Massachusetts Comprehensive Health Curriculum Framework - October 1999

Core Concept

Through health literacy, self-management skills, and health promotion, comprehensive health education teaches fundamental health concepts, promotes habits and conduct that enhance health and wellness, and guides efforts to build healthy families, relationships, schools, and communities.

Health Literacy focuses on acquisition of knowledge and includes:

  • the capacity to obtain, understand, and evaluate health information and services;
  • learning about physical changes and how the body functions; and knowledge of the relationship between movement and health.

Through reading, observation, discussion, and actions students learn to locate information and assess its reliability, make reasoned decisions based on accurate information, and apply their knowledge to their own health and safety. Students learn what it is to be healthy, about development, and about the importance of physical fitness in their overall level of health and wellness. Health literacy is critical for healthy self-management and health promotion.

Healthy Self-Management enables students to:

  • integrate and apply knowledge and skills with respect to their health-related decisions, actions, and conduct;
  • learn to assume increased responsibility for their health-related decisions, actions, and conduct; and
  • consider potential consequences and evaluate outcomes.
  • Healthy self-management entails self-assessment, goal setting, and decision-making based on an understanding of risk and probability. By practicing a repertoire of developmentally appropriate behaviors that promote health, students can significantly increase the likelihood of good physical, emotional, cognitive, social, and environmental health.

    Health Promotion helps students demonstrate:

  • competence in using information and services;
  • how to present accurate information about health; and
  • the capability to respond to health concerns, including emergencies.
  • Knowledge and good communication skills are critical to health promotion. Students learn how to present factual information about health in ways that promote responsible actions while still considering the rights of individuals. Health promotion can take many forms. By contributing to improvements in the health of the natural environment and the physical safety of their communities, students learn what can be accomplished by an individual as well as by a group. Students work with families, school staff, and community members to determine concrete steps they can take to build a strong social fabric that fosters positive growth and development.

    Fundamental health knowledge and skills need to be taught starting in pre-kindergarten and early elementary years, and reinforced and expanded regularly in subsequent grades. A planned, sequential curriculum addresses a variety of topics with increasing degrees of complexity appropriate to students' developmental levels as they move from early to middle childhood and then into adolescence. Such a program ensures thorough, balanced coverage of health content areas, and its success relies on skilled teachers who readily adapt to incorporate emerging health topics.

    Within the research-based strategies that have been found to improve the effectiveness of health education, the following are among the most consistently supported in the health education research literature:
    • Present health information that is accurate and current.
    • Adopt curriculum, instruction, and assessment strategies that guide students toward self-directed, independent, and cooperative learning and living in line with real-life experiences.
    • Incorporate materials, teaching methods, and outcomes that are appropriate to the age, experience, background, and readiness of the students.
    • Employ a variety of teaching methods to involve participants, including experiential activities, role-play, and problem solving.
    • Establish positive school climate by enlisting the involvement, support, and participation of students, parents, business and industry, voluntary and governmental agencies, and community leaders.

    Guiding Principles


    Comprehensive Health Education Teaches Students Fundamental Health Concepts And Skills That Foster Healthy Habits And Behaviors For The Individual And Others Through Sequential And Coordinated Teaching Of Health Education, Physical Education, And Family And Consumer Sciences Education At Each Grade Level, Prekindergarten Through Grade 12.

    Comprehensive health education provides a foundation in public health, medical knowledge, and modes of inquiry into how individuals and societies acquire their health-related knowledge, and empowers students to change unhealthy attitudes and behaviors. Students learn factual information and develop skills for finding and evaluating information and resources, for making decisions, and for setting goals to promote their own health and the health of others. These others may include family, friends, coworkers, neighbors, etc. Physical education focuses on body dynamics, movement, physical fitness, competition, and teamwork. Family and Consumer Sciences education examines the concepts of personal living, family life, parenting, work, nutrition, and consumerism.

    Health education, physical education, and family and consumer sciences education each contribute to comprehensive health education. Together they increase students' knowledge of health concepts, life management skills, and habits that can facilitate lifelong health for the individual and for others. To be most effective, health should be taught regularly, beginning with a student's entry into school and continuing through grade 12. A sequential curriculum introduces concepts and skills in the early grades and reinforces them with more detailed and complex information and skills in the later grades.


    Comprehensive Health Education Teaches Students To Use Fundamental Health Concepts To Assess Risks, To Consider Potential Consequences, And To Make Health Enhancing Decisions.

