ABSTRACT
This chapter focuses on the growth of the health promotion movement, and its impact on contemporary conceptions of health itself. The twentieth-century evolution of health beliefs, then, has had pervasive effects on modern medical care. The common thread through the various national "perspectives on health" was the claim that much improvement was possible without continually increasing health care budgets. The health promoters thus individualized both the root of the problem and many of the remedies. The most dramatic extension of the concept of collective determinants of health has to do with mobilizing whole cities. Ergo, any significant policy change requires the modification of a nation's underlying belief system—what intellectual historians would regard as the prevailing health paradigm. The role of "life-styles" was seized upon with a vengeance, for a variety of different reasons, by politicians, health promoters, and the mass media. At best, "healthy public policy" represents modern utopianism.
