Better Schools through Health: networking for health promoting schools in Europeejed_

Transcription

1 European Journal of Education, Vol. 44, No. 4, 2009, Part I Better Schools through Health: networking for health promoting schools in Europeejed_ GOOF J. BUIJS Introduction Education and health have shared interests and it is frequently considered that unifying these allows schools to become better places to enjoy learning, teaching and working. Over the last 20 years, health promoting schools have shown evidence of improving the health and well-being of the whole school community.this article is a case study about the Schools for Health in Europe (SHE) network, which is becoming one of the most sustainable school networks in Europe and worldwide. The article starts by introducing the health promoting school concept. It describes the shift from the traditional topic-based approach (school programmes on eating, sexual behaviour, drug use) to a whole school approach. A set of international guidelines is available for the health promoting school approach. Then, the article focuses on the advantages of working as a network with direct links with schools, policy makers, practitioners and researchers. It presents the need to pay attention to the health and behaviour of children and young people and goes on to describe the development and impact of creating a network of schools at European level. It focuses on the effects of networking on schools and the changes at school level, as well as at regional and national level. The SHE strategic plan is summarised, as it constitutes a roadmap for the development of the network until Some examples of the results of networking are presented, including the work on developing indicators for health promoting schools within the European context.there is consensus on the underlying principles of these schools in Europe. The article concludes with a short report about the outcomes of the 3 rd European Conference on health promoting schools held in June 2009 in Lithuania and the key points of the Vilnius Resolution, including the specific resolution presented by the young people participating in the conference, which is fundamental in the health promoting school approach of the SHE network. What Are Health Promoting Schools? The health promoting school approach was introduced over two decades ago. The concept is based on the Ottawa Charter presented at the first international conference on health promotion in 1986 (1(4): iii v). It states that health promotion is a process about enabling people, meaning that people can acquire competences to create more control over their health and environment. Until then, the more traditional approach to health education in schools was, and often still is, focused on gaining knowledge about diseases and healthy behaviour based on a closed concept of health. The new paradigm, which is the basis for the health promoting, 9600 Garsington Road, Oxford OX4 2DQ, UK and 350 Main Street, Malden, MA 02148, USA.

2 508 European Journal of Education, Part I school approach, focuses on well-being, the absence of diseases, and lifestyles and living conditions. It is an open concept in which children and young people should be involved.this implies that health promotion in schools, instead of learning how to behave and have knowledge about diseases and health threats and risk behaviour, is a democratic learning process that aims to develop children s and young people s competences in understanding and influencing lifestyles and their living conditions (Barnekow et al., 2006). This approach also takes into account the health and well-being of those who work in schools, teachers, non-teaching staff, managers, volunteers, and others. In summary, what we define as health promoting schools are schools that implement a structured and systematic plan for the health, well-being and development of social capital of all pupils and teaching and nonteaching staff.they have shown evidence of improving the health and well-being of the whole school community. This is seen in the work of Stewart-Brown (2006). School programmes on healthy eating and on mental health promotion that are developed and implemented following the whole school approach are most effective. According to St Leger (2007), the health promoting school approach is the most effective way to influence pupils health behaviour and educational outcomes. Schools, being part of the surrounding community, are designated as one of the settings that help to reduce inequalities in health. Collaboration with other relevant policy areas, for example youth, social and environmental policies and sustainable development, is essential. A set of guidelines for promoting health in schools is now available worldwide. According to this document by the International Union for Health Promotion and Education (IUHPE), the purpose of a health promoting school is twofold: to enhance educational outcomes and to facilitate actions for health by building health knowledge and skills in the cognitive, social and behavioural domains. A considerable body of evidence has emerged in the last 20 years to inform governments, schools, non-governmental organisations (NGOs), teachers, parents and students about effective school health programmes. Integrated and strategic school programmes are more likely to produce better health and education outcomes than those which are mainly information-based and implemented only in the classroom (International Union for Health Promotion and Education (IUHPE), 2009). School programmes on promoting mental health are among the most effective, especially when they include changes in the psycho-social school climate, involve pupils, teachers and parents, focus on developing personal skills and resilience, and are implemented over a longer period, i.e. more than one school year. An example is the Australian programme Mind Matters for secondary schools, which has now been introduced in several countries in Europe, including Germany and Switzerland.The guidelines identify the basic principles and components of this approach which are stated below. A health promoting school: promotes the health and well-being of students. enhances the learning outcomes of students. upholds social justice and equity concepts. provides a safe and supportive environment. involves student participation and empowerment. links health and education issues and systems. addresses the health and well-being issues of all school staff.

