PUB - Publikationen an der Universität Bielefeld

In a school setting, school health professionals are a critical point of interaction between health and schooling. Their tasks far exceed healthcare; in addition to providing acute care and individual counselling, they also fill the role of confidant, are responsible for taking preventative measures and for coordinating external healthcare facilities. From an educational perspective, school healthcare professions are rather to be regarded as integral players whose job is to promote not only the physical health of pupils, but also their psychosocial development, health literacy and social inclusion. While school healthcare professionals have long been regarded as an indispensable part of everyday school life in the English-speaking world, their deployment in Germany is still at the experimental stage, nevertheless with the potential to enhance the school healthcare system over the long term.
The present study comprehensively analyses international publications in the period 1937-2025 and critically examines the effectiveness of school health professionals in the context of health promotion in schools. Despite the abundance of international studies, it is evident that methodological weaknesses often limit the meaningfulness of the results. This dissertation therefore focusses on the extent to which reliable, scientifically substantiated statements can be made about the effectiveness of school health professionals, to which fields of activity and health outcomes they apply and whether vulnerable groups, such as socially disadvantaged children, can derive benefit. The leitmotif of this dissertation is the broader, interdisciplinary understanding of health, which interprets health as being both a prerequisite and a positive outcome of education.
The evaluation of the four studies included clearly shows that school health professionals can demonstrably improve pupils' health and significantly reduce absenteeism, particularly in the case of chronic illnesses such as asthma and diabetes. In the area of prevention and management of infectious diseases - for example during the COVID-19 pandemic - school health professionals have also proven to be an indispensable resource, even if the number of methodologically high-quality impact studies remains disappointingly low. International research also shows that school health professionals can make a focused contribution to reducing health inequalities by providing special support to disadvantaged children.
In Germany, school health professionals’ activities have so far been limited to individual, scientifically monitored pilot projects in a small number of federal states. These have received extremely positive feedback from schools, parents and local authorities and are showing some promising initial successes. However, the current funding is insufficient to allow for nationwide implementation. To exploit the full potential of school health professionals – and to convince decision-makers - what is needed are additional scientifically sound pilot projects and for results to be published in respected specialist journals. Supplementary cost-benefit analyses could also show that investing in school health professionals is not only beneficial to health, but also to wider society and the economy.
In summary, this work clearly demonstrates that school healthcare professionals can make a significant contribution to health improvement and equal opportunities in the German school system. To further prove their effectiveness and establish them more firmly in day-to-day school life, targeted investment, continuous scientific monitoring and committed political support are essential.