course material

1. NUR 4636 Florida State University Health Promotion and Risk Reduction
Paper
Chapter 14 Environmental Health Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
chemical, and biological factors external to a person and all the related factors impacting
behaviors. … encompasses the assessment and control of those environmental factors that
can potentially affect health. … targeted toward preventing disease and creating health-
supportive environments. – WHO (2013) Copyright © 2015, 2011, 2007, 2001, 1997, 1993
environmental health is to ensure the conditions of human health and provide healthy
environments for people to live, work, and play. Accomplished through… ➢➢➢Risk
assessment Prevention Intervention Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
“thinking upstream” framework. Raises questions about oppressive situations. Involves
community members in the definition and solution of problems. Facilitates interventions
that reduce healthdamaging effects of environments. Asks critical questions about clients’
work and home environments to help discern the contributions of specific hazards to
health. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
environmental/ occupational factors Improved timelines and accuracy of diagnosis
Prevents disease and aggravation of conditions Identifies potential work-related
environmental hazards and/or environmental hazards in and around clients’ homes
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 I
PREPARE Environmental Exposure History ● ● ● ● ● ● ● ● I – Investigate potential
exposures P – Present work R – Residence E – Environmental concerns P – Past work A –
Activities R – Referrals and Resources E – Educate Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Figure 14-1 From U.S. Department of
Health and Human Services: Healthy People 2010, ed 2, Washington, DC, U.S. Government
Printing Office, 2000. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
Work-related exposures Outdoor air quality Healthy homes Water quality Food, safety, and
waste management Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an

2. communities, and their surrounding environments that affects health behaviors and habits,
interpersonal relationships, cultural values, and customs Copyright © 2015, 2011, 2007,
-hand smoke Noise exposure Urban crowding Technological
hazards Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 10 Work-
injury or illness Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
of Elsevier Inc. 11 Work- sbestosis Asthma Lung
cancer Agricultural accidents Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
air pollution Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
effect Destruction of the ozone layer Aerial spraying of herbicides and pesticides Acid rain
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14
shelter, and indoor air quality Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsev
Rodent and insect infestation Poisoning from lead-based paint Sick building syndrome
Unsafe neighborhoods Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 16 W
levels, toxic chemical pollution, and pathogenic microorganism levels The balance between
water contaminants and existing capabilities to purify water for human use and plant and
wildlife sustenance Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
supply by human waste Oil spills in the world’s waterways Pesticide or herbicide
infiltration of ground water Aquifer contamination by industrial pollutants Heavy metal
poisoning of fish Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
free from contamination of harmful herbicides, pesticides, and bacteria Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 Food Safety:
d
food chains by ecosystem destruction Carcinogenic chemical food additives FDA food safety
campaign: http://www.fightbac.org/safe-food-handling http://www.foodsafety.gov/ Figure
14-5 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
municipal processes, and human consumption as well as efforts to minimize waste
production Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Poorly designed solid waste dumps Inadequate sewage systems Transport and storage of
hazardous waste Illegal industrial dumping Copyright © 2015, 2011, 2007, 2001, 1997,
and schools Nuclear testing Excessive exposure to x-rays Copyright © 2015, 2011, 2007,

