After urban public health departments adopted health education to improve the health of their residents, the Metropolitan Life Insurance Company undertook a vast nationwide health education campaign as a distinctive advertising and public relations program. The multifaceted campaign included free nursing care for sick policyholders and materials to educate the general public about personal behaviors that contributed to infectious and chronic diseases. It reached more persons than any other public or private health campaign and made the Metropolitan the private counterpart of a national health department during the first half of the twentieth century.

Health education for the general public was considered the newest dimension of public health in the early twentieth century. According to a New York City study in 1929, it had three components: “(1) the spread of knowledge of the facts of disease and health, (2) the increase of the individual interest in healthy living, and (3) the development of the social interest in healthful conditions in the community.” These objectives were to be achieved by “teaching hygiene and training in health habits for individuals.”

Health education was provided to varying degrees by a number of public and private organizations. The health departments of large cities had active programs, but little was done in the towns and villages where most of the population resided. Most states deferred to local jurisdictions on matters concerning health.