title: Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program.
abstract: OBJECTIVE
  Comprehensive school health (CSH) is increasingly receiving renewed interest as a strategy to improve health and learning. The present study estimates the costs associated with implementing and maintaining CSH.
  
  
  METHODS
  We reviewed the accounting information of all schools in the Annapolis Valley Health Promoting Schools (AVHPS) program in 2008/2009. We considered support for nutrition and physical activity programs by the public system, grants, donations, fundraising and volunteers.
  
  
  RESULTS
  The annual public funding to AVHPS to implement and maintain CSH totaled $344,514, which translates, on average, to $7,830 per school and $22.67 per student. Of the public funding, $140,500 was for CSH, $86,250 for breakfast programs, $28,750 for school food policy programs, and the remainder for other subsidized programs. Grants, donations and fundraising were mostly locally acquired. They totaled $127,235, which translates, on average, to $2,892 per school or $8.37 per student. The value of volunteer support was estimated to be equivalent to the value of grants, donations and fundraising combined. Of all grants, donations, fundraising and volunteers, 20% was directed to physical activity programs and 80% to nutrition programs.
  
  
  CONCLUSIONS
  The public costs to implement and maintain CSH are modest. They leveraged substantial local funding and in-kind contributions, underlining community support for healthy eating and active living. Where CSH is effective in preventing childhood overweight, it is most likely cost-effective too, as costs for future chronic diseases are mounting. CSH programs that are proven effective and cost-effective have enormous potential for broad implementation and for reducing the public health burden associated with obesity.
authors.affiliation: Department of Public Health Science, School of Public Health, University of Alberta, Edmonton, AB. arto.ohinmaa@ualberta.ca
authors.forename: Arto
authors.initials: A
authors.lastname: Ohinmaa
authors.forename: Jessie-Lee
authors.initials: JL
authors.lastname: Langille
authors.forename: Stuart
authors.initials: S
authors.lastname: Jamieson
authors.forename: Caroline
authors.initials: C
authors.lastname: Whitby
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Veugelers
mesh_terms: D002648:Child; D003362:Cost-Benefit Analysis; D005381:Financing, Organized / Q000191:economics / Q000458:organization & administration; D006293:Health Promotion / Q000191:economics* / Q000458:organization & administration; D006801:Humans; D009674:Nova Scotia; D052756:Nutritional Sciences / Q000193:education*; D050177:Overweight / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D010806:Physical Education and Training / Q000191:economics* / Q000458:organization & administration; D016730:Program Development / Q000191:economics; D055818:Public-Private Sector Partnerships; D012572:School Health Services / Q000191:economics* / Q000458:organization & administration; D014838:Volunteers