Which of the following are components of the school health programme? Select all that apply.

Competitive selection of the school team

Assertion (A): Health education concentrates on environment and lifestyle rather than heredity. Reason (R): Heredity cannot be changed, whereas environment and lifestyle can be modified. Choose the correct option.

Both A and R are true, and R is the correct explanation of A

Both A and R are true, but R is not the correct explanation of A

Antibodies passed from mother to baby through the placenta and breast milk give

lifelong immunity against all diseases

A school wants to reduce cases of dengue among its pupils. Which measure breaks the chain of infection most directly?

Removing standing water where Aedes mosquitoes breed and using repellents during the day

Giving BCG vaccine to all pupils

Removing standing water where Aedes mosquitoes breed and using repellents during the day

Which statements about health agencies and programmes are correct? Select all that apply.

The WHO's constitution came into force on 7 April 1948

India's Universal Immunisation Programme began in 1985

India was certified polio-free in 1995

The WHO's constitution came into force on 7 April 1948

India's Universal Immunisation Programme began in 1985

The Rashtriya Bal Swasthya Karyakram is a scheme for older persons

Which is the correct sequence of the health–illness spectrum from the positive end?

Positive health, better health, freedom from sickness, unrecognised sickness, mild sickness, severe sickness, death

Better health, positive health, severe sickness, mild sickness, death

Freedom from sickness, positive health, mild sickness, better health, severe sickness, death

Positive health, better health, freedom from sickness, unrecognised sickness, mild sickness, severe sickness, death

Positive health, mild sickness, better health, unrecognised sickness, death

Health Education I: Health, its Objectives and Spectrum, Health Education and its Principles, the Role of Genetics and Environment, Health-Related Physical Fitness, Community Health Programmes, Health Appraisal and Health Instruction, Health-Promoting Agencies, the School Health Programme, Personal Hygiene, and Communicable Diseases with their Prevention and Immunisation

Unit VI is health education, the part of the syllabus that makes the physical educator a health educator too. Nutrition and community health are taught for the dietitian and the extension worker in the platform's Home Science course; this chapter frames health for the physical education teacher: the meaning and spectrum of health, the principles by which health is taught, heredity and environment, the five components of health-related fitness, community and school health programmes and the agencies behind them, personal hygiene, and the communicable diseases a teacher must recognise and help prevent, with immunisation. It is written as textbook education, not personal medical advice.

1. Health: meaning, objectives and spectrum

The World Health Organization's constitution, in force from 7 April 1948 (now World Health Day), defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". The definition is positive and holistic; it has been criticised as an ideal rather than a measurable state, and a spiritual dimension is often added. The dimensions of health are physical (the efficient functioning of the body), mental (the ability to cope with stress, think clearly and realise one's potential), social (satisfying relationships and roles), emotional (recognising and managing feelings) and spiritual (purpose and values). The objectives of health education follow from these: to give people knowledge about health, to develop healthy attitudes and practices, to promote the use of health services, and to make them responsible for their own and their community's health.

Health is not a fixed state but a point on a continuum, the health–illness spectrum, which runs from positive health through better health, freedom from sickness, unrecognised (subclinical) sickness, mild sickness and severe sickness to death; a person's position changes constantly. Health education is the process that helps people move towards the positive end by changing knowledge, attitudes and behaviour. Its principles, as the public health textbooks list them, include interest (start from felt needs), participation (active involvement of learners), proceeding from the known to the unknown, comprehension (at the learners' level and in their language), reinforcement (repetition over time), motivation, learning by doing, credibility of the message and the source, good human relations, and the use of respected local leaders.

Health results from the interaction of heredity and environment. Genetics sets the potential: some diseases are directly inherited (haemophilia, sickle-cell disease, thalassaemia, colour blindness), and many others, such as type 2 diabetes, hypertension, coronary heart disease and some cancers, run in families as a predisposition that lifestyle can bring out or keep in check. The environment determines how much of the potential is realised: the physical environment (air, water, housing, sanitation, climate), the biological environment (micro-organisms, vectors), the social and economic environment (income, education, occupation, culture) and behaviour and lifestyle (diet, activity, tobacco, alcohol, sleep and stress). Because heredity cannot be changed and the environment and lifestyle can, health education concentrates on the latter.

