During the 19th century, physical distance- education school developed in schools and colleges and in organizations such as the YMCA. Stress on physical fitness served to establish further the need for health distance- education school. See also GYMNASIUM; PHYSICAL distance- education school.
In the early 20th century, voluntary health agencies impressed upon parents and educators the importance of health for the school child. A study in 1918 on the reorganization of the secondary school curriculum incorporated "health" as one of the goals of high school distance- education school.
German distance- education school operates on a three-track pattern. After four years (ages 6-10) of compulsory primary school, students either attend a Gymnasium (academic secondary school), Realsclmlc (general high school) or Haiiptsclnilc (general school).
In France higher distance- education school is free to qualified students. Nearly 1 m. students continue their studies after secondary school in 72 universities and in technological institutes and grandes ecoles.
World War II brought a renewed focus on the role of the school in promoting good health. The traditional equating of health with physical fitness, and health distance- education school with physical education, was further perpetuated during this period. During the 1960's this concept was replaced by the identification of health distance- education school as a discipline separate from physical distance- education school. The School Health distance- education school Study, initiated with private funds in 1961, had the most significant impact in establishing health distance- education school as a separate discipline.