4 Health Promotion

Question 1

What are the determinants of health?

Answer 1

The RANGE OF FACTORS that have a powerful and cumulative effect on the health of individuals, populations and communities.
e.g.
The physical environment
Socio-economic environment
Genetic factors
Individual behaviours

Question 2

Describe the HEALTH CAREER IDEA

Answer 2

The concept that your health is a career. Some factors contribute to your health throughout e.g. culture, socio-economic environment, physical environment.
Lots of people go through the same health-related events in their lives. e.g. family planning, screening and are exposed to the same advice from the mass media.

Question 3

What contribution to health do the determinants of health have?

Answer 3

A significant contribution. Thus INDIVIDUALS should NOT be blamed for their poor health/ credited for their good health. Most of the health determinants are out of the control of the individual.

Question 4

How has health promotion developed through time?

Answer 4

Started with interventions into the reform of the physical environment - PUBLIC HEALTH
Then
Targeted individuals behaviour - HEALTH EDUCATION
and now…
Takes a broader approach to health incl. political and social - HEALTH PROMOTION

Question 5

Define Health Promotion

Answer 5

The process of enabling people to have better control over and to improve their health. This is the responsibility of beyond just the health sector for health is a positive concept and involves social and personal resources along with physical capabilities.

Question 6

What are the principles of health promotion? (7 things)

Answer 6

EPHIESM
E Empowering - give individuals more control over their health
P Participatory - Involving all at all stages
H Holistic - Considers mental, physical, social health
I Intersectoral - Collaboration between all sectors
E Equitable - Guided by equity - same for all with same need
S Sustainable - Bringing about changes that will continue once funding has ended
M Multi-strategy - Uses a variety of approaches - policy, legislation etc

Question 7

What is the difference between Public Health and Health Promotion?

Answer 7

Public Health = sets the goals of what health promotion should achieve
Health Promotion= The means of how the goals are going to be met: health education and public health policy

Question 8

What is the role of Public Health England?

Answer 8

To protect and improve the nation’s health and wellbeing
To reduce health inequalities
To empower local communities
To implement new evidence-based ideas

Question 9

What could you say are flaws in the concept of health promotion?

Answer 9

Individuals do still have control over some health determinants
Monitoring and regulating population –> nanny state
Lifestyle choices are not only health risks but also part of a person’s identity.

Question 10

What is Primary Prevention?

Answer 10

Aim to prevent the ONSET of the disease or injury by REDUCING EXPOSURE TO RISK FACTORS.

Question 11

How can primary prevention be achieved?

Answer 11

Immunisation
Prevention of contact with environmental risk factors
Taking precautions e.g. quarantine with communicable disease
Reducing risk factors from health related behaviours

Question 12

What is Secondary Prevention?

Answer 12

To DETECT and TREAT the disease at an EARLY STAGE

Question 13

How can secondary prevention be achieved?

Answer 13

Screening

Monitoring and treating BP

Question 14

What is Tertiary Prevention?

Answer 14

To MINIMISE the EFFECTS of ESTABLISHED DISEASE

e.g. Steroids for asthma / kidney transplants for those with CKD

Question 15

What dilemmas/issues can be raised with health promotion?

Answer 15

1. Ethics of interfering in people’s lives - Nanny state
2. Victim Blaming - focusing on the behaviour change of the individual plays down the effects of the socio-economic and environmental health determinants
3. Fallacy of empowerment - giving people the information does not give them the power to do something about it i.e socio-economic environment may prevent them making the change.
4. Information can reinforce negative stereotypes e.g. HIV patients only have themselves to blame for IV drug use
5. Unequal distribution of responsibility. Women are often responsible for implementing healthy health behaviours in their household.
6. PREVENTION PARADOX- interventions at a population level may not have much effect on the individual. If people do not view themselves as SUSCEPTIBLE/ the target audience for the health promotion activity, they may not take the message onboard.

Question 16

Define evaluation

Answer 16

The rigorous and systematic collection of data to assess the effectiveness of a programme in achieving its objectives.

Question 17

Why do we evaluate health promotion programmes?

Answer 17

Need to provide an evidence-base that they worked/ didn’t work
For accountability purposes
Ethical obligation to ensure no harm was done
To further develop and manage the programme

Question 18

What 3 things can be assessed in a health promotion scheme evaluation?

Answer 18

PROCESS - using qualitative methods to assess if the scheme is being implemented in the best way possible
IMPACT - Assess the immediate effects of the scheme
OUTCOME - Measure the long term consequences of the scheme.

Question 19

How can the timing of the evaluation of OUTCOME influence the findings?

Answer 19

DELAY - some interventions have a delay before their effects are seen
DECAY - some interventions rapidly wear off

Question 20

Why can difficulties be had in evaluating an intervention?

Answer 20

1. DESIGN of the intervention makes it difficult to assess
2. DELAY/LAG in effect
3. Many CONFOUNDING factors
4. HIGH COST of evaluation