2. Health-related physical fitness

Physical fitness is commonly divided into health-related and skill-related components (Caspersen, Powell and Christenson, 1985). Health-related fitness has five components: cardiorespiratory endurance (the ability of the heart, lungs and blood vessels to supply oxygen during sustained activity), muscular strength, muscular endurance, flexibility and body composition (the relative proportions of fat and lean mass). They are called health-related because each is linked to lower risk of disease and better daily functioning, and each can be improved by training. Skill-related (motor) fitness comprises agility, balance, coordination, power, reaction time and speed, which matter for performance in sport more than for health. Health-related fitness tests such as the one-mile run, sum of skinfolds, sit-and-reach and curl-ups are covered in Unit IX.

Health-related component	Meaning	Example of a test
Cardiorespiratory endurance	Sustained supply of oxygen to working muscles	One-mile run, 12-minute run, step test
Muscular strength	Maximum force a muscle group can produce	Grip dynamometer, one-repetition maximum
Muscular endurance	Ability to repeat or sustain contractions	Curl-ups, push-ups
Flexibility	Range of motion at a joint	Sit-and-reach test
Body composition	Proportion of fat to lean mass	Skinfolds, bioelectrical impedance

⚠️ Agility and speed are not health-related fitness

The five health-related components are cardiorespiratory endurance, muscular strength, muscular endurance, flexibility and body composition. Agility, balance, coordination, power, reaction time and speed are skill-related. An option listing speed or agility among health-related components is the usual trap.

3. Community health, health agencies and the school health programme

A community health programme aims at the health of a whole population rather than of individuals alone, through health appraisal, health instruction and health services. Health appraisal is the assessment of health status by screening, periodic medical examination, observation by teachers and parents, and health records; it identifies problems early so that they can be referred and treated. Health instruction is the planned teaching of health knowledge, attitudes and practices through classes, campaigns, the mass media, exhibitions and demonstrations. International agencies that promote health include the World Health Organization (1948, Geneva), UNICEF (1946), the Food and Agriculture Organization (1945), the International Committee of the Red Cross (1863), the World Bank, UNFPA and non-governmental bodies. In India they include the Ministry of Health and Family Welfare, the National Health Mission (the National Rural Health Mission of 2005 extended to urban areas in 2013), the Indian Council of Medical Research, Ayushman Bharat (2018), the Integrated Child Development Services (1975), the Universal Immunisation Programme (1985), the Indian Red Cross Society and St John Ambulance, and many voluntary organisations.

The school health programme has three classical components: health services (medical examination on entry and periodically, screening of vision, hearing, teeth and posture, immunisation, first aid and emergency care, referral and follow-up, and health records); a healthful school environment (safe buildings, adequate light and ventilation, safe drinking water, clean toilets with separate facilities for girls, hygienic mid-day meals, safe playgrounds and a supportive emotional climate); and health instruction (planned teaching of hygiene, nutrition, safety, first aid, disease prevention, reproductive health appropriate to age, and the effects of tobacco, alcohol and drugs). Physical education, school-community links and counselling support all three. In India the Rashtriya Bal Swasthya Karyakram (2013) screens children for defects at birth, diseases, deficiencies and developmental delays, and the mid-day meal programme, now PM POSHAN, supports nutrition. Personal hygiene, the practices that preserve individual health, covers care of the skin (bathing), hair, teeth (brushing twice a day), eyes (light, screen time), ears, nails, hands (washing with soap, especially before eating and after using the toilet), clothing and footwear, posture, rest and sleep, and menstrual hygiene.

