Reflections on the medical model and the objectives of health education

A recent article in the IJHE deals with the linkage of health education to a medical model philosophy and discusses the origins and consequences of medical dominance on health education practice (Vuori, 1980). This paper questions some of the observations and conclusions on which the medical dominance premise is based and argues that historical developments and the current state of affairs of health education do not fully support a medical dominance thesis. For example, there is a historical omission concerning the growth and influence of social and behavioural sciences on health education theory and practice. Also, current health education systems and services in European countries do not unequivocally support the medical influence premise, nor do training programmes and research. The paper further re-examines some statements about the possible consequences of medical dominance on current health education practice, especially as regards the usefulness of single-theme campaigns, the use of health services and the dissemination of medical knowledge. Opinions about the use of individual versus social means of action are discussed, as well as the need for health education to invest more energy in creating favourable attitudes towards the use of legislative and administrative measures. Finally, the discussion centres on the proposition that health education should be more concerned with the internalization of health values. It is argued that it would be useful to re-examine the conceptual base of health education in developmental terms and proposed that we reflect on the organization of health education activities and service around five sectors of socialization. These are interdependent, yet play a specific role in health education throughout the various stages of life.