Health Education From 1775 to 2005

Health education is an innate aspect of public health practice and difficult to discuss as a separate entity. Nevertheless, this special issue of Preventing Chronic Disease provides in-depth examinations of the purposes and uses of health education programs. We thank Neil Hann of the Oklahoma State Department of Health and Carol Russell of the Directors of Health Promotion and Education for serving as guest editors for this issue. Among the earliest recorded health education programs in the United States were those related to military troops of the 18th century during the Revolutionary War. These programs are distinguished by their recognition of a " community , " determined as much by membership in a common group as by geopolitical boundaries. Soldiers were more likely to die of infectious diseases than of battle wounds; camp hygiene was thus a critical aspect of an offi-cer's duties. One of George Washington's first general orders, dated July 4, 1775, states, " All officers are required and expected to pay diligent Attention to keep their Men neat and clean. .. and inculcate upon them the necessity of cleanliness.. .. They are also to take care that Necessarys [latrines] be provided in the camps " (1). Several programs discussed in this issue highlight health education in communities. A report from Texas describes the certification of promotores to serve as community health educators in neighborhoods (2). Oregon has developed a partnership between state public health and Medicaid agencies to encourage its community of health care providers to address the impact of tobacco on asthma morbidity (3). Colorado conducted an assessment of the costs and savings of community fluoridation programs within the state, providing useful information to policymakers on the importance of water fluoridation (4). North Carolina provided microgrants to empower local communities to select and implement their own health promotion projects (5), and in another program, encouraged local health departments to use policy-change and environmental-change strategies to address community risk factors (6). One of the most remarkable reports on public health in the 19th century was the Report of the Sanitary Commission of Massachusetts 1850, also called the Shattuck Report after the chairman of the commission, Lemuel Shattuck (7). This document is considered the first scientific report in the United States describing the health of a population using birth and death rates, comparisons with the rates of other communities, and additional data to support its comprehensive recommendations on …