PBHL 2001 1st Edition Lecture 7 Health PromotionLimitations to Individual InterventionsBenefits small portion of populationHard to keep people involved People only remember about 50% of what they are told in a clinical encounterPeople must change their behavior and it is difficult to maintain those changesAssumption of AutonomyProcedural Accounts: People can deliberate and make decisions without interferenceRelational Account: Social and material circumstances influence deliberation and the ability to take action. Access to adequate nutrition, educational and health care services, safe living environment, etcEnvironment May Encourage the Wrong ActionThe portion size of meals in restaurants has increased by 50% since the 1950’s. People may be discouraged to exercise due to danger like assault and violent animalsPeople have one grocery store in a 3,500 square mile area: food desertInadequate Food SupplyThe U.S. food supply is not consistent with federal dietary guidanceThey examined all food available for consumption in the U.S. by category (vegetables, whole grains)If everyone in the U.S. wanted to follow the federal dietary guidance, it would not be possible. Health Impact Pyramid (Individual)Counseling and EducationClinical InterventionLong-Lasting Protective InterventionsChanging the Environment Socioeconomic Factors (Population)What is an Optimal DefaultMaking the healthy choice the easy (automatic) choice (Ex: Starbucks drinks made “skinny”)Epidemiologic TriangleAgent that causes the disease (e.g., Cholera bacterium)Host harboring the disease (personal characteristics, e.g., age)Environment that causes or allow disease transmission (e.g.,