This paper presents selected findings of a study first conducted in 2005 in Norway, in 141 rural municipalities with highly dispersed settlements (e.g. Solstad 2009; Solstad & Thelin, 2006), and again in 2015, in a further 200 rural municipalities. It asks questions about past and current school structure and about expectations for the next five years, thus providing a picture of school centralisation processes and the need for school transportation all the way from the mid-1980s until today. Comparison of the findings raises concerns about the greater dependence of more children on transportation to school, and the negative effects on their physical health. In 2009, schools’ direct responsibility for children’s physical development required by law since 1936, was removed, although physical education remains a compulsory subject. It seems strange, however, that this move towards the school’s less explicit responsibility comes at a time when children in general get less natural exercise, and when, despite a high level of participation in organized sports and keeping fit, being overweight has become common among school-age children. However, while the schools’ direct responsibility for children’s physical development was weakened, the Public Health Act 2012 clearly strengthened the municipalities’ obligation to take account of health implications in its planning and provision of services. Our concern is that school closures are taking place on a large scale without much attention being paid to the health implications for children. Studies from the 1970s and 1980s disclosed a negative relationship between school transportation and health among the school population (see Solstad, 1973). If we limit ourselves to the schools closed down between 2005 and 2015, the estimates show that the number of children needing school transportation has doubled, as has the distance travelled by children who were already in need of transportation. In this paper we suggest that in the future, decisions about “saving money” by closing down schools should pay more attention to how such closures can have negative effects on the school population. If the school under consideration for closure is very small, the economic gains of closure may be significant in the short run (Solstad 2010). However, taking account of the health risks involved, the negative consequences for society as a whole as well as for the individual, may be negative even if judged only in economic terms.