3 collaborates with parents and the local community. integrates health into the school s ongoing activities, curriculum and assessment standards. sets realistic goals built on accurate data and sound scientific evidence. seeks continuous improvement through ongoing monitoring and evaluation (From: Achieving health promoting schools, Goof J. Buijs 509 Linking Education and Health Schools can contribute significantly to the health and well-being of children.this is supported in the UN Millennium Development Goals, which state that every child has the right to education, health and safety.the SHE network in Europe has added that every child has the right to be educated in a health promoting school.this fits in very well with the the UN Convention on the Rights of the Child and the Council of Europe s European Convention on the Exercise of Children s Rights. In 2007, the World Health Organization (WHO), together with United Nations, international organisations including the World Bank, UNICEF, regional offices of WHO, and experts from all over the world met to draw upon existing evidence and practical experience in promoting health through schools. The meeting led to a statement describing effective approaches and strategies that can be adopted by schools to promote health, education and development.the following five key challenges were identified: the need to continue building evidence and capturing practical experience in school health; the importance of improving implementation processes to ensure optimal transfer of evidence into practice; the need to alleviate social and economic disadvantage in access to and successful completion of school education; the opportunity to harness media influences for positive benefits; and the continuing challenge to improve partnerships among different sectors and organisations. The participants identified actions to respond to these challenges, highlighting the need for action by local school communities, governments and international organisations to invest in quality education and to increase the participation of children and young people in school education (Tang et al., 2009). The health of children and young people in Europe can be called satisfactory. But there is serious concern about their health behaviour in certain areas, including eating, exercise, alcohol use, mental health and sexual health. A rich source of information on this issue is the recent international report from Health Behaviour in School Children (HBSC), a WHO collaborative cross-country study on the wellbeing of young people in industrialised nations. It presents the key findings on patterns of health among young people in 41 countries and regions across Europe and North America and a status report on health, health-related behaviour and the social context of young people s health in The report focuses more especially on health inequalities (WHO Europe, 2008). In Europe, close to 1 in 4 children is overweight, with figures rapidly increasing. There are considerable differences amongst the countries and boys and those from low affluence families

4 510 European Journal of Education, Part I report higher levels of overweight and obesity, particularly in North America and Western Europe. It is recognised that factors linked to living conditions, such as poverty, discrimination, youth unemployment, job insecurity and housing problems have an impact on the health and well-being of children and young people, while schools are regarded as important settings for promoting a healthy lifestyle (WHO Europe, 2009). A WHO report (2009) on the current health status of children and young people in Europe shows that processes and effects of economic hardship and deprivation include: social exclusion and lack of opportunity to engage in activities that promote or support health; impacts of perceived low social and economic status on well-being; direct effects of material deprivation and poverty on social and living conditions; and lack of social support to withstand and cope with hardship. This report concludes that educating children and young people is a strategy to change these trends. At European policy level, this is expressed in the European Union s Council Resolution on the health and well-being of children which was adopted in 2008 (European Union, 2008). The Council of Europe has launched a project called Building a Europe for and with children which promotes children s rights and the protection of children from violence (Council of Europe, 2009). One of the priorities in European Public Health is mental health.this has led to the European Pact on mental health and well-being (European Union, 2008). There is increasing awareness that the voice of children and young people should be heard in these developments. Therefore, in July 2009, as part of its Youth Health Initiative, the European Commission organised the conference Be healthy be yourself, with more than 500 participants, including over 200 young people. It aimed to listen to young people and to actively involve them in the decision-making process about their health. It also generated commitment from stakeholders to improve young people s health. The main conclusion of the EU commissioner for health, Mrs. Vassiliou, was to take joint action on four themes: empowerment and participation; inequalities and vulnerability; communicating health; and mainstreaming these principles across European health policy. So even though European children s health may be relatively good, there is a growing preoccupation across Europe with issues of children s health and wellbeing due to their lifestyles and living conditions. Networking at European Level The time children spend at school is very important for their intellectual, social and mental development. Almost all children in Europe attend school between the ages of 4 and 18. In the 27 EU Member States, there were 98.3 million pupils in 2005 (WHO Europe, 2009). On average, they spend about 1000 hours per year in school. Health and health promotion traditionally are one of the components of the curriculum. Also, school health services are available in all European countries,

