Developing Solutions: Expanding the Focus from the Individual to the Community
"It is unreasonable to expect that people will change their behavior so easily when so many forces in the social, cultural, and physical environment conspire against change. If successful programs are to be developed to prevent disease and improve health, attention must be given not only to the behavior of individuals, but also to the environmental context within which people live."
-Institute of Medicine
In order to develop effective and sustained diabetes and obesity prevention efforts, programs and policies must expand from a focus on individual behavior towards changing food and physical activity environments, thus making healthy lifestyles a viable option for all children and their families. Strategies that focus on individual knowledge and behavior are essential ingredients to practicing healthy lifestyles. However, they are only effective as one piece of a more comprehensive approach that addresses the community context in which individual decisions are made. Lessons from other public health issues — from tobacco to alcohol to seat belts — confirm the need to link behavior to broad systems change. For instance, the greatest reduction in cigarette smoking rates occurred when smoking became less accessible because of higher cigarette taxes and smoking bans in workplaces, restaurants and other indoor spaces. The next wave of obesity and diabetes prevention efforts must shift community norms and resources so that healthy eating and physical activity are the easy, acceptable and accessible choices. The California Endowment's Healthy Eating, Active Communities Program is working to move diabetes and obesity prevention to the next level by initiating systems change efforts to improve food and physical activity environments.
