Dr. Anastasia Snelling is professor and Chair of American University’s Department of Health Studies. Dr. Snelling holds a PhD in Counseling and Development and an MS in Health Fitness Management from American University in Washington, D.C., along with a BS in Clinical Dietetics from the University of Connecticut. She has been a member of the Academy of Nutrition and Dietetics as a registered dietitian for more than 30 years.
NutritionED.org had the privilege of corresponding with Dr. Snelling by email. She took the time to share insights on how the field of health promotion is providing practical solutions to America’s biggest health concerns through nutritional literacy and prevention, marshalling community resources, and empowering individuals through education.
Living healthier is a goal shared by millions of Americans. For most of us, it’s all about feeling better in general — eating healthier, exercising more, and replacing unhealthy habits with ones we can feel better about. For others, it’s a health scare or battle with chronic illness that makes adopting a healthier lifestyle imperative.
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The information we need to make better choices for ourselves is certainly out there. But the challenge of wading through it all and trying to sift out sound advice from the endless stream of new diets and health fads can be a non-starter for many of us trying to make better-informed choices.
The reality of just how confused most of us are about nutrition comes starkly into focus when you ask people to assess their own eating habits.
The CDC’s National Health and Nutrition Examination Survey (NHANES) for 2015-16 and 2017-18 asked 9,700 people to rank their own diets based on their best understanding of proper health and nutrition. The findings were stunning – nearly 85% of survey participants missed the mark in assessing their own nutritional intake. And as you probably already guessed, the overwhelming majority of them believed the quality of their diets to be much better than they actually were.
This lack of nutritional literacy comes with severe consequences. CDC statistics show that 74% of adults in the US are overweight or obese. Ninety-six million are prediabetic. And a full 33% of deaths in America result from some sort of cardiovascular disease. Lifestyle and diet are a factor in every one of these startling statistics.
According to Dr. Snelling, part of the solution to this deadly dilemma lies in empowering people to make informed decisions about their own health. But that sort of empowerment requires more than just good advice about diet and exercise.
Promoting healthier habits, even within a single community, is a complicated business with many factors in play. Dr. Snelling makes no bones about exactly what’s involved.
“A greater focus on individual empowerment and personal responsibility for health requires social, environmental, educational, financial, and cultural supports.”
That’s why the evolving field of health promotion aims to build targeted supports in communities across the world by changing the perception of what it means to live healthy, educating people on how they can take matters into their own hands, and making the healthier choice the easier and more accessible one.
What is Health Promotion?
What Can You Do With a Health Promotion Degree?
What is Health Promotion?
But what is health promotion and how does it create real-world change? How does someone even begin to enter such a dynamic field?
Health promotion is a field focused on empowering people to make informed choices for themselves. It resides on the prevention side of the healthcare industry, with the goal of helping individuals and communities adopt healthier habits to prevent and reverse lifestyle related disease.
As Dr. Snelling points out, health promotion is an inherently interdisciplinary undertaking.
“Health promotion is a behavioral social science that draws from multiple disciplines to promote health and prevent disease and premature death through education and policy-driven activities.”
Every initiative needs to be accessible to the communities it’s designed to serve, and backed by the political will and funding necessary to get it off the ground. And that means every initiative takes teamwork, and every player on the field needs a clear understanding of how each piece comes together to make the campaign successful.
Health Promotion Found It’s First Official Definition in 1986
At the First International Conference on Health Promotion in 1986, the World Health Organization (WHO) outlined the five key components to a successful health promotion initiative. It’s a heavy lift that requires legislators, community leaders and their constituents, and health services providers to all be pulling in the same direction at the same time. The key elements of health promotion may have roots going back to the health and wellness revolution of the 80’s, but they are as relevant today as they were then.
Health Legislation
Health promotion works on the principle that when the healthier choice is the most attractive and accessible one, it’s the one people are more likely to go for. Finding the resources necessary to put healthier options in front of people is something that often has to start in the halls of legislation.
When former First Lady Michelle Obama sponsored the Healthy, Hunger-Free Kids Act of 2010, she set out to bring balance to the food options available in schools. Under the law, school cafeterias are required to follow data-informed nutritional guidelines as outlined by the Department of Agriculture. Without it, schools may have had little motivation or funding to make such drastic changes.
