As we look to the future, onefinal thing becomes strikingly apparent—doing what we have done in the past will not get us to our desired destination.
Treating disease after it has already taken hold has driven health care costs in the United States to unprecedented levels—not to mention the fact that the untold millions of individual health consequences have been heartbreaking.
Moving forward, health promotion and prevention will become a standard way of doing business in this country. In fact, the dominos have already been kicked over and momentum is being gained on a variety of fronts. Hospitals and physicians are now making concerted efforts to address primary prevention in a system that has traditionally focused solely on treating disease. Health insurance companies are now beginning to
TREND11: THENEED FORTALENTEDHEALTHPROMOTIONPROFESSIONALSWILLSKYROCKET 333
reimburse for primary prevention interventions. National legislation, as witnessed by the passage of the Affordable Care Act, now incorporates significant incentives for prevention and healthier lifestyles. Millions of businesses in the United States are hard at work designing results-oriented wellness initiatives in an attempt to contain costs, improve health, and create healthier cultures.
There’s no question that a big part of the future of the United States centers on the notion of health promotion because it has become glaringly obvious to everyone that we need healthy citizens in order to compete on a global level. Indeed, health promotion is no longer just an interesting idea—
it has become a national imperative. To sustain the momentum that has been achieved by the pioneers of this movement, it is essential that training programs be put into place to ensure that talented and effective profes- sionals are available to step into the opportunities that are now emerging. To meet the demand, institutions of higher education, medical schools, com- munity colleges, and a variety of other professional preparation programs will need to dedicate substantial resources toward developing capable men and women who will possess the knowledge, skills, acumen, and desire to step into these programs and lead the way to better health (Hunnicutt &
Chenoweth, 2013).
Summary
In this chapter, eleven trends for the future of health promotion have been presented. When taken together, it is evident that there is still much work to be done if we are to keep our nation’s citizens healthy and our country globally competitive. At the same time, it is also important to see that there are substantial opportunities for individuals to play meaningful and neces- sary roles that will not only help others remain healthy but also provide long and satisfying careers for those who choose to accept the call.
KEY TERMS
1. Baby boomers:Americans born between 1946 and 1964; about eighty million people and the fastest growing segment of the aging population
2. Health status: the measurement of the health of an individual or population as subjectively assessed by the individual or by more objective measures, including life expectancy and presence of disease conditions
3. Health care costs:the actual costs of providing services related to the delivery of health care, including the costs of procedures, therapies, and medications; differentiated from health expenditures, which refers to the amount of money paid for the services, and from fees, which refers to the amount charged, regardless of cost
4. Return on investment:a performance measure used to evaluate the efficiency of an investment or to compare the efficiency of a number of different investments 5. Primary care physician:a physician, such as a family practitioner or internist, who is
chosen by an individual to provide continuous medical care, trained to treat a wide variety of health-related problems, and responsible for referrals to specialists as needed 6. Medical self-care:the care of oneself without medical, professional, or other assistance
or oversight
7. Accelerometers:instruments for measuring acceleration used to assess the daily level of activity of an individual
8. Financial incentives: the use of monetary compensation or goods as incentive for participation in a health promotion program; examples include water bottles, t-shirts, merchandise, and cash
9. Environmental modification:a change made to the physical environment to promote wellness and facilitate healthier lifestyles, such as motivating employees to use stairs instead of the elevator, adding bike lanes and walking trails to a city’s urban environment, and passing legislation prohibiting unhealthy behaviors such as eliminating trans fats or taxing soda
REVIEW QUESTIONS
1. How will the demographics of our society change in the next thirty tofifty years?
2. What do the termslow-risk status andhigh-risk statusmean?
3. What did former surgeon general Carmona state about the status of childhood health?
4. What percentage of the gross domestic product is spent on health care?
5. What percent of health care expenditures is associated with health behaviors?
6. How does the Affordable Care Act work to address health behaviors associated with chronic disease?
7. Should we provide incentives for people to engage in healthy behaviors?
8. What are some individual- and industry-level obesity efforts?
9. What trend is the most surprising to you, and why?
REVIEWQUESTIONS 335
References
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Carmona, R. H. (2004).The growing epidemic of childhood obesity. Hearing before the Subcommittee on Competition, Infrastructure, and Foreign Commerce of the Committee on Commerce, Science, and Transportation, United States Senate, 108th Cong. 2. Retrieved fromwww.surgeongeneral.gov/news/testimony /childobesity03022004.html
Centers for Disease Control and Prevention. (2012).FastStats: Emergency depart- ment visits. Retrieved fromwww.cdc.gov/nchs/fastats/ervisits.htm
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MI: Health Management Research Center.
