State School-Based Physical Activity and Health-Screening Laws
Physical Education and Activity
Every state has some physical education requirements for students. However, these requirements are often limited or not enforced, and many programs are inadequate.1
Many states have started enacting laws requiring schools to provide a certain number of minutes and/or a specified difficulty level of physical activity. Twenty-one specifically require schools to provide physical activity or recess during the school day: Arizona, Colorado, Connecticut, Hawaii, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Mississippi, Missouri, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, South Carolina, Tennessee, Texas and Virginia.
Twenty-eight states currently have laws supporting shared use of facilities, including: Alabama, Arizona, Arkansas, California, Delaware, Georgia, Hawaii, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington and Wisconsin.
Many communities do not have enough safe and accessible places for people to be physically active, indoors and out. Schools often have gymnasiums, playgrounds, tracks and fields, but they are not accessible to the community. Many schools keep their facilities closed after school hours for fear of liability in the event of an injury, vandalism and the cost of maintenance and security. Some states and communities have laws encouraging or requiring schools to make facilities available for use by the community through shared- or joint-use agreements.2 These agreements allow school districts, local governments and community-based organizations to overcome common concerns, costs and responsibilities that come along with opening school property to the public after hours.
Health Assessment and Health Education
Physical activity, nutrition and other factors impact the overall health of students. A number of states have instituted legislation to conduct health assessments to help parents, schools and communities understand the health of children and teens, and nearly every state requires some form of health education classes for students.
Twenty-one states currently have legislation that requires Body Mass Index (BMI) screening or weight-related assessments other than BMI.
- States with BMI screening requirements: Arkansas, California*, Florida, Illinois, Maine, Missouri, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Vermont and West Virginia.
- States with other weight-related screening requirements: Delaware, Iowa, Louisiana, Massachusetts, Nevada, South Carolina and Texas.
* As of July 2010, statewide distribution of diabetes risk information to schoolchildren, California Education Code § 49452.7, replaced individual BMI reporting, California Education Code § 49452.6.
BMI and other health assessments are intended to help schools and communities assess rates of childhood obesity, educate parents and students and serve as a means to evaluate obesity prevention and control programs in that school and community. The American Academy of Pediatrics (AAP) recommends that BMI should be calculated and plotted annually for all youth as part of normal health supervision within the child's medical home, and the Institute of Medicine (IOM) recommends annual school-based BMI screenings.3,4 Centers for Disease Control and Prevention (CDC) has identified safeguards for schools who conduct BMI screenings to ensure they focus on promoting health and positive wellness for children.5
Only two states — Colorado and Oklahoma — do not require schools to provide health education.
Health education curricula often include community health, consumer health, environmental health, family life, mental and emotional health, injury prevention and safety, nutrition, personal health, prevention and control of disease and substance use and abuse. The goal of school health education is to prevent premature deaths and disabilities by improving the health literacy of students.6
According to a 2012 CDC study, health education standards and curricula vary greatly from school to school.7
- The percentage of states that require districts or schools to follow national or state health education standards increased from 60.8 percent in 2000 to over 90 percent in 2012; the percentage of districts that required this of their schools increased from 68.8 percent to 82.4 percent.
- Just over 88 percent of states and 39.1 percent of districts required each school to have a school health education coordinator.
Wellness policies are written documents that guide a local education agency or school district's process to establish a healthy school environment. Wellness policies were originally required by the Child Nutrition and WIC Reauthorization Act of 2004 and updated and strengthened by the Healthy Hunger-Free Kids Act (HHFKA) of 2010. Each local education agency participating in the National School Lunch Program (NSLP) and/or School Breakfast Program must develop a wellness policy. At a minimum, wellness policies must include specific goals for: nutrition promotion; nutrition education; physical activity; and other school-based activities that promote student wellness. Since the update to the rule in 2010, local education agencies are now required to periodically measure and provide an assessment of the wellness program to the public including the implementation of the wellness policy, the extent to which the schools are in compliance with the policy, how well the policy compares to model policies and a description of the progress made in attaining the wellness policy goals.8
Physical Activity and Health-Screening Laws by State
|State||Physical Education Requirement||Physical Activity Requirement||Shared Use Agreements||Health |
|Health Education Requirement|
|y||District of Columbia|
|50 + D.C.||21||28||21||48 + D.C.|
1 Johnston LD, O'Malley PM, Terry-McElrath YM, & Colabianchi N. School policies and practices to improve health and prevent obesity: National secondary school survey results, school years 2006-07 through 2009-10. Volume 2. Ann Arbor, MI: Bridging the Gap Program, Survey Research Center, Institute for Social Research, 2012.
2 Model Joint Use Agreement Resources: Increasing physical activity by opening up school grounds. In ChangeLab Solutions (accessed May 2013).
3 American Academy of Pediatrics. Policy Statement: Prevention of Pediatric Overweight and Obesity. Pediatrics, 112(2):424-430, 2003 and Murray R. Response to 'Parents' Perceptions of Curricular Issues Affecting Children's Weight in Elementary Schools. Journal of School Health, 77(5): 223-230, 2007.
4 Institute of Medicine. Preventing Childhood Obesity: Health in the Balance. Washington, D.C.: The National Academies Press, 2005.
5 Nihiser et al. Body Mass Index Measurement in Schools. J Sch Health. 2007;77(10):651.
6 American Association of Health Education. Comprehensive School Health Education: A Position Statement of the American Association of Health Education, 2003.
7 SHPPS 2012: School Health Policies and Practices Study. In U.S. Centers for Disease Control and Prevention (accessed May 2014).
8 Local School Wellness Policy Implementation Under the Healthy, Hunger-Free Kids Act of 2010: Summary of the Proposed Rule. In United States Department of Agriculture (accessed May 2014).