5 Goof J. Buijs 511 providing primary health care and screening of pupils during their school years. Pupils learn to care for their own health and well-being and that of their peers. Research over several years demonstrates that the impact and effectiveness of what children learn about their health and behaviour are increased by developing a whole approach. Since the early 1990s, schools have engaged in becoming health promoting schools in a number of countries in Europe. They set up national networks that were coordinated at a national level. Thanks to the initiative of the World Health Organization for the European Region, the Council of Europe and the European Commission, these networks were linked with the launch of the European network for health promoting schools in Starting with 7 countries in 1992, it now includes 43 member countries. It demonstrated progress in establishing school health promotion as part of the core work of schools in member countries and in developing cooperation between the health sector and the education sector. At present, the network is called the SHE network Schools for Health in Europe network. It focuses on making school health promotion a more integral part of policy development in both the education and the health sector in Europe. SHE encourages each member country to develop and implement a national policy on school health promotion, building on the experiences within the country, within Europe and globally. This policy will also be supported by enabling schools to actively take part in a wider community in Europe. SHE is recognised as one of the leading international networks on school health promotion. Its main aim is to support organisations and professionals to further develop and sustain school health promotion in each country by providing the European platform for school health promotion. To mainstream its activities, the SHE strategic plan outlines its objectives until These include maintaining and expanding the network into a leading international network and community with a focus on research and creating a knowledge hub for school health promotion. Also, SHE wants to provide ongoing technical support in Member States, with an emphasis on Eastern Europe and the Central Asian Republics. It wants to create and maintain active collaboration with the education sector and other relevant sectors (youth care, social care, environment and sustainable development) at an international level. Examples of Good Practice Two examples of good practice of health promoting school networks operating at a national level are now given.they were presented as case studies during the 3 rd European Conference for health promoting schools and collected in a separate publication (Buijs et al., 2009). Experiences in Slovenia Slovenia was among the first countries to join the European network of health promoting schools, starting with 12 pilot schools in Now, 43% of all Slovenian primary and secondary schools, in total 268 institutions, are members of the national network. The national coordination is through the National Institute of Public Health, with the support of the Ministry of Health and the Ministry of Education. Regional coordination is carried out by regional public health institutes. A recent evaluation demonstrated the success of this network. The most successful methods were:

