of these policies has been a smooth and continuous growth in the implementation of school lunch programs throughout the country. In 1976, among other innovations, rice was introduced as part of the school lunch menu and efforts are continuing towards improving school lunches.

In order to promote the placement of school nutritionists at public compulsory education schools, since 1964 the national government provided municipalities with subsidies for half of their salaries. Later however, obvious imbalances arose in employment and placement of school nutritionists due to differences in the budgetary strength of municipalities, etc. In order to cope with this situation, the School Lunch Law was amended in 1974 and the status of school nutritionist was clarified. Along with this, in order to promote proper placement of school nutritionists. standards for the number of nutritionists were set through revision in the Compulsory Education Standards Law. Along with these measures, revisions were made in the Law Concerning the Share of Salaries of Municipal School Personnel to the effect that school nutritionists' salaries would be borne by the prefecture (the same status as principals, teachers etc.) and at the same time, the national government took over payment of half of their salaries etc. under the Law Concerning the National Treasury's Share of Compulsory Education Expenses. These efforts contributed to the smooth employment and placement of school nutritionists.

The professional duties of school nutritionists were set down in the 1974 Regulations on the Professional Duties of School Nutritionists (tentative). These were further clarified in 1986 through a circular setting down specific duties as follows: l) participation in basic planning for school lunches 2) carrying out nutritional management 3) providing guidance on school lunches 4) sanitation management 5) investigations 6) foodstuff management 7) investigative research, etc.

Through these measures, the roles and duties of school nutritionists (who participate in carrying out the school lunch program as a part of school education) were made clear. Furthermore, efforts are being made for planned reforms concerning the numbers of school nutritionists through the Compulsory Education Standards Law.