A decade of change: A historical and anecdotal record of cardiovascular health promotion in the United States Army: 1979-1989

A historical record of health promotion in the U.S. Army during the years 1979 through 1989 is presented. Featured are individuals and events which brought Army health promotion into a new era. The primary sources of information are the living resource of human participants with direct Army experience who allow the previously untold story to be disclosed. The personal interview is used to capture the factors, both human and organizational, which allowed Army health promotion to reach fruition in some areas, but to be denied success in others. Documents were also reviewed to supplement and support the anecdotal information. The 1979 Surgeon General's report, which emphasized the influence of lifestyle on major diseases, serves as the starting point. Early in the decade the Army emphasized physical fitness. As the decade unfolded and the Army undertook several major research efforts, emphasis shifted to risk factor identification, education and intervention. The decade of change included vast improvements in areas such as cardiovascular screening, smoking restrictions, nutrition guidelines, weight compliance, civilian health promotion, and Army regulations related to health promotion. Areas denied complete success included a cost benefit research effort, a health risk appraisal program and data base, and an identifiable Army-wide health promotion program. In late 1987, the "Fit to Win" program was implemented, but with limited financial and personnel resources. Although the curriculum design was strong, the delivery system was not. There was no one among the leadership to serve as the program's champion. By the end of the decade, there was fear among Army personnel for the Army's ability to sustain health promotion in light of pending budget and personnel cutbacks. This accounting of the events leading to 1989 was an attempt to feature the trials and struggles of those who pioneered the Army's health promotion effort; the results hold strong implications for future efforts of the Army as well as other organizations, both government and private sector based.