3. 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 23 Effects of Environmental
Hazards Figure 14-6 From Environmental Protection Agency: Air Pollution and Health Risk.
http://www.epa.gov/ttnatw01/3_90_022.html. Retrieved March 27, 2013. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 24 Emerging
Natural disasters Global climate change Ozone depletion Fossil fuel burning Marine
dumping Active land mine abandonment in war-torn areas Destruction of tropical rain
forests Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Approach environmental
health at the population level Take a stand; advocate for change Ask critical questions
Facilitate community involvement Form coalitions Using collective strategies Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 26 Chapter 13
Cultural Diversity and Community Health Nursing Copyright © 2015, 2011, 2007, 2001,
competence is respecting and understanding the values and beliefs of a certain cultural
group so that one can function effectively in caring for members of that cultural group.
Culturally competent community health nursing requires that the nurse understand… ➢➢➢
Lifestyle Value system Health and illness behaviors of diverse individuals, families, groups,
and communities Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
of Elsevier Inc. 2 Standards of Practice for Culturally Competent Nursing Care 1. 2. 3. 4.
Social Justice Critical Reflection Knowledge of Cultures Culturally Competent Practice 5.
Cultural Competence in Health Care Systems and Organizations 6. Patient Advocacy and
Empowerment 7. Multicultural Workforce 8. Education and Training in Culturally
Competent Care 9. Cross-Cultural Communication 10. Cross-Cultural Leadership 11. Policy
Development 12. Evidence-Based Practice and Research From: Expert Panel on Global
Nursing and Health (2010) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
an imprint of Elsevier Inc. 3 ➢ ➢
increased to 36% of population By 2025 ➢
than half of all children will be minorities By 2050 ➢➢More than 54% of total population
will be minorities First time in U.S. history that minorities will make up a majority of the
population Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
➢White
44% ➢Hispanic 30% ➢African American 15% ➢Asian 9% ➢American Indians & Alaska
Natives 2% Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
immigrants In 2010, almost 40 million foreign-born individuals in the United States (12.9%
of population) from: ➢➢➢➢Latin America 53.1% Asia 28.2% Europe 12.1% Other regions
9% Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
workforce (HRSA, 2009): ➢➢➢➢➢ -Hispanic 81.8% African American 4.2%
Hispanic 1.7% Asian and Pacific Islander 3.1% Native American and Alaska Native 0.3%
Minority groups tend to be geographically distributed in the United States. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Cultural

4. targets…eliminating racial and ethnic disparities in health Embraced and focused on ways
to close the gaps in health outcomes Focused on disparities among racial and ethnic
minorities, women, youth, older adults, people of low income and education, and people
with disabilities Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint
th diabetes are
seven times more likely to have amputations and develop renal failure than are whites with
care (compared with less than 16% of whites). Copyright © 2015, 2011, 2007, 2001, 1997,
1993 by Saunders, an imprint of Elsevier Inc. 9 Health Disparities (Cont.) AHCRQ (2005)
-Hispanic white
frican Americans (16%) and Hispanic
Americans (13%) are more likely to rely on hospitals or clinics for health care than are
whites (8%). Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 10 Addressing Racial and Ethni
reduced or eliminated when adults have: ➢➢Health insurance and A medical home –
Commonwealth Fund, 2007 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
an imprint of Elsevier Inc. 11 Transcult
focused on a comparative analysis of different cultures and subcultures in the world with
respect to cultural care, health and illness beliefs, values, and practices with the goal of
using this knowledge to provide culturespecific and culture-universal nursing care to
people.” – Leininger (1978) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
the “particularistic values, beliefs, and patterning of behavior that tend to be special, ‘local,’
or unique to a designated culture and which do not tend to be shared with members of
other cultures” – es of
values, norms of behavior, and life patterns that are similarly held among cultures about
human behavior and lifestyles and form the bases for formulating theories for developing
cross-cultural laws of human behavior” – Leininger (1978) Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Transcultural Nursing
life as the most desirable, acceptable, or best, and to act in a superior manner toward
beliefs, values, and patterns of behavior on individuals from another culture. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Leininger’s
nursing similarities and differences focused primarily on human care and caring in human
cultures. Uses world view, social structure, language, ethnohistory, environmental context,
and the generic or folk and professional systems to provide a comprehensive and holistic
view of influences in cultural care and well-being. Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Leininger’s Sunrise Model depicting
the theory of cultural care diversity and universality Figure 13-1 From Leininger MM:

