Structural Approaches to Health Promotion: What Do We Need to Know About Policy and Environmental Change?

Lisa Lieberman, Shelley D. Golden, Jo Anne L. Earp

Research output: Contribution to journalArticlepeer-review

60 Scopus citations


Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is also unclear, often benefiting some communities more than others. Finally, the political nature of policy and environmental change, including the impact on personal autonomy, raises questions about the appropriate role for public health professionals in advancing specific policies and practices that alter the conditions in which people live. This article addresses these issues and ends with a series of questions about the effectiveness and ethical implementation of what we have termed "structural initiatives."

Original languageEnglish
Pages (from-to)520-525
Number of pages6
JournalHealth Education and Behavior
Issue number5
StatePublished - Oct 2013


  • health disparities
  • health education ethics
  • health policy
  • program evaluation
  • public health education
  • public health interventions
  • social ecological model
  • structural approaches


Dive into the research topics of 'Structural Approaches to Health Promotion: What Do We Need to Know About Policy and Environmental Change?'. Together they form a unique fingerprint.

Cite this