Chapter 1

Infant mortality, smallpox, poliomyelitis, measles, tetanus, rubella, diphtheria, program planning, haemophilus influenza type b, these have been controlled and the result is 29.5 years of extra life added to Americans since 1900. And since the 1900 health prevention has changed from addressing environmental factors that require combating nature to changing health behaviors that concentrated on personal responsibility.

America ranks not first but 50th in life expectancy. Also 75% of health spending is on chronic illness. Van Dam in 2008 said all causes of death could be cut by 55% by never smoking, not being over weight, eating a healthy diet, and engaging in physical activity. Only 3 % of Americans, do not smoke, maintain a healthy weight, exercise regularly, and eat 5 fruits and vegetables a day.

Most common causes of death in the U.S are:                      The top causes of the common causes are:
1) Cardiovascular Disease                                                    1) Tobacco
2) Malignant Neoplasms                                                       2) Poor Diet and physical activity
3) Chronic Lower Respiratory Disease                                 3) Alcohol
4) Cerebrovascular Disease                                                  4) Microbal Agents
5) Accidents                                                                         5) Toxic Agents
6) Alzheimer's Disease                                                          6) Motor Vehicles
7) Diabetes Mellitus                                                              7) Fire Arms
8) Influenza and Pneumonia                                                   8) Sexual Behavior ... Illicit Drugs

Health Promotion, which is a broad field encompassing health education, policy, organizational support for actions and conditions to increase the health of an individual, group or community, didn't take off until 1974 where it started with the Canadians publishing "A New Perspective on the Health of Canadians," this concentrated on human biology, the environment, lifestyle, and health care organization. Also in the U.S Congress passed PL 94-317 an act which created which is now know as the Office of Disease Prevention and Health Promotion. ( it might be a good idea to read the "Health People" publication as well as, "Promoting Health/Preventing Disease Objectives: Objectives for the Nation."

Health Education, falls under health communication, and is using a variety of means to provide knowledge, attitudes, or skills that will cause health to improve, be maintained, for individuals, groups or communities.

Health Education Specialists facilitate the development of health policy, procedures, intervention, and systems for individuals, groups and communities. They educate and promote health in primary prevention which involves people who are perfectly healthy, secondary prevention which involves people who have just got sick, and tertiary prevention which involves people who have been through illness and now need to rehabilitate. There was a delineation project used to define the 7 areas aka frameworks the job entailed and the three levels of health education specialists. (read the published document Competency-Based Framework 2010)  These areas involve, assessing health condition, program planning, implementing, evaluating, administrating, acting as a resource person, and communicating health education and health. (if you are thinking into this field, and I think you should give it some thought, check out the NCHEC website, they talk about the content of the tests offered, also look at NCATE and SOPHE and AAHE and SABPAC)

Health promotion moves people toward better health, health prevention keeps people from going towards worse health.

There are many assumptions that have to be accepted by an advocate of Health Education and Promotion. My favorite are that Disease and Health involve biological, psychological, behavioral, and social factor combinations. That the source of disease can be identified and understood. That behavior change is hard. That when talking about behavior we are not pointing a finger at an easy link between fault and a problem, but are instead contemplating the natural course the future is heading and trying to make the river flow in another direction. It is not hard to do, but you believe if it can be done than good things will happen, so you set off to try and do it.

Program Planning is important, it causes you to think through the situation prior. It allows your program to be transparent. It gives you power as once your plan has been accepted you can go on ahead and do it. A plan creates understanding across parties.