This legal maneuvering is essential to real, lasting change. And this bears out in very real ways. A study published in the peer-reviewed journal Health Affairs showed how obesity rates among impoverished children could have been 47% higher by 2018 had the bill never been drafted.
Healthy Environments
Health promotion extends beyond behavioral and lifestyle factors. Everything from our drinking water to the conditions in which we work to the air we breathe can affect our health. Health promotion initiatives take all these factors into account.
Healthcare professionals in mining communities and places with a high concentration of jobs in manufacturing, for example, are faced with the reality of how industrial by-products affect worker health. On top of being on the front lines gathering patient data and participating in workplace safety initiatives, every patient appointment becomes an opportunity to discuss steps that can be taken to mitigate exposure.
You’ll find physicians and nurses doing the same thing in communities across America, addressing public health concerns endemic to the area, from opioid abuse to water quality issues to a lack of access to nutritious foods.
Supporting Community Efforts
Dr. Snelling describes her field as an “art and a science.” That succinct and accurate phrase describes how health promotion advocates are putting ownership of community health back in the hands of individual community members through some creative thinking.
Financially and otherwise, communities ultimately bear the burden of a population in poor health. So, there’s a real incentive for every community member to take ownership of their own health, and just as much incentive for community leaders to engage the communities they serve by promoting fun initiatives designed around prevention.
The most successful campaigns are built around getting community members involved in community-building events that get people outside and moving and spreading the joy of healthy living among friends and neighbors. It’s up to community leaders to help make the concept of individual and community health relevant to everyone.
Helping Individuals Develop Personal Skills
When people think of health promotion, they think of district-level healthy eating programs in their kids’ school cafeteria, or the posters promoting health screenings they see over head in the light rail on their morning commute.
While it might all seem limited in scope, the messaging sticks in peoples’ heads, encouraging them to stay on top of changing health concerns at different stages in life.
Take, for example, a 2017 Australian campaign promoting bowel cancer screenings. The TV spots ran for only seven weeks and only in Victoria. This allowed for an easy side-by-side comparison of the number of screenings taking place in neighboring areas where the ads didn’t run.
Researchers found that while the ads were running, screenings increased dramatically in Victoria. The campaign even caused a rise in clinical visits among population groups that historically rarely went in for screenings.
But there’s more happening here to promote prevention and wellness than just cancer screenings. Consider what happens when people who don’t normally visit the doctor decide to go. They register as new patients with healthcare providers in their area. They begin to address other health concerns. And their attitudes change as they learn to discuss their own health and connect with a community that’s there to help them.
Through targeted outreach like this, people learn to confront health issues that have the potential to pose serious problems down the road.
Reorienting Healthcare Services
As Dr. Snelling states, health promotion is a behavioral social science focused on approaching health issues within their own unique contexts with prevention being the goal. Conventional medicine, on the other hand, is more about treating symptoms and conditions following the allopathic method. Bringing these different approaches together is one of the main goals in the field of health promotion.
Statistics about healthcare access clearly show the need for a more prevention-focused approach to healthcare. In 2018, the National Opinion Research Center (NORC), a massive social research organization founded in 1941, found that 44% of Americans skipped going to the doctor when they needed to because of the cost. A similar proportion reported skipping recommended tests or treatments for the same reason.
With an eye toward solving problems at the system-level, the field will be on the frontlines of restructuring healthcare to help avoid such issues and bring more people into the fold.
What Can You Do With a Health Promotion Degree?
Health promotion experts at every level bring a diverse set of skills and knowledge to the table. They need to be up on the latest in health and medical research, be familiar with compliance laws and public policy, and in many roles, they also need to know a thing or two about organizational management. A bit of psychology doesn’t hurt either when it comes to encouraging people to take ownership of their own health.
Today, master’s-level health education and health promotion degrees aim to cover all those topics with classes that center on:
- Health and medicine
- Organizational structuring and management
- Quantitative and qualitative research methods
- Health education
- Programming development and administration
- Public health policy and promotion
- Specific and relevant health topics like nutrition, exercise, mental health, and disease prevention
Typically, these programs require students to have a bachelor’s degree, but not necessarily a bachelor’s in health education or health promotion. The field needs talented and impassioned individuals of all kinds, and academic training in other disciplines can often be seen as an advantage.
For example, a business undergrad with a passion for health and fitness might pursue a master’s in health promotion to add a layer of scientific understanding to their already robust organizational development skills. On the other end of the spectrum, a seasoned RN or allied health professional could pursue a master’s in health promotion as a way to transition from direct patient care to policy work.
