November 10, 2020

When Are We Going to Teach Health?: Duncan Van Dusen

Here’s a fact–health improves learning. Yet nationwide, elementary school students spend 12 times more classroom hours studying history than health. Even worse, most kids don’t get enough physical activity, and over five million underage youth vape. In his new book, When Are We Going to Teach Health?, Duncan Van Dusen makes a novel, sometimes irreverent case for prioritizing whole child health in K to 12 schools.

Using case studies, tips, and recommended actions, he describes proven youth empowerment and skills-based health education techniques to increase kids’ physical activity, healthy food choices, and decrease youth vaping.

Drew Applebaum: Hey listeners, my name is Drew Appelbaum. I’m excited to be here today with Duncan Van Dusen, author of When Are We Going to Teach Health? Duncan, thank you for joining. Welcome to the Author Hour podcast.

Duncan Van Dusen: Great to be here. Thanks, Drew.

Drew Applebaum: Let’s kick this off. Why don’t you give us a rundown of your professional background?

Duncan Van Dusen: Well, I started my career actually in the private sector in venture-funded technology companies. The biggest thing I learned there was how to scale an organization, how to identify an idea that has merit, and how to get it out to a lot of people quickly. We had the great fortune of getting on to a really good idea in the early 2000s. It was basically a piece of financial software that was very, very successful. We ended up selling that company to Bank of America in 2005 for about $100 million, which was great.

Then I faced the midlife crisis of, “What do I really want to do?” That was when I got into public health, went back to school, and got the degree Masters in Public Health, which I finished in 2009. Then I really started working on problems of child health and problems of health behavior promotion.

In 2014, we formed the CATCH Global Foundation, which is, at this point, the largest provider or one of the very largest providers of K-12 health education curriculum in the world. That ended up becoming the inspiration for this book, which I’ve been working on for the last two and a half years.

The Impact of Health

Drew Applebaum: Awesome. What was the inspiration behind the book? Was there an aha moment? And why was now the time to write it?

Duncan Van Dusen: Well, when I started writing it, I had no idea how now was going to really be the time to write it. Really, the inspiration for the book was the large amount of time that I spent in schools, working with district administrators, health and PE professionals, teachers, et cetera, and realizing a couple of things.

First of all, there is not always a good enough appreciation of the extent to which health can impact education. There’s a phrase that’s common parlance, I guess you could say in the education circles, which is, Whole Child. It’s essentially the philosophy or paradigm that schools exist not just to produce academic robots, but they exist to produce whole children, who can be happy, and successful in life, and that children’s safety, and children’s health, and so on is as much a part of the educational process as anything.

In the first part of the book, the first subject of the book really is showing the evidence around Whole Child, and why schools should make teaching health part of their mission. It’s not just because teaching health helps people be healthier, it’s because teaching health helps people be better learners. If you’re in the business of helping kids learn, which is obviously the business that schools are in, it’s in your best interest. You ignore health at your peril because it’s an important ingredient to kids’ academic success. Let alone their long-term life success. That seed and realizing how much there was to do to make the case for the why of health in schools was really the first inspiration.

Then the second inspiration, as I got more and more into it, there are actually a lot of districts and educators who’ve started to embrace the Whole Child paradigm. It’s relatively new. But if you go out now–and I make this point and look at the top ten districts in the country by size, the ten largest school districts–five of them have the phrase Whole Child in their mission statements or in their strategic planning, so it’s starting to gain currency.

But then there’s another gap, which is the what and the how. So even if at the board level or at the superintendent level, we’re starting to think about and talk about the Whole Child, what does that mean in practice? What does that mean for a principal? What does that mean for an individual teacher? The second part of the book really goes into what it takes to make teaching health effective and how we can do it on a day-to-day basis at a grassroots level.

Then the third point that I think is important to make and that the book makes is that many individuals in the system are getting this and they are doing it to the extent that they can. However, the system is not their friend. Our K-12 educational system is not geared to teaching health. You might think, “Well, COVID probably corrected that, right?” Well, not so much.