6 512 European Journal of Education, Part I in-service training for teachers in health promotion; having a school team in each school; systematic planning and evaluation of school tasks related to health; working meetings with school leaders three times per school year; a leading health theme for each school year; an annual conference for all schools in the network; a bulletin with good practice examples; and professional management of the network and support to schools. Difficulties that were encountered were frequent government changes, especially in the health and in the education sector, lack of financial resources for schools and the fact that teachers time is increasingly taken up with tasks relating to the core curriculum. School leaders from health promoting schools in Slovenia emphasise the importance of systematic planning, evaluation and working on interpersonal relations between pupils, parents and teachers. The Example of Scotland Developing the school as a health promoting setting has been an area of focus and discussion for almost 20 years in Scotland, which joined the European Network of Health Promoting Schools in It was gradually recognised that for the health promoting schools approach to be sustainable in Scotland there should be a strong partnership between the health and education sectors, acknowledging the contribution of each and building developments into existing education structures, policies and practice. With health, education and other key partners collaborating to ensure policy coordination and coherence, two recent developments have taken health promotion in schools to another level. Introduced in the Scottish Parliament in the spring of 2006, a new act enshrines the health promoting school and new nutritional regulations in schools. Curriculum for Excellence is the new education framework for all schools in Scotland. Health and well-being is a new and important curricular area, which has been identified as the responsibility of all staff, together with literacy and numeracy. Curriculum for Excellence will be the vehicle that will ensure future delivery of health promotion in Scottish schools. Key findings in learning from the Scottish example highlight the importance of: recognising and acknowledging existing practice; establishing strong partnerships between health and education at all levels; building onto and into existing mechanisms and structures where possible; strengthening cross-sectorial collaboration; and cross-government work. What Networking at the European Level Can Achieve The ongoing support at international level fromwho Euro, the Council of Europe and the European Commission is key for the existence of the SHE network. This unique and sustainable partnership of the three organisations creates a strong driver and basis for the network which is coordinated by the Netherlands Institute for Health Promotion (NIGZ), acting as a WHO collaborating centre for school health promotion. At the national level, the SHE national coordinator is the key contact

7 Goof J. Buijs 513 person for the development and implementation of school health promotion.there are 43 member countries in the European region, from Iceland to Kazakhstan. Most coordinators were nominated by their national Ministry of Health and their Ministry of Education. This ensures a strong commitment to the project. Evaluation research within the network on the involvement of the Ministry of Education has shown its crucial importance for the success of national programmes (Piette, 2002). In general, collaboration with partners from outside the school is one of the main keys to success in developing the health promoting schools approach, not only between different sectors at the national, regional and local level (i.e. education, health, social welfare, youth care, sport etc.), but also with everyone involved in the everyday life of the school (i.e. school psychologists, school nurses, parents, paediatricians, school social workers, etc.). Every year, the SHE coordinators meet in the SHE assembly, which is the deciding body of the network. There is an interesting diversity among European countries concerning school health promotion. In most countries, there are national programmes on school health promotion and national and regional networks of health promoting schools. A recent publication resulting from the 3 rd Conference on health promoting schools (Buijs et al., 2009) gives interesting insight into what is currently happening in Europe, with case studies of practice. The focus of these national networks is on children and young people between 4 and 18 years of age who are attending school. Some countries, including Slovenia and Estonia, have national networks of healthy preschools, targeting the 0-4 year-olds. Germany has a national network of health promoting universities, reaching students as from the age of 18. In the sections below, some examples are presented of networking in school health promotion at the European level. Developing Indicators for Health Promoting Schools An example of successful networking at a European level is the joint development of indicators for health promoting schools. International workshops were held on the practice and evaluation of the health promoting schools approach in Europe between 1998 and They led to case studies on different stages and levels of indicator development and evaluation.the publication (Barnekow, 2006) contains reports of case studies from 20 European countries that were divided into 4 groups: overviews of indicator development at national level development of indicators for regional strategies and support structures using indicators at the school and classroom level involving teachers and students in developing indicators. It shows the cultural diversity and pluralism within Europe on health concepts, education systems, methods of enquiry and interpretation of evidence, as well as the relevance and potential of working together on this relevant issue. Many European countries have made considerable progress in developing indicator systems and associated tools for assessment and evaluation. Some examples are given below: 1. One important development is the attempt to integrate the development of health promotion indicators with approaches to conceptualising and assessing the educational quality of schools (in the case studies of Germany, Scotland and Switzerland).

