In health, M2
The birth of U.S. colleges can be traced to events spread between 1636 when the Massachusetts legislature passed a bill that would pave the way in 1639 for the chartering of Harvard College (later Harvard University). In the next one hundred and thirty years a number of colleges would be created, though none would contain any health or medical education. It was not until the College of Philadelphia (later the University of Pennsylvania) created the first professorship in medicine in 1765 that health, as a college issue, would appear (Rudolph, 1990). While this effort in Pennsylvania would create a form of health education, the concept of health education as it is known today would not appear for almost two hundred more years.
The colonial curriculum most frequently included Latin, Greek, logic, Hebrew, rhetoric, natural philosophy (physics), mental philosophy (metaphysics), moral philosophy (later separated to include ethics, political science, economics and sociology), and mathematics. No mention of hygiene or health was found in the early college education plans (Rudolph, 1990). Following the American Revolution at the end of the century, new colleges were chartered in many new states including North Carolina, Vermont and Tennessee, with a few offered medical education, but not addressing health beyond the response to disease (Rudolph, 1990).
This century of health education in higher education would see the advent of classes addressing hygiene and health issues. The first college to introduce courses in hygiene was Harvard College in 1818 (Means, 1975). Notable schools including Dartmouth, Williams, Yale, and Amherst would follow Harvard within a few years. While many of these schools would require coursework, not all would offer academic credit toward graduation requirements for this effort (Turner & Hurley, 2002).
In 1824, Thomas Jefferson included a college of anatomy and medicine from the initial designs of the University of Virginia. While this would be an example of early medical education, it did not have a focus on health education as is known today (Rudolph, 1990). Just two years later, Virginia would take a step toward health education with a determination by the Board of Visitors that a Professor of Medicine would be available for thirty minutes, three days a week to assist students with personal health concerns (Turner & Hurley, 2002).
Throughout the later 1800s more colleges added some form of health service, but the focus remained on the physical well-being of students and the only documented health education for students came from those schools who had physical education classes (Turner & Hurley, 2002). Additionally, with the rise of the professional college football coach, the coaches were seen as advocates for “clean-living and high-thinking.” First to be given a professional rank and tenure was Coach Stagg at the University of Chicago (Rudolph, 1990).
At the end of the century, a number of colleges had now included some form of hygiene or health education into the curriculum and a few of these courses were taught by staff from the college health services. By 1895, Cornell University in New York had physical training and hygiene courses that were required yearlong studies, though elective to the main curriculum (Rudolph, 1990). In 1899, Yale University begins to permit undergraduates to take courses in medicine as a part of their studies, where this course of study had previously been limited to professional schools for post-baccalaureate students (Rudolph, 1990).
A major shift in approaches to health education and the coming of modern health education concept would occur in the next one hundred years. This century would see physical education, hygiene and related courses introduced into the college curriculum and when combined with efforts to control communicable diseases would bring the health education side of public health onto college campuses (Grace, 2002). Before the mid-point of the century, the U.S. Department of Labor would recognize Health Education as a specific health service occupation in the Standards Occupation Classification and the end of the century would see the establishment of the National Commission for Health Education Credentialing (Zimmer, 2002).
Meanwhile, the early 1900s also saw parents of college students calling for health education to be offered on campus (Zimmer, 2002).
In 1925, the American Student Health Association created a standing committee on informational hygiene (Boynton, 1971). This is followed two years later by publication of a report from The Presidents’ Committee of Fifty on College Hygiene. In the report, the committee describes objectives that should be a part of a comprehensive student health service including:
5. To discover illogical or defective health attitudes and habits and supply appropriate scientific information and advice for their correction.
7. To teach hygiene by means of the pertinent scientific information and advice given the individual student concerning the nature and importance of his health needs as show by his health examination, consultations, and conferences (Storey, 1927).
These objectives would provide a foundation for the growing need for educating students on health information that they are not receiving from other sources.
In 1936, an international conference on college and university student health services was held in Athens, Greece. During the conference, discussions included “prophylactic means for bettering the health of students,” and conservation of health status (Turner & Hurley, 2002). One year later, in the U.S., a survey of 352 schools yields no information on health education activities in college health, as no questions on the topic were included (Turner & Hurley, 2002).
In 1939, a book titled The Health of College Students is published which acknowledges that educating college students on matters of health is of primary importance. The author discusses how health education has evolved in different departments on college campuses. The book goes on to say “the most important single health problem of college student revolves around their health ignorance. The most fundamental activity of the college health program, therefore, is concerned with the dissemination of sound health information” (Diehl & Shepard, 1939). During this time on U.S. college campuses, members of the hygiene faculty primarily handled health education. The author offered a critique on the health education activities by going on to say, “many colleges are forced to delete or limit hygiene teaching because no member of the faculty is equipped to teach the subject” (Diehl & Shepard, 1939).
One of the landmark surveys of college health would take place in 1953. Doctors Moore and Summerskill would receive responses from 1157 colleges and universities, representing sixty-one percent of higher education institutions in the U.S. at the time. In response to this survey, 200 colleges stated that they had “no responsibility for health of students in any way” (Moore & Summerskill, 1954).
Of the 957 other responding schools, researchers found that eighty percent of schools with a college health service also offered courses in health education, with slightly more than fifty percent of schools requiring a health education course for all students and another twenty-five percent requiring these courses for select majors (usually health-related). A department other than the health services supervised more than sixty percent of the health education activities. In this survey, prevention of disease, a common objective of health education today, is limited to vaccine and immunization issues. Nutrition, now common in college health education programs, was a function of health services at a little over one third of the surveyed schools. From a staffing perspective, a small number of schools acknowledged having a dietician or nutritionist on staff, but otherwise, no mention of health education or health promotion staff can be found (Moore & Summerskill, 1954).
The Fourth National Conference on Health in Colleges (1954) was held and health education is widely discussed. The definition of health education would vary widely during this meeting, with some discussing the idea of health education academic courses and others mentioning health educators as part of the student health staff (Ginsburg, 1955).
In 1957 Millersville State Teachers College in Pennsylvania (later Millersville University) conducted a self-study of the college health program and dedicated an entire chapter to health education. Included in the chapter are standards found on the campus. It should be noted that most of the health education activities discussed in the report were accomplished via classroom-based courses while the study authors do acknowledge activities of “incidental health education” (Pucillo, 1957).
In a book published in 1964, the editor suggests that college health services have assumed the responsibility for health education and preventative medicine in an effort to reduce the need for treatment. The book also claims that institutional health education programs (academic programs) have preceded and are better organized than the college health services. There are discussions within the text that the idea of special hygiene classes given to large groups of students are now “more the exception than the rule,” reflecting a reversal of the early trend in health education on college campuses. They go on to discuss the idea that health programs should be in line with, and facilitate the educational mission of, the institution (Farnsworth, 1964).
Another development of the 1980s was the move to link health education with the academic and life preparation missions of colleges and universities. Leafgren & Elsenrath discussed in 1986 that any effort at health promotion begins with an assessment of the current health status of entering students. The next step is to assist students interested in making progress toward the next level of wellness. “A campus that emphasizes wellness programming for its student body will assist those students in gaining a competitive edge for graduation and successful placement in the business world” (Leafgren & Elsenrath, 1986).
______
Michael P. McNeil, MS
Assistant Director, Alice! Health Promotion
Health Services at Columbia
212-854-5453 phone
mm3117@columbia.edu
Chair, ACHA Health Promotion Section
ACHA Alternate Representative, IATF
Downstate NY Coordinator, The Bacchus Network
??Please consider the environment before printing this e-mail.
Filed under: Featured Articles and
Leave a Reply