BACKGROUND: Schools and the education sector are positioned as critical strategies for the promotion of young people’s health and well-being. Increasingly, schools are seen as a frontline technology to absorb the responsibility for and cost of health promotion and care, with little or no increase in funding, staffing or professional development for teachers. This paper draws on data from an Australian study that examined the nature and extent of health-related work undertaken by teachers and schools, to determine the cost-benefit of this work and the broader economic contribution of teachers and schools to the preventive health agenda.METHODS: The Teachers as Health Workers project engaged 12 schools and approximately 400 teachers across Queensland, Australia. The schools comprised a combination of elementary and secondary schools located in both metropolitan and regional areas. Mixed-method data collection included questionnaires, time-use diaries and semi-structured interviews. Further, questionnaire data was used to conduct economic modelling to capture the element of teacher time diverted from ‘education’ to ‘health work’ and the potential economic transfer from the education sector to the health sector.FINDINGS: Teachers reported spending almost ten hours per week undertaking health work with their students. Whilst teachers generally found this health work to be satisfying, qualitative data revealed that teachers incurred substantial personal and emotional costs. Preliminary economic modelling indicates an economic transfer of around $20,000 per teacher from the education sector to health services. CONCLUSIONS: Findings reveal the significant policy and economic implications of teachers and schools conducting health work. If teachers spend a significant part of their contact with students undertaking a range of health-related work, then questions emerge regarding the efficient use of society’s resources. At an individual level, the nature of this work can have a considerable cost to teachers, which may be ameliorated by enhanced professional development and increased teacher support in this field. However, this investment in teacher’s health work needs to be considered in the context of the loss of education time and resources. In contexts where positive social benefits occur then it is efficient to invest resources in teacher’s health work, however if education time is compromised resulting in a negative social benefit, health work and provision should be diverted to alternative services.