8 514 European Journal of Education, Part I 2. There is an interesting example of cross-national collaboration and agreement in the specification and application of indicators in the joint case study from Estonia, Latvia and Lithuania. 3. Other case studies are more focused on specific and local aspects of school health indicator development in a country. The reports from the Czech Republic and The Netherlands show a shift from centralised to regional systems of support for school health promotion. 4. Several reports emphasise processes of active consultation of teachers and students in clarifying useful indicators for health-promoting schools (e.g. Cyprus and Ireland). Demonstrating how teachers and students can formulate and use indicators at the level of the school and the classroom and in relation to concrete educational and health issues is also essential (reports from Denmark, Finland and Romania). As a result, it is recommended to further share knowledge on existing indicator systems for health promoting schools in the European network and internationally. There is a need for further systematic development and research on indicators. European Conferences on Health Promoting Schools Another example of successful networking in school health promotion is the three European conferences that have been organised since Their overall aim was to share experiences, provide evidence and help to put the issue higher on the European and national political agendas. 1. At the first European conference, the main principles for health promotion in schools were outlined (Greece, 1997). Consensus was reached on ten principles including democracy, participation and empowerment and proclaiming the right for every child to be educated in a health promoting school. The event attracted more than 400 participants from schools and regional and national organisations, as well as national coordinators, researchers and policy makers. 2. At the second European conference in Egmond aan Zee, The Netherlands (2002), the importance of partnerships between the education and health sectors was emphasised.the Egmond Agenda is a tool to help establish and develop school health promotion across Europe. It has been used by national coordinators for professionalising their work, for example in The Netherlands. 3. The third European Conference, Better schools through health,vilnius, Lithuania, June 2009, aimed to provide a next step in school health promotion in Europe by common actions across sectors and borders. During the conference, young people played an active role in sharing their ideas and working together on making their school a better place to learn and work. At thevilnius conference, there were more than 300 participants from 31 countries, including 39 young people (from secondary schools in Estonia, Finland, Latvia, Lithuania,The Netherlands, Portugal and, Spain).The young people had a parallel programme consisting of a workshop where they shared ideas and demonstrated their ability to act.they showed their potential to work towards a shared goal, as was illustrated by their contribution to the conference resolution.

9 Goof J. Buijs 515 The three-day event brought together specialists from health, education and social sectors, policy makers, and representatives from municipal and youth organisations, parents organisations and academic institutions, as well as all those with a professional interest in school health promotion. They discussed effective ways of investing in school health promotion in Europe by common action across sectors and borders. Also, it was an occasion to alert policy makers that improving the health of children and young people in the school setting and the broader community needed stronger political support. The conference provided ample opportunities to disseminate best practice in the scientific, practical, and political aspects of school health promotion. The focus areas included: education, health determinants, policies and strategies, effectiveness and evidence, sustainable development, and new challenges. These themes were supplemented by discussions on professional capacity building and deliberations aimed at supporting the EU Member States in closing the current gaps in the implementation of health promotion in schools. Support to all European countries in developing effective strategies, policies and good practices on school health promotion in Europe was also an important issue on the agenda. The Vilnius Resolution The Vilnius Resolution was presented, discussed and adopted during the 3 rd European conference. It marks the main outcomes of the conference as a next step in the development of school health promotion in Europe. For the first time, the work of students during a European conference was included, demonstrating their active involvement and participation, which are part of the underlying principles of the health promoting school approach. Statement by young people We, the young people at the conference, have concluded that there are some problems that we can deal with and others for which we need adult s help. We emphasize that true health is holistic health, meaning mental and physical balance, clean environment, cooperation with people, good rest and a balanced diet. We want school leaders, teachers and students to try to create a healthier and better society which should think about the present and the future. We want to have greener school surroundings. We want to cooperate with students from other countries to have more discussions with scientists and politicians about our problems. We want more practical and learning activities on health promotion and consultations by experts in stressful situations. We think that if we follow the holistic approach, we will be able to deal with our health, including eating disorders, a lack of rest, and make our society or even the country stronger. We believe that if we lead an active life, help the poor, believe in what we do, cooperate with teachers to make our learning environment better and warmer, that we will then be able to have a healthier and happier life. We can and must lead a healthy lifestyle ourselves, showing how wonderful it is to be healthy, active and positive. We also must persuade parents to be active and take part in health promoting activities.

