Singapore is a small island-country, about 700 sq km in area, with a total population of 4.5 million and a resident population of 3.6 million. Its rich ethnic mix comprises 76% Chinese, 13% Malays, 9% Indians, and 2% of other ethnic origins. Twenty percent of the population is under 15 years of age. The healthcare system is comprehensive and access is good, as reflected in the infant mortality rate of 2.6 per 1,000 live births and a life expectancy of 80 years. There are about 350 government primary, secondary, and preuniversity level schools attended by children from 6 to 18 years old. The first 6 years of education, starting at 6-years-old and covering primary one to primary six levels, are compulsory. There is opportunity for every child to have secondary school education (4 years). The mean number of years of schooling is 9.3 years, with 60% of the population currently holding a secondary or higher qualification. Postsecondary and tertiary education choices are offered by several polytechnics, institutions of technical education, three universities, and other specialty education institutions. The population literacy rate is 95.4% The origins of school health promotion can be traced to the 1970s and 1980s, when the Ministries of Health and Education worked together on the school health education syllabus and curriculum materials. Over those years, the Ministry of Health offered a wide range of programs in schools addressing smoking, nutrition, exercise, mental health, oral health, and sexually transmitted diseases (STDs) individually. These topics and activities were well accepted by schools and achieved a broad reach to students and teachers annually.