health education, health promotion the big picture…

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Health Education, Health Education, Health Promotion Health Promotion The BIG picture… The BIG picture…

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Page 1: Health Education, Health Promotion The BIG picture…

Health Education, Health Education, Health PromotionHealth Promotion

The BIG picture…The BIG picture…

Page 2: Health Education, Health Promotion The BIG picture…

Health education beginnings…Health education beginnings…

In 1945 a physician named H.S. Mustard commented that:In 1945 a physician named H.S. Mustard commented that:

“ “A new profession known as Health Education is arising. A new profession known as Health Education is arising.

Too often these workers are without the restraint that Too often these workers are without the restraint that

comes from scientific training and are not well comes from scientific training and are not well

grounded in factual material relating to health and grounded in factual material relating to health and

disease. They do however possess a stimulating disease. They do however possess a stimulating

enthusiasm and in varying degrees, competence in enthusiasm and in varying degrees, competence in

catching the public interest.”catching the public interest.”

Page 3: Health Education, Health Promotion The BIG picture…

The Macro ViewThe Macro View

Health education/promotion:Health education/promotion:• “ “A process of creating environments A process of creating environments

conducive to health, in which people are conducive to health, in which people are better able to take care of themselves.”better able to take care of themselves.”

WHO, 1986

Page 4: Health Education, Health Promotion The BIG picture…

What we are up against…What we are up against…

““A billion hours ago, human life A billion hours ago, human life emerged here on earth…A billion emerged here on earth…A billion minutes ago, Christianity minutes ago, Christianity emerged…A billion Coca-Cola’s emerged…A billion Coca-Cola’s ago, was yesterday morning.”ago, was yesterday morning.”

-Information obtained from Coca Cola’s annual report, 1996-Information obtained from Coca Cola’s annual report, 1996

Page 5: Health Education, Health Promotion The BIG picture…

What we are up against…What we are up against…

In the 1970’s, McDonalds became one of the worlds largest purchasers of satellite photography.

Along with a computer program called Quintillion, McDonalds could observe urban sprawl patterns developing in the entire country. Quintillion would then automatically select sites for it’s new stores

Page 6: Health Education, Health Promotion The BIG picture…

WorkWork

Page 7: Health Education, Health Promotion The BIG picture…
Page 8: Health Education, Health Promotion The BIG picture…

The American Waist The American Waist LandLand

Page 9: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1985BRFSS, 1985

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 10: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1986BRFSS, 1986

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 11: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1987BRFSS, 1987

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 12: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1988BRFSS, 1988

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 13: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1989BRFSS, 1989

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 14: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1990BRFSS, 1990

No Data <10% 10%–14%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 15: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1991BRFSS, 1991

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 16: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1992BRFSS, 1992

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 17: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1993BRFSS, 1993

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 18: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1994BRFSS, 1994

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 19: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1995BRFSS, 1995

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 20: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1996BRFSS, 1996

No Data <10% 10%–14% 15%–19%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 21: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1997BRFSS, 1997

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 22: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1998BRFSS, 1998

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 23: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 1999BRFSS, 1999

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 24: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2000BRFSS, 2000

No Data <10% 10%–14% 15%–19% ≥20

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 25: Health Education, Health Promotion The BIG picture…

Obesity Trends* Among U.S. AdultsObesity Trends* Among U.S. AdultsBRFSS, 2001BRFSS, 2001

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Page 26: Health Education, Health Promotion The BIG picture…

Source: Behavioral Risk Factor Surveillance System, CDC

(*BMI 30, or ~ 30 lbs overweight for 5’4” person)

No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

(*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

Obesity Trends* Among U.S. AdultsBRFSS, 2002

Page 27: Health Education, Health Promotion The BIG picture…

www.cdc.govwww.cdc.gov 2727

Diabetes Trends 1990-2001Diabetes Trends 1990-2001

■ No Data ■ <10% ■ 10%-14% ■ 15%-19% ■ 20%-24% ■ ≥25%

Page 28: Health Education, Health Promotion The BIG picture…

Is it just lack of willpower?Is it just lack of willpower?““A great reducing A great reducing

exercise consists exercise consists of placing both of placing both hands against hands against the edge of the the edge of the table and table and pushing back.” pushing back.”

Page 29: Health Education, Health Promotion The BIG picture…

What we are up against…What we are up against…

McDonald’s has as part of it’s corporate mission the burden of seeing to it that American’s are never more than 4.5 minutes from the nearest outlet.

Fast Food Nation

Page 30: Health Education, Health Promotion The BIG picture…

Health educator?Health educator?

