Health Promotion, Wellness and Chiropractic

This section was compiled by Frank M. Painter, D.C.
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Chiropractors as the Spinal Health Care Experts
A Chiro.Org article collection

Enjoy these learned articles about chiropractors as first-contact Spinal Health Care Experts.

Maintenance Care, Wellness and Chiropractic
A Chiro.Org article collection

This Research page contains articles that document the beneficial effect of chiropractic care on general health and wellness.

Primary Prevention in Chiropractic Practice:
A Systematic Review

Chiropractic & Manual Therapies 2017 (Mar 14); 25: 9 ~ FULL TEXT

More research efforts have been put into wellness than into prevention of musculoskeletal disorders or public health-related disorders. It therefore seems that parts of the chiropractic profession are in search of an understanding of various aspects of clinical practice over and above its traditional musculoskeletal role. Interestingly, only a small proportion of chiropractic patients consult for primary prevention (PP), despite the readiness of the profession to offer such services.

Community-based Free Clinics: Opportunities for
Interprofessional Collaboration, Health Promotion,
and Complex Care Management

J Chiropractic Education 2016 (Mar); 30 (1): 25–29 ~ FULL TEXT

Many chiropractic institutions operate free or outreach clinics. [1–3] Health care services are offered for no cost to low-income, uninsured, or underinsured individuals with the overarching goal of decreasing health disparities. [4] The Council on Chiropractic Education requires that an institution “conducts and supports service activities congruent with its mission, goals, and objectives.” [5]

A Framework For Chiropractic Training In
Clinical Preventive Services

Chiropractic & Manual Therapies 2013 (Aug 20); 21: 28 ~ FULL TEXT

The 2010 Patient Protection and Affordable Care Act provides incentives for both patients and providers to engage in evidence-based clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF). Depending upon the application of the new health care act, Doctors of Chiropractic (DC) may be considered to be covered providers of many of these services. It is therefore essential that DCs’ training prepare them to competently deliver them. The aim of this commentary is to describe a framework for training in clinical preventive services, based largely on the USPSTF recommendations, which could be readily integrated into existing DC educational programs.

Opportunities to Integrate Prevention Into the Chiropractic
Clinical Encounter: A Practice-based Research Project
By the Integrated Chiropractic Outcomes Network (ICON)

Topics in Integrative Health Care 2011 (Oct 7): 2 (3) ~ FULL TEXT

Chiropractic patients in this sample presented with risk factors amenable to physician counseling. Their DCs reported routinely providing advice on some risk factors, and a substantial proportion of patients with risk factors reported receiving advice from their DC. Chiropractic practices, in which patients with chronic pain have frequent follow-up visits, present an opportunity to advise patients on health risks, which could contribute to improved health outcomes.

Advising on Prevention in Chiropractic: A Look at
Public Health Promotion and Health Behavior
Theory Use in Clinical Education Settings

Topics in Integrative Health Care 2011 (Mar 30): 2 (1) ~ FULL TEXT

Chiropractic care is among the more commonly used Complementary and Alternative Medical (CAM) therapies. Spinal co-morbidities include many of the most common causes of premature death and disability. Health promotion and disease prevention have been used in the profession and taught in educational settings but not yet fully embraced in usual practice. This manuscript reviews areas in which health promotion has been emphasized in chiropractic education along with instances in which health behavior theories (HBTs) have been applied. Chiropractic clinical and educational programs should consider application of HBTs to move clinicians and interns forward regarding better advising roles with patients related to prevention and health promotion.

Public Health, Wellness, Prevention, and Health Promotion:
Considering the Role of Chiropractic
and Determinants of Health

J Manipulative Physiol Ther. 2009 (Jul); 32 (6): 405–412 ~ FULL TEXT

Prevention, wellness, and health promotion are often neglected when compared to short-term care treatments (eg, antibiotics) and disease prevention (eg, vaccinations). Unfortunately, many people presently rely upon the health care system to fix their health problems that may have developed over a period of years rather than modifying their behaviors to promote good health and prevent chronic illnesses. Chiropractic's historical approach to patient health has focused on the patient's innate, homeostatic powers of the body to heal, which include physical, psychosocial, emotional, and/or spiritual components. [9] As stated by Palmer, [12] chiropractic's founder, “Functions performed in a normal manner and amount result in health. Diseases are conditions resulting from either an excess or deficiency of functioning.” Thus, the chiropractic profession embraced a broad definition of health years before the World Health Organization adopted its 1946 definition that health is, [13] “[a] state of complete physical, mental, and social well-being and not merely the absence of disease.”