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Hammergren, J., & Harkins, P. (2008).Skin in the game: How putting yourselffirst today will revolutionize health care tomorrow. Hoboken, NJ: John Wiley & Sons.
STUDENT ACTIVITIES
1. If physical activity becomes recognized as a“common medical intervention,” should health insurance companies subsidize exercise programs? Why or why not?
2. Identify what government programs are already in place to reverse chronic disease trends.
3. Describe three additional environmental modifications that you would recommend to increase physical activity for Americans.
4. Based on the trends outlined in this chapter, write a 250-word call to action on what Americans should know about societal health.
Hoffman, J., Salerno, J. A., & Moss, A. (2012).The weight of the nation: Surprising lessons about diets, food, and fat from the extraordinary series from HBO.
New York: St. Martin’s Press.
Hunnicutt, D., & Chenoweth, D. (2013).What wellness professionals earn. White paper. Omaha, NE: Wellness Council of America.
Kaiser Family Foundation and Health Research and Educational Trust. (2012, September 11). 2012 employer health benefits survey. Retrieved from http://
kff.org/private-insurance/report/employer-health-benefits-2012-annual-survey Kerr, N. A., Yore, M. M., Ham, S. A., & Dietz, W. H. (2004). Increasing stair use in a
worksite through environmental changes. American Journal of Health Promo- tion,18(4), 312–315.
Kotlikoff, L. J., & Burns, S. (2005).The coming generational storm: What you need to know about America’s economic future. Cambridge, MA: MIT Press.
National Institute of Diabetes and Digestive and Kidney Diseases. (2008, October).
Diabetes prevention program. Retrieved fromhttp://diabetes.niddk.nih.gov/dm /pubs/preventionprogram
O’Donnell, M., & Mitts, L. (2013, February 18). Should employees get insurance dis- counts for completing wellness programs?Wall Street Journal. Retrieved fromhttp://
online.wsj.com/news/articles/SB10001424127887324610504578273673319849976 Ogden, C. L., Caroll, M. D., Kit, B. K., & Flegal, K. M. (2012, January).Prevalence of obesity in the United States, 2009–2010. National Center for Health Statistics.
Data Brief no. 82. Retrieved from www.cdc.gov/nchs/data/databriefs/db82 .pdf
US Census Bureau. (2012). Table 2: Projections of the population by selected age groups and sex for the United States: 2015 to 2060. 2012 National Population Projections: Summary Tables. Retrieved from www.census.gov/population /projections/data/national/2012/summarytables.html
US Census Bureau. (2013).Annual estimates of the resident population for selected age groups by sex for the United States, states, counties, and Puerto Rico Commonwealth and Municipios: April 1, 2010 to July 1, 2012. Retrieved from http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml
?src=bkmk
Wellness Councils of America. (2010a). Culture clash: How we win the battle for better health; An expert interview with Dr. Steve Aldana.WELCOA’s News &
Views. Retrieved fromwelcoa.org/freeresources/pdf/steve_aldanapart2.pdf Wellness Councils of America. (2010b). Dr. Ken Cooper speaks out on getting
(and keeping) Americans healthy: An expert interview with Dr. Ken Cooper.
WELCOA’s News & Views. Retrieved fromwww.absoluteadvantage.org/uploads /files/newsviews_kcooper.pdf
Wellness Councils of America. (2010c). The good, the bad, and the just plain scary:
An expert interview with Dr. Wayne Westcott. WELCOA’s News & Views.
