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THE SCIENCE OF HEALTH PROMOTION

Intervention Focus

Commentary

Research: Smoking Control; Financial Analysis 
Kenneth E. Warner 123 THE COSTS OF BENEFITS: Smoking Cessation and Health Care Expenditures
Guest commenator Dr. Kenneth E. Warner reflects on the unique contribution of the articles by
Martinson et al and Musich et al in this issue in helping to explain why former smokers having higher medical costs than current smokers
Brian C. Martinson
Patrick J. O’Connor
Nicolaas P. Pronk
Sharon J. Rolnick

 

125

Smoking Cessation Attempts in Relation to Prior Health Care Charges: The Effect of Antecedent Smoking-related Symptoms
In an effort to understand why former smokers have higher medical costs than current smokers, health care charges were examined in the 6 months prior to quitting smoking among a stratified random sample of 8000 members of a midwestern managed care organization. Health plan members who had any inpatient charges (RR 5 1.9), any emergency room or urgent care charges (RR 5 1.4), total charges in the top tertile (RR 5 1.5), and outpatient charges in the top tertile (RR 5 1.6) were more likely to quit smoking. Among smoking adults with one or more chronic diseases at baseline, being in the top two tertiles of total charges or ambulatory care charges was predictive of a subsequent smoking event.

 

Shirley Musich
Stephanie D. Faruzzi
Chifung Lu
Timothy McDonald
David Hirschland
Dee W. Edington

 

133

 

Pattern of Medical Charges After Quitting Smoking Among Those With and Without Arthritis, Allergies, or Back Pain
Medical care charges were examined among 20,332 employees of General Motors to examine thetimeframe related to changes in medical charges after quitting smoking for those with and withoutchronic conditions. Among those with no chronic conditions, former smokers who had quit less than 5years earlier had medical charges greater than current smokers and never smokers ($3356; $2613;$2203). For smokers who had quit 5–9, 10–14, and 15 or more years earlier, medical charges began to approach those of never smokers ($2361, $2448, $2301). For those with chronic conditions, charges were highest for current smokers ($4208), but remained high for those who had quit less than 5 years and 5–9 years earlier ($4027; $4050) but began to approach those of never smokers ($3108) for those who had quit 10–14 and more than 15 years earlier ($3396, $3256).

 

SPECIAL ISSUE: CREATING A NEW VISION FOR HEALTH PROMOTION
Introduction

Paul E. Terry 

143

Creating a New Vision for Health Promotion: Taking a Profession to a New Level of Effectiveness in Improving Health 
Creating a New Vision
J. Michael McGinnis 146 A Vision for Health in Our New Century
Given the determinants of health, and the resources available to us, this author envisions an approaching century in which every child has the right start, all people have the opportunity for lifelong vitality through healthy lifestyles, we live in safe and nurturing environments, no addicted person goes untreated, all have the medical care required, none are estranged through societies neglect, and each will have choices for a humane conclusion at the end of life.

 

Shoshanna Sofaer
Jessie Gruman

 

 

151 Consumers of Health Information and Health Care: Challenging Assumptions and Defining Alternatives
The role of the individual as a health care ‘‘consumer’’ has changed dramatically in recent years. The authors describe how the term ‘‘consumer’’ is used by various stakeholders, the assumptions that underlie the notion that a ‘‘consumer’’ can have a significant impact on their own health, challenge the evidence base of these assumptions, articulate a set of principles to inform an alternative, more productive and feasible role for individuals with respect to their health and health care; and identify the implications of those principles for health promotion and health care professionals in the 21st century.

 

John M. Wilkinson
Paul V. Targonski

 

 

157 Health Promotion in a Changing World: Preparing for the Genomics Revolution
The authors suggest that revolutionary change in medicine is about to occur, in part because of the sequencing of the human gene. However, no advances in genomics or genetic engineering in the foreseeable future will obviate the need for exercise, prudent diet, smoking cessation, or generally healthy lifestyles. This revolution will produce more targeted screening and presymptomatic treatment of risks, require development of new ethical confidentiality and legal standards, and force us to question our conceptions of race and other factors.

 

Achieving a New Vision

Paul E. Terry  162 Leadership and Achieving a Vision—How Does a Profession Lead a Nation?
The author examines the role of leadership in achieving a new vision for health promotion. Leadership challenges and threats, and contemporary views on leadership are reviewed to frame the opportunity available to the health promotion profession to change national health policy. He concludes by describing the actions every professional can take to play a leadership role in helping to achieve the new vision articulated in this special issue.
Allan Best
Daniel Stokols
Lawrence W. Green
Scott Leischow
Bev Holmes
Kaye Buchholtz

 

168 An Integrative Framework for Community Partnering to Translate Theory Into Effective Health Promotion Strategy
The authors make a case for narrowing the gap between health promotion research and practice by developing an overarching framework and applying it to comprehensive health promotion strategy. The framework integrates four models: the social ecology, Life Course Health Development, PRECEDEPROCEED, and community partnering models. They suggest that the critical next steps towards closing the gap between health promotion research and practice are investing in networks that promote, support, and sustain ongoing dialogue and sharing of experience; finding common ground in an approach to community partnering; and gaining consensus on the proposed integrating framework.

 

Clyde H. Evans
Linda C. Degutis

 

 

177 What It Takes for Congress to Act
The authors describe the structure of the US congress, the nature of the legislative process, and suggeststrategies for effective advocacy efforts.

 

Perspectives From the Health Professions

Stephen N. Blair
Barry A. Franklin
John M. Jakicic
Ben Kibler

 

 

182 New Vision for Health Promotion Within Sports Medicine
The authors describe the optimal role of health promotion within sports medicine, as well as opportunities, barriers, and strategies to make this vision a reality.

 

Cynthia Reeves Tuttle
Brenda Derrick
Angie Tagtow

 

 

186 A New Vision for Health Promotion and Nutrition Education
The authors describe the optimal role of health promotion within nutrition and nutrition within health promotion, as well as opportunities, barriers, and strategies to make this role a reality.

 

Patricia A. Chiverton
Kathryn McCabe Votava
Donna M. Tortoretti

 

 

192 The Future of Nursing in Health Promotion
The authors discuss how the role of nurses must shift from managing illness to teaching people how to remain healthy. An important part of this shift is an evidence-based understanding of the relationship between lifestyle and health.

 

Robin Dibble  195 Eliminating Disparities: Empowering Health Promotion Within Preventive Medicine
The author describes the current and optimal role of health promotion within Preventive Medicine, as well as opportunities, barriers, and strategies for moving Preventive Medicine towards this optimal role.

 

Bonita Lynn Beattie
Nancy Whitelaw
Molly Mettler
David Turner

 

 

200 A Vision for Older Adults and Health Promotion
The authors describe the current and optimal role of health promotion in serving older adults, as well as opportunities, barriers, and strategies for utilizing community organizations to move toward this optimal role.

 

 

 

American Journal of Health Promotion 248-682-0707

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