Prevention and Health Promotion by Chiropractors
American Journal of Lifestyle Medicine 2008; 2 (6): 537–545 ~ FULL TEXT

Chiropractic care includes a variety of minimally invasive approaches, with both treatment and prevention as essential elements of clinical practice. Although chiropractic adjustment (manipulation) is the signature therapy and best-known identifier of the profession, the practice of chiropractic involves more than manual therapeutics. In general, chiropractors seek to bring a holistic worldview to the doctor–patient encounter, seeking not only to relieve pain and restore neuromusculoskeletal function but also to support the inherent self-healing and self-regulating powers of the body. Aside from applying their diagnostic training to the evaluation of a variety of physical disorders and delivering manual adjustments and related therapeutic interventions, many chiropractors encourage patients to take an active role in restoring and maintaining health, with particular emphasis on doctor-guided self-care through exercise and nutrition. In this review, the authors summarize the peer-reviewed literature on chiropractic and prevention, describe health promotion and wellness approaches currently taught at chiropractic colleges and used in chiropractic clinical settings, discuss duration of care, emphasize the importance of interprofessional cooperation and collaboration, and address the hypothesis that chiropractic adjustments yield preventive effects.

   The Meridel I. Gatterman series on   “Health Promotion and Wellness”   

CCE Adopts Health Promotion and Wellness Competencies
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (April 24, 2006)

Counseling patients on habits and lifestyle has long been a part of chiropractic practice, identified by doctors of chiropractic [1, 2] and those who study what doctors of chiropractic say they do in practice. [3, 4] Vear included counseling in the standards of chiropractic practice in 1992, stating that "chiropractic educational institutions place great emphasis on patient counseling." [1] The CCE standards recognize that health promotion and wellness are a part of the standards for chiropractic education and wellness. The 2003 CCE Standards for Doctor of Chiropractic Programs [5] state: "Doctors of chiropractic must be able to provide wellness care and to promote health maintenance to perform common screening procedures and wellness assessments in different age groups."

Health Promotion and Wellness
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (October 12, 2006)

As primary-contact practitioners, chiropractors share the responsibility of licensed health professionals for promoting health and preventing disease. [2] This is consistent with the Association of Chiropractic Colleges (ACC) paradigm that includes health promotion in its statement of the scope of chiropractic practice. [3]

Health Promotion and Wellness:
A Paradigm Lost?

Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (September 14, 2006)

Following completion of a book for patients titled Chiropractic, Health Promotion, and Wellness, [1] I received a short description of the book from the publisher that stated, "Chiropractors have traditionally offered manipulation for neuromuscular skeletal problems. Today, many chiropractors are repositioning themselves as wellness providers." I promptly replied that chiropractors have traditionally counseled patients on health promotion and wellness. In mentioning this incident to a well-known research director, a non-chiropractor who has been involved with chiropractic for 14 years, he responded, with equal surprise, that practicing health promotion and wellness is not a new direction for chiropractors. [1]

Health and Wellness Promotion for Older Adults
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (August 27, 2007)

Eighty-eight percent of older adults seek some form of complementary and alternative care. This is more than twice the national average of 42 percent reported by Eisenburg. [3] With the graying of the baby boomer generation, a large number of older adults will be seeking to promote health and wellness by continuing the fitness programs they started when they were in their 40s and 50s.

Assessment of Community Needs for Health
Promotion and Wellness

Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (October 22, 2007)

Chiropractic physicians as autonomous practitioners offer first-contact care. In addition to managing acute and chronic conditions, they are well-situated to promote the health and wellness of both patients (people seeking care for health problems) and clients (apparently healthy people). [1] Individuals increasingly are seeking active participation in their own health care. To effectively fulfill the role of health promotion and wellness practitioners, chiropractors must assess the needs for health promotion and wellness in their individual communities. Factors that should be considered when assessing a community’s health-promotion and wellness needs include: access to health-promotion and wellness resources, risk exposure, income levels, cultural norms, health insurance coverage and barriers to access.

Health Promotion: Whose Job Is It?
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (December 17, 2007)

Health promotion often is associated with disease prevention and considered a public health problem. [1] With the significant reduction in the prevalence of infectious diseases as a result of improved nutrition, sanitation and better living conditions in industrialized nations, chronic diseases related to self-imposed lifestyles have become increasingly important. These “lifestyle diseases,” including obesity, hypertension and chronic pain from arthritis, are as compromising to quality of life as are the more life-threatening conditions such as heart disease, stroke and cancer. So whose job is it to address “lifestyle diseases”?

