Communication efforts to improve public health have a long history, but really found their voice in the 19th century. For the next 100 years educational efforts to improve public health in the area of infectious disease were very successful. Two main areas of health communication evolved to focus on either health care delivery with regard to health care settings or health promotions that are generally concerned with mass media health campaigns. The current challenge of chronic disease poses new challenges for health communication and health communicators are responding using market segmentation, targeting, persuasion, social marketing, and other approaches.