Critics of health education policy in the United States fault it for ignoring the unequal ability of Americans to adopt more healthy behavior and for underestimating the social, economic, and political causes of disease. Many critics hypothesize that health education in a less bourgeois society would be more equitable and less individualistic. This article tests that hypothesis by analyzing the current Cuban health education program aimed at the reduction of chronic diseases. It argues that while the Cuban program appears to be every bit as individualistic as the North American program, theirs may not be comparable to ours because Cubans are less likely than Americans to reify the state. At least among supporters of the revolution, Cubans do not automatically make a conceptual distinction between the individual and the society. Discussions about responsibility for disease prevention take on new meaning in this light.
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