BM - Health promotion Flashcards
What is the WHO definition of health promotion?
Ottawa Charter for Health - WHO (1986)
Health promotion is the process of enabling people to increase control over and to improve their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions.
What is the NICE definition of health promotion?
Giving people the information or resources they need to improve their health. As well as improving people’s skills and capabilities, it can also involve changing the social and environmental conditions and systems that affect health.
What is health promotion?
Has developed over last 30 years or so. In 1980s there was a a shift away from health being defined by a medical model. In 1940s when NHS was launched it was focused on illness being acute. As time went on there was a shift from acute to chronic illness and there was am impact on lifestyle changes, meaning that promotion of healthy lifestyles become more important. At WHO conference was where they considered how to get people to do this.
What is health?
World Health Organisation definition of health (1946):
“a state of complete physical, mental and social wellbeing and not merely the absence of disease of infirmity”
As we define illness as being chronic then we need to look further than that initial cause or symptoms.
WHO has a set of particular assumptions about health and what we expect health to be. Havent achieved equality in access to health care globally. Was recognised early on that its important to involve a number of sectors in health care.§
What are the holistic assumptions of the WHO?
articulated in a range of publications and declarations:
• Health is a fundamental human right
• Inequality in health within and between nations is unacceptable
• Health as a major social goal
• There is a reciprocal relationship between health and social development
• It is necessary to involve a number of different sectors to work towards health
• Individuals have a right and duty to participate individually and collectively in their own healthcare
Education is a means of developing communities’ capacity to participate
What is health according to the WHO review?
A resource for everyday life, not the objective of living
A positive concept emphasizing social and personal resources, as well as physical capacities
Health promotion is not just the responsibility of the health sector. It goes beyond life-styles to wellbeing.
What is the rationale for health promotion?
Top causes of premature death in the UK (2014) are strongly influenced by lifestyle eg smoking, diet, inactivity
Burden on individual quality of life
Cost to health services in treatment and cost to economy
Prevention is cheaper than cure
What are the key principles of health promotion?
WHO 1984
The involvement of the whole population in the context of their everyday life, enabling people to take control of, and have responsibility for their health
Tackling the determinants of health, ie an upstream approach, which demands the cooperative efforts of a number of different sectors at all levels, from national to social
Utilising a range of different, but complementary, methods and approaches - from legislation and fiscal measures, organisational change and community development to education and communication
Effective public participation, which may require the development of individual and community capacity
Defines the role of health professionals in education and advocacy for health
What is health education?
The process of educating people about their health and helping them to voluntarily make health enhancing behaviour changes
Health education is any planned activity designed to produce health - or illness-related learning (Tones and Green, 2004)
Health education is described as a core component of Health Promotion
Historical overview of health promotion
• National health service set up in 1947
• Whitehall longitudinal study began 1967 - employment grades
• By 1970s clear that many health problems persisted - re-assessment required - upstream focus - term lifestyle key determinant of health
• 1980s attention to persistence of inequalities in health - international guidelines to limit marketing of infant formula in poor countries - consumer boycott of Nestle
• Black report 1980 - social class health inequalities widening
• Limitations of health education recognised
• 1986 Ottawa charter - change in emphasis
• 1998 Acheson Report - inequalities in health continue to widen
• 1999 - saving lives: our healthier nation - green paper
• 2004 - choosing health - white paper
2010 healthy lives, healthy people: our public health strategy in England
Set standard of care by NHS. Whitehall study began in 1970s looking at how peoples health developed depending on their occupational grade. Followed up for a long period of time, still ongoing, monitoring their health.
What is the rainbow model?
Dahlgren and Whitehead 1992
- General socioeconomic, cultural and environmental conditions
- agriculture and food production, education, work environment, living and working conditions, unemployment, water and sanitation, health care services, housing
- social and community networks
- individual lifestyle factors
- age, sex and hereditary factors
The conceptual framework of health promotion
Five main action areas: - Build healthy public policy - Create supportive environments - Strengthen community action - Develop personal skills Reorient health services
What are the WHO’s health promotion strategic approaches?
Hubley and Copeman, 2013
Health education - intellectual, psychological and social dimensions relating to activities that increase the abilities of people to make informed decisions affecting their personal, family and community well-being. This process is based on scientific principles and facilitates learning and behavioural change in both personnel and consumers, including children
Service improvement - promoting change in services to make them more effective accessible or acceptable to the community
Advocacy - activities directed at changing policy of organisations or governments
What are the three components of comprehensive health promotion?
Health education
(communication directed at individuals, families and communities to influence awareness/knowledge, decisions, beliefs and attitudes, empowerment, behaviour, community participation)
Service improvement (improvements in quality and quantity of services - accessibility, case management, counselling, patient education, outreach, social marketing)
Advocacy
(agenda setting and advocacy for healthy public policy - policies for health, income generation, removal of obstacles, discrimination, inequalities, gender barriers)
What are the 5 models of health promotion?
- behaviour change approach
- medical approach
- social change approach
- self-empowerment (client centred) approach
- educational approach
Naidoo and Wills 2000
