Without intentional and collaborative input from stakeholders and members of the communities we serve, Lifestyle Medicine (LM) is at risk of evolving in ways that are inapplicable and even alienating to diverse and underserved populations. To mitigate this risk, this paper advocates for implementing transdiagnostic, culturally affirmative, trauma-informed, and integrative treatment frameworks that address mental, social, and physical health in tandem. It demonstrates how the Community as Medicine model can bridge the divide between clinical settings such as Federally Qualified Health Centers (FQHCs) and community settings, such as YMCAs, improving accessibility for diverse groups. It also shows how emerging professional identities—exemplified by health coaches—can be cultivated to expand the reach of care while simultaneously opening pathways to employment. By centering inclusivity, cultural affirmation, and interprofessional collaboration, LM can more effectively meet the needs of vulnerable communities and enhance overall public health outcomes.
RileyWJ. Health disparities: gaps in access, quality and affordability of medical care. Trans Am Clin Climatol Assoc. 2012;123:167-172. https://www.ncbi.nlm.nih.gov/pubmed/23303983
2.
SmedleyBDStithAY. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. 1st ed.Washington, DC: National Academies Press; 2003.
3.
WilliamsDRRuckerTD. Understanding and addressing racial disparities in health care. Health Care Financ Rev. 2000;21(4):75-90. https://www.ncbi.nlm.nih.gov/pubmed/11481746. Accessed January 14, 2025.
4.
Office of Disease Prevention and Health Promotion. Social determinants of health. Healthy People 2030; nd.
National Academies of Sciences, Engineering, and Medicine. Federal Policy to Advance Racial, Ethnic, and Tribal Health Equity. The National Academies Press. 2023;36. doi:10.17226/26834
7.
CookJTFrankDA. Food security, poverty, and human development in the United States. Ann N Y Acad Sci. 2008;1136(1):193-209. doi:10.1196/annals.1425.001
8.
KeJFord-JonesEL. Food insecurity and hunger: a review of the effects on children’s health and behaviour. Paediatr Child Health. 2015;20(2):89-91. doi:10.1093/pch/20.2.89
9.
RoyerMFGuerithaultNBradenBBLaskaMNBrueningM. Food insecurity is associated with cognitive function: a systematic review of findings across the life course. Int J Transl Med (Basel). 2021;1(3):205-222. doi:10.3390/ijtm1030015
10.
AndersonEDurstineJL. Physical activity, exercise, and chronic diseases: a brief review. Sports Med Health Sci. 2019;1(1):3-10. doi:10.1016/j.smhs.2019.08.006
11.
DurstineJLGordonBWangZLuoX. Chronic disease and the link to physical activity. Journal of sport and health science. 2013;2(1):3-11. doi:10.1016/j.jshs.2012.07.009
12.
LippmanDStumpMVeazeyE, et al.Foundations of lifestyle medicine and its evolution. Mayo Clin Proc Innov Qual Outcomes. 2024;8(1):97-111. doi:10.1016/j.mayocpiqo.2023.11.004
13.
CarmonaRShurneyD. Future directions for health equity and lifestyle medicine: insights from former US surgeons general. Am J Lifestyle Med. 2022;16(5):594-598.
14.
TaylorLATanAXCoyleCE, et al.Leveraging the social determinants of health: what works?PLoS One. 2016;11(8):e0160217. doi:10.1371/journal.pone.0160217
15.
McGinnisJMWilliams-RussoPKnickmanJR. The case for more active policy attention to health promotion. Health Aff. 2002;21(2):78-93. doi:10.1377/hlthaff.21.2.78
16.
MarmotM. Social determinants of health inequalities. The Lancet (British edition). 2005;365(9464):1099-1104. doi:10.1016/S0140-6736(05)71146-6
17.
BharatiRKovachKASayessPPolkE. Impact of physicians’ perception of social determinants of health (SDoH) on the practice of lifestyle medicine. Findings from a family physicians survey. Am J Lifestyle Med. 2024;15598276241277460. doi:10.1177/15598276241277460
18.
