My Reaction to Sharrock and Iedema

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I plead guilty to the charge that I fell into the trap of what Sharrock and Iedema call "evolutionary transcendence discourse" in my selection and characterization of landmark publications in our earlier series. I plead innocent, however, to the suggestion that my contribution to that discourse should be seen as constructing "an oppositional, hierarchical, and thus binary relationship between health promotion and health education."  Indeed, I have argued there and elsewhere that health education should remain a mainstay, touchstone, and foundation for the continuing development of health promotion. That might be tantamount to an evolutionary relationship, but not an oppositional, hierarchical, or binary one.

    Some in the movement to broaden the scope of our political influence and our social and behavioral science work in public health sought to replace health education with health promotion, to build health promotion on the ashes of health education, or at least to promote health promotion by disparaging health education. Not I. As one whose graduate degrees and philosophical orientation were in public health education, I was prepared to defend the pivotal, integrated, and central role that health education should play in health promotion. I argued in the 1970s in federal documents defining health promotion for U.S. policy, and in my keynote address at the 1979 IUHPE world conference in London, and in my Background Paper for the World Health Assembly in 1981 that health promotion should be defined as any combination of health education and related organizational, political, and environmental supports for action conducive to health. Evolutionary? Yes. Oppositional, hierarchical, or binary? I think not.

    The post-modernist discourse is an intellectually stimulating and potentially practical challenge to our world view, and I am perhaps more susceptible to modernist and positivist habits of outlook and approach to work in this field than most of my younger colleagues. Hence, my devotion in the last decade to the pursuit of a participatory research agenda, one that would move us from a preoccupation with "evidence-based practice" to more practice-based evidence. I would hate to think that my contributions would be remembered as oppositional, hierarchical, or binary in their view of health education and health promotion. The "educational approach" to health promotion planning, as my textbook with Marshall Kreuter argues, assures health promotion a socially responsible and responsive construction of policies and programs.