Abstract
Objective: Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH.
Methods: We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers.
Results: The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs.
Discussion: The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely costeffective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.
Key words: Costs, cost effectiveness, public health, childhood obesity, nutrition, physical activity, school health
Résumé
Objectif: L’Approche globale de la santé en milieu scolaire (AGSS) est de plus en plus remarquée comme stratégie d’amélioration de la santé et de l’apprentissage. Notre étude estime les coûts associés à la mise en oeuvre et au maintien de l’AGSS.
Méthode: Nous avons examiné les données comptables de toutes les écoles du programme Annapolis Valley Health Promoting Schools (AVHPS) en 2008–2009. Nous avons examiné le soutien aux programmes de nutrition et d’activité physique provenant du système public, des subventions, des dons, du produit des collectes de fonds et des activités bénévoles.
Résultats: Le financement public annuel aux écoles participantes pour mettre en oeuvre et maintenir l’AGSS s’est élevé à 344 514 $, soit en moyenne 7 830 $ par école (22,67 $ par élève). De ce financement public, 140 500 $ étaient liés à l’AGSS, 86 250 $ aux programmes de petit déjeuner, 28 750 $ aux programmes de politique alimentaire des écoles, et le reste à d’autres programmes subventionnés. Les subventions, les dons et le produit des collectes de fonds ont pour la plupart été obtenus localement. Ils se sont chiffrés à 127 235 $, soit en moyenne 2 892 $ par école (8,37 $ par élève). La valeur du bénévolat a été estimée comme étant équivalente à la valeur combinée des subventions, des dons et du produit des collectes de fonds. De ces subventions, dons, fonds recueillis et activités bénévoles, 20 % ont été destinés à des programmes d’activité physique et 80 % à des programmes alimentaires.
Discussion: Les coûts publics de la mise en oeuvre et du maintien de l’AGSS sont minimes. Ils ont exercé un effet de levier ayant permis de recueillir un financement local considérable, en nature et en espèces, qui témoigne de l’appui de la collectivité à l’alimentation saine et à la vie active. Lorsque l’AGSS prévient efficacement le surpoids chez les enfants, elle est probablement rentable, car les coûts des futures maladies chroniques augmentent. Les programmes de l’AGSS qui s’avèrent efficaces et rentables se prêtent extrêmement bien à une mise en oeuvre généralisée et à la réduction du fardeau pour la santé publique associé à l’obésité.
Mots clés: coûts et analyse des coûts, efficacité (économie), santé publique, obésité infantile, nutrition, exercice physique, service hygiène scolaire
Footnotes
Conflict of Interest: None to declare.
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