THE WORDS "health education" are variously used to refer to a broad spectrum of activities ranging from the simple provision of public information to elaborate programs for the training of highly specialized health manpower. In this paper I will use the definition adopted by the President's Committee on Health Education: "Health education is a process that bridges the gap between health information and health practices" (1). Within the broad spectrum of health education my specific concern is with patient education. This process begins with the imparting of factual information to patients, but it also includes interpretation and integration of the information in such a manner as to bring about attitudinal or behavioral changes which benefit the person's health status. Thus, patient education not only involves the world of medical scientific facts, but in its process it is also closely interwoven with psychology, sociology, behavioral science, and cultural anthropology. An organized program for patient education requires a systematic effort by one or more health professionals in a health service delivery setting. It consists of a number of orderly steps which include assessing the patient's knowledge about his health, determining the patient's health educational needs, the provision of information in a manner most understandable and acceptable by the patient, assuring as much as possible that this information is integrated into the patient's attitudes and, finally, followup to assure that the new information has indeed produced behavioral changes with beneficial effect upon the person. This process frequently must be directed not only to the patient himself but also to other per-
PROGRAMS DESIGNED TO INTRODUCE health and the health occupations to high school students are not new, but the numerical impact of these efforts has been negligible. Throughout the 1960s various hospitals reported programs for high school students (1-4), but the minor importance of the health occupations in secondary school curriculums is apparent from the fact that in 1966 only 0.08 percent of the nation's high school students were enrolled in health vocational training programs (5). Mo're recently, health has been a vehicle for the teaching of science at the secondary level (6), and a few programs provide academic credit for small numbers of carefully selected students with outstanding academic records (2). Since 1971, some programs have emerged that are directed specifically to minority group students (7). Furthermore, at least eight medical schools are currently sponsoring high school programs of varying size and scope, most of which are also aimed at minority students (8,9).
ALTHOUGH many health problems achieve publicity and priority through emotional appeals on behalf of those who are afflicted with the disorder, few health problems are invested with symbolic, civic, or ethnic content. Poliomyelitis and its association with President Roosevelt is perhaps the best example of a health issue achieving this civic symbolism and subsequent grassroots support through the vehicle of the March of Dimes. Recently the problem of sickle cell anemia has become invested with the symbolic ethnic identity of the black community. The relatively widespread nature of the disorder naturally focuses the community's concern. The prevalence rate of sickle cell anemia in black infants in this country is 1 in 400. Approximately 1 in 10 blacks are heterozygous carriers of the trait for hemoglobin S, and therefore information about their sickle cell status should be available, if desired, to serve as a basis for informed decisions about childbearing. The fact that the molecular biology of the disease is well elaborated and yet no cure or even fully successful treatment is available increases community concern. Finally, the probable survival advantage held by the trait carrier in malarial regions (1), balanced polymorphism, is often mentioned in public media presentations on sickle cell anemia, and it is presented'in terms of the tenacity, strength, and will to live of the black race. This turns defect into asset and makes the resolution of the former concerns seem less difficult. Although some black professionals have been concerned about placing too much emphasis on sickle cell anemia when clearly many other health problems disproportionately affect persons in the