    Comprehensive health education equips students to assess risks in an informed manner in their everyday lives. Students learn how to identify and evaluate various types and degrees of health risk and become aware of specific behaviors that pose risks for themselves and others, now and in the future. Students learn how to determine the likely consequences of their actions and how to determine which information is needed to assess health risks and to make responsible decisions. Influences on personal health, including why people relapse into unhealthy conduct and behaviors and how relapse can sometimes be prevented, are important health concepts.

    Comprehensive health education teaches students to inquire and solve problems competently. Students set goals, appraise risks, and demonstrate behaviors and conduct that protect and enhance their health. In this way, and in partnership with families and communities, health education supports the resilience of students.


    Comprehensive Health Education Teaches Skills That Assist Students To Understand and Communicate Health Information Clearly For Self-Management And Health Promotion.

    Comprehensive health education teaches students to identify health information and resources that are current and applicable to their lives. Students learn the types of questions to ask and information to provide when talking with health professionals.

    In our society, health information is communicated through a variety of means, such as through health care providers, the media, including professional publications, and health-related events. Through health education, students acquire media literacy by learning to determine if health information is accurate, with whom to share health information, and how to avoid communicating inaccurate information. Health education provides criteria for interpreting conflicting health research and in finding resources for independent research into health topics.


    Comprehensive Health Education Contributes To The Capacity Of Students To Work In A Positive Manner With Families, School Staff, Peers, And Community Members To Enhance Personal Health And Create A Safe And Supportive Environment Where Individual Similarities And Differences Are Acknowledged.

    Comprehensive health education provides opportunities for students to join with their families, peers, school staff, and community members to build safe schools and communities.

    As with the other Frameworks, health contributes to learning about similarities and differences among students.

    Health education helps students recognize that personal health is part of the dynamic interaction between individuals and their social environments. Students study ways in which peers, families, mentors, groups, and institutions foster healthy attitudes and expectations of success. Students examine protective factors that support healthy behaviors and habits. Students learn how health promotion is related to caring appropriately for their own health needs and showing others how to maintain and improve their health. Comprehensive health education supports the connections between physical, emotional, cognitive, and social health.

    Health education helps students recognize conditions that would make their school safe and accepting of the dignity and worth of all individuals regardless of race, gender, disability, sexual orientation, religion, or social or economic background. Students learn about the kinds of activities that build trust and community, the importance of a broad coalition in these activities, and how to make known the presence of support services in their school and community.


    Comprehensive Health Education Is Strengthened Through Collaboration And Partnerships Among All Components Of The Coordinated School Health Program And Other Subjects. The components of a coordinated school health program include classroom-based education as well as program components that are support or service oriented.

    Classroom-Based Education

  • Comprehensive Health Education (PreK-12)
  • Health Education
  • Physical Education
  • Family and Consumer Sciences Education

    Support and Service Components

  • Food and Nutrition Services
  • Health Services
  • Counseling, Psychological, and Social Services
  • Parent, Family, and Community Involvement
  • Health Promotion for Staff
  • Safe and Healthful School Environment
  • Health education, physical education, and family and consumer sciences teachers collaborate with other school health program staff to connect students with services and activities and provide a healthy school environment for students. When these components are linked in a planned, coherent, mutually supportive system, they reinforce health knowledge and skills as well as attitudes and behaviors that help students stay healthy. For example:

  • Health services, food and nutrition services, and psychological and counseling services provide direct services to students.
  • Health education involves families in the life of the school, helping them to support students' academic achievement and health.
  • Health promotion programs for staff enable teachers and other staff members to recognize the importance of lifelong health, and to model healthy behaviors for students.
  • A safe and healthy school environment is a necessity for successful teaching and learning. When instruction and services work together, they can build alliances with the community that improve physical, educational, and social outcomes for all students. The district health coordinator is integral in planning and facilitating the implementation of a comprehensive and coordinated school health program.

    Comprehensive health education is also related to other subjects in many ways. For example, health information that is based on scientific and quantitative research is linked to mathematics, science, and technology/engineering. The study of epidemiology and the effect of health on shaping human affairs are a part of the study of history. When health education focuses on human relationships it is connected to the social sciences. Health education is connected with practicing movement and behavioral skills and therefore has natural affinities with the performing arts. Health education focuses on communication skills and accurate reporting, which draw heavily on English language arts. Conversations in foreign languages classrooms often include discussions of health-related areas such as food, families, household management, and vocabulary of directional movement, physical activities, and sports.