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Health education in Australia
Derek Colquhoun
Centre for the Body and Society Faculty of Arts, Deakin University, VIC
Abstract
Health education is at a crossroads. The practices of most health educators have been tossed aside as new developments have been taken on board. For instance, in schools in the last few years no other curriculum area in the primary, secondary or tertiary sectors has undergone such concerted pressure both from within and from outside. School health educators have even questioned their very right to teach the content of their programs in the way they do. Because of the very nature of the problems facing teachers of health education, the content available to teachers which subsumes under the name of health, has burgeoned out of all proportion. New areas of our lives are coming under the auspices of the concept `health education'; new alliances with other school subjects are being forged; new and different illnesses mean more attention must be paid to them in the school curriculum at the expense of other, just as plausible areas; the teacher's role is changing (towards more of an advocate?); the rhetoric of medical researchers is being questioned; teachers and employers are demanding better qualifications in health education; more and more areas of day-to-day living are becoming health conscious (for example, the increased number of smoking bans in public places); there have been calls to make Australia the `clever country' - what is the significance of this for the curriculum? Because of a complex interaction of the above, health education as a school subject is suffering from an identity crisis. For instance, school health education around Australia is variously called or subsumed under different subject areas including; personal development, health studies, lifeskills, personal and social education, health and human relations, and so on.
With this context in mind it is clear that health educators have not been given the support they need in the form of a critique of conventional practices, to allow them to make intelligent decisions about what constitutes health education and how health education works in practice. This has been half the problem; in addition, teachers, practitioners and researchers have often been blinded by technical questions of `how' rather than 'why'. Typical questions include; How do we teach sexuality? How do we implement this or that health education package? How can I fit health education into my busy timetable? We tend not to ask the `why' questions such as why do I teach health education in this way? Why do I look upon the human body in my teaching the way I do and what messages are being conveyed to my pupils because of this? Why do I teach about `the plumbing' in sexuality yet ignore broader issues such as the sexual stereotyping of women in the media? Why do we teach about self-esteem in school health education when other areas of the school curriculum are just as important in developing or damaging self-esteem?
Having said all this it must be stressed that the purpose of this paper is not to blame the victim - I do not believe in bashing health educators! Rather, it is about examining the theoretical and practical options of a social science discipline undergoing dramatic change and development. T he new framework for health education will identify the major areas for future research. In particular, I will be concerned with unearthing the dominant discourse in health education; a discourse which guides our practice at a subconscious level and which implicitly means that in our practice we tend to take things for granted, `given' or `natural'. Throughout this discussion I will raise some issues which have been omitted for too long in discussions of health education but which are now coming to the fore. As Beckett (1990) points out, there have been too many omissions in research in health education. In particular, it can be characterised as being largely atheoretical and concerned with issues of pedagogy and instrumentality. Rigour, interrogation and discussion have been sorely lacking whilst practitioners have busied themselves with teaching and implementing (often `expertly' designed) programs, packages and `innovations'. I will not therefore highlight individual research projects, rather, I will attempt to illustrate many of the emerging problematic issues facing health educators in Australia. I will be particularly concerned with discussing the significance of some of the key issues which the emergent interest in health promotion has brought to light and which have been identified by the group working in Western Australia (see Fisher et al, 1984 as an example). The popularity of health promotion is rooted in an awareness of the limitations of health education per se and also the realisation of the possibilities of health promotion. This trend to view health education within a social and environmental framework has already begun. One landmark publication in Australia has been the special edition of Unicorn in which several authors criticised dominant versions of health education yet also gave hope for a new `critical' health education (Australian College of Education, 1990).
After I analyse the dominant discourse of health education and the ways in which this dominant discourse is manifest in practice, I will explore a socio-cultural framework which allows a critical scrutiny of health education in both the school and community contexts. With this in mind I will suggest that health education is taking on board a socially critical perspective which encourages critical thinkers and not mere cultural `dopes' who are initiated into dominant cultural norms and values.
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