This study uses a public health lens to review evidence about the impacts of wearing a school uniform on students’ health and educational outcomes. It also reviews the underlying rationales for school uniform use, exploring historical reasons for uniform use, as well as how questions of equity, human rights, and the status of children as a vulnerable group are played out in debates over school uniforms. The literature identified indicates that uniforms have no direct impact on academic performance, yet directly impact physical and psychological health. Girls, ethnic and religious minorities, gender-diverse students and poorer students suffer harm disproportionately from poorly designed uniform policies and garments that do not suit their physical and socio-cultural needs. Paradoxically, for some students, uniform creates a barrier to education that it was originally instituted to remedy. The article shows that public health offers a new perspective on and contribution to debates and rationales for school uniform use. This review lays out the research landscape on school uniform and highlights areas for further research.

Early messaging from the government about the 2021 health system reforms placed considerable emphasis on the central role of primary health and community care (PHCC) to meet reform goals. 1 The PHCC sector welcomed this focus. For over a decade, the Ministry of Health (MOH) has allowed gaps to develop between strategy, policy and health system performance, especially for PHCC as noted by two major reviews, the Waitangi Tribunal Hauora Report (Wai 2575) 2 and the Health and Disability Services Review Report (HDSR 2020). 3 Since the 2010s, there has been little government attention or acknowledgement of the importance of primary care, despite PHCC being the 'front door' to our publicly funded health system. Meanwhile, PHCC's guiding strategy remains the 20-year-old Primary Health Care Strategy (PHCS 2001). 4 In light of this, how does PHCC fare in the reforms so far? PHCC and government action based on recommendations of reviewsThe Pae Ora (Healthy Futures) Act is the health reform's legislative vehicle. With population health as a principle and a strong focus on health equity, it establishes new Pae Ora health system entities, including the Māori Health Authority (MHA). The Act places considerable emphasis on localities and locality plans; however, the Act is silent on PHCC, its features and its role. Although the legislation stipulates specific sector plans and strategies, PHCC is again absent, though six other strategies are present, including five population health strategies. 1

In the original article, there was a mistake in Table 2 as published. "Health and Safety can be enhanced by uniform design" should have been placed in the "Positive impact" column, not the "Neutral impact" column. "Non-inclusive design can reduce girls' and overweight students' confidence to participate in sport; Bullying and social exclusion for uniform following rules; Inflexible uniform policy harmful for gender-diverse students." was placed in the "Neutral impact" column, and should be in the "Negative impact" column. In all parts of the table semicolons were incorrectly changed to full stops. The corrected Table 2 appears below.In the original article, there was an error. "and socio-cultural contexts which inform uniform use" was incorrectly written as "and socio-cultural context in which inform uniform is used."A correction has been made to Results, first paragraph, final sentence: "Here, evidence has been arranged according to a public health lens of analysis. First, this section examines the proximate educational and health impacts of uniform garments and uniform policy on students to determine whether there are immediate health or education impacts of uniform use or policy. Second, rationales for uniform use are examined, as well as distal factors that influence student experience. This section examines the broader institutional, and socio-cultural contexts which inform uniform use."In the original article, there was an error. The word "is" was missing.A correction has been made to Part 1: Literature for Educational and Health Impacts of Uniform; Does Uniform Influence Educational Outcomes? First sentence:"Starting with the evidence for the impact of uniform on educational outcomes (the core in Figure 1), there is little convincing evidence that uniform improves academic achievement."In the original article, there was an error. The word "as" was missing.A correction has been made to Part 3: Human Rights and Uniform Use; Uniform and Freedom of Religion, paragraph 3, first sentence:"Whatever the social context, outward signs of faith can challenge both uniform rules and wider societal values such as secularity in public institutions."In the original article, there was an error. The word "has" was missing.A correction has been made to Discussion, paragraph 5, second sentence: "This review has highlighted that uniform has become a proxy for many issues."