This article discusses the findings from a study mapping out the priorities, policies and practices of local authorities concerning health promotion (HP) and health education (HE) in primary and lower secondary schools in Denmark. The aim of the study was to identify the gaps, tensions and possibilities associated with the demand to increase the quality and effectiveness of HP in schools. The recent national school reform, which emphasizes the importance of health and well-being while simultaneously increasing the focus on performance and accountability in terms of subject proficiency and narrowly defined academic attainment, provides the broader political context for the study. Data were generated through a structured online survey administered to all 98 Danish municipalities. Respondents were educational consultants or others representing the administrative units responsible for the municipality's schools. The findings were discussed within the conceptual framework of Health Promoting Schools. The study points to a potential tension between the health and education sectors, despite evidence of intersectoral collaboration. While there is a strong policy focus on health and well-being in schools, it is disconnected from the utilization of the HE curriculum by the municipal consultants. The study also points to a lack of professional development opportunities for teachers in the field of HP in schools. On the basis of these findings and theoretical perspectives used, we argue that HP in schools needs to (re)connect with the core task of the school, education, and to integrate both health and education goals in local priorities, policies and practices.

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The article aims to explore the following question: ‘How is education for sustainable development and health education in schools approached and contextualized at a municipal level, and what contradictions and tensions might local structures imply for sustainable health promoting school development?’ Based on interviews with key agents at the municipal level in Denmark and drawing on a knowledge exchange network, the article identifies and discusses the following three themes across education for sustainable development and health education: (i) autonomy, engagement and ownership; (ii) open frameworks and invitations to ‘run with the ball’; and (iii) ad hoc professional development. A main conclusion in the article is that local approaches are largely based on plurality and voluntarism, and are formed around enthusiasts. There is a risk that this framework becomes so flexible that it ‘falls apart’ in the balance between rigidity and flexibility.