Retrieved from www.absoluteadvantage.org/uploads/files/newsviews_westcott .pdf
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Wellness Councils of America. (2010d). Taking a stand on sitting down: An expert interview with Dr. Steven Blair.WELCOA’s News & Views. Retrieved fromwww .absoluteadvantage.org/uploads/files/interview_blair_hazards_of_sitting.pdf Wood, R. W. (2012, September 15). If soda tax can make it in NY it can make it
anywhere. Forbes. Retrieved from www.forbes.com/sites/robertwood/2012/09 /15/if-soda-tax-can-make-it-in-ny-it-can-make-it-anywhere
WEBLINKS
Chapter 1: Health Promotion
American Public Health Association www.apha.org
Centers for Disease Control and Prevention www.cdc.gov/about/history/tengpha.htm www.cdc.gov/nchs/fastats/lifexpec.htm www.cdc.gov/chronicdisease
www.cdc.gov/socialdeterminants Infectious Disease Society of America
www.idsociety.org/Index.aspx
National Association of Chronic Disease Directors www.chronicdisease.org
Office of Disease Prevention and Health Promotion http://odphp.osophs.dhhs.gov
Society of Public Health Education www.sophe.org
US Department of Health and Human Services www.hhs.gov/healthcare/rights
World Health Organization www.who.org
www.who.int/topics/infectious_diseases/en www.who.int/topics/chronic_diseases/en www.who.int/topics/health_promotion/en
Chapter 2: Health Behavior Change Theories and Models
Education
www.education.com/reference/article/social-cognitive-theory Euromed Info
www.euromedinfo.eu/the-health-belief-model.html Instructional Design
www.instructionaldesign.org/theories/social-learning.html National Cancer Institute: Theory at a Glance
www.cancer.gov/cancertopics/cancerlibrary/theory.pdf Pro-Change Behavior Systems
www.prochange.com/transtheoretical-model-of-behavior-change Substance Abuse and Mental Health Services Administration
www.samhsa.gov/co-occurring/topics/training/change.aspx
Chapter 3: Program Planning Models
American College Health Association
www.acha.org/healthycampus/ecological_model.cfm Centers for Disease Control and Prevention
www.cdc.gov/hrqol/featured-items/match.htm
www.cdc.gov/violenceprevention/overview/social-ecologicalmodel.html www.cdc.gov/healthcommunication/healthbasics/whatishc.html Making Health Communications Programs Work
www.cancer.gov/cancerstopics/cancerlibrary/pinkbook PRECEDE-PROCEED Model
www.lgreen.net/precede.htm Weinreich Communications
www.social-marketing.com/Whatis.html
Chapter 4: Tobacco Use
American Cancer Society www.cancer.org
American Legacy Foundation www.legacyforhealth.org
American Lung Association www.lung.org
American Nonsmokers’Rights Foundation www.anrf.org
National Cancer Institute www.cancer.gov SmokeFree.gov
www.smokefree.gov
Smoking Cessation Leadership Center http://smokingcessationleadership.ucsf.edu Tobacco Free Kids
www.tobaccofreekids.org
Chapter 5: Eating Behaviors
Center for Science in the Public Interest www.cspinet.org
Cornell University Food and Brand Lab http://foodpsychology.cornell.edu
Food Politics Blog by Marion Nestle of New York University www.foodpolitics.com
Leanwashing
www.leanwashingindex.com MyPlate
www.choosemyplate.gov
National Heart, Lung, and Blood Institute (NHLBI) Portion Distortion http://hp2010.nhlbihin.net/portion
Nutrition Source—Harvard School of Public Health www.hsph.harvard.edu/nutritionsource
The Nutrition Transition Program at The University of North Carolina at Chapel Hill
www.cpc.unc.edu/projects/nutrans 2010 Dietary Guidelines for Americans
http://health.gov/dietaryguidelines/2010.asp
WEBLINKS 341
Yale Rudd Center for Food Policy and Obesity www.yaleruddcenter.org/what_we_do.aspx?id=7
Chapter 6: Physical Activity Behaviors
Active Living Research
http://activelivingresearch.org/policies-and-standards-promoting -physical-activity-after-school-programs
Alliance for a Healthier Generation www.healthiergeneration.org
American Alliance for Health, Physical Education, Recreation, and Dance www.aahperd.org
Healthy Children
www.healthychildren.org/English/ages-stages/gradeschool/fitness /Pages/Promoting-Physical-Activity-as-a-Way-of-Life.aspx Let’s Move!
