The purpose of this paper is to update and enhance the 1989 Association for Health Education (AAHE) Scholar presentation, "Reflections on Directions in Health Education: Implications for Policy and Practice," at the American Association for Health Education (AAHE) National Convention in Boston. It describes and complements the notion of shifting health from one based on disease and a medical model by advancing our understanding that many premature deaths are preventable and by noting the importance of risk factors with behavioral influences as an important component. However, while recognizing the importance of individual responsibility and personal behavior, it labels the shift to focusing on individual health behaviors as "micro myopia" and highlights several negative implications. It also suggests using a macro approach on a population level that may be equal or more effective and efficient. Recognizing the value and need to incorporate both micro and macro approaches, this article suggests the use of a social ecological model for health promotion that takes into consideration public policy, community, institutional, interpersonal and intrapersonal factors. Health educators should consider utilizing an ecological approach in both practice and professional preparation. As in the 1989 paper, the goal is to stimulate thought and discussion.