Health promotion in a shrinking military: the call for structural integration and a conceptual systems approach

The evolution of health promotion in the military is reviewed and contrasted with developments in private sector activities. Programs in both arenas generally take a mechanistic, mortality and risk factor-based approach which targets lifestyle and behavioral change. In the military, that has resulted in a fragmentation of function and perception in the line and medical communities about health promotion. A "world view" model and a conceptual systems approach to health promotion are presented in which human resources, occupational health, life-style, and health benefits programs are integrated to achieve efficiencies in program management, decreased mortality, and reduced medical care costs.