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Strategies, Practices, and Models for Delivering Programs 185

Pacific Islanders, whereas non - Hispanic whites have experienced declines as an overall
percentage of the U.S. population (U.S. Census Bureau, 2004, table A - 1).
Concurrent with these changes in the racial and ethnic composition of the popula-
tion are changes in population age. Data from the Administration on Aging (2002)
show that some thirty-three million Americans, or approximately 12 percent of the
total U.S. population, are over the age of 65. This number represents a tenfold increase
in this age group since the 1900s, and it makes individuals aged 65 and above one of
the fastest growing population segments in the country. Population estimates also pre-
dict that the number of people aged 65 and over will double in the next three decades.
In 2000, a majority of the individuals aged 65 and over (84 percent) were non - His-
panic whites, and although their majority status is expected to continue until 2050, the
exact proportion of whites will also decrease in this age group.
The exact number of people who are gay, lesbian, bisexual, or transgender (trans-
sexual) (GLBT) in the United States is difficult to ascertain, with several studies dif-

fering in their estimates. Extrapolating from data in the 2000 Census, which found
some six hundred thousand households with same - gender couples in the United States,
Rubenstein, Bradley Sears, and Sockloskie (2003) estimate that there are 1.2 million
people who are gay and lesbian in the United States. This richly diverse group, which

defies stereotypes, represents a significant proportion of the U.S. population in need of

culturally appropriate health education messages. To date little research has been con-

ducted to address the specific health education needs of this population group as well
as to identify barriers they experience in accessing health care services (Clark, Land-
ers, Linde, & Sperber, 2001; Gee, 2006; Gruskin, 1999).

Market Segmentation

As described at the beginning of this chapter, the field of health education is focused
on assisting individuals to ascertain their optimal health status. Health disparities
based on, among other things, race and ethnicity and the changing U.S. demographic

profile provide powerful justifications for reaching different population groups with
tailored health education programs. This approach requires a market segmentation that
is not easily adopted by purists in the field but that is supported by the professional lit-

erature. Situational and environmental factors that may influence health educators ’

ability to implement a successful health education program include, but are not limited
to, the target population ’ s socioeconomic status, country of origin, English language

proficiency, and acculturation.
Research has shown that in order for health education programs to be effective they
must be tailored to the needs of the target population. Some authors (Acosta - Deprez &
Monroe, 1996; Airhihenbuwa, 1995a; Luquis & P é rez, 2003; Pinzon & P é rez, 1997)
have provided solid arguments for developing health education programs targeting
members of diverse racial and ethnic groups; however, we would be derelict in our edu-
cational mission if we failed to take into account the health literacy of the members of
the target population (Porr, Drummond, & Richter, 2006), their language preference

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