Learning and Teaching Health

Learning health not only involves learning how to become healthy, but, and perhaps more importantly, learning how to stay healthy. In other words, learning and teaching health is equivalent to learning and teaching prevention. How does HPES approach prevention education?

Prevention is not like treatment. When people are sick they seek treatment and care. Providing equitable access to treatment means making it physically and financially possible for all people to get quality help when they are ill. But people do not seek help with prevention. In fact, those who need it most are least likely to seek or accept the lessons and methods of preventing illness and injury. Moreover, those whose behavior flies in the face of healthy decision-making and disease prevention typically do not simply endanger themselves. They often directly and adversely affect others, and they also contribute to social norms and risk-friendly environments that make it more likely that others will behave in unhealthy ways. Preventive systems that primarily respond to those who voluntarily seek their help are dismal failures.

Health attitudes and behaviors are complex, social, and often emotional. People of all ages actively interpret their experiences and construct their beliefs and behaviors, often unconsciously and without critical examination, and in the context of the strengths and weaknesses of their upbringing and community. We are not independent and empty vessels to be filled by discrete, creatively-packaged bundles of messages. We are complex learning organisms.

As a result, health learning must be active and participatory. Medicine is individual — everyone has his or her own body. But health is social and depends on norms and environments that support or undermine healthy choices. So much of what we do through peer education is to help, coax, tempt, trick, and even force young people to think things through, to question and probe, examine and reconsider together.

In education, sequence always matters. It is certainly the job of peer education to provide scientifically accurate information about how to stay healthy — but it makes a big difference if we provide the "right" answers before, or after, learners have had the chance to puzzle and reason and dispute over the questions. Peer educators are educators, and the most important thing educators do is to ask good questions.

We can best describe learner-centered, active and social health learning metaphorically: We are helping youth to build a stronger foundation for a house they will feel is their own and hopefully choose to live in. Even more important, we are helping them learn to build, not asking them to move into some pre-fabricated model — and we are insisting that they cannot build alone, that the building and living in this house is a community affair. This sort of health learning, while it is only one goal of peer education, cannot be done from the front of the room. It requires small-group work not usually practical without peer educators.