Access to Health Promotion and Wellness Care
in the United States

Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (January 15, 2008)

If one considers that access to "sick care" in America is unequal, surely access to health promotion and wellness strategies are just as disparate. The attainment of a good standard of health promotion for the entire population is a reasonable goal. Access to health promotion should not be dependent on socioeconomic status, [1] cultural background [2] or bias against certain conditions such as learning disabilities, mental health problems and AIDS. [3]

Health Promotion and Wellness:
To Whom Does It Belong?

Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (May 20, 2009)

With the growing trend for some groups to take a proprietary view of a current bandwagon, the popularity of health promotion and wellness has become a vehicle for furthering self-interest agendas. It would seem that health promotion and wellness should first belong to patients – not political organizations, entrepreneurs, academic institutions or doctors using it as a marketing tool. When doctors of chiropractic are patient-centered, this growing trend in health care focuses first on the promotion of health and wellness in the patients we serve. When promoted solely as a practice management tool or denigrated as outside the scope of practice of chiropractors, the best interest of the patient is ignored.

Lasting Health Care Reform Requires
a Health Care Revolution

Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (July 29, 2010)

The current polarization within health care stems largely from a clash between two different health care paradigms that go as far back as ancient Greece. The Coans, led by Hippocrates, adhered to a holistic world view in which the patient was viewed as a whole and promotion of health included diet, exercise and a balanced lifestyle. In contrast, the Cnidian School focused on diseases of parts located in organs or organ systems. [2] The Coan School held that disease had a natural basis that was the result of an imbalance within the person. The Cnidian tradition saw diseases as real entities with an existence distinct from the person. [2] The current biomedical model dominated by specialists is a legacy of the Cnidian School. [3] Health care research and treatment practices today are directed by the prevailing reductionistic paradigm, thereby lacking focus on health promotion and wellness.

Health Promotion and Wellness Initiatives
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (March 11, 2008)

Over the past four years, a number of initiatives have been undertaken by the chiropractic community to promote the health and wellness of patients and the general public. A number of these initiatives were under the auspices of the American Chiropractic Association's (ACA) committee on health promotion and wellness. Chaired by Ron Rupert, dean of research at Parker Chiropractic College, and assisted by Cathy Burke, ACA education director, a number of subcommittees instituted initiatives that put health promotion and wellness at the forefront of academic endeavors.

Preventive Medicine, Health Promotion and Wellness
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (October 21, 2008)

While to some, the terms preventive medicine, health promotion and wellness are used synonymously, the differences are important for chiropractors. Preventive medicine is concerned with the prevention of disease. [1] Health promotion is broader and deals with dysfunction in addition to prevention of disease. Health promotion is built on a positive image of health, rather than a risk factor model. [2] Wellness is a dynamic state of health in which an individual progresses toward a higher level of functioning, achieving an optimum balance between internal and external environments.

Health Promotion, Wellness and Primary Care
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (May 20, 2009)

Two articles in the Feb. 26, 2009 issue of DC [1, 2] brought to mind the ongoing paradox of chiropractors as primary care providers and spinal specialists. While the major focus of the chiropractic research agenda is the continuing promotion of the idea of chiropractors as specialists, this concept has not worked well for many in the profession and denies patients the benefits we can offer as primary care doctors. As long as we are satisfied to limit ourselves to one area of the body (the spine) and one modality (manipulation), we can readily be dismissed as therapists rather than full-fledged physicians. And by designating chiropractors as specialists with a co-pay double that of primary care practitioners, insurers can limit the amount paid out by making the coverage equal to the co-pay.

Health Promotion: Wellness For Chiropractic Practice
Meridel I. Gatterman, MA, DC, MEd
Dynamic Chiropractic (August 12, 2011)

Fall Prevention: Statistics and Strategies:   Falls are a common cause of morbidity and the leading cause of nonfatal injuries and trauma-related hospitalizations in the United States. In a recent study, fall-related injuries accounted for 6 percent of all medical expenditures for people age 65 and older in the U.S. [1] And according to the Centers for Disease Control and Prevention (CDC), in the year 2000, falls among older adults cost the U.S. health care system more than $19 billion. With the population aging, the number of falls and the costs to treat fall-related injuries are both expected to increase. [2]

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