Combating 'Ignorance... the greatest enemy of health': health education in Australia, 1945 – 1981.

In the second half of the twentieth century Australian state and federal governments became increasingly attracted to health education as a public health measure. This reflected the growing prevalence of lifestyle-related medical conditions during the period, whose onset and development were largely dependent on individuals' behaviour. How these health education policies and programs were implemented in post-war Australia has yet to receive sustained historical attention, and this thesis addresses this absence by examining government-implemented health education in the thirty-five years following World War Two. Three case studies were used to analyse governments' motives and methods for modifying citizens' health-related behaviour: school health education, the Australian Road Safety Council campaigns, and the 'Life. Be in it' program. Comparisons with health education programs that were developed outside of the stated time frame of the thesis were also made to highlight unique aspects of the case studies and to place them in their historical context. The underlying motivation of Australian governments was to increase citizens' economic productivity and to decrease health expenditure. However Australia's liberal democracy presented policymakers with an ethical dilemma of how to modify citizens' behaviour in a non-coercive manner. It was found that government-implemented health education programs endorsed the notion of self-responsibility to achieve this. By focusing on the responsibility of citizens, governments were also able to deflect attention away from areas where they could have made a greater investment or imposed stricter regulations on industry. Furthermore, the case studies demonstrated that health education policies and programs were shaped more by economic, cultural and political factors than by research or evidence-based practice. This was shown through the continued use of methods whose effectiveness had earlier been questioned or discredited. Health education's greatest contribution to public health during the period was raising awareness of health issues that facilitated the public's acceptance of more coercive government measures to modify behaviour. Through the exploration of policymakers' motives and methods, this study places post-war government-implemented health education in its historical context, which has thus far been neglected in accounts of Australian public health.