Zofia Hammerin

Promoting the health of children remains a global and national priority, as reflected in the proliferation of public health policies, strategies, and guidelines over the past decade. While these documents aim to improve health outcomes, they also play a critical role in shaping how children and young people are constructed as health subjects. This study critically examines recent national public health policy documents from Sweden and Norway through a health promotion lens, focusing on the discursive positioning of children. Drawing on theoretical insights from critical childhood studies and public health policy research to frame our discourse analysis, we identify dominant narratives that frame children primarily as passive, dependent, and vulnerable. These adult-centric discourses, rooted in risk and knowledge paradigms, offer limited space for agency, participation, or rights-based approaches. Despite strong rhetorical commitments to equality and child health, the policies risk reinforcing hierarchical power relations and deficit-based views of childhood. We argue that aligning public health policy with health promotion principles requires reframing children not merely as future investments, but as present rights-holders and active contributors to their own health. Embedding participatory mechanisms and expanding comparative research across welfare contexts may foster more inclusive and empowering policy development. This study contributes to ongoing debates on child agency, policy framing, and the role of discourse in shaping health promotion practice.

The aim of this dissertation is to contribute new knowledge regarding teachers’ involvement instudent health work. This is investigated from four perspectives: (1) policy documents, (2) teachers’perspectives, (3) students’ perspectives, and (4) the perspectives of student health professionals andschool principals.To achieve the aim of the dissertation, five research questions are addressed: 1) How are nationalguidelines regarding teachers’ health-promoting work recontextualized in local policy documents?2) How do teachers describe their student health work within their daily teaching practice? 3) Whatroles in teachers’ student health work emerge from students’ narratives? 4) How are teacherspositioned in student health work by other professional actors within the school? 5) Whatprofessional role for teachers in student health work emerges from the studies included in thedissertation?In recent years, the teacher has assumed an increasingly central role in promoting students’ health.However, national guidelines for teachers’ work in this area are often vague or insufficient, whichmay lead to stress and burnout among teachers as well as difficulties in collaboration with otherprofessional groups. This dissertation is a compilation thesis consisting of four individual studiesand a comprehensive summary (kappa). The first four research questions align with each respectivestudy, while the fifth is addressed through a synthesis presented in the results section of thecomprehensive summary. The theoretical framework is based on symbolic interactionism andpragmatism. The empirical data consists of local documents called student health plans, andinterviews with teachers, students, student health professionals and school principals.The first study is a document analysis, revealing that teachers’ health promotion often becomesempty, floating and invisible when national guidelines are recontextualized in local documents. Thismeans that the concept of “health promotion” is not associated with any specific actions orencompasses widely differing actions. The second study, based on interviews with teachers, showsthat their student health work in everyday teaching is described through two overarching themes:building positive relationships and supporting students’ academic success. These findings areconceptualized using the theoretical notion of social pedagogical recognition.In Study III, students were interviewed. The findings highlight four dominant roles teachers assumein health promotion work: (1) A Creator of Joyful Learning, (2) A Creator of a Sense of Control,(3) A Spreader of Happiness, and (4) A Creator of a Sense of Value. In students’ narratives, bothdidactic and relational competencies are emphasized, competencies that are seen as mutuallydependent and inseparable.Study IV is based on interviews with school principals, school nurses, school counsellors, andspecial educational needs coordinators. This study illustrates how teachers are simultaneouslypositioned as both central and marginalized within student health work. The roles ascribed toteachers are contradictory: on the one hand, they are seen as less competent help-seekers; on theother, as potentially competent health promoters.The fifth research question is addressed in the synthesis in the thesis summary (kappa). Thissynthesis indicates that the professional role of teachers in student health work, while partly fluid,contains a shared core. The theoretical concepts educative relationships and educative environmentsare employed to conceptualize this core.Defining a specific role for teachers in student health work proves to be challenging. The limitedempirical material in this dissertation points to a more general issue: the current national guidelinesand policy documents often leave room for interpretation. Through interaction, the various actorsinvolved in student health work (teachers, students, and other professionals) fill these policy gapswith their own norms and expectations. This can place teachers in an uncertain position, where theirrole remains unclear and implicit. Although this is not necessarily the case in all schools, thestructure allows for such ambiguity to arise in many contexts, making it a systemic issue.However, the findings also indicate a positive dimension: within this complexity and uncertainty,the teachers in this dissertation appear capable of crafting meaningful roles for themselves in studenthealth work. If policymakers aim to clarify the teacher’s role in this work, the results of thisdissertation offer valuable insights that could inform further development. The type of healthpromotion work described in the dissertation includes competencies that most teachers alreadypossess and cultivate in their professional practice, positioning them as experts in their own domain.Establishing a clearly defined area of expertise for teachers within student health work may reduceinterprofessional tensions and foster better collaboration, which in turn could lead to improvedhealth outcomes for students.

School has been identified as a suitable arena for targeting improvements in the health of children and young people. Teachers are highlighted as crucial contributors to student health which has resulted in changes in the teaching profession. The aim of this study is to examine the students’ perspective on the role of the teacher in working with student health. Interviews with 34 students aged 16–19 years were carried out. Data were analysed using qualitative content analysis with theoretical underpinnings from pragmatism and symbolic interactionism. This approach identified four dominating roles for teachers: (1) a creator of joyful learning, (2) a creator of a sense of control, (3) a spreader of happiness, and (4) a creator of feeling valued. This study shows that the role of the teacher in working with student health is in acting, not in being, and that this role is constantly (re)created through interaction. The student perspective on the role of the teacher in student health work has close similarities to the role of the teacher in inclusive teaching, merging relational competence with didactic skill. In conclusion, we argue that developing teachers’ didactic as well as relational competency, along with understanding competence within a pragmatic and symbolic interactionist theoretical framework, could improve student health practices.

Purpose: The aim of this study was to investigate how teachers are positioned within the narratives of other professional actors with regard to working with student health. This report addresses two main research questions: “How are teachers positioned by other professional actors in the context of working with student health?” and “What roles are teachers assigned in student health work within the narratives of these professionals?” Design/methodology/approach: A qualitative design with an interactionist approach was adopted to examine the position and roles assigned to teachers when working with student health. Interviews were conducted with nine principals and members of the student health team at two large Swedish high schools. Responses were transcribed verbatim and analysed using thematic analysis and the theoretical framework. Findings: Teachers are given both a central and a marginalized role. Although they are sometimes described as essential for student health, they are rarely positioned as competent within this work. Practical implications: The emphasis on high-quality teaching as a contributor to student health represents a practical pathway for schools. Teachers should be supported in creating inclusive, participatory and structured classrooms that inherently promote well-being. Originality/value: This paper is the first of its kind to examine roles and positions assigned to high school teachers when working with student health in a Swedish context. The results are also valuable in other contexts. Since promotion of student health requires teamwork, it is essential for the main actors to understand each other’s roles and potential contributions, which this study contributes to.

This article aims to contribute a social pedagogical perspective of high school teachers’ descriptions of working with student health in their teaching practice in Sweden. Ten high school teachers were interviewed. The teachers considered their student health work as consisting of two main aspects: creating a good relationship and helping the students to succeed. These aspects are implicitly and explicitly described as comprising the recognition of the actors’ social and pedagogical identities. This study shows that social pedagogical recognition is significant for common success in school practice in relation to student health work. Clarifying the teachers’ responsibility and competence in student health work and strengthening teachers in their identity as health promoters could improve student health practice.