Strategies for health promotion.

A key element in most efforts to prevent disease and promote health is behavioral change to lower risk. One-to-one programs to help people change their behavior are seriously limited because of the difficulty people have in making behavioral changes and because one-to-one programs do little to modify those forces in the community that continually produce new people at risk. In addition to one-to-one programs, therefore, environmental strategies for disease prevention are needed. Several clues regarding environmental interventions can be gleaned from the study of patterns of disease distributions. Not only are environmental approaches to prevention more efficient and practical than one-to-one programs, they also may shed new light on our understanding of disease etiology.