5. Culture, care, diversity, and universality: a theory of nursing, New York, 1991, National
League for Nursing Press. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
including knowledge, beliefs, art, morals, law, customs, and any other capabilities and habits
acquired by virtue of the fact that one is a member of a particular society (Tylor, 1871).
Culture represents a person’s way of perceiving, evaluating, and behaving within his or her
world, and it provides the blueprint for determining his or her values, beliefs, and practices.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17
Overview of Culture (Cont.) Four basic characteristics of culture—it is: 1. Learned from
birth through the processes of language acquisition and socialization 2. Shared by members
of the same cultural group 3. Adapted to specific conditions related to environmental and
technical factors and to the availability of natural resources 4. Dynamic – Sir Edward Tylor,
1871 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
are not common to all members of the culture Enables them to be a distinguishable
subgroup May be based on ethnicity, religions, occupation, health-related characteristics,
age, gender, sexual preferences, or geographic location Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 Culture and Formation of
lems related to values and norms: ➢➢➢➢➢What is the
character of innate human nature (human nature orientation)? What is the relationship of
the human to nature (personnature orientation)? What is the temporal focus of human life
(time orientation)? What is the mode of human activity (activity orientation)? What is the
mode of human relationships (social orientation)? Copyright © 2015, 2011, 2007, 2001,
1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Human-
Innate human nature may be good, evil, or a combination of good and evil. The dominant
U.S. cultural group chooses to believe the best about a person until that person proves
otherwise. – Kohls (1984) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 21 Person-
subjugated to nature in a fatalistic, inevitable manner. Harmony, in which people and nature
exist together as a single entity. Mastery, in which people are intended to overcome natural
forces and put them to use for the benefit of humankind. Copyright © 2015, 2011, 2007,
focus may be on the past, with traditions and ancestors playing an important role in the
client’s life. The focus may be on the present, with little attention paid to the past or the
future. The focus may be on the future, with progress and change highly valued. Copyright
© 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 23 Activity
largely nondevelopmental in nature. Growing, in which the person is selfcontained and has
inner control, including the ability to self-actualize. Doing, in which the person actively
strives to achieve and accomplish something that is regarded highly. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 24 Social Orientation
xist by virtue of heredity and kinship ties. Follow an ordered
succession and have continuity through time. Collateral relationships: Focus primarily on

6. group goals—and family orientation is important. Individual relationships: Personal
autonomy and independence dominate; group goals become secondary. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 25 Culture and the
-cultural differences may exist in: ➢Structural differences ➢Functional
diversity ➢Socialization context ➢Sex roles and parenting values Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 26 Culture and
of a family or unrelated individuals based on: ➢Income ➢Wealth ➢Occupation ➢
Educational attainment ➢Power Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Poverty guidelines ➢Determined by comparing pretax cash income with the poverty
threshold adjusted for family size and composition issued annually by USDHHS. ➢The U.S.
Census Bureau (2012) reported that the poverty rate in 2011 was 15% • African American
population—27.6% • Asian population—12.3% • Hispanic population—25.3% • Children
under 6 years—24.5% Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
resources ➢Upper, middle, and lower classes • Total family income, occupation, and
educational level • Age, sex, material possessions, health status, family name, location of
residence, family composition, amount of land owned, religion, race, and ethnicity ➢➢A
disproportionate number of individuals from the racially and ethnically diverse subgroups
are members of the lower socioeconomic class Outcome of social stratification is social
inequality Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier ➢➢Perhaps the
single most important factor in SES. Child’s educational development affected more by
differences in levels of formal schooling than by cultural differences or economic indices.
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 30
➢➢➢➢➢➢
Cultural definition of food Frequency and number of meals eaten away from home Form
and content of ceremonial meals Amount and types of food eaten Regularity of food
consumption Social contacts during meals Beware of cultural stereotyping. Cultural food
preferences are often interrelated with religious dietary beliefs and practices. Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 31 Culture and
➢➢
general understanding of religious calendars. • Know the customary days of religious
worship. • Learn about special days of observance or celebration. Ask clients what religious
practices they follow. Religious beliefs may influence a client’s belief about the cause of
illness, perception of its severity, choice of healer, and source of consolation. Assess
spiritual needs of clients. Know the difference between religion and spirituality. Remember
that various religions have shared beliefs. Copyright © 2015, 2011, 2007, 2001, 1997, 1993
by Saunders, an imprint of Elsevier In
older adults in very different ways. Tasks of older adults ➢➢
integrity in accepting responsibility for their own lives To have a sense of accomplishment
Older adults develop their own means of coping with illness through self-care, assistance

