Environmental health education: a different orientation.

The indiviual behaviour, group habits and corporate activities that are the keys to environmental prevention are markedly different in character from the personal hygiene and illness behaviours of primary care and patient education. Education for personal care is oriented towards the educatee's own future behaviour and related to the internal processes of his or her physiological organism. It is learning that is aimed both at children and adults. In contrast, in environmental prevention, education is oriented to changing present behaviour related to external stressers and feedbacks. In most programmes this learning is aimed at adults. The health education impact on environmental risks differs in three distinct types of environmental programmes i.e.: (1) when control applies cost-effective technological advances (sewer systems, etc.) which usually bring about behaviour change with little educational effort; (2) when the programme aims at correcting infectious or injurious conditions which require adequate motivation on the part of the people; and (3) when the focus is on social stressers and behaviours, on the reduction of chronic diseases and mental disorders, an area where education and community organization have then a major role to play. Do techniques that effectively develop awareness, communicate information, develop individual or group know-how, and thus lead to preventive action differ between patient behaviour education and environmental health education? The answer must be a partial but important "yes". In environmental prevention programmes the motivating appeal has to be more altruistic, more "other" oriented, and the programme has to be group involving. The behaviours to be changed are not one's own alone, but those common among individuals or corporate bodies around one. In fact, health education faces five challenging problems in the area of environmental risk prevention. First, how do we most quickly and effectively communicate our concern about some stresser or behavioural matter to a specific population? Second, how can we keep voluntary community organizations, which we have helped to develop, from faltering or expiring after three or four years of useful endeavour? Third, how do we reach the populations typified by anomic personalities--the withdrawn, disillusioned or apathetic? Fourth, how do we identify key influential people and interest them in becoming involved in our environmental programmes, in participating in the setting of priorities and contributing to their realization? And last but not least, how can we best ensure that health education services will be provided to community organizations long enough in order to obtain confirmation that the population's behaviour changes have become self-continuing habits or customs?