Case 6- health promotion Flashcards
Public health
The science of preventing disease and promoting health through the organised efforts and informed choices of society, organisations, public and private communities and individuals.
Globalisation of risk factors
The increase in risk factors across the world such as drinking and smoking. As well as the ageing population
Public health interventions
An action that bring about identifiable outcomes. It is applied to many, most or all members in a community. It aims to deliver a net benefit to the community or population as well as benefits to individuals. It involves various sectors and organisations, for example education or the police. Aims to prevent disease a well as promote health and well being. It aims to improve health and reduce health inequalities.
What does public health encompass
Health promotion and disease prevention
Health promotion
Enables people to increase control and improve their health. Health promotion encompasses health education, prevention and health protection
Health education
Aimed at promoting positive health and preventing or reducing ill health in individuals and groups, through influencing the beliefs, attitudes and behaviour of those with power and the whole community. This could be advertisement or formal education in school
Health protection
Comprises legal controls over regulations and policies and voluntary codes of practise which aim to enhance positive health and prevent ill health.
3 Types of health protection with examples
Legal controls= wearing seat belts in cars, not smoking in public areas. Fiscal control (monetary measures)= congestion charge reduces air pollution and improves health. The sugar, alcohol and tobacco tax. Voluntary codes- calorie count on goods, challenging under 21 when asking ID.
Difference between health promotion and disease prevention
Disease prevention differs from health promotion because it focuses on specific efforts aimed at reducing the development and severity of chronic diseases and other morbidities. Health promotion is more general and is about the actions that a person can take to be healthier, like brushing your teeth
Primordial prevention
Prevents the initiation of the risk factors in the first place through social and economic policies affecting health, i.e. making binge drinking less socially acceptable.
How can a physician promote health
1) Screen their patients for risk factors
2) Provide up to date public health information
3) Maintaining systems about collecting data about the health of their clients
4) Going into the community and taking about health promotion i.e. at schools
5) Communicating sensitive information i.e. sexual health
6) Travel health advice
Health impact pyramid
1) Counselling and education
2) Medical care
3) Preventative medicine
4) Making healthy decisions the default
5) Socioeconomic factors.
Near the top are factors which require increasing individual effort, near the bottom are factors that have increasing public health impact
Public health- counselling and education
For example tobacco warning labels. Though it is cheap it is not often effective though it may be the only thing available. More effective when maintained over time. Relies on individuals making a lot of change with not a lot of support.
Public health- medical care
Medication, inhaler etc. These are very expensive, will not be effective if the patient is not willing to engage. You may not be able to access these patients, for example, if they are not formerly diagnosed. Not useful in reducing the chances of them getting a disease.
Public health- preventitive medicine
For example, smoking cessation interventions. Can be accessed via your GP. Are open to a lot of the population and use simple techniques to encourage cessation. Requires the patient to want to stop smoking
Public health- making health decisions the default
For example, the smoking ban (Health act 2006). Legally stops people from making unhealthy decisions. Make a big impact. May not effect what people do in private. Though it reduces passive smoking wont affect active smoking
Public health- socioeconomic factors
Such as poverty/health inequality, will make the biggest difference. Affects a large section of society. Very expensive and political, some governments may choose not to implement them. May take a long while to make a difference.
How can you measure effectiveness of health promotion
Using QALY- quality adjusted life year
Effectiveness of health promotion
They can change people’s health behaviours both now and in the future. This is likely to have impact on the individuals family as well. It is also very cheap. Improves a patients health outcome
Health promotion evaluation
During evaluation we assess whether an intervention has worked (outcome) and how an intervention has performed (process). When looking at outcome you need to assess both short term and long term. By looking at the process we can see if it is reproducible and could be done again.
Evaluation
An assessment that is as systematic and impartial as possible of a strategy or policy
Why do we look at the process in evaluation
To see if the process is feasible and if people will realistically implement the change in their everyday life. This is important if the process is to be scaled up as you would need to avoid unacceptable side effects. You ask for qualitative advice on the service, for example, it may need lengthening
What to do when evaluating
You will want to evaluate at the end (summative) and during (formative) an intervention. You may want to interview people during the process. You will need to use multiple methods of evaluation as lots of factors will determine whether the intervention was successful. You will need both quantitative and qualitative data
Challenges with public health
There are several interacting components, asking people to change several often challenging behaviours, involves many groups or organisations, have a number of different desired outcomes. You have to allow for a level of variability or tailoring of the intervention.
