health education, health promotion the big picture…
Post on 19-Dec-2015
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Health Education, Health Education, Health PromotionHealth Promotion
The BIG picture…The BIG picture…
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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.”
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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
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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
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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
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WorkWork
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The American Waist The American Waist LandLand
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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)
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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
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www.cdc.govwww.cdc.gov 2727
Diabetes Trends 1990-2001Diabetes Trends 1990-2001
■ No Data ■ <10% ■ 10%-14% ■ 15%-19% ■ 20%-24% ■ ≥25%
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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.”
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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
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Health educator?Health educator?
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Steps in the right directionSteps in the right direction
19511951
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Going nowhere fastGoing nowhere fast
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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 …
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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).
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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
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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.
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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
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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
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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
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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
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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
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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
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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
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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.
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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…”
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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!