As health concepts develop through exposure to, and experience with particular contexts, and as health concepts influence health behaviour, it is important for actors in health promotion programmes to understand an individual's health concepts. This study focussed on health concepts among socially disadvantaged children in France, Germany, Italy and Switzerland—a hitherto less researched population group. We conducted focus groups with a total of 167 children aged 7–11 years (mean=8.76 years, SD=0.68). The aim of this study was to explore if the life situation across four different countries leads to similar health concepts, and how the particular, national health discourses are reflected in the children's health concepts. The data were analysed through a structured qualitative content analysis and revealed four categories: ‘Symbols/symptoms of health/illness', ‘Emotionality', ‘Healthy/unhealthy practices', and ‘Consequences of health problems'. The children's health concepts are linked to concrete events and objects, and they are able to think in logical sequences. However, the children's causal argumentation is uni-dimensional; they do not cover the complexity of the development of health problems. In particular, overweight stands for illness and is exclusively the result of unhealthy practices. In their concepts, the children reflect the national health promotion programme discourses about overweight. They seem to understand the messages of health education as ‘behaving well means being healthy'; however, such a health education message initiates accusations of ‘unhealthy persons'. In consequence, challenges for sensitive health education programmes (at school) are discussed.