For Whose Benefit? The Politics of Developing A Health Education
Curriculum
Equity concerns in relation to health education
There are a number of key health indicators (documented in a wide
range of New Zealand health surveys and publications), which impinge
upon health education content and pedagogy. For example, recent
reports indicate the low health status of some of our children and
young people compared to other OECD countries. Such students are
disproportionately members of minority cultures and lower socio-economic
groups (Public Health Commission, 1994a). New Zealand has high rates
of child abuse and youth suicide (UNICEF, 1994), alcohol-related
problems (Public Health Commission, 1994b), unplanned pregnancies
and sexually transmitted diseases (STDs), (Maskill, 1991), as well
as unintentional injuries, preventable deaths and disabilities from
motor vehicle accidents (Public Health Commission, 1994a). A recent
discussion paper on trends in Māori mental health, Ngāā
Ia Ō Te Oranga Hinengaro Māori (Te Puni Kokiri, 1993),
highlights the current lack of awareness of and support for mental
health issues for young Māori. The 1994 Public Health Commission's
Draft Discussion Paper on Pacific Island Health Information:
The Health of Pacific Islands People in New Zealand identifies
a need for greater sensitivity to the diverse cultures and the values
of Tangata Pasifika in New Zealand.
More specifically in relation to classroom and school contexts,
there is now a wide-ranging body of national and international research
which analyses the complex inter-personal dynamics of the social
relations within such contexts. This work has direct implications
for educational equity and needs to be considered in implementing
all health education programmes. For example, in New Zealand Alton-Lee
and Nuthall (1991) have highlighted the hidden processes of gender
and racial bias that operate to the detriment of many students at
the classroom level and create barriers to learning. The emphasis
in The New Zeealand Curriculum Framework (Ministry of Education,
1993) on a gender inclusive curriculum should ensure that the curriculum
addresses the lives of all girls and young women, including those
from non-dominant ethnic and class groups. It must examine and challenge
the restrictive, damaging hegemonic portrayals of masculinity presented
to and lived out by many boys and young men in our society (Connell,
1994; Sears, 1992; New South Wales Government Advisory Committee
on Education Training and Tourism, 1994). Studies such as Lind and
Maxwell's (1995) analysis of children's experiences of violence
at school reveal widespread patterns of harrassment and bullying,
as does Maxwell et al.'s (1996) study of South Canterbury schools.
The removal of barriers to learning will not be secured by changing
the behaviour of a few isolated individuals, but rather through
school wide approaches which are necessary to promote intervention
and enduring changes in such behaviours (Lind and Maxwell, 1995).
The development of a new health and physical education curriculum
statement provided an important opportunity to address the above
concerns. Contemporary research in health education suggests that
student centred, interactive learning approaches are most successful
(Bremberg, 1991; James and Fisher, 1991; McDonald, 1994; Sussman,
1991). Approaches which use cooperative learning strategies and
discussion groups enable students to bring their own perspectives,
values and experiences to the learning situation and are likely
to be inclusive and preferable for girls (Holden, 1993) and for
Māori and Pacific Island students, as opposed to more competitive
and teacher-directed approaches. The latter are typically more prescriptive,
with the teacher assuming major responsibility for the curriculum
content thereby reducing students' autonomy and responsibility for
their own learning. They also tend to encourage competition between
students which can limit opportunities for learning from each other.
Student-centred, interactive learning approaches require teachers
to build into their classrooms a safe, trusting, supportive environment
where students and their ideas are valued, where critical analysis
is encouraged, where prejudices are exposed and challenged, and
where there is a major emphasis on building self-esteem and developing
interpersonal skills.
Utilising such teaching approaches, and seriously addressing issues
of inequity, emphasises the centrality of political action and individual
and community empowerment for effective health education. This represents
a major discursive challenge to an enterprise-based market economy
which is underpinned by, and promotes, a model of the individual
as asocial and personally responsible. It also challenges a conception
of education which accords primacy to the acquisition of skills
as opposed to knowledge.
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