CassoobhoyASardanaJJBenigasSTipsJKeesA. Building health equity: action steps from the American college of lifestyle medicine’s health disparities solutions summit (HDSS) 2020. Am J Lifestyle Med. 2022;16(1):61-75.
19.
NabaweesiRHannaMMuthukaJK, et al.The built environment as a social determinant of health. Prim Care. 2023;50(4):591-599. doi:10.1016/j.pop.2023.04.012
OrthUBerkingMBurkhardtS. Self-conscious emotions and depression: rumination explains why shame but not guilt is maladaptive. Pers Soc Psychol Bull. 2006;32(12):1608-1619. doi:10.1177/0146167206292958
22.
KimSThibodeauRJorgensenRS. Shame, guilt, and depressive symptoms: a meta-analytic review. Psychol Bull. 2011;137(1):68-96. doi:10.1037/a0021466
23.
CândeaDSzentágotaiA. Shame and psychopathology: from research to clinical practice. J Cognitive Behav Psychotherap. 2013;13(1):101. https://www.proquest.com/docview/1439086906
24.
AspholmRR. Deaths of despair: gang violence after the crack crisis. Crit Crim. 2022;30(1):49-69. doi:10.1007/s10612-022-09624-1
25.
StoddardSAHenlySJSievingREBollandJ. Social connections, trajectories of hopelessness, and serious violence in impoverished urban youth. J Youth Adolesc. 2011;40(3):278-295. doi:10.1007/s10964-010-9580-z
26.
KrishnaswamiJSardanaJDaxiniA. Community-engaged lifestyle medicine as a framework for health equity: principles for lifestyle medicine in low-resource settings. Am J Lifestyle Med. 2019;13(5):443-450. doi:10.1177/1559827619838469
27.
Emmert-AronsonBGrillKBTrivediZMarkleEAChenS. Group medical visits 2.0: the open source wellness behavioral pharmacy model. J Altern Complement Med. 2019;25(10):1026-1034. doi:10.1089/acm.2019.0079
28.
RosasLGChenSXiaoL, et al.The effectiveness of Recipe4Health: a quasi-experimental evaluation. Am J Prev Med. 2024;68:377-390. doi:10.1016/j.amepre.2024.10.020
29.
Thompson-LastadAChiuDTRuvalcabaD, et al.Food as medicine, community as medicine: mental health effects of a social care intervention. Health Serv Res. 2025;e14431. doi:10.1111/1475-6773.14431
30.
FratesBBonnetJPJosephRPetersonJA. Lifestyle Medicine Handbook: An Introduction to the Power of Healthy Habits. 2nd ed.Monterey, CA: Healthy Learning; 2020.
31.
DeciELRyanRM. The “what” and “why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inq. 2000;11(4):227-268. doi:10.1207/S15327965PLI1104_01
32.
UemuraKYamadaMOkamotoH. The effectiveness of an active learning program in promoting a healthy lifestyle among older adults with low health literacy: a randomized controlled trial. Gerontology. 2020;67(1):1-11. doi:10.1159/000511357
33.
DevineCMFarrellTJHartmanR. Sisters in health: experiential program emphasizing social interaction increases fruit and vegetable intake among low-income adults. J Nutr Educ Behav. 2005;37(5):265-270. doi:10.1016/S1499-4046(06)60282-0
34.
MortonDRankinPKentLDysingerW. The complete health improvement program (CHIP): history, evaluation, and outcomes. Am J Lifestyle Med. 2016;10(1):64-73. doi:10.1177/1559827614531391
35.
American Diabetes Association. The Diabetes prevention program (DPP): description of lifestyle intervention. Diabetes Care. 2002;25(12):2165-2171. doi:10.2337/diacare.25.12.2165
DalgleishTBlackMJohnstonDBevanA. Transdiagnostic approaches to mental health problems: current status and future directions. J Consult Clin Psychol. 2020;88(3):179-195. doi:10.1037/ccp0000482
38.
