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Most health care is self-care. By far, most health related activities are carried out by the individual and family members in the privacy of their home ( Santa-Barbara 1979). How successful these practices are, to a large extent, determines the individual's need for using professional health care services. Therefore, these personal health practices, which are largely the responsibility of the individual, determine the costs of the health care system. The so-called "lifestyle diseases," which account for such a high proportion of the total health care budget ( Lalonde 1974), are the result of personal activities over which the professional health care system has traditionally had little influence. These lifestyle diseases are the result of inadequate self-care.
Health education as a means of influencing health behaviors is a relatively recent phenomenon. Surveys indicate that health is highly valued by most of us. Yet in typically human fashion, we are generally ignorant about many basic facts of health care (for example, Pratt 1956; Haley, Aucoin, and Rae 1977), and even fewer of us act on what we know (for example, Wilson 1970).
Both health professionals and corporate leaders now view health education programs as a cost-effective means of influencing personal health behaviors of large numbers of people. The goals of health education are to increase the health status of large numbers of people and to concomitantly reduce health care costs. For example, the recent decline in smoking behavior by more than 40 million North Americans ( McGinnis 1985) is a clear demonstration that change can occur. The financial savings to both the individuals involved and their employers is significant ( Kristine, Arnold, and Wynder, 1977).
However, many lifestyle behaviors remain that continue to generate more health problems than the burgeoning health care system can handle. There are simply not enough health care professionals to treat these lifestyle diseases once they occur. More health care professionals and more expensive treatments in the traditional medical model are not the answer. Prevention of disease is the strategic choice for the future. Health education programs in the workplace represent a promising approach to disease prevention. There are benefits for both the individual employee and the employer, and, because of these benefits, the workplace provides an ideal opportunity for launching and sustaining the necessary lifestyle changes.
However, the current burden of responsibility for health care remains largely and solely with the individual and the family--the very source of the problem. The difficulties individuals and families have in maintaining a high degree of physical and mental health are many and varied and beyond the scope of the present chapter (for example, Pratt 1976).
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