As you read this, a few months have passed, but for me writing it, only a week has passed. Seven days ago, I was working at home when my office called to tell me to turn on the television. Airplanes had already crashed into the North and South towers of the World Trade Center and the Pentagon. I turned on the television to see smoke pouring out of both buildings, then, in what seemed like both seconds and hours, watched on live television as both buildings collapsed. I heard of another plane crash in Pennsylvania and wondered how many more would come down. All of those people! Was my brother John in Manhattan OK? Were our editors at Columbia OK? All the telephone lines to New York were down. Like most Americans, and people around the world, I suspect I will remember this whole sequence of events the rest of my life.

One television scene showed a United States congressman standing on the roof of a building in Washington, D.C., with smoke pouring out of the Pentagon behind him. I don't remember his name or his exact words, but he said something like the following: "I hope the American people get it now. Our number one priority is not education; it's not health care; it is defense." These comments made me concerned about the future of health promotion. How receptive would Congress be to our current efforts to make health promotion a more important part of national policy (HealthPromotionAdvocacy.org)? Would employers cut health promotion program budgets? How would the average person respond to our efforts to help them make behavior changes?

This congressman was correct in the short term. Our top priority right now must be to develop a diplomatic, financial, political, legal, and military response which ensures the safety of the United States, enhances the safety of all people in all nations of the world and does so in such a way to contribute to world peace. Our next priority must be to help those who have been hurt physically, emotionally, and financially by this tragedy. But then, as both President Bush and Mayor Giuliani have exhorted us, we must get back to our lives; not just struggling to live, but enhancing the quality of our lives.

When corporate and federal policy makers can again regain a long-term focus, the objective, financial arguments for health promotion will still be valid. Almost 3,000 people in the United States die prematurely each day from smoking, sedentary lifestyle, poor nutrition, obesity, substance abuse, and other unhealthy behaviors, and thousands more are disabled. These behaviors are also responsible for at least 25% of medical costs and substantial losses in productivity. These facts will again be persuasive to federal policy makers and employers.

Ironically, this crisis may provide the unexpected stimulus we have long needed to push health promotion permanently beyond the physical dimension. Although many have accepted our definition of optimal health as a "balance of physical, emotional, social, spiritual and intellectual health" (O'Donnell, American Journal of Health Promotion 1989;3:3-5), most programs have been limited to the physical dimension because of the morbidity and medical care cost data cited above. However, the emotional, social, and spiritual dimensions are especially important now. What can we do to help people survive emotionally through this tragedy, and then to rebuild their lives? What can we do as a society on a local basis to create social networks which support people during such difficult times, and on a global basis to somehow bridge such huge differences in beliefs and perspectives between peoples of the world? What can we do to enhance global peace? Perhaps most important of all, what can we do to help each person reflect on their purpose and priorities in life, and build those priorities into their daily activities?

The health promotion work we all do will play an important part in our nation's recovery and its efforts to enhance the quality of all of our lives. Defense is our focus now, but quality of life will soon take priority.

Michael P. O'Donnell, PhD, MBA, MPH
Editor in Chief, American Journal of Health Promotion