1. Health Education, Health Promotion The BIG picture…

2. 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. Too often these workers are without the restraint that comes from scientific training and are not well grounded in factual material relating to health and disease. They do however possess a stimulating enthusiasm and in varying degrees, competence in catching the public interest.” “A new profession known as Health Education is arising. Too often these workers are without the restraint that comes from scientific training and are not well grounded in factual material relating to health and disease. They do however possess a stimulating enthusiasm and in varying degrees, competence in catching the public interest.”

3. The Macro View Health education/promotion: Health education/promotion: “A process of creating environments conducive to health, in which people are better able to take care of themselves.” “A process of creating environments conducive to health, in which people are better able to take care of themselves.” WHO, 1986

4. What we are up against… “A billion hours ago, human life emerged here on earth…A billion minutes ago, Christianity emerged…A billion Coca-Cola’s ago, was yesterday morning.” -Information obtained from Coca Cola’s annual report, 1996

5. 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

6. Work

8. The American Waist Land

9. Obesity Trends* Among U.S. Adults BRFSS, 1985 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

10. Obesity Trends* Among U.S. Adults BRFSS, 1986 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

11. Obesity Trends* Among U.S. Adults BRFSS, 1987 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

12. Obesity Trends* Among U.S. Adults BRFSS, 1988 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

13. Obesity Trends* Among U.S. Adults BRFSS, 1989 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

14. Obesity Trends* Among U.S. Adults BRFSS, 1990 No Data <10% 10%–14% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

15. Obesity Trends* Among U.S. Adults BRFSS, 1991 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

16. Obesity Trends* Among U.S. Adults BRFSS, 1992 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

17. Obesity Trends* Among U.S. Adults BRFSS, 1993 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

18. Obesity Trends* Among U.S. Adults BRFSS, 1994 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

19. Obesity Trends* Among U.S. Adults BRFSS, 1995 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

20. Obesity Trends* Among U.S. Adults BRFSS, 1996 No Data <10% 10%–14% 15%–19% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

21. Obesity Trends* Among U.S. Adults BRFSS, 1997 No Data <10% 10%–14%15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

22. Obesity Trends* Among U.S. Adults BRFSS, 1998 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

23. Obesity Trends* Among U.S. Adults BRFSS, 1999 No Data <10% 10%–14%15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

24. Obesity Trends* Among U.S. Adults BRFSS, 2000 No Data <10% 10%–14% 15%–19% ≥20 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

25. Obesity Trends* Among U.S. Adults BRFSS, 2001 No Data <10% 10%–14%15%–19% 20%–24% ≥25% (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman)

26. 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. Adults BRFSS, 2002

27. www.cdc.gov 27 Diabetes Trends 1990-2001 ■ No Data ■ <10% ■ 10%-14% ■ 15%-19% ■ 20%-24% ■ ≥25%

28. Is it just lack of willpower? “ A great reducing exercise consists of placing both hands against the edge of the table and pushing back.”

29. 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

30. Health educator?

31. Steps in the right direction 1951

32. Going nowhere fast

33. The entire US federal budget spent on nutrition education is 1/5 the amount spent to market Altoids… Chew on this …

34. Health education/promotion levels Educational – information is available when it is needed. Educational – information is available when it is needed. Political – health educators advocate for change. Political – health educators advocate for change. Economic – Make health affordable, and provide incentives (WHP). Economic – Make health affordable, and provide incentives (WHP).

35. Health education/promotion levels Social – working with community is true empowerment. Social – working with community is true empowerment. Policy – Upstream/downstream Policy – Upstream/downstream Organizational – UA wellness Organizational – UA wellness

36. The Micro View You can do it if you just try! You can do it if you just try! Pull yourself up by your bootstraps, quit whining, and get healthy! Pull yourself up by your bootstraps, 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.

37. What has to be done Primary Prevention Primary Prevention What is being done… What is being done… SECONDARY PREVENTION SECONDARY PREVENTION TERTIARY PREVENTION TERTIARY PREVENTION

38. Certified Health Education Specialist (CHES) Have met the standards of competence established by National Commission for Health Education Credentialing (NCHEC) Have met the standards of competence established by National Commission for Health Education Credentialing (NCHEC) Successfully passed exam Successfully passed exam Required Continuing Education - 75 yrs over 5 years Required Continuing Education - 75 yrs over 5 years

39. CHES Framework/Competencies 1. Assess individual and community needs for health education 2. Plan effective health education programs 3. Implement health education programs 4. Evaluate the effectiveness of health education programs

40. CHES Framework cont. 5. Coordinate the provision of health education services 6. Act as a resource person in health education 7. Communicate health and health education needs, concerns and resources

41. CHES Benefits Employers and consumers can be assured that a CHES has met national standards as a health education professional. Employers and consumers can be assured that a CHES has met national standards as a health education professional. Required Continuing Education - ongoing quality assurance Required Continuing Education - ongoing quality assurance

42. Where are Health Educators Employed? Schools (K-12) Schools (K-12) Colleges and Universities Colleges and Universities Workplaces Workplaces Health Care Facilities Health Care Facilities Community Organizations & Government Agencies Community Organizations & Government Agencies

44. Why is Health Education Important? Improves the quality of life for all people. Improves the quality of life for all people. Saves lives & reduces premature deaths Saves lives & reduces premature deaths By focusing on prevention, it saves society money that would be spent on medical treatment or rehabilitation. By focusing on prevention, it saves society money that would be spent on medical treatment or rehabilitation.

45. The task of future health educators… “If a kid is born today, for the first time in history, there is the real potential that they will be outlived by their parents…”

46. Life is not a concession stand… Now that’s a double-header!