Prevention/promotion in America: still spitting on the sidewalk

Using a metaphor from disease prevention and health promotion efforts from the early 1990s, prevention and promotion efforts of the late 1900s are examined. Primary analyses are made on societal failures to grapple effectively with the major health problems associated with smoking, motor vehicles, and guns. Critical examples are described where American society and decision-makers lack commitment to prevention and promotion ideals and, in these and other situations, have actively encouraged the growth of health problems. The conclusion is drawn that the American society has acquiesced to let the major killers and disablers of children and adults to continue unabated. A stronger commitment to promotion and prevention is encouraged.