MartinPMurrayLKDarnellDDorseyS. Transdiagnostic treatment approaches for greater public health impact: implementing principles of evidence‐based mental health interventions. Clinical psychology (New York, N.Y.). 2018;25(4):e12270. doi:10.1111/cpsp.12270
39.
CroweMJordanJBurrellB, et al.Clinical effectiveness of transdiagnostic health management interventions for older people with multimorbidity: a quantitative systematic review. J Adv Nurs. 2016;72(10):2315-2329. doi:10.1111/jan.13011
40.
SweeneyAFilsonBKennedyACollinsonLGillardS. A paradigm shift: relationships in trauma-informed mental health services. BJPsych Adv. 2018;24(5):319-333. doi:10.1192/bja.2018.29
41.
HarperJ. The Trauma-Informed Coach. Bristol: Right Book Press; 2022.
42.
LevensonJ. Trauma-informed social work practice. Soc Work. 2017;62(2):105-113. doi:10.1093/sw/swx001
43.
StelterR. The Art of Dialogue in Coaching. 1st ed.Milton Park: Routledge; 2018.
44.
MendozaNSMorenoFAHishawGA, et al.Affirmative care across cultures: broadening application. Focus (American Psychiatric Publishing). 2020;18(1):31-39. doi:10.1176/appi.focus.20190030
45.
GlickmanNSGulatiS. Mental Health Care of Deaf People. 1st ed.Milton Park: Routledge; 2003.
46.
FelizVAHobbsSDBorundaR. Strengthen and respect each thread. Int J Environ Res Public Health. 2022;19(21):14117. doi:10.3390/ijerph192114117
47.
NolanTSAlstonAChotoRMossKO. Cultural humility: retraining and retooling nurses to provide equitable cancer care. Clin J Oncol Nurs. 2021;25(5):3-9. doi:10.1188/21.CJON.S1.3-9
48.
HongS. Trauma-informed cultural humility mental health practice: centering history among african American women. Soc Work. 2023;69(1):64-72. doi:10.1093/sw/swad045
Thompson-LastadA. Group medical visits as participatory care in community health Centers. Qual Health Res. 2018;28(7):1065-1076. doi:10.1177/1049732318759528
51.
RussellHASandersMMollLMurphyMLaniganAMCarrollJK. Using a group medical visit model to promote healthy behaviour change with an underserved population. Fam Pract. 2020;37(4):507-512. doi:10.1093/fampra/cmaa028
52.
MenonKMousaAde CourtenMPSoldatosGEggerGde CourtenB. Shared medical appointments may Be effective for improving clinical and behavioral outcomes in type 2 Diabetes: a narrative review. Front Endocrinol. 2017;8:263. doi:10.3389/fendo.2017.00263
53.
KirshSRAronDCJohnsonKD, et al.A realist review of shared medical appointments: how, for whom, and under what circumstances do they work?BMC Health Serv Res. 2017;17(1):113. doi:10.1186/s12913-017-2064-z
Abu DabrhAMReddyKBeechBMMooreM. Health & wellness coaching services: making the case for reimbursement. Am J Lifestyle Med. 2024;15598276241266784. doi:10.1177/15598276241266784
George Family Foundation. YMCA of the north receives $8 million gift for groundbreaking george wellbeing initiative. PR Newswire. 2022. https://search.proquest.com/docview/2720899194. Accessed January 14, 2025.
59.
HoodCMGennusoKPSwainGR, et al.County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med.. 2016;50(2):129-135. doi:10.1016/j.amepre.2015.08.024. 26526164.
60.
HestonASchwartzALJustice-GardinerHHohmanKH. Addressing physical activity needs of survivors by developing a community-based exercise program: LIVESTRONG® at the YMCA. Clin J Oncol Nurs. 2015;19(2):213-217. doi:10.1188/15.CJON.213-217
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