- Bruce Simons-Morton: National Institutes of Health, Bethesda, MD 20892-7510, USA. mortonb@mail.nih.gov
Health is best understood within an ecological context. Accordingly, health promotion involves processes that foster supportive environments and healthful behavior. Thus, effective health promotion programs are typically multilevel, focusing not only on the population at risk but also on the environmental conditions that contribute so importantly to health and health behavior. Health behavior is important at each societal level. Arguably, accomplishment of health promotion goals at each societal level requires changes in the behavior of those who control or influence the health outcomes of interest. Recognition of three distinct types of health behavior can guide multilevel health promotion program planning. Personal-health behavior affects the health of the person who engages in that behavior. Health-related behavior includes actions taken by proximal others that directly affect the health of others, although usually not purposefully. Health-protective behavior is undertaken purposefully to foster the health of others. Regardless of the outcome of interest or societal level, similar health promotion processes can be employed to alter health behavior.