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Note: This blog has been reprinted with permission based on a recent listserv post from Paula Swinford, the Director of Wellness and Health Promotion at the University of Southern California.

A Student Affairs colleague asked the other day: What is the difference between prevention and health promotion?

I rattled off an answer, but I wanted to clarify because this distinction is essential to the success of the growing student wellbeing conversations that are taking place on campuses across the nation. When it comes to prevention and health promotion, institutions of higher education need to be doing both. While overlap between the two exists, we sometimes must contrast before we can compare and, ultimately, appreciate this overlap.

At the University of Southern California, the Division of Student Affairs mission is to strengthen a culture driven by student well-being. We do this through our ability to support, educate, and engage while addressing our four goals for 2020.

Generally, well-being is defined as a good or satisfactory condition of existence; a state characterized by health, happiness, and prosperity; our collective welfare. There is a great deal of scientific research around well-being. There is little research around wellness, which is defined subjectively as an optimal state of health. To get to student well-being at USC we have set four goals, which I imagine these would easily fit on almost any college campus these days.

  1. Enhance the culture of equity, diversity, and inclusion.
  2. Cultivate a culture where individuals and communities thrive.
  3. Disrupt the culture of at-risk substance use.
  4. Foster a culture of consent and healthy relationships.

What is at the core of these four goals?

To a physician these are public or population health goals, because that delineates them from the individual health practiced most often in our current medical system. However, a student affairs professional could just as correctly say these four goals are learning environment goals, goals for global citizens, or appropriate young adult (student) development goals. All are correct. Each is a unique professional lens, perspective, or filter.

What each of these professional lenses has in common is the desire for more capacity: to become more able or more whole. This includes the capacity to live fully, to bring more than you thought you could to life, and, through the shared experience of community, to become even more able in ways one could never be as an individual.

In many circles, health is synonymous with capacity.

Health care is capacity care and repair provided by professionals most often after the fact. These professionals are qualified by licensing entities to provide this care and repair.

Prevention is reducing risks to capacity. For example, when a fire happens in a building, prevention is the act of enacting or enforcing building codes for insulation, ensuring adequate room capacities, clearly marking exits, etc. Effective prevention requires data, critical thinking, engineering, enforcement, and clear instruction.

Health promotion is a process of enabling the community to create capacity enhancement in ways that extend beyond repair and risk reduction.

Enhanced capacity makes it easier to repair.

Enhanced capacity adds resilience when activities require risk.

Enhanced capacity expands the quality and sustainability of the ecosphere.

By design, health promotion is grounded in community development, not in delivery from a licensed service provider. The Health Promotion process is open to all of us, thus the state has not licensed any one profession to provide it. This makes it a very special process. However, there are those who are more skilled in facilitating the process and have a content knowledge of what has worked in the past. Effective health promotion requires data, critical thinking, community engagement, personal skills, policy analysis, and consideration of the built environment. The health promotion process also asks health care and safety providers to reorient towards prevention.

For a thought experiment, you might consider a community of middle school children. There is a system to repair their capacity in the school nurse and universal access to the health care delivery sector.  There is a system to identify and reduce risks in the safety specialists who have installed hand sanitizer, fire extinguishers, and the capacity regulations that exist within the building.  What would this community of middle school children want to do to create capacity enhancement? That system is the process of health promotion.

Health promotion is the process of enabling people (communities) to increase control over, and to improve, their health (capacity). It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions.

This International Charter asks those who would shepherd the health promotion process to Advocate, Enable, and Mediate.

These are partnering actions rather than service provider actions. Partner with your populations and see where it leads. The end result may be a new future for Student Affairs.

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