Increasing numbers of school districts nationwide have adopted policies to prohibit junk food sales, ban tobacco use during school events and require physical education classes in elementary grade levels, according to a major new study released Monday by the Centers for Disease Control and Prevention.

Increasing numbers of school districts nationwide have adopted policies to prohibit junk food sales, ban tobacco use during school events and require physical education classes in elementary grade levels, according to a major new study released Monday by the Centers for Disease Control and Prevention.

The 2012 School Health Policies and Practices Study is the largest and most comprehensive survey yet to assess school health policies. While the report generally found favorable trends in policies promoting physical health, policies supporting mental and social health were inconsistent, researchers said.

Among the signs of progress in the report, 67.5 percent of school districts in the U.S. had policies in 2012 that prohibited all tobacco use during any school-related activity, compared to 46.7 percent with such policies in 2000. In addition, the percentage of school districts that allowed soft drink companies to advertise soft drinks on school grounds decreased from 46.6 percent in 2006 to 33.5 percent in 2012, and the percentage of school districts that required elementary schools to teach physical education increased from 82.6 percent in 2000 to 93.6 percent in 2012.

While the report did not break down findings by state, hundreds of school districts in California are registered with the state as “tobacco free,” and the state has been a national leader in passing laws that ban the sale of soda at school and require nutritious school meals. The state has been less successful in insuring that students have physical education classes, despite a law requiring such instruction at school, advocates say. Several studies have documented poor compliance, with schools saying they are strapped for time and resources because of extensive testing requirements and budget cuts.

Students who overeat, under-exercise or use tobacco are at risk for a lifetime of poor health, the report stated, noting that schools must play a role because “preventing such behaviors during childhood is easier and more effective than trying to change unhealthy behaviors during adulthood.”

"Good news for students and parents – more students have access to healthy food, better physical fitness activities through initiatives such as ‘Let’s Move,’ and campuses that are completely tobacco free," said Tom Frieden, director of the CDC, in a statement.

Policies on mental health inconsistent

But policies for school mental health and social services didn't fare as well in the report.

"State- and district-level policies supporting broad school mental health and social services were far from universal or consistent," the report stated. "The delivery of school mental health and social services would improve if policies were in place to frame a comprehensive support system for students rather than separate programs or services."

In a look at school-based health centers, more than 70 percent of states had at least one school-based health center that offered both health services and mental health and social services to students. Among states with at least one center, 43.6 percent funded school-based health center services from the state budget, 25.6 percent funded them from Medicaid, 23.1 percent funded them from school district budgets, and 7.7 percent funded them from public grants. California has 226 school-based health centers in place, with more in the works.

The report gathered extensive data on policies that govern student health, including the finding that more districts are discouraging the practice of taking students out of physical education class as punishment for a behavior or academic infraction. Seventy-one percent of districts prohibited or actively discouraged schools from excluding students from physical education to punish them for bad behavior or failure to complete class work in another class, the report found. The majority of districts – 68.4 percent – also prohibited or actively discouraged schools from using physical activity (e.g., laps or push-ups) to punish students for bad behavior in physical education.

"Exemptions decrease the perceived importance of and support for participation in physical education for all students and also reduce opportunities for students to accumulate more physical activity in their daily lives," the report stated. "CDC recommends that such waivers and exemptions not be used."

'Encouraging' signs

Recess time was also protected in 44.2 percent of districts that prohibited or actively discouraged elementary schools from excluding students from all or part of recess for bad behavior or failure to complete class work.

The use of gear to protect students from sports injuries has increased, the study found.

"Between 2000 and 2012, changes also were detected in the percentage of districts that had adopted a policy requiring that students wear appropriate protective gear when engaged in interscholastic sports (from 73.4 to 83.7 percent) as well as when engaged in physical activity clubs or intramural sports (from 40.8 to 57.9 percent)," the report said.

Although skin cancer is the leading type of cancer in the U.S., according to the CDC, the study found that sun safety continues to be a low priority for states and districts. Fewer than one third of the states had developed or assisted in developing model policies, policy guidance or other materials.

"It's encouraging to see the student health is becoming a higher priority for schools across the nation," said Barbara Raymond, director of schools and neighborhoods at The California Endowment health foundation. "These schools understand that health, in mind and body, is a driver of academic success."

Raymond added that it was important to emphasize the findings at a time when education policymakers are deciding how school success should be measured under California's new Local Control Funding Formula, which gives schools more control over how they will allocate their budgets and also provides extra funding for schools with large numbers of low-income students.

"Often times, physical or mental health issues lead to students having trouble focusing in class, missing too much school or having behavior problems," she said. "We hope school leaders will use new funds to invest in health approaches that keep students in school, ready to learn and on track for success."