I don't pretend to know the health education literature in any  
significant detail, but as far as I can see, no matter what  
interventions are tried, it's a person's own will and the internal and  
external pressures on their decision-making that results in any  
lasting change to behaviour.

Motivational interviewing, or social marketing, I make the decision to  
change, no one else.

In that regard, I sometimes question (in an ultimate, teleological  
kind of way) the value of health education, irrespective of health  
education's important and necessary role.

At the very least, I question why we concentrate so hard on trying to  
change people's behaviours, when it could be argued that we can't  
really do anything about it anyway. The act of making choices is way  
too complicated and situational for that.

So it flows then that we should be trying to influence the  
distribution of such choices, namely, the things that structure  
people's opportunities and chances to make good decisions.

A potentially subtle, gaping, and crucial difference.

CQ


Quoting Dennis Raphael <[log in to unmask]>:

> The USA has the greatest proportion of people earning low wages of any
> rich nation.
>
> The USA is the only rich nation that does not provide health care as a
> matter of course.
>
> The USA provides among the lowest benefits in the form of disability
> supports, family benefits, pensions, and active labour policy among rich
> nations.
>
> The USA has the lowest union membership rate and collective bargaining
> rate of any developed nation.
>
> The USA taxes rich people at the lowest rates among any rich nation.
>
> Providing more education will simply shift individuals around but will
> still not address the political and economic situation that produces so
> many poor people.
>
> That is why "education" is not the answer to the USA health problem!
>
> dr
>
>
>
> Of related interest:
>
> Poverty and Policy in Canada: Implications for Health and Quality of Life
> by Dennis Raphael
> Foreword by Jack Layton
> http://tinyurl.com/2hg2df
>
> Staying Alive: Critical Perspectives on Health, Illness, and Health Care,
> edited by Dennis Raphael, Toba Bryant, and Marcia Rioux
> Foreword by Gary Teeple
> http://tinyurl.com/2zqrox
>
> Social Determinants of Health: Canadian Perspectives, edited by Dennis
> Raphael
> Foreword by Roy Romanow
> http://tinyurl.com/yptzae
>
> See a lecture!  The Politics of Population Health
> http://msl.stream.yorku.ca/mediasite/viewer/?peid=ac604170-9ccc-4268-a1af-9a9e04b28e1d
>
> Also, presentation on Politics and Health at the Centre for Health
> Disparities in Cleveland Ohio
> http://video.google.com/videoplay?docid=-4129139685624192201&hl=en
>
> Dennis Raphael, PhD
> Professor, School of Health Policy and Management
> York University
> 4700 Keele Street
> Toronto ON M3J 1P3
> 416-736-2100, ext. 22134
> email: [log in to unmask]
> http://www.atkinson.yorku.ca/draphael
>
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