Actually, I got an email from the largest electronic newsletter for educators in the country. I won’t mention it by name. They said they decided not to publish an excerpt from my book. The reason they decided not to publish an excerpt of my book essentially boils down to with all that’s going on with COVID, health education just isn’t a priority right now. It tells you to some degree everything you need to know about the system.

If the fact that literally, health is preventing schools from opening or preventing them from doing their work the way that they normally do it and the way that they can do it effectively. If health is preventing that from happening, and we still aren’t valuing health education, then I think that explains why I wrote a book titled, When Are We Going to Teach Health?

Who Is a Health Educator?

Drew Applebaum: Now, who is this book for? Is it only for administrators or teachers or can parents get information from the book as well?

Duncan Van Dusen: Parents can absolutely get information from the book. They’re definitely part of the audience. In fact, parents probably have more impact and can have more impact collectively on whether schools do or don’t prioritize health than any of us.

When we think about educators, the term educators is commonly thought of as being classroom teachers, but educators are much more than that. Educators are principals, educators are librarians, educators are staff in a school. I point out that cafeteria staff can be mobilized as health educators. They know the kids. They know the menus. They can encourage kids to try healthy foods.

Then, of course, there’s the whole superstructure around district administrators, superintendents, lawmakers, policymakers, and then there are parents. When you think of educators in that way, there are some 50 million adults whose full-time or part-time job is, in that sense, educators.

Then you add the 50 million Americans who are themselves, K-12 students. You’re talking about 100 million people, which is a third of our population. A third of our country is engaged to one degree or another in the K-12 educational system, and they’re all potentially in the audience for the book, especially the 50 million who are the adults.

Drew Applebaum: Now, can you tell us why health education in schools looks the way it does right now?

Duncan Van Dusen: That’s really the $64,000 question. I think there are a couple of reasons that it looks the way it does. One reason that it looks the way it does is that schools are subject to a large number of mandates and they’re subject to a large amount of inertia. Every time something new comes along, we want to add it, and there’s never any subtraction. This became particularly apparent, for example, during the no child left behind era. Anything that was perceived even remotely as peripheral to the core as it was defined by that law became second fill or got thrown out entirely.

There’s essentially a practical matter that in order to meet compliance requirements, in order to perform the standardized test, which has become not only the measure of students but the measure of schools, anything that isn’t tested isn’t taught. So, health is caught in a little bit of a catch-22 where we can’t really test it seriously because we don’t teach it seriously, and we won’t teach it seriously because we’re not testing it seriously. I hear people at all levels of the educational system say all the time, “We will never do health seriously because it’s not on the test.” Well, there’s an easy solution to that. Let’s put it on the test.

The second reason that I think health does not get enough attention from schools is the largely unspoken perception that it’s just not the school’s job. It’s kind of a parent’s job to teach health. Health is perceived to a large degree as an oral and social tradition, and there are certain parents who don’t want the school to get involved. You see that most commonly when you talk about sex education. That is a real flashpoint, and actually, that’s one of the reasons that I don’t discuss sex education in this book because it’s very, very controversial. That’s where the concept of should school even be involved at all is probably best made.

But when it comes to other aspects of health, for example, physical education, nutrition, and tobacco avoidance, which are the three foundational behaviors that I discuss in this book, and they’re at the root of essentially all communicable disease prevention. Those are things that parents are not equipped to teach fully. Nutrition, for example, it’s complicated. There are macronutrients and micronutrients and benefits of plant-based diets and the balancing of different foods.

The idea that we as a society are just letting parents and communities abstractly teach these very important concepts is dangerous. I think it is part of the reason that we see such health disparities. In other words, the gap in health matches gaps in education and gaps in income level. If we’re leaving communities and parents to teach health, then those that don’t have the capacity, or time, or knowledge or skills to do that, that’s really hurting a segment of society that arguable needs health education the most.

The only place that something that everyone needs to know can be taught is in schools. One of the fundamental questions is, is health something everybody needs to know?

Skills and Empowerment

Drew Applebaum: Now, what does effective health education look like to you?