4. Communicable diseases and immunisation

A communicable disease is caused by an infectious agent (a bacterium, virus, fungus, protozoan or worm) that can be transmitted from an infected person, animal or reservoir to a susceptible host. The chain of infection runs from the agent through its reservoir and a portal of exit, a mode of transmission and a portal of entry to a susceptible host, and prevention works by breaking a link: treating the source, interrupting transmission (sanitation, safe water, vector control, hand-washing, masks, safe sex, screened blood) or protecting the host (immunisation, nutrition). Diseases are grouped by mode of transmission. Airborne and droplet diseases include tuberculosis (bacterial; persistent cough, fever, weight loss; prevented by BCG vaccination, early diagnosis and full treatment), measles, influenza, diphtheria, whooping cough and COVID-19. Water- and food-borne diseases, spread by the faecal–oral route, include cholera, typhoid, hepatitis A and E, polio and diarrhoeal diseases, prevented by safe water, sanitation, food hygiene and hand-washing, with oral rehydration for diarrhoea. Vector-borne diseases include malaria (the Plasmodium parasite, carried by the female Anopheles mosquito), dengue and chikungunya (viruses carried by the Aedes mosquito, which bites by day) and filariasis, prevented by removing breeding sites, nets and repellents. Contact diseases include scabies, ringworm and leprosy, and blood-borne and sexually transmitted infections include HIV and hepatitis B.

Immunisation protects the host by stimulating immunity. Active immunity is produced by the body itself after infection or vaccination and is long-lasting; passive immunity is borrowed antibodies, from the mother across the placenta and in breast milk, or from injected immunoglobulin, and is short-lived. Vaccines may be live attenuated (such as oral polio, measles and BCG), inactivated (killed), toxoids (tetanus and diphtheria) or subunit and newer types. India's Universal Immunisation Programme, launched in 1985, provides free vaccines against a growing list of diseases including tuberculosis, polio, diphtheria, pertussis, tetanus, hepatitis B, Haemophilus influenzae type b, measles and rubella, with rotavirus and pneumococcal vaccines added more recently; Mission Indradhanush (2014) was launched to raise coverage. The Pulse Polio campaign (from 1995) led to India's certification as polio-free by the WHO, as part of the South-East Asia Region, in 2014. The exact schedule should be taken from current official guidance.

Disease	Agent	Main mode of spread	Key prevention
Tuberculosis	Bacterium (Mycobacterium tuberculosis)	Airborne droplets	BCG, early detection, complete treatment
Malaria	Protozoan (Plasmodium)	Female Anopheles mosquito	Mosquito control, nets, early treatment
Dengue	Virus	Aedes mosquito (day-biting)	Remove standing water, repellents
Cholera, typhoid	Bacteria	Contaminated water and food	Safe water, sanitation, hand-washing, vaccination
Hepatitis B, HIV	Viruses	Blood, sexual contact, mother to child	Screened blood, safe sex, sterile needles; vaccine for hepatitis B

Key takeaways

The WHO (1948) defines health as complete physical, mental and social well-being, not merely the absence of disease; health lies on a spectrum from positive health to death.
Health education works by interest, participation, the known to the unknown, comprehension, reinforcement, motivation and learning by doing; heredity sets potential and environment and lifestyle realise it.
Health-related fitness has five components: cardiorespiratory endurance, muscular strength, muscular endurance, flexibility and body composition.
Community health uses health appraisal and instruction; the school health programme combines health services, a healthful environment and health instruction.
Communicable diseases are prevented by breaking the chain of infection; the UIP (1985) immunises children and India was certified polio-free in 2014.

Practice questions (10)

Attempt each one before opening the answer. Every explanation names the tempting wrong option as well as the right one, because that is where marks are lost.

