Social ecological model and chiropractic: Current examples and suggestions for community health efforts

Background: The social ecological model (SEM) addresses public health issues using a systems approach. The SEM has five levels of influence, which include: intrapersonal, interpersonal, organizational/environmental, community, and policy. Although chiropractic is the third largest health care profession in the United States, the focus has tended to be on the patient (interpersonal) level instead of social levels that are needed for public health interventions. However, chiropractic has been forging new ground into the field of public health and the SEM may provide a guide for how chiropractic can be effective with improving public health beyond the intra and interpersonal levels. Objective: To discuss how the SEM can serve as a foundation on which chiropractic may address public health issues and become more involved in promoting healthy communities. Methods: A literature search of PubMed was performed to search for examples of how chiropractic may be applied to each of the five levels of SEM. Results: Currently there are few studies on the higher levels of the SEM. There is a greater number of studies that focus on intra and interpersonal health than social ecological studies that involve higher levels of order such as community and policy. Conclusion: Viewing chiropractic through the lens of SEM shows that there may be a great opportunity for research on a social ecological level. Exemplars of published studies may aid in establishing future directions for a systems approach to public health promotion at a community level.