Duncan Van Dusen: That’s a great question. I think the most important thing I’ll say is there’s a lot of detail in the book about that. The most important thing I would say about that is, health is not just a matter of knowledge, which is one of the reasons it’s different from other school subjects, and it requires a specialized pedagogical technique. What health is really about is skills and empowerment for youth to know, not only why exercise is beneficial to the body or why making healthy food choices is beneficial. But how to do that, how to resist one’s own temptations and inclinations not to exercise, not to eat in a healthy manner, and how to resist the social temptations not to exercise and not to eat in a healthy manner.

I described how a couple of behavioral theories apply to this, specifically social cognitive theory, which is really a very fancy way of saying, monkey see, monkey do. We imitate the behaviors that we see, specifically from the role models that we value. Kids value their teachers. Kids value their principals. If a kid goes into the principal’s office and there’s a giant bowl of candy on the desk, what does that say? That the way to make you feel comfortable is to provide an unhealthy food choice. That is going against healthy attitudes and beliefs.

A lot of health education, it’s not just in the classroom, it’s in the environment. It’s about what you know, it is about what your social environment is, and it’s about what your physical environment is as well.

Our work with CATCH and part of what the book does in this section really shows principals, teachers, everyone how you can do the little things and ultimately the big things that are going to make a school’s environment healthy. That skill-building and that role modeling, those are really far more important to the overall process of shaping health behavior than just didactic knowledge.

Then, let me just add one other thing, which I think is really important and it’s becoming more and more important, and it aligns with an educational philosophy, which is called active learning. Which is, it’s not just about listening, it’s also about doing. The schools that are the most successful in my experience with teaching health to mobilize kids. Instead of saying, “Hey, let’s have a faculty team that’s going to promote health, and let’s put up a big poster with fruits and vegetables on it.” And that’s good by the way. That’s a good thing to do.

What’s even better is, “Let’s have the kids do it. We’re in our class anyway, we’re painting something anyway. Let’s paint fruits and vegetables.” Not all the time, but that’s an example of something that we can do that ties into health education. Let’s empower kids to express why health is important to them, to make their own healthy choices. As kids get older, they can do projects essentially talking to their peers, and advocating in their communities. These types of empowerment-oriented activities make health beliefs part and parcel of kids’ identities. Ultimately, that is what drives long-term healthy behavior. Not anything that I could say or not anything that you can say. We want to help it come from within.

Drew Applebaum: What would you say to parents or administrators that think that a longer, more robust health class will take kids away from subjects like science or math?

Duncan Van Dusen: Well, science and math education are incredibly important in our world. I’d be reluctant to take time away from science and math. The first thing I guess I would say is, if we were starting from scratch, how would we use kids’ days? How would we use kids’ years? An interesting test, and I think a test that all parents can relate to, because when you do homework with your kids, one of the most common things you hear is, “When am I going to use this?” That’s a thing that kids love to ask and that’s not a thing that parents love to answer.

Why do we not love to answer it? Because when it comes to lots of topics, we really don’t have a very good answer. I cannot imagine a parent struggling to answer the question, when am I going to use health? And I’ve never heard a kid, and I’ve got a couple of kids, I’ve never heard a kid ask, when am I going to use health? We know and they know that’s something you use for your whole life.

Can the same claim be made by everything that’s in the curriculum? On average, an elementary school child gets 421 hours per year of English Language Arts. They get 82 hours per year of history and 7 hours pers year of in-classroom health education. History is important, but is it 12 times more important than health?

An individual teacher, let’s say, or an individual principal may say, “Well, I would like to reformulate the allocation of these subjects, but I can’t,” which is a very fair claim and very common. Then what I would suggest is, if you believe in health education, are there ways to integrate health education into the subject that you’re already teaching? For example, lots of health concepts do relate to science, so nutrition, micronutrients, macronutrients, how the digestive system works. Those are scientific topics, and those are topics that are taught commonly at the elementary level.

You could pretty easily integrate more proactively talking about nutrition when you’re talking about the digestive system. You could integrate talking about exercise when you’re talking about the cardiovascular system, and what the effects of having a strong cardiovascular system are. Mood control, weight control, muscle health, bone health, immune health. This is something that has, I think, finally dawned on people. We’ve been very fortunate in this country not to have a lot of immune-related health crisis, especially among kids or among the population as a whole, because we’ve developed so many great vaccines against common diseases.

