A questionaire was sent to school nurses in rural districts of Shimane Prefecture asking them about the problems in the school health education and the school health guidance.
The quantitative and qualitative improvement of the working conditions of school health nurses, and the effective co-operation between domestic education and school education based on the understanding of the changes of rural society is needed for the future development of health education. Above all the amplification of the “problem-oriented school health education” in each school is needed to establish a scientific point of view of school children.

Problems in the school health care system of children were studied in rural districts of Shimane Prefecture, Japan. Questionaires which were concerned with the policy and the evaluation of school health care, present situation of health examination in schools, and cooperative activities in the field of school health care between schools and communities were sent to school nurses.
Owing to the recent changes of the general life conditions in rural districts, the life style and the health conditions of children in rural districts became somewhat similar to those in cities. Psychological complaints, psychosomatic diseases, school phobia, obesity and adult diseases such as peptic duodenal ulcer became common in many schools in rural districts.
An inadequate understanding about school health care in teachers and in families, lack of specialists and school nurses in school health care system, few epidemiological studies on the health conditions of children, and the insufficient cooperative activities among schools, families and communities were revealed as important problems to be solved. The scientific health education in schools, adequate health counselling system and the complete health care should be established on the basis of actual living conditions of children and cooperation between school health care and community health care.