Health Promotion and Disease Prevention
Health Goes Global wanted to highlight the writing of a member of our board and Clean Water Project Manager, Ethan Klausmeyer. Klausmeyer is passionate about breaking down the barriers between health providers and patients. 90 million Americans and millions more around the world are health illiterate. This piece is one method he uses to explain disease prevention in non-healthcare terms to patients and those interested in improving their quality of life.
Health Promotion and Disease Prevention
by: Ethan Klausmeyer
Health promotion and disease prevention are endeavors aimed at enhancing the quality of health and well-being in the individual, family, group and society at large. Health promotion and disease prevention have assumed different roles in cultures throughout history. Precise definitions often change with time, influenced by politics, society, religious and philosophical viewpoints. While these terms may carry a fluidity and diversity of definition, the end goal is both empowerment and health enhancement. For the health care professional, these topics will inevitably arise in patient discourse. This discussion aims to cultivate an explanation of these terms to offer in the clinical setting. It will then touch upon the current state of health promotion and disease prevention in the United States, as well as how the current health care system may better serve its communities through the improvement of health education.
Let us use the topic of personal finance to offer an analogy of health promotion. In one’s lifetime, as a functioning member of a society, an individual will choose a career and work for many years earning income. There are also inevitable expenses that one will have to deal with - taxes, mortgage payments, insurance, utilities, etc. – that take away from the individual’s net income. Collectively this is called an income statement. The individual may choose to greatly affect their income statement with investments in assets and liabilities. In the simplest sense, an asset is anything that puts money into one’s pocket overtime, and a liability is anything that takes money out of one’s pocket overtime. The goal of personal finance then, is to seek out assets to invest in, thus increasing one’s net income. Many individuals are not clearly educated on the difference between an asset and a liability, and thus fall prey to a multiplicity of financial disasters, tipping the scales to favor expenses, and eventually waking up one day wondering where all their money went.
In the clinical setting, the income statement equates to the patient’s overall well-being. Income equates to health, expenses equate to illness. Throughout one’s life, the goal is to achieve and maintain a high level of health, as well as limiting illness as best possible. The way to go about promoting health and preventing disease is through everyday choices. The actions one makes each day can be thought of as micro-investments. Some are assets, while others are liabilities. Here are some examples of what may fall into the category of assets as it relates to overall well-being: ethics, values, responsibility, support systems, family, education, diet, exercise, and sleep. Choosing a lifestyle that embraces these assets, one will discover an enhancement of health, a more fulfilled life, a sense of personal empowerment, and an overall state of well-being. On the other hand, investment in health liabilities overtime leads to a decreased state of well-being, and inevitably, illness. Health liabilities include drugs, alcohol, stress, anger, poor diet, lack of sleep, smoking, and very little exercise. In both the world of finance and the world of public health, millions of individuals commonly ignore the logic of their choices, and instead act on emotion. Instead of playing out the potential effects of the investment long term, the logic is ignored.
The current state of health in the United States is shocking. According to the CDC, 26.9 million people of all ages—or 8.2% of the US population—has diagnosed diabetes. 210,000 children and adolescents younger than age 20 years—or 25 per 10,000 US youths— has diagnosed diabetes. (National Diabetes Statistics Report, 2020). The prevalence of obesity was 42.4% in 2017/2018. From 1999–2018, the prevalence of obesity increased from 30.5% to 42.4%, and the prevalence of severe obesity increased from 4.7% to 9.2% (National Health and Nutrition Examination Survey, 2017–2018). Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer. These are all preventable. Suffice it to say, the state of health promotion in the United States is in dire need of medical help. It is imperative that health care providers educate each patient regarding their personal lifestyle choices to promote health and prevent disease.
Health education starts with honest, clear, judgment free conversations between patient and clinician, examining facts and offering support. Each patient who walks away better informed as to their current lifestyle and choices, ready to make a change, should be celebrated as a victory. For the 20-year habitual smoker: ‘Ask, Advise, Assess, Assist, Arrange’ (Agency for Healthcare Research and Quality, 2012). For the struggling alcoholic, offer resources for counseling, small groups, and develop a plan. One of the biggest struggles this nation faces, and something that still remains majority below water is mental health, namely, anxiety and depression. As we learn more as a medical and scientific community, we have a responsibility to our patients to educate them on these illnesses and allow for open dialogue. Such is the burden of today’s medical professionals, but together as an integrative team using many hard-earned skills, techniques, and methods, we can promote health, and prevent disease.