TAILIEUCHUNG - An Ecological Perspective on Health Promotion Programs

As shown later, much of the resultant risk to human populations and the ecosystems upon which they depend comes from the pro- jected extremely rapid rate of change in climatic conditions. Indeed, the prospect of such change has stimulated a great deal of new scientific research over the past decade, much of which is elucidating the complex ecological disturbances that can impact on human well-being and health—as in the following example. The US Global Change Research Program (Alaska Regional Assessment Group) recently documented how the various effects of climate change on aquatic ecosystems can interact and ripple through trophic levels in unpredictable ways. For example, warming in the Arctic. | An Ecological Perspective on Health Promotion Programs Kenneth R. McLeroy PhD Daniel Bibeau PhD Allan Steckler DrPH Karen Glanz PhD MPH During the past 20 years there has been a dramatic increase in societal interest in preventing disability and death in the United States by changing individual behaviors linked to the risk of contracting chronic diseases. This renewed interest in health promotion and disease prevention has not been without its critics. Some critics have accused proponents of life-style interventions of promoting a victim-blaming ideology by neglecting the importance of social influences on health and disease. This article proposes an ecological model for health promotion which focuses attention on both individual and social environmental factors as targets for health promotion interventions. It addresses the importance of interventions directed at changing interpersonal organizational community and public policy factors which support and maintain unhealthy behaviors. The model assumes that appropriate changes in the social envữonment will produce changes in individuals and that the support of individuals in the population is essential for implementing environmental changes. INTRODUCTION During the past 20 years there has been a dramatic increase in public private and professional interest in preventing disability and death in the United States through changes in individual behaviors such as smoking cessation weight reduction increased exercise dietary change injury prevention protected sexual activity and participation in screening and control programs. While much of this interest in health promotion and disease prevention has been stimulated by the epidemiologic transition from infec- Kenneth R. McLeroy and Daniel Bibeau are with the Department of Public Health Education University of North Carolina Greensboro. Allan Steckler is with the Department of Health Behavior and Health Education University of North Carolina Chapel Hill. Karen Glanz is .

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