Health Promotion and Disease Prevention Initiatives

Negative health behaviors such as smoking, excessive alcohol use, having an unhealthy diet, engaging in risky sexual activity, and leading a sedentary lifestyle are costly to individuals, families, and society as a whole (CDC, 2017). These costs often include the actual monetary costs of health problems and increased medical care, years of potential life lost, and loss of potential productivity (Sculpher, 2001). When individuals engage in unhealthy activities and/or forego participating in healthy ones, it can have a lasting effect on their overall health and mortality (Behrens et al., 2013; Booth, Roberts, & Laye, 2012; McCullough et al., 2011).

Negative health behaviors can increase the risk of morbidity, mortality, and poor quality of life. For example, according to Behrens et al. (2013), non-smokers live an average 6.5 years longer than smokers. If this statistic is broken down to a smaller time unit, each cigarette smoked reduces a person’s life by approximately 11 minutes. Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including nearly 42,000 deaths resulting from secondhand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day (Health & Services, 2014). 

Cigarette smoking is perhaps the most preventable cause of premature morbidity and mortality. Smoking harms every organ in the body, people who smoke also put themselves at risk for chronic diseases that accompany smoking (Control & Prevention, 2005). These diseases include heart attack, stroke, lung diseases, and many different types of cancer (Jha et al., 2013).

Not only is tobacco use costly to one’s health it also costly monetarily. Experts estimate that complications caused by smoking the United States cost $96.8 billion in lost productivity per year and takes over 480,000 lives per year (Maciosek, Xu, Butani, & Pechacek, 2015). These diseases not only reduce the amount of years a person lives but also reduces their quality of life.

Another negative health behavior that is associated with significant costs to Americans is excessive alcohol use. Heavy or excessive alcohol use can cause deleterious health outcomes such as liver cirrhosis, pancreatitis, and various cancers (Johnson et al., 2014). People who drink excessively can shorten their life span by an average of 30 years (Johnson et al., 2014; Sacks, Gonzales, Bouchery, Tomedi, & Brewer, 2015). Excessive alcohol consumption costs the nation almost $250 billion in 2010 (Sacks et al., 2015). Two of every $5 of that total cost was paid by government; three quarters of the costs were due to binge drinking, and nearly 88,000 lives are lost per year (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011; Control & Prevention, 2013). Alcohol abuse can also lead to issues with absenteeism from work, job loss, family problems, and mood swings (Brick, 2012).

Similar to smoking and drinking alcohol, eating an unhealthy diet can lead to poor health, specifically obesity, hypertension, and diabetes (Bauer, Briss, Goodman, & Bowman, 2014). Obesity that is caused by unhealthy diets and sedentary lifestyle causes many other diseases. More than 29 million people in the United States have diabetes, up from the previous estimate of 26 million in 2010 (Rowley, Bezold, Arikan, Byrne, & Krohe, 2016). Not only is the prevalence of diabetes expected to grow but also increasing is the amount of money needed to care for those who have diabetes - $245 billion in 2013 (Association, 2013). Diabetes is the seventh leading cause of death for American adults (Bauer et al., 2014; Kochanek, Murphy, Xu, & Arias, 2014).   


Very similar to an unhealthy diet, a sedentary lifestyle can reduce a person’s expected lifespan by increasing their risk of chronic diseases. A sedentary lifestyle can lead to obesity, diabetes, heart disease, and hypertension (Bastien, Poirier, Lemieux, & Després, 2014). These diseases can in turn result in early morbidity, reduced quality of life, and premature mortality (Wilmot et al., 2012). 

Another costly health practice is unsafe sexual behavior. This includes not using condoms when having sexual intercourse, especially with new or multiple sexual partners. Approximately 41% of high school students said they did not use protection the last time they had sex (Kann et al., 2014). This risky sexual behavior can result in sexually transmitted infections (STI) or an unintended pregnancy. CDC’s estimates in 2013 for STI’s 

show that there are about 20 million new infections in the United States each year, costing the American healthcare system nearly $16 billion in direct medical costs alone (Control & Prevention, 2014).

Costs of Unhealthy Behaviors on Families

When individuals engage in negative health behaviors or do not adopt health-promoting behaviors, it also negatively impacts their family members. Smoking, excessive alcohol use, having an unhealthy diet, engaging in unprotected sexual activity, and leading a sedentary lifestyle all have an impact on the family (Taylor, Repetti, & Seeman, 1997). One major impact of all of the negative health behaviors listed includes loss of productivity and employment resulting in less potential income to support a family financially (Zhang, Bansback, & Anis, 2011). 

Poor health behaviors have a trickle-down effect for families. More specifically if a member of the family smokes, they are putting their family members at risk for second and third hand smoke. Second and third hand smoke results in breathing issues especially in children such as asthma, bronchitis, and chronic pulmonary obstruction disorder (Morrison, Fraser, Lurie, Travis, & Leader, 2012). Children of parents who smoke are also more likely themselves to smoke as they grow older (Schuck, Otten, Engels, & Kleinjan, 2012). Learned behavior from parents can have a powerful impact on a child’s future habits. For example, unhealthy diets among parents can cause a whole family to eat unhealthy and lead to obesity in children and long-term effects on food preferences of children (Larsen et al., 2015).

Funding Parameters and Criteria for Applications

Request for Applications

The American Society for Health Improvement (ASHI) is requesting applications that will address and overcome specific barriers that impede positive healthy behaviors and positive health outcomes within a specific priority population. Successful applications will establish targeted programs, policies, and/or systems that address specific variables that impact positive health promotion or disease prevention. For example, applicants may:

1. Implement a theory-based intervention that will reduce a specific negative behavior and/or increase a positive, health promoting behavior within a specific priority population.
2. Implement health education and outreach through the use of experienced community health workers and/or patient navigators with existing community-based partnerships.
3. Implement an effective health communication campaign or communication system that includes theory-based communication and decision aids to motivate healthy behavior.
4. Provide programs that improve participants’ access to and use of health education or medical services (e.g., mammography) as part of a comprehensive approach to reducing barriers to positive health behaviors. Note: Programs attempting to increase a specific health screening test in a specific priority population must provide means for program participants to easily and inexpensively receive needed follow-up tests and treatment – if their screening test was positive.
5. Systematically track, measure and report positive health behaviors, screening behavior (e.g. mammogram rates), or health outcomes by race, SES, and ethnicity.
6. Implement or enhance institutional or community policies that identify at-risk individuals and actively engage them in health promotion/disease prevention.

Applicants should use a comprehensive approach and strive to implement various evidence-based approaches that influence various levels of socio-ecological influence. Priority will be given to applications that implement theory-based, multiple strategies at multiple levels of ecological influence and at multiple levels of prevention. Applicants must clearly indicate what level(s) of the socio-ecological model and what level(s) of prevention they are targeting with their grant activities.

Eligible Applicants

Applicants must meet the following requirements:

1. Must be a public health major, premed/public health major, or public health minor.
2. Lives within the same geographical region of the priority population.
3. Documented history of success in designing and implementing health promotion/disease prevention programs.
4. Demonstrate capacity to execute the proposed plans described in the application.
5. Demonstrate collaborative partnerships with other agencies and/or organizations.
6. If the applicant’s program is focused on increasing screening behavior, the applicant must agree to provide follow-up tests and treatment for individuals who have a positive screening test at no cost to the individual regardless of his/her ability to pay (Please note: We will not fund any application that has screening as a component if it does not meet this requirement)

Sample Solution