7. from others, and social support groups. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 33 Cross-
… between a nurse and client attempts to understand the other’s point of view from a
cultural perspective. ➢Nurse-client relationship ➢Space, distance, and intimacy ➢
Overcoming communication barriers ➢Nonverbal communication ➢Language ➢Touch ➢
Gender Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 34 Health-
based values, beliefs, attitudes, and practices. Include the client’s beliefs about the cause of
illness: ➢➢➢
perspective Understand the role and value of folk or religious healers. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 35 Health-Related
Bel
conditions are perceived, diagnosed, labeled, and treated. Expression of pain is culturally
determined. Some conditions are culturally defined—a culture-bound syndrome. Copyright
© 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 36
self-care. ➢➢ ng environment
Cultural negotiation is used when conceptual differences exist between client and nurse. ➢
Same words but different meanings ➢Same phenomenon; different notions of causation ➢
Different memories or emotions associated with the term and its use Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 37 Cornerstones of
communities’ priorities and needs Establish caring relationships Remain grounded in social
justice Provide care for the whole person Promote health based on epidemiological
evidence (evidence-based practice) Collaborate with community resources – Keller,
Strohschein, & Schaffer, 2011 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
Saunders, an imprint of Elsevier Inc. 38 Management of Health Problems in Culturally
financing health services Developing health professionals from minority groups Enhancing
cooperative efforts with the nonfederal sector Promoting a research agenda on minority
health issues Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Elsevier Inc. 39 Providing Health Information and Education
increase public awareness about health problems. ➢Plan health information campaigns: •
Be sensitive to cultural factors. • Involve community leaders. • Acknowledge existing
cultural beliefs and practices. • Involve families, churches, employers, and community
organizations as support systems. • Use lay volunteers to organize community support
networks. ➢Client education should be interpersonal; carefully use credible printed
materials and audiovisuals. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders,
“culturological” assessment. Conduct a cultural self-assessment. Seek knowledge about local
cultures. Recognize political issues of culturally diverse groups. Provide culturally
competent care. Recognize culturally based health problems. Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 41 Culturological

8. nd racial origins of the cultural group with
which the client identifies Values orientation Cultural sanctions and restrictions
Communication Health-related beliefs and practices Nutrition Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 42 Culturological
cultural support Educational background Religious affiliation Cultural aspects of disease
incidence Biocultural variations Developmental considerations Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 43 Resources for Minority
➢Office
of Minority Health • Disadvantaged Minority Health Improvement Act of 1990 ➢Indian
Health Service • Indian Self- ➢
National Center on Minority Health and Health Disparities (NCMHD) Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 44 Federally
Disparity Collaboratives (HDC) Racial and Ethnic Approaches to Community Health (REACH
2010) National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Ryan White
Comprehensive AIDS Resources Emergency (CARE) Act B National Center on Minority
Health and Health Disparities (NCMHD) Copyright © 2015, 2011, 2007, 2001, 1997, 1993
by Saunders, an imprint of Elsevier Inc. 45 Chapter 4 Health Promotion and Risk Reduction
Copyright © 2015, 2011, 2007, 2001, 1997,. 1993 by Saunders, an imprint of Elsevier Inc.
organizational, economic, and environmental supports for behavior of individuals, groups,
or communities conducive to health (Green & Kreuter, 1991) …that which is motivated by
the desire to increase well-being and to reach the best possible health potential (Parse,
1990) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
specific intent to prevent disease, detect disease in the early stages, or maximize health
within the constraints of disease (Parse, 1990) … an important step in maintaining health
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3
model, to a focus on multidimensional aspects such as the social, cultural, and
environmental facets of life and health (Benson, 1996) Health is viewed not only as an
important goal, but as a resource for living (WHO, 1986) Copyright © 2015, 2011, 2007,
2001, 1997
the health promotion initiative for the nation. … challenges individuals, communities, and
professionals … to take specific steps to ensure that good health, as well as long life, are
enjoyed by all. – U.S. Department of Health and Human Services, 2012 Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Healthy People
➢➢➢➢Attain high-quality, longer lives free of preventable
disease, disability, injury, and premature death. Achieve high equity, eliminate disparities,
and improve the health of all groups. Create social and physical environments that promote
good health for all. Promote quality of life, healthy development, and healthy behaviors
across all life stages. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an