Page 31: Health Education, Health Promotion The BIG picture…

Steps in the right directionSteps in the right direction

19511951

Page 32: Health Education, Health Promotion The BIG picture…

Going nowhere fastGoing nowhere fast

Page 33: Health Education, Health Promotion The BIG picture…

The entire US The entire US federal federal budget spent budget spent on nutrition on nutrition education is education is 1/5 the 1/5 the amount spent amount spent to market to market Altoids…Altoids…

Chew on this …Chew on this …

Page 34: Health Education, Health Promotion The BIG picture…

Health education/promotion levelsHealth education/promotion levels

EducationalEducational – information is available – information is available when it is needed.when it is needed.

PoliticalPolitical – health educators advocate – health educators advocate for change. for change.

EconomicEconomic – Make health affordable, – Make health affordable, and provide incentives (WHP).and provide incentives (WHP).

Page 35: Health Education, Health Promotion The BIG picture…

Health education/promotion levelsHealth education/promotion levels

SocialSocial – working with community is – working with community is true empowerment. true empowerment.

PolicyPolicy – Upstream/downstream – Upstream/downstream

OrganizationalOrganizational – – UA wellnessUA wellness

Page 36: Health Education, Health Promotion The BIG picture…

The Micro ViewThe Micro View

You can do it if you just try!You can do it if you just try! Pull yourself up by your bootstraps, Pull yourself up by your bootstraps,

quit whining, and get healthy!quit whining, and get healthy! Where’s your will power??Where’s your will power?? Blaming the victim.Blaming the victim. Downstream approach.Downstream approach.

Page 37: Health Education, Health Promotion The BIG picture…

What has to be doneWhat has to be done

Primary PreventionPrimary Prevention

What is being What is being done…done…

SECONDARY SECONDARY PREVENTIONPREVENTION

TERTIARY TERTIARY PREVENTIONPREVENTION

Page 38: Health Education, Health Promotion The BIG picture…

Certified Health Education Certified Health Education Specialist (CHES)Specialist (CHES)

Have met the standards of Have met the standards of competence established by National competence established by National Commission for Health Education Commission for Health Education Credentialing (NCHEC)Credentialing (NCHEC)

Successfully passed examSuccessfully passed exam Required Continuing Education - 75 Required Continuing Education - 75

yrs over 5 yearsyrs over 5 years

Page 39: Health Education, Health Promotion The BIG picture…

CHES CHES Framework/CompetenciesFramework/Competencies

1. Assess individual and community 1. Assess individual and community needs for health educationneeds for health education

2. Plan effective health education 2. Plan effective health education programsprograms

3. Implement health education programs3. Implement health education programs

4. Evaluate the effectiveness of health 4. Evaluate the effectiveness of health education programseducation programs

Page 40: Health Education, Health Promotion The BIG picture…

CHES Framework CHES Framework cont.cont.

5. Coordinate the provision of health 5. Coordinate the provision of health education serviceseducation services

6. Act as a resource person in health 6. Act as a resource person in health educationeducation

7. Communicate health and health 7. Communicate health and health education needs, concerns and education needs, concerns and resourcesresources

Page 41: Health Education, Health Promotion The BIG picture…

CHES BenefitsCHES Benefits

Employers and consumers can be Employers and consumers can be assured that a CHES has met assured that a CHES has met national standards as a health national standards as a health education professional.education professional.

Required Continuing Education - Required Continuing Education - ongoing quality assuranceongoing quality assurance

Page 42: Health Education, Health Promotion The BIG picture…

Where are Health Educators Where are Health Educators Employed?Employed?

Schools (K-12)Schools (K-12) Colleges and UniversitiesColleges and Universities WorkplacesWorkplaces Health Care FacilitiesHealth Care Facilities Community Organizations & Community Organizations &

Government AgenciesGovernment Agencies

Page 43: Health Education, Health Promotion The BIG picture…

The Health Education Workforce

Hospitals

Government

Individual and family social services

Practice Setting Total Employed % of Total

Other settings

Source: U.S. Department of Labor, 1999

11,180 27

8,590 21

8,070 20

Miscellaneous health and allied services 3,890 10

Office and clinics of MDs 2,170 5

Colleges, universities 2,000 5

124,760

Page 44: Health Education, Health Promotion The BIG picture…

Why is Health Education Why is Health Education Important?Important?

Improves the quality of life for all Improves the quality of life for all people.people.

Saves lives & reduces premature Saves lives & reduces premature deathsdeaths

By focusing on prevention, it saves By focusing on prevention, it saves society money that would be spent society money that would be spent on medical treatment or on medical treatment or rehabilitation. rehabilitation.

Page 45: Health Education, Health Promotion The BIG picture…

The task of future health The task of future health educators…educators…

““If a kid is born today, for the first If a kid is born today, for the first time in history, there is the real time in history, there is the real potential that they will be outlived by potential that they will be outlived by their parents…”their parents…”

Page 46: Health Education, Health Promotion The BIG picture…

Source: MokdadAH, et al. J Am Med Assoc1999;282:16.

No Data <10% 10%-14% 15-19% 20%

Obesity -Life is not a concession stand…

Now that’s a double-header!