Health education, health promotion and the open society: an historical perspective.

This article provides an historical perspective within which two recent, alternative directions for health education are examined. Each direction is seen as reflecting a unique vision of health promotion, with the first focusing primarily on personal behavior change and the latter on a broad empowerment/environmental model of health promotion. Key historical developments in the evolution of these two perspectives are examined, as are some of the assumptions and ideological values underlying these alternative approaches. The World Health Organization's "Healthy Cities Project" then is used to illustrate the broader vision of health promotion in practice. While recognizing that the health educator has contributions to make on both the micro and macro change levels, a case is made for moving the field of health education further in the direction of this broader model of health promotion, and roles for the health educator within such a paradigm are outlined.