9. environment Physical environment Policies and interventions Access to high-quality health
care Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Inc. 7 Figure 4-1 From U.S. Department of Health and Human Services. Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Theories in Health
Transtheoretical Model (TTM) Theory of Reasoned Action (TRA) Copyright © 2015, 2011,
2007, 2001, 1997, 1993 by Saunders,
is “the probability that a specific event will occur in a given time frame” (Oleckno, 2002). A
risk factor is an exposure that is associated with a disease (Friis & Sellers, 2004). Risk
Assessment is a systematic way of distinguishing the risks posed by potentially harmful
exposures. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
Exposure assessment Risk estimation Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by
➢➢
has control Examples: smoking, lifestyle, eating habits, activities Nonmodifiable risks ➢➢
Individual has little or no control Examples: genetics, gender, age, environmental exposure
Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12
➢➢ duals to react to actual or
potential threats to their health Risk communication … ➢➢… is the process of informing the
public regarding threats … is affected by perceptions, process, and actions Copyright ©
2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Tobacco and
populations and those living below poverty level Most common form of chemical
dependency Tobacco in all forms is harmful. Copyright © 2015, 2011, 2007, 2001, 1997,
for teachable moments Assess client’s tobacco use Explore willingness to quit Refer to
cessation programs Encourage attempts to quit Copyright © 2015, 2011, 2007, 2001, 1997,
Third leading lifestyle-related cause of death for the nation Short-term use causes acute
risks Long-term effects have major impact on health and social issues Influenced by legal
drinking age ➢# 1 used and abused drug among U.S. youth Copyright © 2015, 2011, 2007,
2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Health Promotion Activities
vent underage drinking Assist with enforcement of legal drinking age
Identify individuals and groups at risk of abuse and dependence Educate adults and youth
on dangers of alcohol Requires a community-wide effort to address the problem on several
fronts Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
—one of most modifiable risk factors Imbalance of
caloric intake and physical activity Complex interplay among metabolism, genetics,
behavior, environment, culture, and socioeconomic status Geographic areas, age, ethnicity
all influence weight Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
s
have different nutritional needs For individualized plans, see http://myplate.gov/ Educate

10. clients about: ➢Balancing caloric intake and physical activity ➢Servings vs. portion control
➢Eating away from home affects “portion distortion” ➢Using social media and mobile
applications to help Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
health promotion and disease prevention purposes Leisure activities are influenced by level
of education, gender, age, economic level, geography One’s environment plays a significant
role in activity level Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an
imprint of Elsevier Inc. 20 Health Promotion Acti
“walkable” neighborhoods and cities Determine recommended exercise levels for
individuals Visit http://www.cdc.gov/physicalacti vity/data/facts.html Copyright © 2015,
2011, 2007, 2001, 1997, 1993 by Saunders, an imp
Requirements change with age and life circumstances Regulated by waking time and
circadian rhythms Hormones during sleep affect memory, blood pressure, and kidney
function. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of
➢➢
Identify disorders that may affect daily activities Keep sleep log Practice sleep hygiene ➢➢
Establish environment that promotes sleep Avoid food and activities that interfere with
sleep Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier
Inc. 23