10 516 European Journal of Education, Part I The conference resolution contained statements targeting both the political levels (international, national and regional) and the school level. International, National and Regional Level As a result of the discussion of the conference, the participants called on governmental, non-governmental and other organisations at international, national and regional level: 1. To adopt and extend the health promoting school approach as part of school development. 2. To guarantee long-term support through international, national and regional policies and strategies, combined with sufficient resources and capacity. 3. To acknowledge that planning, monitoring and evaluating and the involvement of children and young people are all necessary when implementing a comprehensive health promoting school programme with realistic objectives. 4. To foster continuous professional development for education, health and other staff. 5. To develop and maintain an infrastructure for international, national and regional coordination and communication on and support for health promoting schools. 6. To celebrate and share milestones and successes. School Level They urged the school community (including pupils, parents, teaching and nonteaching staff, management, school boards) to use the support available: 1. To introduce, maintain and further develop the health promoting school approach, building this into sustainable school development. 2. To involve the whole school community and partner organisations. 3. To secure sufficient commitment, resources and capacity. 4. To foster continuous professional development for staff. 5. To ensure that children and young people are actively involved in decision making and all stages of programming. 6. To celebrate and share milestones and successes. The European conference contributed to the process of collecting and consolidating the evidence base for school health promotion. It created possibilities to examine variations in national and regional implementation policies, strategies and models of good practice among European countries. The conference revealed the increasing importance to focus on the promotion of health in the school setting and build on the European Mental Health Pact. Evidence was provided to identify the existing, but less developed areas, including the links between health promotion and sustainable development. One outcome of the conference was the collection of case studies of the practice of school health promotion: Better schools through health: learning from practice.

11 Goof J. Buijs 517 The SHE Pillars and Core Values for Health Promoting Schools The final example of collaborating and networking at European level is the recent definition of the shared underlying principles in Europe on the health promoting school approach called the SHE core values and pillars (Buijs, 2009). These provide a basis for all the schools that are working together and underpin their actions and programmes. The five SHE core values are equity, sustainability, inclusion, empowerment and democracy. Equity Health promoting schools ensure equal access for all to the full range of educational and health opportunities. This in the long term makes a significant impact in reducing inequalities in health and in improving the quality and availability of life-long learning. Sustainability Health promoting schools acknowledge that health, education and development are closely linked. Schools act as centres of academic learning. They support and develop a responsible and positive view of pupils future role in society. Health promoting schools develop best when efforts and achievements are implemented in a systematic way for a prolonged period, for at least 5-7 years. Outcomes (both in health and education) mostly occur in the medium or long term. Inclusion Health promoting schools celebrate diversity and ensure that schools are communities of learning, where all feel trusted and respected. Good relationships among pupils, between pupils and school staff and between school, parents and the school community are important. Empowerment and action competence Health promoting schools enable children and young people, school staff and all members of the school community to be actively involved in setting health-related goals and in taking actions at school and community level, to reach these goals. Democracy Health promoting schools are based on democratic values and practise the exercising of rights and taking responsibility. The five SHE pillars are: whole school approach, participation, school quality, evidence and link with communities. Whole school approach to health There is a coherence between the school s policies and practices in the following areas which is acknowledged and understood by the whole school community. This approach involves:

12 518 European Journal of Education, Part I a participatory and action-oriented approach to health education in the curriculum; taking into account student s own concept of health and well-being; developing healthy school policies; developing the physical and social environment of the school; developing life competencies; making effective links with home and the community; making efficient use of health services. Participation A sense of ownership is fostered by students, staff and parents through participation and meaningful engagement, which is a prerequisite for the effectiveness of health promoting activities in schools. School quality Health promoting schools support better teaching and learning processes. Healthy students learn better, healthy staff works better and have a greater job satisfaction. The school s main task is to maximize school outcomes. Health promoting schools support schools in achieving their educational and social goals. Evidence School health promotion in Europe is informed by existing and emerging research and evidence focused on effective approaches and practice in school health promotion, both on health topics (e.g. mental health, eating, substance use), and on the whole school approach. Schools and communities Health promoting schools engage with the wider community. They endorse collaboration between the school and the community and are active agents in strengthening social capital and health literacy. Conclusion In Europe, the health and well-being of children and young people are high on the international and national political agendas. Schools play a very important role in improving their health and well-being and contribute to reducing the existing inequalities in health. The health promoting school approach supports a healthy start in life for children and young people. Health contributes to better learning. Increasingly, health and well-being are regarded as an entry-point for school improvement and school development. Collaboration with the education sector and with new school policy areas, such as sustainable development and equity, is of high priority. There is a need for further systematic development and research on indicators in order to evaluate the impact and effectiveness of health promoting schools. There is a need for closer collaboration between the health sector and the education sector and integral educational quality systems.

