Chapter 1

Health Promotion in the New Century

Health System Problems

• Cost• Access• Health Levels• Quality

The Real Problem

• Our current health care delivery system devotes the vast majority of its resources to

CURE rather than PREVENTION

Definitions

• Health Education is the process of providing education to individuals about health.

• Health Promotion is a much broader term than health education. It usually involves a combination of educational, regulatory, environmental, or political approaches.

Health Promotion

• Health promotion was an outgrowth of several disciplines including: school health education, public health, medicine, and psychology.

Timmreck (2003)

Major Determinants of Health

• Environmental Factors• Individual Behaviors

Health

• Absence of pain, disability, disease• Length of life• Physiological efficiency• Adaptation• Complete physical, mental, and social well-

being• Fulfilled needs

Leading Causes of Mortality

• Tobacco• Physical Inactivity• Diet and Weight

Human Behavior

• Human behavior contributes to approximately 40% of premature mortality in this country. It seems obvious that more attention and resources need to be made available to the behavioral aspects of disease, disability, and premature death.

McGinnis (2002)

The Third Era in Health

• Increase in longevity• Spectrum of health• “The compression of morbidity”• Increased prevalence of chronic diseases• Health disparities

The Future of Public Health

• The “Future of the Public’s Health in the 21st Century” Institute of Medicine (2002) notes the great national achievements in health during the 20th century, but expresses concern about the government’s public health infrastructure ability to meet future challenges without substantial changes.

Chronic Diseases

• Self induced chronic diseases and the inability to provide health care services for millions of people in the richest country in the world are clear signals that something is radically wrong with the United State’s current health care system.

Influence of Health

• Breslow (2006) questions how we spend our money in relationship to its impact and influence on health. He says that many of the best studies show that access to medical care has only about 10% of the influence on health status, but that 88% of the money goes to that. Whereas health behaviors indicate about 50% of the influence on health and only 4% is spent on health behaviors.

Insurance

• Two Major Types– Casualty Insurance- Found in car or home

insurance. This works very well as long as most people practice safety measures concerning automobile and home use.

– Social Insurance- usually ignores risks and shares the costs equally among participants.

Healthy People

• The key to the Healthy People concept is the premise that the personal habits and behaviors of individuals are the key determinants in whether or not that individual will remain well or become ill later in life.

Three Levels of Prevention

• Primary• Secondary• Tertiary

Chronic Diseases

• Long Incubation Period• No Cure• Caused by high-risk behaviors

Rising Expectation About Health Care

• There has always been a rising expectation concerning the value of health services, especially treatment for conditions that already exist. This belief has helped to shape this country’s health care delivery system into a provider of care after illness occurs.

Discussion Questions

• What is the difference between health education and health promotion programs?

• Name and explain the three levels of prevention.

• What are the major determinants of health in the United States?

• What do we mean by upstream and downstream health care delivery?