Women's Health Promotion
Barbara K. Rimer National Cancer Institute, Rockville, MD
Colleen M. McBride Duke University Medical Center
Carolyn Grump University of North Carolina
Health promotion has been defined by Green and Kreuter (1990) as the combination of educational and environmental supports for actions and conditions of living conducive to health. Within this broad definition, health promotion includes such diverse health promoting behaviors as appropriate nutrition, smoking prevention and cessation, exercise, stress management, and screening for prevalent diseases (e.g., cancer). Because women can expect to live longer than ever before, their lifelong health habits will become more important. Fletcher (1995) observed, “Many of the deadliest conditions for women are stopped not only by knowing more molecular medicine but knowing better how to help our patients to shed unhealthy habits and adopt healthy ones.”
It is important that health promotion for women not be seen as a set of isolated recommendations and activities but within an integrated framework (Rimer, 1995b) that addresses the potential synergistic effect of both good and bad health habits (Lane, Macera, Croft, & Meyer, 1996). As an example, quitting smoking reduces the risk of three major killers of women-cancer, heart disease, and stroke-as well as other conditions and diseases like the complications of diabetes. Decreasing dietary fat may not only decrease the risk of heart disease but also breast and colon cancers. And regular exercise may reduce not only the risk of heart disease and osteoporosis but also of breast and colon cancers. Health habits interact in other ways as well. For example, there is evidence that smokers may be less likely to get mammograms and regular exercise (Orleans, Rimer, Salmon, & Kozlowski, 1990; Rimer et al., 1990; McBride, Curry, Taplin, Anderman, & Grothaus, 1993), and women who practice more health promoting behaviors report a more favorable health status (Lane et al., 1996). Neither health behaviors nor their consequences exist in a vacuum.
An assessment of women's health habits and risk factors indicates that there is much room for improvement. Currently, nearly 25% (more than 22 million women) of women are current cigarette smokers, 20% have cholesterol of 240 mg/dl or greater, 20% have high blood pressure, and 35% are obese. Moreover, 73% of adult women do not report regular participation in aerobic exercise, and minority women and those with lower levels of education are the most likely to be sedentary. Most women still are not getting regular mammograms or colorectal cancer screening. Clearly, the need for effective women's health promotion has never been greater.
Solutions and programs must be appropriate for women, that is, reflect the psychological, social, economic and political realities of women's lives. Ruzek and Hill (1986) stressed the need for positive health information reflective of women's own experience of health and illness. Consequently, effective health promotion strategies must be drawn from a continuum of interventions that can be applied not only at the individual, family, and organizational levels but also at the community and policy levels (Chesney & Ozer, 1995). Interventions also must reflect life-span needs and concerns unique to women. Moreover,