In this article, human ecology is defined; its historical and intellectual roots are traced through various disciplines to its applications in public health and health promotion today; its strengths and limitations are described; some potential contributions of systems theory are suggested; and some emerging ecological models of health promotion are anticipated.
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References
1.
StokolsD. Establishing and maintaining healthy environments: toward a social ecology of health promotion. Am Psychol1992;47:6–22.
2.
RichardLPotvinLKishuckNPrlicHGreenL. Assessing the integration of an ecological approach in health promotion programs. Am J Health Promot1996;10:318–28.
3.
LabonteR. Death of program, birth of metaphor: the development of health promotion in Canada. In: PedersonAO'NeillMRootmanI, editors. Health promotion in Canada: provincial, national and international perspectives. Toronto: Saunders Canada, 1994:72–91.
4.
PinderL. The federal role in health promotion: art of the possible. In: PedersonAO'NeillMRootmanI, editors. Health promotion in Canada: provincial, national and international perspectives. Toronto: Saunders Canada, 1994:92–106.
5.
GreenLWOttosonJM. Community ecology, organization, and health. Community health. 7th edition. St. Louis: Times Mirror–Mosby College, 1994:31–61.
6.
RogersES. Human ecology and health: an introduction for administrators. New York: Macmillan, 1960.
7.
RosenG. A history of public health. New York: MD Publications, 1958.
8.
SydenstrickerE. Health and environment. New York: McGraw-Hill, 1933.
9.
BrownERMargoGE. Health education: Can the reformers be reformed?Int J Health Serv1978;8:3–25.
10.
FreudenbergN. Shaping the future of health education: from behavior change to social change. Health Education Monographs1978;6:372–7.
11.
GreenLW. National policy in the promotion of health. International Journal of Health Education1979;22:161–8.
12.
AllegranteJPGreenLW. When health policy becomes victim blaming. N Engl J Med1981;305:1528–9.
13.
ParkREBurgessEWMcKenzieRD, editors. The city. Chicago: University of Chicago Press, 1925.
14.
GriffithsWKnutsonAL. The role of mass media in public health. Am J Public Health1960;50:515–23.
15.
LionbergerHF. Application of diffusion research in agriculture to heart disease control. Berkeley: California State Department of Public Health, 1964.
16.
LowrySGMayoSCHayDG. Factors associated with the acceptance of health care practices among rural families. Rural Sociology1958;23:198–202.
17.
YoungMAC. Review of research and studies related to health education communication: methods and materials. Health Education Monographs1967;1(25):18–24.
18.
GreenLW. Identifying and overcoming barriers to the diffusion of knowledge about family planning. Advances in Fertility Control1970;5:21–9.
19.
RogersEM. Communication strategies for family planning. New York: Free Press, 1973.
20.
GreenLW. Diffusion and adoption of innovations related to cardiovascular risk behavior in the public. In: EnelowAJHendersonJB, editors. Applying behavioral science to cardiovascular risk. New York: American Heart Association, 1975.
21.
AndersonOW. Infant mortality and social and cultural factors: historical trends and current patterns. In: JacoEG, editor. Patients, physicians and illness. Glencoe, IL: Free Press, 1957:10–24.
22.
AndersenR. A behavioral model of families' use of health services. Chicago: University of Chicago, Center for Health Administration Studies, Research series No.25, University of Chicago Press, 1968.
23.
CroogSH. Ethnic origins, educational level, and responses to a health questionnaire. Human Organization1961;20:65–9.
24.
FriedsonESilverGA. Social science in family medical care. Public Health Rep1960;75:489–93.
25.
GrayRMKeslerJPMoodyPM. The effects of social class and friends' expectations on oral polio vaccination participation. Am J Public Health1966;56:2028–32.
26.
HollingsheadABRedlichFC. Social class and mental illness: a community study. New York: Wiley, 1958.
27.
LambertC.JrFreemanHE. The clinic habit. New Haven, CT: College and University Press, 1967.
28.
SuchmanEA. Sociology and the field of public health. New York: Russell Sage, 1963.
29.
BarkerRG. Explorations in ecological psychology. Am Psychol1965;20:1–14.
30.