13 Goof J. Buijs 519 The SHE network demonstrates how networking at an international and national level can be effective and sustainable. Networking at a European level has stimulated the development of indicators for health promoting schools. Also, three European conferences were organised by the network, attracting a wide audience of researchers, policy makes, practitioners and schools. The most recent adopted the Vilnius Resolution, which is a new tool for governments and schools to introduce school health promotion, intended to help put health promoting schools higher on the international and national educational and public health agendas. Finally, shared underlying principles for the health promoting school approach and the SHE core values and pillars have been adopted by the European network. NOTE For information about the SHE network and the 3 rd European conference, including the Vilnius Resolution: REFERENCES Barnekow, V. et al. (2006) Health Promoting Schools: a resource for developing indicators (International Planning Committee). Buijs, G. (2009) SHE Strategic Plan : schools for health in Europe network (NIGZ, Woerden, The Netherlands). Buijs, G., Jociute, A., Paulus, P.& Simowska, V. (2009) Better schools through health: learning from practice. Case studies of practice presented during the third Conference on Health Promoting Schools, Vilnius, Lithuania, June 2009 (VASC/NIGZ, Lithuania). Council of Europe (2009) Building a Europe for and with Children European Pact for Mental Health and Wellbeing (2008) EU High Level Conference Together for mental health and wellbeing, Brussels, June European Union (2008) Council Resolution on the Health andwell-being of Children International Union for Health Promotion and Education (Iuhpe) (2008) Achieving Health Promoting Schools. Piette, D. et al. (2002) EVA Tracking down ENHPS Successes for Sustainable Development and Dissemination: The EVA2 Project (Copenhagen, WHO). Stewart-Brown, S. (2006) What is the Evidence on School Health Promotion in Improving Health or Preventing Disease and specifically,what is the Effectiveness of the Health Promoting School Approach? (Copenhagen, WHO European region). St. Leger, L., Kolbe, L., Lee, A., Mc Callc, D.& Young, I (2007) School health promotion: achievements, challenges and priorities, in: D. Mc Queen & C. Jones (Eds) Global Perspectives on Health Promotion Effectiveness (Springer). Tang,K.C.et al. (2009) Schools for health, education and development: a call for action, Health Promotion International, 24, pp Who Europe (2008) Inequalities inyoung People s Health: HBSC international report from the findings of the 2005/2006 survey (Copenhagen). Who Europe (2009) A Snapshot of the Health of Young People in Europe (Copenhagen).

14 Better Schools through Health: networking for health promoting schools in Europeejed_1410_1 1 Education and health have shared interests. Unifying these allows schools to become better places to enjoy learning, teaching and working. Health promoting schools have shown evidence of improving the health and well-being of the whole school community. At the European level, the Schools for Health in Europe (SHE) network is one of the most sustainable school networks in Europe and worldwide. This article explains how health helps to create better schools. It focuses on the advantages of working as a network at a European level with direct links with schools, policy makers, practitioners and researchers. It describes the impact of networking on schools, what changes take place at the school level, and also at the regional and national level. The SHE strategic plan, which is a roadmap for the future development of the network until 2012, is summarised. Some examples of the results of networking are presented, including the work on developing indicators for health promoting schools within the European context. The article concludes with a report of the 3 rd European Conference on health promoting schools held in June 2009 in Lithuania, with the Vilnius Resolution as its important outcome.