Who is Responsible for Health Promotion and Education?

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Health promotion and disease prevention are more relevant today than ever before considering some of the key issues affecting the US Healthcare system. According to CMS, national healthcare expenditures rose 9.7% in 2020 to $4.1 trillion, accounting for 19.7 percent of the gross domestic product (1).  The US spends over $10,000 per capita on healthcare expenditures, more than any other leading nation, yet reports the worst health outcomes and lowest life expectancy rates among this group (2).  Specifically, rates of chronic conditions such as obesity were higher in the US than those abroad. Americans have been paying substantially higher prices for their healthcare and getting far less value in medicine for their money.

HealthyPeople2020Changes in the nation’s healthcare reimbursement model over the last five years that encourage higher-quality and lower-cost value-based care have helped to spur an increase in preventative medicine by incentivizing medical practices and healthcare organizations. Unfortunately, the COVID-19 pandemic has stymied some of these efforts and muddied survey and outcome data. Many projected Healthy People 2020 goals were not met, and the Healthy People 2030 goals have been adjusted to make up for this lack of progress (3).  Patient satisfaction surveys such as the Consumer Assessment of Healthcare Providers and Systems (CAHPS) include a focus on health promotion and education that aims to boon these renewed efforts.

doctor reviewing dataFor example, there are several questions from the (CG-CAHPS) Clinician & Group Survey pertaining to whether or not specific preventative methods were taken by a patient’s care team to ensure optimal health. Some of these questions include:

  • Whether or not the care team spoke with the patient regarding a healthy diet and healthy eating?
  • Whether or not the care team discussed exercise or physical activity with the patient?
  • If the care team talked about specific health goals?
  • If the patient was asked about things that make it challenging for them to take care of their health?
  • If the care team discussed all the patient’s prescription medicines?
  • If the care team asked about feelings of sadness, emptiness or depression?
  • Whether the care team discussed subjects that worry or cause the patient stress?
  • If the care team discussed any of the patient’s personal problems such as a family problem, alcohol use, drug use, mental or emotional illness?

medium shot man drinking water gymFocusing on Health Promotion and Education

Health promotion is the process of enabling individuals to improve and increase control over their health(4).  It goes beyond the treatment and cure and covers a spectrum of social and environmental interventions intended to prevent the root causes of poor health.

Health promotion addresses behavioral risk factors such as smoking, obesity, diet, and physical inactivity. It also focuses on areas of mental health such as injury prevention, opioid and other drug abuse control, alcohol control, health behavior related to HIV, and sexual health.

Oral health blue and yellow brochure template. Dentist visits. Prevention. Leaflet design with linear icons. 4 vector layouts for presentation, annual reports. Questrial, Lato-Regular fonts usedStrategies Involved with Health Promotion and Education

Health Promotion includes a wide range of activities focused on disease prevention and improving the quality of life for those in poor health. It involves non-medical interventions such as lifestyle change, health education, better nutrition, physical activity, and avoidance of exposure to harmful substances such as alcohol and cigarette smoking.

Strategies for health promotion focus on activities such as social marketing, and practice-based education directed to patients in the waiting room using health promotional literature, audiovisual material, and multimedia. The benefit of health promotion in the clinical environment is that it is focused on the needs of the patient, whether it is literature to assist with smoking cessation or information regarding diet or exercise programs for patients with heart disease.

However, health promotion is not just the responsibility of healthcare organizations and medical practices. According to the World Health Organization, there are three key elements to health promotion:

  1. Good Governance
    Effective health promotion requires the government to make health promotion and disease prevention a priority in policy and factor its implications into all the decisions.
  2. Health literacy
    Individuals should be given the ability to acquire the information they need to make healthy choices. (Whether it is healthcare services or the food they eat)
  3. Healthy Cities
    Strong leadership and commitment are essential to building healthy communities.

Health promotion and education is an important piece to a much larger and deeper puzzle that is facing the US healthcare system today. It is not solely the responsibility of providers, but also the government, local leadership, healthcare organizations, and ultimately the patient who can help prevent illness and the chronic diseases that have cost the country billions and the lives of so many.

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  1. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html
  2. https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019
  3. https://www.healthypeople.gov/2020
  4. https://www.who.int/news-room/questions-and-answers/item/health-promotion

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