Читать книгу Health Promotion Programs - (SOPHE) Society for Public Health Education - Страница 20

In 2020 the new decade opened with COVID-19 ushering in a new health era with a new context for health, health promotion, and health promotion programs. The public paid attention to COVID-19. Fear was rampant. COVID-19 caused the public to be anxious and afraid. Hope about vaccines, drugs, and cures was high. The pandemic showed the power of actions at multiple levels by individuals, groups, healthcare systems, community human service organizations, businesses, schools, colleges and universities, and governments to combat the virus. The actions span from individual behaviors to governmental policies and legislation—hand washing, social distancing, and self-quarantine combined with stay-at-home orders and travel restrictions. Businesses made employee and customer health promotion and safety a priority. The actions had clear health outcomes that impacted individuals and whole populations of people and communities across the globe.

Conversely, the lack of action and delays to address the virus, to promote and protect health, had pervasive and negative, if not fatal, consequences for individuals and whole populations of people. The balance between health and economic systems was tested and debated, providing a context for action. Promoting and protecting health was laid bare at the intersection of health and economic status, with all sectors of the economy impacted by the virus, but with different economic groups and communities experiencing the virus in distinct and different ways. The lack of social justice and health equity added to the COVID-19 burden that many individuals and communities were already experiencing.

COVID-19 is a brutal exclamation point to America’s pervasive ill health. Americans with obesity, diabetes, heart disease, and other diet-related diseases were three times more likely to suffer worsened outcomes from COVID-19, including death. Had we flattened the still-rising curves of these conditions, it is quite possible that our fight against the virus would have looked very different. The need for health promotion programs is greater than ever.

In the new health era, health promotion is about so much more than about healthcare, where the focus is on tertiary prevention—improving the quality of life and reducing symptoms of a disease you already have (Figure 1.1). Health promotion is about factors outside the traditional boundaries of healthcare—health behaviors (tobacco use, sexual activity), social and economic factors (employment, education, income), and physical environment (air quality, water quality). These three combined (i.e. policies, programs, and health factors) are linked to 80 percent of the health outcomes to impact and improve length and quality of life (University of Wisconsin Public Health Institute & Robert Woods Johnson Foundation, 2021).

Figure 1.1 Health promotion is associated with more than just healthcare to impact health outcomes linked to length and quality of life

Source: Modified from Population Health Management: Systems and Success, UWPHI & Robert Woods Johnson Foundation, 2020. © 2020, University of Wisconsin Public Health Institute & Robert Woods Johnson Foundation.

Health promotion programs are designed, implemented, and evaluated in complex and complicated dynamic environments. They are multifaceted and multi-leveled. We work directly with people trying to figure out how to best address their health needs. We work in schools, colleges and universities, communities, workplaces, and healthcare organizations. At the same time, we are surrounded by forces greater than any organization and group of individuals. The result is that processes of planning, implementing, and evaluating health promotion programs unfold in a nonlinear progression of small steps forward and sometime a couple steps backward. It is dynamic.