School health education: from biomedical to socioecological approach

Abstract

School health education has been a matter of intense research. Some works have focused on the dominance of the biomedical approach and the need to encourage health promotion in textbooks and in teaching. The classical biomedical approach to health, taken as a mere absence of disease, has a limited vision of health, with implications for its understanding by teachers and students, and especially for an effective construction of individual and collective healthy practices. A possibility to overcome these difficulties is complementing the biomedical approach with another health approach to surpass its limitations. The present study intended to present a critical review of the literature aiming at analysing the theoretical and practical indicators that differentiate health approaches and so identifying the most appropriate ones for school health education. The corpus of this study consisted of articles published in peer review scientific journals. Four databases were used, two in English (Scopus and ERIC) and two in Latin language (LILACS and SciELO). All abstracts of the obtained 5717 articles were read but only 974 appeared to discuss theoretical health aspects or health practices. Of these, 644 were excluded because they were in books, proceedings or thesis. Other 161 were eliminated because they were repeated articles or not appropriate to the study, as they did not discuss different ways of thinking and acting in health. The final 169 relevant articles were fully analysed. Five health approaches were identified: religious, biomedical, ethnomedical, behavioural and socioecological. Biomedical and socioecological approaches were identified as presenting very distinct characteristics, the former being more traditional and strongly rooted in the modern technological society and the latter of multidimensional features and still in progress. School health education can benefit from the recognition of these two approaches to be used complementarily: biomedical approach with emphasis on diseases and prevention; socioecological approach giving students the opportunity to reflect on multifactorial aspects influencing their own health and so empowering them to exercise their healthy choices as free citizens and promoters of their own health and of their community.