Behavior Change or Empowerment : On the Goals of Health Promotion

One important ethical issue for public health work and health promotion is to try to determine what the goals for these practices should be. This paper will, therefore, try to clarify some of the issues concerning what these goals are thought to be, and what they ought to be. It will primarily discuss two common approaches in health promotion, namely behavior change and empowerment. For this purpose two “ideal types” will be created of these approaches, making them clear alternatives. For empowerment I will use my own previous analysis. For the behavior approach I will construct a conception that focuses on central, common features found in the literature on the topic.The general aim of this paper is to investigate what the similarities and differences are between the behavior change approach and the empowerment approach, concerning their immediate (instrumental) goals or aims, and relate them to the ultimate goal of health promotion and public health work, which is taken to be quality-of life-related health (and longevity). The paper ends with an ethical evaluation of the strengths and weaknesses of these two goal models, and, it argues that we should prefer empowerment to behavior change. Behavior change has relatively narrow targets, normally “life-style” changes, such as smoking cessation, weight loss, increased condom use, or increased exercise, whereas empowerment strengthens the “whole” individual – her autonomy, self-confidence, skills and general control – in achieving better health, and therefore creates a more solid foundation for future health and longevity