Today, we are faced with a host of health problems that require individual action. . . . Bringing about that action requires education. The task is made unusually difficult because of the insidious nature of the chronic diseases, the lack of any action individuals may take, the age-group that must be influenced, the large number of agencies that are involved, and the need for modification of some of our cultural patterns and value systems. This is the challenge to the profession of health education.
There are additional difficulties in stimulating appropriate individual action to prevent or control the chronic diseases. A single action, such as being vaccinated or immunized, protects a person for a period of time—often for a long period of time—whereas the actions that must be taken to prevent further disability from a chronic disease often require a complete change in the pattern of one’s daily living. Changing one’s diet and changing the kinds and amounts of physical and mental activity permitted require radical readjustment in an individual’s life. Because it is not possible to define adequately the actions persons should take, because these actions do not seem to relate directly to prevention of a condition, and because these actions may require radical changes in life, it is extremely difficult to effect desirable changes in behavior.
Present-day health problems differ from those with which public health traditionally has been concerned in the amount of individual understanding necessary to prevent and cure the diseases or to avoid accidents. Avoiding disability and death from these causes depends a great deal more on individual understanding and action than did the prevention of the infectious diseases.
Not every person needs to know about or take specific preventive action to be protected from a communicable disease. For example, if a community, through the action of a few of its citizens and its government, installs a safe water supply and sanitary sewage disposal, all members of the community will benefit. The immunization of even a few children in a community affords some protection to the others, for each immune child in a population reduces the chance of transmission of the disease.
If the challenge is to be met, most of the educational efforts must be concentrated upon adults outside the classroom where the problems may arise. It will not suffice to give students in grade school or even in college a body of the latest scientific information and expect them to use the information when they reach the age when chronic diseases are most prevalent. Such an expectation overlooks an important research finding in psychology—we forget rapidly information that is not functional in our daily lives.
But even if people did remember everything they learned in grade school or college, would the latest scientific information of today serve as guides to the behavior of students when they become older? Certainly everyone would hope not, for with the dynamic nature of medical research today, there is every indication that many of the tools for dealing with the diseases of today will become much more precise. If the limited information now available were remembered and used by students in later life, it might serve as a deterrent to the real action the students should take. . . .
What, then, should be the educational focus? Rather than concentrating on imparting an organized series of health facts, should the major emphasis not be on developing among students skill in solving health problems when they occur? In every school or college, some health situation is constantly arising in which individuals or groups must take action for their health. All too often, instructors decide upon the action to be taken without giving students the opportunity to gather information regarding the problem, to evaluate it, to develop their own solution, and to put these solutions into operation.
If, however, students have the experience of making the decisions, they will learn how to assemble pertinent facts from a variety of sources—a far more important achievement than that of having acquired an extensive body of knowledge about health. They will also have an opportunity to develop the ability to discriminate between reliable and unreliable information. This latter skill is particularly important at this time, for with the rapid advance of scientific discovery, it is often not easy to distinguish research achievement from the exorbitant claims of quacks or the overzealous desire for publicity on the part of a pseudoinvestigator.
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