Changing Concepts in Public Health Education *

Determination of the exact events leading to the origin of any social movement is difficult; with public health education those factors which set the wheels in motion are hard to identify. In the late nineteenth century, schools in widely scattered areas introduced the first meager courses in physical education, home economics, and in an understanding of the evils of alcohol and narcotics. At the same time a few health departments began the superficial inspection of school buildings and medical inspection of school children;15 and New York State prepared its first health pamphlets.7 It is a far cry from this to the modern concept of a total health education program, and the intervening years are crowded with accounts of new activities, from the first groping steps of a few far-sighted individuals to the extensive programs under development at the present time. Looking back on the period of exploration certain landmarks can be readily identified. In the early twentieth century, the organization of the National Tuberculosis Association with education as one of its major objectives,8 the employment of the first school nurse in New York City,15 and the inclusion of a school principal, in the city of Baltimore, as a member of the nurse-physician team to plan for the health of the school child,9 stand out as major accomplishments. Tragedy is too often the immediate stimulus for scientific or social progress, and when medical examinations for the armed forces in World War I trained a search-light upon the poor health of American youth, they undoubtedly influenced the development of the child health movement. In any event, the following years brought increased interest in this field. Almost immediately the Child Health Organization was formed,9 and the National Education Association adopted health as one of its cardinal principles.' The term "health education" was also conceived at this time,9 and during the following decade major emphasis continued to be placed upon school health education, accompanied by