www.letsmove.org
National Coalition for Promotion Physical Activity www.ncppa.org
National Physical Activity Plan www.physicalactivityplan.com
President’s Council on Fitness, Sport, & Nutrition www.fitness.gov
Robert Wood Johnson Foundation www.rwjf.org
2008 Physical Activity Guidelines for Americans www.health.gov/paguidelines
Chapter 7: Stress, Emotional Well-Being, and Mental Health
American Institute of Stress www.stress.org
American Psychiatric Association www.psychiatry.org
American Psychological Association www.apa.org
The Center for Mind-Body Medicine www.cmbm.org
MentalHealth.gov www.mentalhealth.gov
National Alliance on Mental Illness www.nami.org
National Institute on Mental Health www.nimh.nih.gov
The Substance Abuse and Mental Health Services Administration www.samhsa.gov
Chapter 8: Clinical Preventive Services
American Health Insurance Plans www.ahip.org
Centers for Disease Control and Prevention www.cdc.gov
The Community Guide
www.thecommunityguide.org
National Institutes of Health—Office of Disease Prevention http://prevention.nih.gov
National Prevention Strategy
www.surgeongeneral.gov/initiatives/prevention/strategy Partnership for Prevention
www.prevent.org
US Preventive Services Task Force www.uspreventiveservicestaskforce.org
WEBLINKS 343
Chapter 9: National and State Initiatives to Promote Health and Well-Being
Association of State and Territorial Health Officials www.astho.org
Centers for Disease Control and Prevention www.cdc.gov
Healthy People 2020 www.healthypeople.gov
National Association of City and County Health Officials www.naccho.org
National Conference of State Legislatures www.ncsl.org
National Institutes of Health www.nih.gov
US Department of Agriculture www.usda.gov
US Department of Health and Human Services www.hhs.gov
Chapter 10: Settings for Health Promotion
American College Health Association www.acha.org
American Community Garden Association www.communitygarden.org
American School Health Association
www.ashaweb.org/i4a/pages/index.cfm?pageid=1 Center on Developing Children, Harvard University
http://developingchild.harvard.edu/resources/reports_and _working_papers/foundations-of-lifelong-health Centers for Disease Control and Prevention
www.cdc.gov/family
www.cdc.gov/nationalhealthyworksite/index.html
Coordinated School Health (CDC) www.cdc.gov/HealthyYouth/cshp Food and Nutrition Service, USDA
www.fns.usda.gov/cnd/governance/legislation/cnr_2010.htm International Association for Worksite Health Promotion
www.acsm-iawhp.org/i4a/pages/index.cfm?pageid=1 International Health, Racquet and Sport Association
www.ihrsa.org
National Association for Community Health www.nachc.com
National Wellness Institute www.nationalwellness.org Wellness Councils of America
www.welcoa.org YMCA
www.ymca.net
Chapter 11: Health Promotion–Related
Organizations, Associations, and Certifications
The Academy of Nutrition and Dietetics www.eatright.org
American Alliance for Health, Physical Education, Recreation, and Dance www.aahperd.org
American Association of School Health www.ashaweb.org
American College of Nutrition
www.americancollegeofnutrition.org American College of Sports Medicine
www.acsm.org
American Heart Association www.heart.org
American Public Health Association www.apha.org
WEBLINKS 345
Institute of Health and Productivity Management www.ihpm.org
Society for Public Health Education www.sophe.org
Chapter 12: Trends in Health Promotion
Administration on Aging
www.aoa.gov/AoARoot/%28S%282ch3qw55k1qylo45dbihar2u
%29%29/Aging_Statistics/index.aspx American Health Insurance Plans
www.ahip.org
American Medical Association www.ama-assn.org
The Center for Public Education
www.centerforpubliceducation.org/You-May-Also-Be-Interested -In-landing-page-level/Organizing-a-School-YMABI/The-United -States-of-education-The-changing-demographics-of-the-United -States-and-their-schools.html
Centers for Disease Control and Prevention
www.cdc.gov/workplacehealthpromotion/businesscase/reasons /changing.html
Health Care Cost Institute www.healthcostinstitute.org
Institute of Health and Productivity Management www.ihpm.org
Kaiser Family Foundation http://kff.org
National Business Group on Health
www.businessgrouphealth.org/toolkits/et_financialincentives.cfm National Center for Health Statistics
www.cdc.gov/nchs US Department of Labor
