The social ecology of health promotion: implications for research and practice.

Daniel Stokols,Richard L Bellingham,Judd Allen

doi:10.4278/0890-1171-10.4.247

Daniel Stokols, Richard L Bellingham + Show 1 more

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https://doi.org/10.4278/0890-1171-10.4.247

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Abstract

Author(s): Stokols, D; Allen, J; Bellingham, RL | Abstract: The editor and associate editors of this special issue on the social ecological applications of health promotion recognize the successful early growth and progress of the health promotion field but also identify some of the shortcomings that may be improved by a social ecological approach. They also discuss each of the articles that follow in the context of the whole issue.

Highlights

Recent studies have documented the substantial health benefits and financial savings associated with manydisease prevention and health promotion programs. ~5 Examples of effective strategies include employee health risk appraisal, counseling, and lifestyle change programs,6,r cultural change strategies within organizational settings, 8,9 and the provision of clinical preventive services to enhance maternal and child health? °,11 A mid-decade appraisal of progress toward meeting the Healthy People 2000 goals in the United States found substantial reductions in adult use of tobacco products and in alcohol-related automobile deaths and moderate gains in the proportion of adults exercising regularly and eating less fatty diets
The limitations of earlier disease prevention and health promotion programs highlight the need for a major paradigm shift, away from narrowly focused interventions aimed primarily at changing individuals’ health behavior, toward more comprehensive ecological formulations that address the interdependencies between socioeconomic, cultural, political, environmental, organizational, psychological, and biological determinants of health and illness.21~ 22 The articles presented in this special issue of the American Journal of Health Promotiondelineate a social ecological paradigmfor understanding the complex community and enviromnental origins of public health problems, and for organizing disease prevention and wellness programs that can effectively ameliorate those problems
It has long been recognized that patterns of health and illness are closely linked to a variety of sociocultural, political, and physical-environmental conditions within communities. ~’z6 The "new public health" outlined in the Ottawa Charter gave explicit emphasis to social causes of illness, above and beyond the physicalenvironmental health threats that exist in certain communities. 27,~s The social ecological paradigm for health promotion extends these earlier notions by providing a set of conceptual and methodological principles, drawn largely from systems theory, for organizing comprehensive, communityb2a~sed health promotion programs

Summary

Introduction

Recent studies have documented the substantial health benefits and financial savings associated with manydisease prevention and health promotion programs. ~5 Examples of effective strategies include employee health risk appraisal, counseling, and lifestyle change programs,6,r cultural change strategies within organizational settings, 8,9 and the provision of clinical preventive services to enhance maternal and child health? °,11 A mid-decade appraisal of progress toward meeting the Healthy People 2000 goals in the United States found substantial reductions in adult use of tobacco products and in alcohol-related automobile deaths and moderate gains in the proportion of adults exercising regularly and eating less fatty diets.

Results

Conclusion