At American University (AU), Dr. Snelling has guided the development of the comprehensive health promotion curriculum to support student achievement. As Snelling explained, “Our students go on to work in corporate health promotion, healthcare organizations, nonprofits, schools, universities, government and community organizations.” She also notes that every AU graduate who has gone on to take the Certified Health Education Specialist exam has passed.
Health promotion spans an array of professions across a number of industries, from policy-oriented roles to hands-on community advocacy work. Here are just five careers that shape the field into the rich, multidisciplinary tapestry it is today.
Community Health Specialist
Community health specialists are responsible for conducting community health research, guiding and organizing health education programs, and doing a bit of marketing to reach people who need help the most.
As the name suggests, community health specialists work more with groups of people than individuals. They are often employed with:
- Private companies
- Religious organizations
- Schools
- Federal, state, and local governments
- Healthcare providers and facilities– from nursing homes to outpatient care facilities
Though this role is focused on administrative work, community health specialists are often the go-to people for questions about health and health-related programs.
Onsite Wellbeing Coordinator
Also called workplace or onsite wellness specialists, wellbeing coordinators are like community health specialists, but tend to work in a more hands-on capacity with people in their workplaces. They often coordinate events like free health screenings, conduct employee orientations in coordination with HR staff, and appoint workplace health ambassadors.
Onsite health coordinators work for both public and private employers. Since the onsite health coordinator is often the face of an organization’s health promotion activities, they must be approachable, friendly, and trustworthy. On top of that, a real working knowledge of the unique health risks that the workplace communities they serve are exposed to is central to this role.
Health Promotion Program Coach
Health coaches help people reach their personal health goals. They might help a person find the right research-backed diet, exercise routine, stress management technique, or anything else that could help promote health and longevity. Most importantly, health coaches make sure the resources clients need to achieve their goals are both practical and accessible.
Many companies offer health coaching to their employees through wellness programs. Insurance companies, healthcare organizations, and fitness centers sometimes have their own health coaching staff as well.
In some cases, health coaches have a defined area of expertise. Some become sports nutritionists at gyms or for collegiate and professional teams. Others opt to pivot into roles as exercise coaches in similar capacities.
Health Communication Specialist
Health communication specialists are experts in the art of marketing and communication. They’re involved in every aspect of developing and disseminating the public health messaging we see in everything from social media marketing campaigns to conventional printed media, billboards and posters. It’s their job to make sure messaging is clear and consistent across every channel it’s delivered through, and always well-aligned with the goals of the campaign.
And when you consider that big public health initiatives are almost always a team effort that relies on multiple organizations and contractors in the media space, you start to appreciate how vital inter-organizational communication is to the success of these campaigns. That means the work that health communication specialists do is also about keeping campaign messaging well-aligned across partner organizations, and between management teams, internal stakeholders, and outside contractors.
There’s a lot of careful planning and execution involved in media strategy, and health communication specialists are there to bring it all together and ensure a successful campaign.
Health Policy Specialists
Policy specialists work with everyone from lawmakers to health system executives to make healthcare services and healthy options more accessible to the communities they serve. They conduct research, apply for funding, create presentations, and advocate for health policies that align with community goals. Along with having a real understanding of matters concerning community and individual health, health policy specialists must be skilled at navigating the legal, political, and financial avenues necessary to make health services more accessible.
Whether at the local, state, or federal level, the goal of health policy is to enact laws and implement programs that create an environment where people have access to healthy choices and preventative healthcare services. This often means getting buy-in from the legislators who can greenlight community programs as well as the local leaders, industry groups, and employers that may be involved in rolling those programs out. This is a job that involves liaising with state and federal agencies, company representatives, and healthcare providers, bringing stakeholders together to make health promotion initiatives a reality.
The Hunger-Free Kids Act that brought healthier food options to school cafeterias by establishing nutritional standards and the Affordable Care Act that made healthcare accessible to millions of Americans represent two of the biggest health policy wins in recent memory.
Health promotion is a field with many well-defined professional roles, all involved in putting resources to work to promote healthier communities. But it’s a lot more than that. It’s also the idea that there is a smarter way of thinking about community health and a better way to promote healthy living and longevity. And that idea has sparked a movement that’s not only making resources more accessible to underserved communities, but that is also empowering people through education to live their best lives by making healthier choices.