www.dol.gov/oasam/programs/history/herman/reports /futurework/conference/trends/trendsi.htm World Population on Aging
www.un.org/esa/population/publications/worldageing19502050
INDEX
A
ABCS program, 230–231 ABIM Foundation, 236
ACA.SeeAffordable Care Act (ACA)
Academy of Nutrition and Dietetics, 302–304 Accelerometers, 330, 335
ACIP.SeeAdvisory Committee on Immunization Practices (ACIP) Action stage of change, 33
Active Living Research, 166 Adair, L. S., 118
Advisory Committee on Immunization Practices (ACIP), 223, 237; and Health Resources and Services Administration (HRSA), 227; and vaccines, 225–227 Advocacy, 317
Affordable Care Act (ACA), 16, 18, 72.See alsoPatient Protection and Affordable Care Act (2010)
Agency for Healthcare Research and Quality (AHRQ), 223
Aging adults, 323–325 Ajzen, I., 39, 41–43 Alberg, A., 100 Aldana, Steve, 329 Alessandro, M., 5 Alexander, R., 101 Allen, B. J., 271 Allshouse, J., 133, 135 Alzheimer’s Association, 207
American Academy of Family Physicians, 188 American Association of Retired Persons
(AARP), 274
American Association of State Highway and Transportation Officials, 332
American Cancer Society, 275, 276, 299 American College Health Association, 308 American College of Nutrition (ACN),
304
American College of Sports Medicine (ACSM), 168, 273, 306, 314 American Council on Exercise, 315
American Fitness Professionals & Associates (AFPA), 315
American food environment, 131–138; and added sweeteners, fats, and oils, 134, 145;
beverages in, 133, 145; cheese in, 135; and comparison of food availability and dietary recommendations, 136 Fig. 5.4; and comparison of average American diet with 2010 Dietary Guidelines, 135 Tab. 5.4; and farm subsidies as culprit, 137–138; and food availability in pounds per person, 132 Tab. 5.3; and food industry: friend, foe, or both?, 136–137; food supply and
consumption in, 131–135; fruits and vegetables in, 132–133, 144; grains in, 132, 144; meat and protein foods in, 133–134, 145; and portion sizes, 138; and where Americans eat, 135–136
American Heart Association (AHA), 87, 275, 276, 300–301
American Indian, smoking rate of, 76 American Journal of Clinical Nutrition, 309 American Journal of Health Promotion,
309
American Lung Association, 276; of West Virginia, 105
American Music Therapy Association, 199, 200
American Nonsmokers’Rights Foundation, 75, 97, 98
American Psychiatric Association, 207 American Psychological Association, 188, 200 American Public Health Association (APHA),
307
American School Health Association, 308–309
Ammerman, A. S., 31 Anderson, D. R., 200 Andrews, J., 100 Andrews, M., 120 Antin, T.M.J., 119, 120 Apostolopoulou, M., 124 Appelhans, B. M., 143
Arizona Department of Health Services, Division of Behavioral Health Service, 262 Armitage, C.J.I., 34, 36
Association membership, benefits of, 309 Association of State and Territory Health
Officials (ASTHO), 263, 267; and
legalization of medical marijuana map, 263 Fig. 9.7; and newborn screening: congenital heart disease, current status, 26 Fig. 9.8 Atari, 7
Atienza, A. A., 31 Atkins, D., 107–108, 333 Audage, N. C., 209–210
Autonomous nervous system (ANS), 191–192, 211
B
Baby boomers, 322, 334 Bailey, W., 106
Baker, J. P., 226–227 Balk, E. M., 143
Bandura, A., 27–30, 38, 44
Barnard, R. J., 122–125 Baum, A., 119
BecomeanEX.org, 101 Beech, B. M., 272
Behavior change: and health belief model (HBM), 36–39; and historical perspective, 36–46; models of, 36–46; presented theories of, and their constructs, 45 Tab. 2.4;
and processes of change, 34–36; theories of, 26–36; and theory of planned behavior (TPB), 39–43; trans theoretical model (TTM) of, 31–36
Behavioral Risk Factor Surveillance System (BRFSS), 257, 267; map showing 2010 data for alcohol consumption, 258 Fig. 9.5
Behavioral science, advances in, 233 Bertuccio, P., 86
Bike application, 164 Bike Share programs, 178 Bing, 293
Biology, as determinant of health, 13 Blair, Steven, 330
Blakey, C., 165 Blonna, R., 190
Bloomberg, Michael, 140 Blue-collar worker, 6 Blue Zones Project, 179
Body mass index (BMI), 281, 295 Boehmer, T. K., 159
Boffetta, P., 86 Bogar, C. T., 284 Bohlmeijer, E., 197 Bondi, M. A., 107–108 Bongers, P. M., 201 Boon, A., 85
Booske, B. C., 60, 65 Bowling, M., 165 Brassington, G. S., 31 Breckon, J., 271 Breneman, V., 121