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An Ecological Perspective on Health Promotion Programs

Department of Public Health Education, University of North Carolina, Greensboro

Daniel Bibeau, PhD

Department of Public Health Education, University of North Carolina, Greensboro

Allan Steckler, DrPH

Department of Health Behavior and Health Education, University of North Carolina, Chapel Hill

Karen Glanz, PhD, MPH

Department of Health Education, Temple University, Philadelphia

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 pro motion 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 atten tion on both individual and social environmental factors as targets for health promo tion 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 environment will produce changes in individuals, and that the support of individ uals in the population is essential for implementing environmental changes.

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