Chapter 2: Prevention, Health, and Wellness

Introduction

In 1979, following the Surgeon General's report on the health of the nation, the U.S. government developed a national prevention agenda. Today, the Office of Disease Prevention and Health Promotion in the Department of Health and Human Services oversees this agenda through Healthy People 2020.^17,24,25 The vision for Healthy People 2020 is "a society in which all people live long, healthy lives." The four overarching goals of this agenda are: (1) attain high quality, longer lives free of preventable disease, disability, injury, and premature death; (2) achieve health equity, eliminate disparities, and improve health of all groups; (3) create social and physical environments that promote health for all; and (4) promote quality of life, healthy development and healthy behaviors across all life stages.

Key Terms and Concepts

Health. General physical, mental, or spiritual condition of the body.^23,24

Wellness. A state of good health²³ often achieved through healthy lifestyle choices including the following six dimensions of wellness described by the National Wellness Institute¹⁵:

• Social: Interacting and contributing to one's community or environment.

• Occupational: "Personal satisfaction and enrichment in one's life through work."

• Spiritual: Finding and living a life that has meaning and purpose.

• Physical: Making appropriate nutritional choices and participating in regular physical activity.

• Intellectual: Actively using your mind to develop new skills and learn new information.

• Emotional: Accepting and managing our feelings in all personal interactions.

Health promotion. Contributing to the growth and development of health^2,23

Health-Related Quality of Life (HRQOL). The total effect of individual and environmental factors on function and health status, including physical, psychological, and social components.² Between 2004 and 2008, 16.3% of persons in the United States rated the HRQOL as poor to fair.⁶

Fitness and Physical Activity. Refer to Chapter 7.

Role of Physical Therapy in Healthy People 2020

Two examples of Healthy People 2020 goals that physical therapists can help address are found in Table 2.1. When assessing the data related to adult physical activity by age group, the percentage of adults participating in moderate physical activity decreases with age. Data from 2008 shows that 38% of adults aged 18 to 24 years meet the objective, whereas only 26% of adults aged 64 to 75 years do.⁴ Interestingly, the goal of Healthy People 2010 was for 50% of all adults over age 18 to participate in at least 30 minutes of moderate intensity physical activity 5 or more days/week. From 2000 to 2008, the average has been 32%. Adults aged 18 to 24 years reached a peak of 42% in 2003 and have since declined to 38%.⁴