Table 1.
Comparison of educational structures in Germany, Canada, and USA with relevance for the education for health literacy perspective.
| Germany | Canada | USA | |
|---|---|---|---|
| K-12 System Structure | Federal system; academic year runs Fall—Summer (e.g., October–August) | Provincial/territorial system with provinces (10) and territories (3) having autonomy; academic year runs Fall—Spring (e.g., September–June) | Federal system with strong role for local governments; academic year (Fall—Spring (e.g., August–June) |
| K-12 School Governance | Mostly controlled by the 16 Länder (states) | Most guidelines set at the province and territory level. | Mostly in control of local school boards. |
| Higher Education System Structure | Federal academic education framework available, but due to the national higher education act, the sixteen state governments have the responsibility for design, content and aims of their universities. However, to certain degree the state and federal government(s) collaborate. | Provincial/territorial system is responsible for education and regulate standards; no federal accreditation; academic year split into 3 semesters [Fall (end of Aug/start of Sept to December), Spring (January to April), Summer (April/May to July/August)] | Federal and state systems responsible. Accreditation involves non-governmental entities as well as federal and state government agencies. Accreditation’s quality assurance function is one of the three main elements of oversight governing the Higher Education Act’s (HEA’s) federal student aid programs. |
| Higher Education Governance | Internal with university president, team of administrative leaders (provost, chancellor, faculty senate, deans, department chairs) | Internal with university president, team of administrative leaders (provost, chancellor, faculty senate, deans, department chairs) | Internal with university president, team of administrative leaders (provost, chancellor, faculty senate, deans, department chairs) |
| Testing | Secondary schools in Germany are divided among several tiers. Cumulative test to leave school. | Similar to US, almost all provinces conduct standardized tests from junior kindergarten into high school (e.g., reading, writing, math, science), but these vary by province. | Since 2002, there is a requirement for testing of all students in middle grades and sometimes in high school. These tests are standardized by state. Only basic skills test required to complete school. |
| Teacher Training | Standards for teacher education are centralized within each state with some coordination across states. | Standards for teacher education Teaching is selective in Canada. | Teacher training is decentralized, state requirements vary widely, and oversight can be lax. |
| Teacher Pay | Most teachers are civil servants and are paid well (relative to their US counterparts). | Teachers are paid well (relative to their US counterparts). | Teachers are paid poorly. |
| Curriculum Consistency | Curriculum recommendations and frameworks available provided by the Kultusministerkonferenz (KMK) but, due to the federated system the states modify those based on their needs and policies. | Much consistency across schools and districts in curriculum and teaching methods. | Little consistency in training, curriculum, or methods. |
| Federal Government Focus | Health equity and health inequalities in several policies and the health promotion law. | A strong common commitment to equity across provinces/territories | Compensatory education for students from low-income backgrounds and special education for students with disabilities. |
| Equity | In general whole-of-society, but families, special needs (“inclusion”) and Immigrant and refugee communities are a focus for equity efforts. (idealistic; implementation of equity action is not secured) | Focus on at risk youth, migrant, and indigenous populations. Canada has many immigrant families, but is one of the few countries where migrant children achieve at a level similar to their non-migrant counterparts. | Focus on racial/ethnic minorities and urban inequities. While the federal government’s role has focused on ensuring equity for disadvantaged populations, deep inequities by race/ethnicity remain. |
| Groups of Focus for Equity | Migrants, students with disability and special needs (“inclusion”), to a certain degree all students are supposed to benefit from equity action in schools. (idealistic; implementation of equity action is not secured; Germany has a multi-track school system in place starting with secondary school and which might contribute to inequities and inequalities by its very structure as at the end of primary school pupils are being distinguished by their marks, which determine which school they can attend within this multi-track system.) | Canada has many immigrant families, but is one of the few countries where migrant children achieve academic outcomes at a level similar to their non-migrant counterparts. | Compensatory education for students from low-income backgrounds and special education for students with disabilities. |
| How Health Literacy is Addressed | No formal, national health literacy standards available. Guidelines exists (e.g., Digital education standards; Life-skills in the school health promotion strategy) | No formal, national health literacy standards available. Guidelines exists (e.g., School Health Guidelines, Sexual Health Education Guidelines) | National Health Education Standards: Achieving Health Literacy; Achieving Excellence (NHES, 1995; 2007) |
| Whole School Approach | No mandatory whole-school approach, but a modified Health Promoting School approach is in some regions in place, where participation of schools is not mandatory. Health literacy is not yet part of this. | No mandatory whole-school approach, but many provinces have a website for their own Healthy Schools approach with resources. Provinces vary with their framework used. Extent to which health literacy is a part of this varies across provinces. | Whole School, Whole Community, Whole Child approach promoted nationally; extent to which this is utilized varies across states. Health literacy is embedded in this. |
| Pisa Score Science * | 509 | 496 | 528 |
| Pisa Score Reading | 509 | 497 | 527 |
| Pisa Score Math | 506 | 470 | 516 |
| Pisa Share of Top Performers in At Least One Subject Science, Reading and Mathematics | 19.2 | 13.3 | 22.7 |
| Pisa Share of Low Achievers in All Three Subjects (Below Level 2) | 9.8 | 13.6 | 5.9 |
Note: Benchmark scores for low performance can be found http://www.oecd.org/pisa/pisa-2015-results-in-focus.pdf [67].