Youth health education content

The core framework of "Adolescent Health Education Content" has long gone beyond the traditional narrow scope of "physiological hygiene + safety reminders". Currently, the core content recognized by domestic academic circles and front-line practical fields covers the four dimensions of physical health, mental health, social adaptation health, and moral health. The ultimate goal is to help teenagers establish the understanding that "health is an individual's lifelong independent responsibility" instead of passively obeying external health rules.

Two years ago, I went to a key middle school in an eastern province to do health intervention research. I still remember the scene when the moral education director pulled me to complain: the school had a health education class for one semester, and the content was all about "three exercises and one eye protection", "don't fall in love early in adolescence" and "wash your hands before eating and after using the toilet". During the class, half of the students were doing homework, and some boys in the back row were secretly making noises, saying that this class was a "mother-in-law's lecture class", but no one listened at all. This is also a common problem in health education in many schools - they always use content from twenty years ago to apply to today's children, and naturally no one buys it.

At this point, I have to mention the differences in the content of sex education that have been quarreling for almost ten years in adolescent health education: the conservative point of view has always been very clear. Sex education only needs to cover physiological structure, sexual assault prevention, and contraceptive knowledge. Talking too much about gender equality, sexual consent, and emotional needs will easily "induce children to try it prematurely."”； However, the "Guidelines for the Introduction of Life Safety and Health Education into Primary and Secondary School Curriculum Materials" issued by the Ministry of Education in 2022 has clearly included gender equality, anti-gender violence, and emotional responsibility as requirements. Scholars who hold this view generally believe that if they are secretive, they will instead allow children to find answers from pornographic websites and inappropriate short videos, which is more risky. Nowadays, front-line practices also have their own choices: many pilot schools in Shenzhen and Shanghai are already providing sex education in different grades. Lower grades teach "the areas covered by swimsuits cannot be touched by others", junior high schools teach "respecting each other's wishes in love", and high schools even discuss "how to treat sexual minorities"” ； However, many schools in third- and fourth-tier cities still only dare to mention a few words about the reproductive system in biology classes, leaving the rest up to parents.

Less controversial than sex education, but more likely to be ignored, is the content related to mental health. Last year, I met a provincial high school sophomore girl who was ranked among the top 10 in her grade all year round. However, she had to hide in the toilet and induce vomiting after every major exam. Her parents always told her that "being fat will distract her and affect her studies." The school's health class only talked about "maintaining a standard weight." No one ever told her that excessive anxiety about weight has fallen into the category of body image disorder and is a psychological problem that requires intervention. Data from the 2023 National Student Physical Health Survey show that the detection rate of depression among adolescents in our country is about 17.5%. However, there are now considerable differences in the arrangement of this content: many schools feel that mental health is originally the responsibility of the class teacher, and there is no need to include it in the unified content of health classes. After all, each child’s situation is different. ； However, scholars in the field of public health generally disagree with this view. A survey published by "China School Health" last year showed that nearly 40% of head teachers have a biased understanding of depression and anxiety disorders, and even think that children are "just hypocritical." If all mental health content is left to the head teacher, it may cause secondary harm.

There are also many contents that people have never included in health education before, such as how to identify fake health science popularization and how to resist the marketing trap of tobacco, alcohol and betel nut. In a health class at a middle school in Changsha last year, the teacher took several Internet-famous betel nuts packaged like milk tea and sparkling water and asked students to look for the health warnings on them. Only 3 of the 45 children in the class could find them, and the rest thought they were ordinary Internet-famous snacks. Can you believe it? Survey data in 2023 shows that the trial rate of betel nut among teenagers aged 15-19 in my country has exceeded 8%. Many children are deceived by this kind of packaging disguised as snacks. Previous health classes only talked about "don't eat betel nut" in general, which was of no use at all.

I have been doing youth health intervention for 7 years. To be honest, the most annoying thing is when people ask me "Can you give me a unified content list?" How can there be any universal list? What left-behind children in mountainous areas need most is content on preventing drowning, preventing falls, and how to take care of themselves when a guardian is absent. Children in cities may need more content on how to deal with Internet addiction, body image anxiety, and school bullying. If a unified standard is imposed, it will only become empty words that no one listens to. Previously, we conducted a pilot project in a school for migrant children and put "how to use natural gas correctly" and "what to do immediately if bitten by a dog" into the health class. The children's participation was particularly high because these are problems they actually encounter every day.

In fact, the industry is not pursuing any perfect content framework. No matter what dimension of content it is, the core logic is the same: Don’t put prohibitions on children from the perspective of adults, but from the perspective of children, help them solve real health problems. After all, health is never something that can be achieved by others’ demands. It must be made to make them feel important.