health and healthcare. The increasing use of technologies, especially the Internet and personal mobile devices, to manage health highlights the potential of technology tools to improve population health. COVID-19 caused a massive acceleration in the use of telehealth. Consumer adoption skyrocketed, from 11 percent of U.S. consumers using telehealth to 46 percent of consumers now using telehealth to replace cancelled healthcare visits. No longer are healthcare and health promotion programs just at a given site (i.e. school, workplace, clinic, hospital). Technology supports individuals’ engagement and full participation in promoting their health as well as being decision makers in their healthcare. We are not limited to a physical place, and therefore health promotion programs are not limited to a particular site. They can and do work within homes, schools, universities, communities, and workplaces, thereby involving family, colleagues, peers, co-workers, and friends. A key in the new health era is equity in peoples’ capacity and resources to access technology to promote their health.
In the new era, health promotion is intertwined within the healthcare system which is dominated by large commercial interests driven by investors’ demand for profit, by non-profits almost equally focused on revenues, and by government policy decisions that are sometimes shaped by larger ideological, political, and budgetary concerns. For better and worse, healthcare has become big money and big politics. As a result, for the foreseeable future, the structure and cost of healthcare in the United States will continue to be a problem. The healthcare system is overwhelming for even the most sophisticated consumer. We need to know how to navigate the systems for ourselves and the people we serve.
Health is political. It is part of the American psyche. The health of Americans is a priority, but what that means—and what role the federal government plays—has changed significantly over the years and particularly in relation to promoting health. While many Presidents of the United States have made incremental changes to federal health policy and the American psyche, it has often been those changes that affect our social determinants that had the greatest influence on our access to better healthcare, health promotion, and prevention of disease.
The most recent example of governmental health action is the 2010 Patient Protection and Affordable Care Act (ACA). While the ACA did not accomplish all of the reforms many had hoped, it opened the door for significant changes to the status quo and ensured that for decades its reforms are the starting point for future health reform and technologies. It can be expected, particularly in presidential election years candidates will campaign on platforms to dismantle the ACA, call to replace it with a more universally available healthcare plan, while others will want to improve the ACA.
Summary
Health promotion programs represent an evolution that has passed through revolutionary steps in the quest to promote health. Today, health promotion programs use both health education and environmental actions to promote good health and quality of life for all. The Healthy People initiative is a public-private partnership that allows local health promotion programs to link their health promotion programming with national data and information.
Health promotion programs are the product of deliberate effort and work by many people and organizations to address a health concern in a community, school, college and universities, healthcare organization, or workplace. And even though individuals across these sites may share broad categories of health concerns focused on diseases and human behavior, each setting is unique. Effective health promotion programs reflect the individual needs of a priority population as well as their political, social, ethnic, economic, religious, and cultural backgrounds.
Health promotion programs involve stakeholders, advisory boards, champions, and advocates in program planning, implementation, and evaluation in order to ensure effective programming.
A new health promotion era emerged from the pandemic. COVID-19 fundamentally changed many aspects of peoples’ lives. The work of promoting health has gained prominence and importance but at the same time is intertwined with larger and more volatile societal forces. It is our professional responsibility to figure out how to forge ahead to do the work of health promotion for our community and society.
For Practice and Discussion
1 What preliminary ideas did you have about the definition and role of health promotion programs prior to reading this chapter? How do these compare with what you have learned in this chapter? How do you see the relationship between health promotion, health equity, and social justice?
2 Visit the Healthy People 2030 website (www.healthypeople.gov). Pick a chapter and explore the objectives. As you explore the chapter, think of your school and how you might use the Healthy People 2030 information for a specific objective to build a case for implementing a health promotion program to address the identified health concern on your campus. Prepare a brief (250-word) statement to use to support your argument for a program.
3 What do you think it would be like to work in a health promotion program? This chapter talks about health promotion programs in five settings—schools, workplaces, colleges and universities, healthcare organizations, and communities. Which setting is of most interest for you with regard to working in a health promotion program? What is attractive about this setting and the people in the setting? Who are the setting stakeholders?
4 What role does technology play in how you, family members, and friends promote your own health? How often do you use the Internet to find health information? What wearable technologies and apps do you use?
5 How do you navigate the societal forces (social justice and equity, technology, healthcare system, health is political) in the emerging health era to formulate and take action to promote the health of the individuals and communities for which you care and serve?
| KEY TERMS | |
| Advocate Advisory boards Champion Colleges and universities Communities Ecological health perspective Health Health education Health equity Health promotion Health promotion programs Health status Healthcare organizations Healthy People 2030 Interpersonal level | Intrapersonal level Jakarta Declaration Lalonde report Ottawa Charter Patient Protection and Affordable Care Act or Affordable Care Act (ACA) Population level Priority population Schools Settings Social Determinants of Health Social justice Stakeholders Workplaces World Health Organization |
References
1 Alber, J., Allegrante, J. P., Auld, M. E., & Breny, J. (2020). Looking back and moving forward: SOPHE’s 70 years of work in health education. Health Education and Behavior.
2 American College Health Association. (2020). Healthy campus framework. www.acha.org/HealthyCampus
3 Arnold, J., & Breen, L. J. (2006). Images of health. In M. O’Neill, S. Dupéré, A. Pederson, & I. Rootman (Eds.), Health promotion in Canada (2nd ed., pp. 3–20). Canadian Scholars’ Press.
4 ASCD®. (2021). ASCD whole child initiative. www.ascd.org/whole-child.aspx
5 Breslow, L. (1999). From disease prevention to