But that’s come back in a flurry with COVID, right? Now, immune health is something we think about every day. Are we teaching kids that having a healthy exercise routine can help their immune system? Are we teaching kids that making healthy food choices can help their immune system because of the phytochemicals that are in a plant-based diet? These are basic concepts that schools can integrate into the fabric of what they’re doing. It doesn’t necessarily need to be a dedicated period that’s called health. That would be great, but there are other ways to get there without, so to speak, taking time away from other important subjects.

Drew Applebaum: Now, many children are at home for school right now. Do you have any tips or are there resources available for parents or educators at home with their children this semester?

Duncan Van Dusen: Yes. There are a ton of resources. The one that I’m most familiar with is the one that we offer from CATCH, which is called CATCH Health at Home. So, you can just Google CATCH Health at Home. It’s entirely free, there’s an educator track, there’s a parent track, and there are all kinds of free activities, many of them have videos and free lessons. There are actually a couple of lessons that specifically talk about the physical health, immune health connection that I just described.

One of the most commonly used resources actually is a handwashing lesson. This is a perfect example of the kind of thing that is not taught. It’s not taught really at all to kids or adults. So, you saw when COVID broke out how essentially, all of a sudden, we’re trying to teach this long-distance through media because people didn’t really know how to do it. So, the handwashing lesson has been very popular. That’s in CATCH Health at Home too.

Drew Applebaum: Now, half the proceeds from this book will help fund education in low-income schools. Can you tell us more about this?

Duncan Van Dusen: Yes, absolutely. Half the proceeds are going to go to a program called CATCH Promise, which you can also Google that term and read about that work. What CATCH Promise does is, it focuses on schools that have at least 75% of their students eligible for free and reduced lunch, which is essentially lower-income communities.

As I mentioned earlier, unfortunately, because of health disparities, lower-income communities often have lower health status as well. Having this type of Whole Child programming, including physical education, nutrition education, and environment of wellness and tobacco prevention. Those core foundational health behaviors are so important to kids.

CATCH finds communities that are willing to prioritize this and willing to do the work to put this Whole Child programming in and make it free. The CATCH Promise program essentially, the goal is to take the money element out of the equation for these lower-income communities. Yes, there’s still effort, we can’t take that element out of the equation, there needs to be some community ownership. But at least taking the money out of the equation makes the programming more accessible to lots of places.

We have a hundred districts that are eligible for CATCH Promise. You can see their names on the CATCH Promise page, and 26 of them actually already use CATCH Promise programming. It’s been very popular. We launched it about three years ago, and we’ve reached hundreds of thousands of kids through this program who otherwise would not have gotten health education programming.

Education Requires Health

Drew Applebaum: Duncan, writing a book especially, one which will help so many people and children, it’s no small feat, so congratulations.

Duncan Van Dusen: Well, thanks, Drew. It’s been a great opportunity to talk to you about it. I hope it’s helpful to people.

Drew Applebaum: Absolutely. If people could take away just one thing from this book, what would you like it to be?

Duncan Van Dusen: The one thing I would want people to take away from this book is, health requires education, and education requires health. Health is not just a matter of common sense. If health were a matter of common sense, we would have figured it out already. There’s a science to health education, there are techniques for it, and it’s something that is best left to professionals. Not something that we can just kind of do on the side at home or expect kids to just absorb.

Meanwhile, education requires health. Health produces more successful learners. As we’re seeing with the COVID crisis, if we are not healthy, we literally cannot have a proper education system at all. If that isn’t enough evidence to show the value of health to education, I don’t know what would be.

Drew Applebaum: Duncan, it’s been a pleasure and I’m so excited for people to check out this book. Everyone, the book is called When Are We Going to Teach Health and you can find it on Amazon. Duncan, besides checking out the book, where can people find you?

Duncan Van Dusen: The easiest way to reach me is [email protected] or you can just go to www.teachhealth.org and see my email and other resources there.

Drew Applebaum: Awesome, Duncan. Thank you so much for coming on the show today.

Duncan Van Dusen: All right. Pleasure talking to you, Drew. Have a good day.