Numerous reports and studies have touted the benefits of school health education for over five decades and extensive public health data support an association between education levels and health outcomes. This paper recounts the "tacit" approval given to school health education historically by reviewing reports issued by various governmental and nongovernmental organizations from the 1960s to the present. Whereas these reports and studies demonstrate an influence on the status of modern school health education programs, many of the barriers to effective school-based programs described 50 or more years ago continue to be challenges for school health education advocates. Additional elements that may further impact the delivery and of quality of school health education negatively in the next decade include legislation that places pressure on schools to improve students' performance on subject areas that do not include health; a declining tax base for funding education programs in general; the deterioration or complete disappearance of school health education professional preparations programs; and evolving technology that alter the ways in which students learn.