Spiritual_Wellness_Holistic_Health_and_the_Practic

328 Philosophical Foundations of Health Education
schools (Krieger & Lashof, 1988) and the general community (Rundall & Phillips,
1990). More recent advocacy approaches have focused on developing consortium
approaches to the delivery of HIV services (McKinney, 1993), and have been used to
develop community - based HIV prevention programs for Americans of Asian and
Pacific Islander backgrounds (Wong, Chng, & Lo, 1998). Targeted educational interventions,
which have included organizational change policy, directed at female bar
workers and the managers of the establishments in which they are employed have
demonstrated significant reductions in STD and prevention of HIV infection (Morisky
et al., 1998).
Racial and Ethnic Minorities
Advocacy approaches have been used in numerous efforts by health educators and
other professionals to reduce health disparities for racial and ethnic minorities. These
include reducing teenage pregnancy (Liburd & Bowie, 1989), improving access to
health services for the Latino population in St. Louis (Baker et al., 1997), mobilizing
minority communities in Indiana to facilitate enactment of legislation for a minority
health initiative to reduce preventable disease (Russell, 1997), and developing
improved community - wide asthma care for low - income minority populations (Wilson
et al., 1998).
Youth Violence
Advocacy has been used as a public health strategy in the prevention of youth violence
(Cohen & Swift, 1993). These efforts have resulted in laws being passed at the local
and state levels that make it more difficult for young people to purchase handguns and
other firearms. A model program that relies heavily on advocacy, and that has been
effective in bringing about changes in media coverage of the issues, as well as community
and policy change, is the California Violence Prevention Initiative (California
Wellness Foundation, 1994). This multiple - component advocacy effort was designed
to reduce violence among youth and young adults. The initiative included policy
development, community action programs, leadership development, public education,
and research. Through such advocacy, communities throughout California have been
able to promote and enact gun - control legislation at both the state and local levels
(RAND and Stanford Center for Research in Disease Prevention, 1997).
CONCLUSION
Despite the overall decline in mortality rates in recent decades, there is persuasive
evidence (only a small portion of which could be reviewed here) that disparities in
health are increasing along the lines of race and ethnicity. This is especially troubling
given that America ’ s population is projected by demographers to grow even more
racially and ethnically diverse in the next century. Advocacy will become increasingly
necessary if we are to stimulate the community political action and economic and