During the 19th century, physical education developed in schools and colleges and in organizations such as the YMCA. Stress on physical fitness served to establish further the need for health education. See also GYMNASIUM; PHYSICAL EDUCATION.
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 education.
German education 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 education 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 education with physical education, was further perpetuated during this period. During the 1960's this concept was replaced by the identification of health education as a discipline separate from physical education. The School Health Education Study, initiated with private funds in 1961, had the most significant impact in establishing health education as a separate discipline.