BaerDM. A note on the absence of a Santa Claus in any known ecosystem: a rejoinder to Willems. J Appl Behav Anal1974;7:167–70.
31.
WillemsEP. Behavioral technology and behavioral ecology. J Appl Behav Anal1974;7:151–65.
32.
Rogers-WarrenAWarrenSF. Ecological Perspectives in Behavior Analysis. Baltimore: University Park Press, 1977.
33.
HovlandCJanisILKelleyHH. Communication and persuasion. New Haven, CT: Yale University Press, 1953.
34.
FlayBR. Social psychological approaches to smoking prevention: review and recommendations. In: WardWBMullenPD, editors. Advances in Health Education and Promotion, vol.2, Greenwich, CT: JAI Press, 1987:121–80.
35.
WordenJKFlynnBSGellerBM. Development of a smoking prevention mass-media program using diagnostic and formative research. Prev Med1988;17:531–58.
36.
LewinK. Forces behind food habits and methods of change. Bulletin of the National Research Council1943;108:35–65.
37.
NyswanderDB. Solving school health problems. New York: Oxford University Press, 1942.
38.
MorganLSHorningBG. The community health education program. Am J Public Health1940;30:1323–30.
39.
SteuartGW. Health, behavior and planned change: an approach to the professional preparation of the health education specialist. Health Education Monographs1965;1(20):3–26.
40.
MicoPR, editor. The heritage collection of Health Education Monographs (4 vols.). Oakland, CA: Third Party Associates, 1982.
41.
ChavisDMWandersmanA. Sense of community in the urban environment: a catalyst for participation and community development. Am J Community Psychol1990;18:55–81.
42.
MillerNE. Learning: some facts and needed research relevant to maintaining health. In: MatarazzoJDWeissSMHerdJA, editors. Behavioral health: a handbook of health enhancement and disease prevention. New York: Wiley, 1984:199–208.
43.
BanduraA. Social learning theory. Englewood Cliffs, NJ: Prentice-Hall, 1977.
44.
ClarkNM. Social learning theory in current health education practice. In: WardWBSimondsSKMullenPDBeckerMH, editors. Advances in health education and promotion, vol. 2. Greenwich, CT: JAI Press, 1987:251–75.
45.
ParcelGSBaranowskiT. Social learning theory and health education. Health Education1981;12(3):14–8.
46.
DeweyJ. The public and its problems: an essay in political inquiry. Chicago: Gateway Books, 1946.
47.
AndersonCCreswellWH. School health practice. 8th ed.St. Louis: Times Mirror/ Mosby, 1985.
48.
KolbeLJ. Increasing the impact of school health promotion programs: emerging research perspectives. Health Education1986;17(5):47–52.
49.
ParcelGSSimons-MortonBGKolbeLJ. Health promotion: integrating organizational change and student learning strategies. Health Educ Q1988;15:435–50.
50.
HayesMVFosterLFosterH. Community environment and health. Western Geographic Series 27. Victoria, British Columbia: University of Victoria Press, 1992.
51.
HayesMVWillmsManson S. Healthy community indicators: the perils of the search and the paucity of the find. Health Promotion International1990;5:161–6.
52.
McLeroyKRBibeauDStecklerAGlanzK. An ecological perspective on health promotion programs. Health Educ Q1988;15:351–77.
53.
MacDonaldGBunionR. Health promotion, discipline or disciplines? In: BunionR, and MacDonaldG, editors. Health promotion: disciplines and diversity. London: Routledge, 1992:6–19.
54.
ThorogoodN. What is the relevance of sociology for health promotion? In: BunionRMacDonaldG, editors. Health promotion: disciplines and diversity. London: Routledge, 1992:42–65.
55.
GreenLWRaeburnJ. Contemporary developments in health promotion: definitions and challenges. In: BrachtB, editor. Health promotion at the community level. Newbury Park, CA: Sage, 1990;29–44.
56.
MinklerM. Health education, health promotion and the open society: a historical perspective. Health Educ Q1989;16:17–30.
57.
EisenbergL. The human nature of human nature. Science1972;176:123–28.
58.
PaulBD, editor. Health, culture and community. New York: Russell Sage, 1955.
59.
FosterGM. Traditional cultures and the impact of technological change. New York: Harper, 1962.
