As an early career teacher, physical education to me was about sports and getting kids active. But as my career has progressed and I’ve thought more about my role as a physical and health educator, I’ve started to wonder about whether the way that I teach health or engage my students in learning about health is really helping them to become healthier individuals.
So I did what any good inquirer would do. I consulted the research and I reached out to experts in the field to help me understand my role as a physical and health educator in the teaching of health to my students. What I quickly came to understand is that this is a complex issue and an issue that the physical and health education community has been struggling to find an answer to for some time.
I recently released a podcast on the topic which you can listen to below, or by subscribing on your favourite podcast player.
Pathogenic vs Salutogenic: What the Health?
Historically, approaches to the promotion of health have often been founded on a deficit or risk model. This model emphasizes patterns of ill health and diseases, their prevelance and how to treat and or avoid the diseased condition. When employed within the context of a school health and physical education program, such approaches emphasize the idea that a problem exists. One that must be fixed. This approach is rooted in a pathogenic approach to health education, involving minimizing the risk of falling ill, and has received international precedence within many health and physical education curriculums.
By adopting a salutogenic approach, health is not regarded as something that a person either has or does not have. Instead, it is about what promotes or prevents the development of health and wellbeing. Health is then regarded as dynamic, something one is always in the process of becoming. A salutogenic approach to health is related to creating and improving the experience of physical, mental and social wellbeing.
In a salutogenic, strengths-based model, the approach would focus on the knowledge, understanding and skills to enhance different assets and resources to promote people’s health and wellbeing. In order to live a good life, students would learn how physiological, psychological, social, cultural, environmental, and economic resources help or hinder people to develop their health and foster their growth as change agents in society in order to promote healthy lives for all.
As an example, instead of exclusively asking questions about how decreased participation in physical activity should be avoided because of the correlation between decreased physical activity and the risk for coronary heart disease. We could also ask how learning in about and through movement promotes people’s strengths and resources in order for them to live a good and enjoyable life. In this way, physical activity is beneficial for students health in many more ways – social, psychological, and cultural – than just as a protection against disease. Importantly, this approach does not exclude addressing risks or illnesses influencing health development. However, the orienting questions become “Why do people stay healthy?” and “What keeps people healthy?”
So What Now?
As a physical educator in a country like Canada, or other similar countries like Australia and New Zealand, where physical education and health education have been brought together and teachers tasked with delivering a health curriculum intended to address concerns for at-risk behaviors or students, there are concerns that a more prevailing healthism discourse relating primarily to fitness and physical wellbeing is influencing the way that a curriculum is both interpreted and delivered.
So, what can we do as physical educators? Who should be tasked with teaching health? Should this salutogenic approach be our focus? Can we expect to really impact the health of our students in the short amount of time we see them?
I asked the experts for their thoughts around the role and responsibility that physical educators have in teaching health. For this podcast I spoke with:
- Mikael Quennerstedt from Örebro University in Sweden.
- Sarah Benes and Holly Alperin, authors of books on Skills Based Health Education.
- Andy Milne ,2017 SHAPE America Health Teacher of the Year.
The Role of Physical Educators
If we are to move away from the implicit belief among many physical educators that exercise through the notion of fitness leads to health, and that exercise is essential to health and that being fit and having a slender body are proof of health, there needs to be a radical shift in focus for health education practice from teaching young people, how to be healthy toward the different ways in which young people do health and how they learn to make sense of themselves as healthy or not in the local and global context within which they live.
Quennerstedt suggests that we move beyond the pathogenic notion of health and physical education and instead focus on asking salutogenic questions. Not seeking answers to the issues of health, but as alternatives to questions about risks and deficit. Questions about health should focus on health resources or barriers for health development and not on simply avoiding risk. Instead of looking at things like why girls drop out of sport, perhaps ask the question “Under what circumstances they stay in sport?”
While physical educators, undoubtedly have a role to play in the promotion of health for young people within our schools, perhaps it’s not the content heavy approach that we’ve been using for so long. Perhaps, if we start to ask more salutogenic questions and consider alternative ways of viewing health. To explore implementing a skills based approach to health, perhaps we can make a greater impact upon the health of the young people that we serve, instead of expecting them just to run and get fit to reduce the risk of them being obese and contracting some lifestyle disease.
Salutogenisis offers health and physical educators, a wider and more positive perspective on health, and on how movement activities can enrich people’s lives rather than merely reduce the risk of illness. This perspective allows curriculum developers to promote a strengths-based or skills-based approach in contrast to a pathogenic or deficit approach to health
It would be foolish to think that there are not going to be challenges and bumps along the road as we try to change the way that we view and teach health and physical education. I hope the information and conversations shared in this podcast and blog post have provided some food for thought for you as you consider the best way to approach health education. I hope you feel empowered to ask questions and critically reflect upon the way that health education is taught in your setting. My big takeaway. And what I’ll leave you with as we finish is, It’s not about what we teach in health education. It’s more about how we go about it.
Nathan Horne is a physical & health educator, currently based in Canada. Nathan is also the founder of iPhys-Ed.com & The PhysEd Library. Be sure to never miss out on any of iPhys-Ed.com’s future posts by connecting with us via Twitter, Facebook, Youtube or Instagram. Nathan can be contacted on Twitter @PENathan.
What the Health? Great title👏
Very interesting and thought provoking article. I will plan to listen to the podcast soon! The positive approach has always been the best approach in all things.
Thank you!
Nathan,
Nicely done. I enjoyed the article and I agree that a Salutogenic approach is much better than a Pathogenic-dominated one.
I think what would really add more to this discussion is a clear definition or explanation of “Health,” or at least what YOU take Health to be. This is a term that means something different to different people (which is fine, of course), so it’s a good idea to offer up your version right away.
Last thing, and sorry to get a little nit-picky here, but rather than “reach” potential, maybe it would be better to talk about activating it? Saying that we reach potential makes it sound like there is a potential future form that we are destined to become and all we have to do is finally get there someday. I’m not convinced that’s what’s actually happening. Instead, we ARE potential desiring potentiation, and so potential is something we activate every moment in our aims to be and live well together.
Thanks!
Nate
This was very thought provoking but sadly a true reflection of health teachers as a secondary subject to PE. I really enjoyed listening to this and now challenging some of these common experiences in health classes.
Thank you 🙂