Opportunities for health promotion: including the chronically ill and disabled

One of the aims of health promotion and illness prevention is to reduce the prevalence of chronic disease that is so apparent in the developed countries, yet the very individuals who already have chronic diseases and disabling conditions constitute a sizeable population which could contribute to health promotion programs. There are two chief elements which argue for an extension of health promotion toward the chronically ill and disabled: (1) the lifestyle management which is characteristic of health promotion is similar in many respects to the comprehensive self-care regimens followed by chronically ill persons, and (2) the philosophy of independent living for disabled persons shares social foundations with the concept of health promotion and could add the strength of social advocacy to health promotion. This paper examines social and medical variables linking the two health trends of health promotion and independent living for disabled persons. Observations of a U.S. independent living program, The Timbers, are reported to illustrate an active combination of the two philosophies. Finally, sociological implications are presented, with a focus on the potential of health promotion programs.