60.
SellsSB. Ecology and the science of psychology. In: WillemsEPRaushHL, editors. Naturalistic viewpoints in psychological research. New York: Holt, Rinehart, and Winston, 1969:15–30.
61.
GreenLWKrecuterMW. Health promotion planning: an educational and environmental approach. Mountain View, CA: Mayfield, 1991.
62.
SlobodkinLB. Intellectual problems of applied ecology. Bioscience1988;38:337–42.
63.
KayJJSchneiderE. Embracing complexity: the challenge of the ecosystem approach. Alternatives1994;20(3):32–9.
64.
PittmanDJ. The new temperance movement in the United States: What happened to macro-structural factors in alcohol problems?Addiction1993;88:167–70.
65.
KingAW. Considerations of scale and hierarchy. In: WoodleySKayJJFrancisG, editors. Ecological integrity and the management of ecosystems. Delray, FL: St. Lucie, 1993:19–46.
66.
GreenLWLewisFM. Measurement and evaluation in health education and health promotion. Palo Alto, CA: Mayfield, 1986.
67.
FarquharJWFortmannSPMaccobyN. The Stanford five-city project: design and methods. Am J Epidemiol1985;122:323–34.
68.
SalonenJTKottkeTEJacobsDRHannanPJ. Analysis of community based cardiovascular disease prevention studies—evaluation issues in the North Karelia projevt and the Minnesota heart health program. International Journal of Epidemiology1986;15:176–82.
69.
JacobsDRLuepkerRVMittelmarkMB. Community-wide prevention strategies: Evaluation design of the Minnesota heart health program. Journal of Chronic Disease1986;30:775–88.
70.
LuepkerRVMurrayDMJacobsDRJr. Community education for cardiovascular disease prevention: risk factor changes in the Minnesota heart health program. Am J Public Health1994;84:1383–93.
71.
WagnerEHKoepsellTDAndermanC. The evaluation of the Henry J Kaiser Family Foundation's community health promotion grant program: design. J Clin Epidemiol1991;44:685–99.
72.
SheaSBaschCE. A review of five major community-based cardiovascular disease prevention programs. Part II: Intervention strategies, evaluation methods and results. Am J Health Promot1990;4:279–87.
73.
GreenLWRichardL. The need to combine health education and health promotion: the case of cardiovascular disease prevention. International Journal of Health Promotion and Education1994;1:11–7.
74.
NutbeamDSmithCCatfordJ. Evaluation in health education: a review of possibilities and problems. J Epidemiol Community Health1990;44:83–9.
75.
GreenLWMcAlisterAL. Macro-intervention to support health behavior: some theoretical perspectives and practical reflections. Health Educ Q1984;11:322–39.
76.
BrachtN. Introduction. In: BrachtN, editor. Health promotion at the community level. Newbury Park, CA: Russell Sage, 1990:19–25.
77.
ThompsonBKinneS. Social change theory: application to community health. In: BrachtN, editor. Health promotion at the community level. Newbury Park, CA: Russell Sage1990;45–65.
78.
ElderJPSchmidTLDowerPHedlundS. Community heart health programs: components, rationale, and strategies for effective interventions. J Public Health Policy1993;14:463–79.
79.
BrachtNGleasonJ. Strategies and structures for citizen partnerships. In: BrachtN, editor Health promotion at the community level. Newbury Park, CA: Russell Sage1990;109–24.
80.
GreenLW. Prevention and health education. In: LastJWallaceR, editors. Public health and preventive medicine, 13th ed.Norwalk, CT: Appleton and Lange, 1991.
81.
GreenLW. Refocusing health care systems to address both individual care and population health. Clin Invest Med1994;17:133–41.
82.
FrankishCJGreenLW. Organizational and community change as the social scientific basis for disease prevention and health promotion policy. Advances in Medical Sociology1994;4:209–33.
83.
BoothroydPEherleM. Healthy communities: what they are, how they're made. Vancouver, BC: Centre for Human Settlements Research Bulletin, The University of British Columbia, 1990.
84.
ButterfossFGoodmanRWandersmanA. Community coalitions for prevention and health promotion. Health Educ Res1993;8:315–30.
85.
