If education is social, ubiquitous and only partially authorized by authorities, what are the implication for health? One has but to look at the current campaigns about diet or exercise to realize how limited state or foundation sponsored expert health education can be–whether one is concerned with knowledge or with every day practice. Much health education takes place through more or less focused instruction over a lifetime of conversations with many others, as well as at times of health crises involving oneself or those closest to us. Given the multiplicity of these settings, we must expect individual responses, both cognitive and practical, to emerge from a collision of authoritative, informal and chance educational moments. Brief moments of attention to official information, personal anecdotes, familial strategies, off hand advice or interpretation from consociates, randomly obtained information from the internet or other semi-formal sources, psychological predispositions to process certain types of information over others, personal lifestyle and cultural preferences, the specifics of the health or disease issue or part of the body involved, the particular range of relevant defining personal bodily habits, awareness of the tenacity of such habits and the force of personality emanating from all actors involved can all play crucial roles in health behavior, practitioner choice and treatment undertaken. This cacophony of sources for “health education” is ongoing. While the formal health educators act on increasingly elaborate techniques of educating, holding the attention of the “students” and presenting information through multiple, creative channels, they usually still loose the battle of changing actions and improving health status. Ultimately the obstinate refusal of this informal, comprehensive educational sector to bow to official paradigms and rational choice choices demonstrates how human education is so comprehensively omnipresent that it remains impressively resistant to manipulation from above. This paper explores what we have begun to learn about these processes in earlier research and makes a case for where we need to go to do full justice to the work of all on health matters, and in the hope that it will make expert intervention more circumspect. It is necessarily a messy, reality based realm that is ultimately indeterminate, disorderly, uncontrollable, and resistant to study that does not build from facing what people actually do.
Paper (January 28 final draft)