Health education's contributions to public health in the twentieth century: A glimpse through health promotion's rear-view mirror

A lesson of the first half of the century was that growth and technological development brought new health problems and challenges in their wake, many of which were to prove more intractable to technological fixes than the on es that had been so dramatically fixed before. Massive expansions of resour ces in support of the extension of these medical fixes resulted in an escal ation of costs that had to be reigned in by breaking from the resource-base d planning cycle that had prevailed through two eras of expansion. The 1970 s ushered in an era of cost containment as the central theme of new policie s. They included provisions for health promotion that sought to find new ha ndles on the intractable social and behavioral aspects of the demand for he alth care resources, especially through primary prevention and building of capacity for community, family, and individual self-management of health pr oblems and programs. Lessons from this era for public health in the next ce ntury are considered.