SheaSBaschCE. A review of five major community-based cardiovascular disease prevention programs. Part I: Rationale, design and theoretical framework. Am J Health Promot1990;4:203–13.
86.
LefebvreRCLasaterTMCarletonRAPetersonG. Theory and delivery of health programming in the community: the Pawtucket heart health program. Prev Med1987;16:80–95.
87.
McAlisterALPuskaPSalonenJTuomllehtoJKoskelaK. Theory and action for health promotion: ilustrations from the North Karelia project. Am J Public Health1982;72:43–50.
88.
NutbeamDCatfordJ. The Welsh heart programme evaluation strategy: progress, plans and possibilities. Health Promotion1987;2:5–18.
89.
MittelmarkMBLuepkerRVJacobsDR. Community-wide prevention of cardio-vascular disease: education strategies of the Minnesota heart health program. Prev Med1987;15:1–17.
90.
CheadleAPsatyBMDiehrP. An empirical exploration of a conceptual model for community-based health promotion. International Quarterly of Community Health Education1992–1993;13:329–63.
91.
MacallanLNarayanV. Keeping the heart beat in gramplan—a case study in community participation and ownership. Health Promotion International1994;9:13–20.
92.
SchwartzRSmithCSpeersMA. Capacity-building and resource needs of state health agencies to implement community-based cardiovascular disease programs. J Public Health Policy1993;14:480–93.
93.
Von BertalanffyL. General system theory: foundations, development, applications. New York: George Braziller, 1968.
94.
MillerGJ. The theory of living systems. McGraw Hill, 1978.
95.
LevineDMGreenLWDeedsSG. Health education for hypertensive patients. JAMA1979;241:1700–3.
96.
MoriskyDEDeMuthNMField-FassMGreenLWLevineDM. Evaluation of family health education to build support for long term control of high blood pressure. Health Educ Q1985;12:35–50.
97.
GreenLW. Individuals vs. systems: an artificial classification that divides and distorts. Health Link1986;2:29–30.
98.
MeekJ. An analysis of comprehensive health promotion program's consistency with the systems model of health. Am J Health Promot1993;7:443–51
99.
NicolasDRGobbleDC. World view, systems theory and health promotion. Am J Health Promot1991;6:30–34, 54.
100.
World Health Organization. Alma-Ata 1978: primary health care. Geneva: World Health Organization, Health for All Series No. 1, 1978.
101.
US Department of Health and Human Services. Promoting health in special populations. Washington, DC: Office of Disease Prevention and Health Promotion 1981. Reprinted in J Public Health Policy1987;8:369–423.
102.
World Health Organization, Health and Welfare Canada, Canadian Public Health Association. Ottawa Charter for health promotion, Can J Public Health1986;77:425–30.
103.
EppJ (1986). Achieving health for all: a framework for health promotion. Can J Public Health1986;77:393–408.
104.
HancockT. Healthy communities: the role of the academic health center. In: SkeltonWDOsterweisM, editors. Promoting community health. Washington, DC: Association of Academic Health Centers, 1993.
105.
World Health Organization. Formulating strategies for health for all by the year 2000. Geneva: World Health Organization, Health for All Series, No. 2, 1979.
106.
MahlerH. The meaning of “health for all by the year 2000”. World Health Forum1981;2:5–22.
107.
GreenLW. New policies for health education in primary health care: background document for technical discussions of the thirty-sixth World Health Assembly, 1983, and questions for consideration by member states. Geneva: World Health Organization, TDs/HED/82.1, 1982.
108.
GreenLW. New policies in education for health. World Health1983;(April-May):13–17.
109.
World Health Organization: New policies for health education in primary care: report on the technical discussions, thirty-sixth World Health Assembly. Geneva: World Health Organization, A36/Technical Discussions/4, 13 May 1983.
110.
GreenLW. Reconciling policy in health education and primary health care. International Journal of Health Education24(suppl 3):1–11.
111.
GreenLW. The theory of participation: a qualitative analysis of its expression in national and international health policies. Advances in Health Education and Promotion1986;1(Pt A): 211–36.
112.
GreenLW. Determining the impact and effectiveness of health education as it relates to federal policy. Health Education Monographs1978;6(suppl 1):28–66.
113.