How many components of health-related physical fitness are there in the standard classification? Type the number.
Numerical answer — type the value.
Show answer
Answer: 5
The five are cardiorespiratory endurance, muscular strength, muscular endurance, flexibility and body composition. Adding agility, balance, coordination, power, reaction time or speed mixes in the six skill-related components.
Malaria is transmitted by
1. contaminated drinking water
2. the female Anopheles mosquito
3. the Aedes mosquito
4. airborne droplets
Show answer
Answer: B — the female Anopheles mosquito
The Plasmodium parasite is carried by the female Anopheles mosquito. The day-biting Aedes carries dengue and chikungunya, contaminated water spreads cholera and typhoid, and droplets spread tuberculosis and influenza.
Which of the following is a component of skill-related rather than health-related fitness?
1. Agility
2. Flexibility
3. Body composition
4. Muscular endurance
Show answer
Answer: A — Agility
Agility is skill-related, along with balance, coordination, power, reaction time and speed. Flexibility, body composition and muscular endurance are three of the five health-related components.
Which of the following are components of the school health programme? Select all that apply.
1. A healthful school environment
2. Health services
3. Health instruction
4. Competitive selection of the school team
Show answer
Answer: A — A healthful school environment; B — Health services; C — Health instruction
The three classical components are health services, a healthful school environment and health instruction. Team selection is part of the extramural sports programme, not of school health.
Assertion (A): Health education concentrates on environment and lifestyle rather than heredity. Reason (R): Heredity cannot be changed, whereas environment and lifestyle can be modified. Choose the correct option.
1. Both A and R are true, and R is the correct explanation of A
2. Both A and R are true, but R is not the correct explanation of A
3. A is true, but R is false
4. A is false, but R is true
Show answer
Answer: A — Both A and R are true, and R is the correct explanation of A
Both are true and R explains A: since genes set a potential that cannot be altered by education, health education works on the modifiable factors, diet, activity, hygiene, tobacco and alcohol, that decide how much of that potential is realised.
Antibodies passed from mother to baby through the placenta and breast milk give
1. lifelong immunity against all diseases
2. natural passive immunity
3. artificial active immunity
4. natural active immunity
Show answer
Answer: B — natural passive immunity
Borrowed maternal antibodies give natural passive immunity, which is short-lived. Vaccination gives artificial active immunity and recovery from infection natural active immunity; no immunity protects against all diseases for life.
Screening pupils for defects of vision, hearing and posture belongs to which part of a community or school health programme?
1. Health appraisal
2. The healthful environment
3. Immunisation
4. Health instruction
Show answer
Answer: A — Health appraisal
Screening and medical examination assess health status, which is health appraisal, followed by referral and follow-up. Health instruction is teaching, immunisation protects against specific diseases and the environment concerns buildings, water and sanitation.
A school wants to reduce cases of dengue among its pupils. Which measure breaks the chain of infection most directly?
1. Giving BCG vaccine to all pupils
2. Removing standing water where Aedes mosquitoes breed and using repellents during the day
3. Using bed nets only at night
4. Boiling drinking water
Show answer
Answer: B — Removing standing water where Aedes mosquitoes breed and using repellents during the day
Dengue is spread by the day-biting Aedes mosquito, so removing its breeding sites and protecting pupils during the day interrupts transmission. BCG protects against tuberculosis, boiling water against water-borne disease, and night-only nets miss a day-biting vector.
Which statements about health agencies and programmes are correct? Select all that apply.
1. India was certified polio-free in 1995
2. The WHO's constitution came into force on 7 April 1948
3. India's Universal Immunisation Programme began in 1985
4. The Rashtriya Bal Swasthya Karyakram is a scheme for older persons
Show answer
Answer: B — The WHO's constitution came into force on 7 April 1948; C — India's Universal Immunisation Programme began in 1985
The WHO constitution took effect on 7 April 1948 and the UIP began in 1985. The RBSK (2013) screens children, and 1995 is when Pulse Polio began; polio-free certification came in 2014.
Which is the correct sequence of the health–illness spectrum from the positive end?
1. Better health, positive health, severe sickness, mild sickness, death
2. Freedom from sickness, positive health, mild sickness, better health, severe sickness, death
3. Positive health, better health, freedom from sickness, unrecognised sickness, mild sickness, severe sickness, death
4. Positive health, mild sickness, better health, unrecognised sickness, death
Show answer
Answer: C — Positive health, better health, freedom from sickness, unrecognised sickness, mild sickness, severe sickness, death
The spectrum runs from positive health through better health and freedom from sickness to unrecognised, mild and severe sickness and death. Freedom from sickness lies below positive health, which is the point of the WHO's definition.