LalondeM. A new perspective on the health of Canadians. Ottawa: Canadian Department of Health and Welfare, 1974.
114.
LaframboiseHL. Health policy: breaking it down into more manageable segments. Journal of the Canadian Medical Association1973;108:388–91.
115.
Public Health Service. Healthy people: Surgeon General's report on health promotion and disease prevention. Washington, DC: US Department of Health, Education and Welfare, 1979.
116.
US Department of Health and Human Services. Healthy People 2000: national health promotion and disease prevention objectives. Boston: Jones and Bartlett, 1990.
117.
deLeeuwEJJ. Health promotion: the sane revolution. Maastricht, The Netherlands: Van Gorcum, 1989.
118.
GreenLW. Canadian health promotion: an outsider's view from the inside. In: PedersonAO'NeillMRootmanI, editors. Health promotion in Canada: provincial, national and international perspectives. Toronto: Saunders Canada, 1994;314–26.
119.
KickbushI. Approaches to an ecological base for public health. Health Promotion1989;4:265–8.
120.
RaeburnJBeagleholeR. Health promotion: Can it redress the health effects of social disadvantage?Community Health Studies1989, 13(3):289–93.
121.
WinslowC-EA. The unfilled fields of public health. Science, 1920;51:23.
122.
PerreaultRRoyDRenaudL. Promotion de la santé: un exercice de mise en application de la Charte d'Ottawa. Revue Canadienne de Santé Publique1992;83(1):34–7.
123.
CaplanR. The importance of social theory for health promotion: from description to reflexivity. Health Promotion International1993;8(2)47–157.
124.
PolandBD. Learning to “walk our talk”: the implications of sociological theory for research methodologies in health promotion. Can J Public Health1992;83(suppl 1):S31–46.
125.
StevensonHMBurkeM. Bureaucratic logic in new social movement clothing: the limits of health promotion research. Can J Public Health1992;83(suppl 1):S47–53.
126.
CanitzBSmithTBoutilierM. Achieving health for all: a perspective from the field. Can J Public Health1987;78:416–7.
127.
StachenkoSJenicekM. Conceptual differences between prevention and health promotion: research implications for community health promotion. Can J Public Health1990;81:53–9.
128.
HancockT. The evolution, impact and significance of the Healthy Cities/Healthy Communities movement. Journal of Public Health Policy1993;14(1):5–18.
129.
AshtonJ. The Healthy Cities project: a challenge for health education. Health Educ Q1991;18(1):39–48.
130.
ChamberlinRW. Think globally act locally: the WHO Healthy Cities project. Developmental and Behavioral Pediatrics1992;13(5):366–7.
131.
BaumFE. Healthy Cities and change: social movement or bureaucratic tool?Health Promotion International1993;8(1):31–40.
132.
WinettRA. Ecobehavioral assessment in health lifestyles: concepts and methods. In: KarolyP, editor. Measurement strategies in health psychology. New York: Wiley, 1985:147–81
133.
AshmoreWSharerRJ. Discovering our past: a brief introduction to archeology. Mountain View, CA: Mayfield, 1988:189.
134.
AllenJAllenRF. Achieving health promotion objectives through cultural change systems. Am J Health Promot1986;1:42–9.
135.
AllenJAllenRF. A sense of community, a shared vision and a positive culture: core enabling factors in successful culture-based change. In: PattonRDCisselWB, editors. Community organization: traditional principles and modern applications, Johnson City, TN: Latchpin Press, 1990:5–18.
136.
GreenLWKrotkiKJ. Class and parity biases in family planning programs: the case of Karachi. Social Biology1968;15:235–51.
137.
GreenLWKrotkiKJ. Proximity and other geographical factors in family planning clinic utilization in Pakistan. Pakistan Development Review1966;6:80–104.
138.
GreenLW. Should health education abandon attitude change strategies? Perspectives from recent research. Health Education Monographs1970;1(30):25–48.
139.
GreenLW. Toward cost-benefit evaluations of health education: some concepts, methods and examples. Health Education Monographs1974;2(suppl 1):34–64.
140.
QuirkMWapnerS. Notes on an organismicdevelopmental, systems perspective for health education. Health Education Research1991;6:203–10.
