Health Promotion Flashcards
What are determinants of health
A range of factors that have a powerful and cumulative effect on the health of populations, communities and individuals.
The physical environment
the social and economic environment
Our individual genetics, characteristics and behaviours
“The context of people’s lives determine their health and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to control many of the determinants of health”
Define health promotion
“The process of enabling people to increase control over and to improve their health. …. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to wellbeing”
What is primary prevention in terms of health promotion?
To prevent the onset of disease or injury - by reducing exposure to risk factors
4 main approaches:
- Immunisation
- Prevention of contact with environmental risk factors
- Taking appropriate precautions - communicable
disease
- Reducing risk factors from health related behaviours
What is secondary prevention in terms of health promotion?
To detect and treat a disease (or its risk factors) at an early stage (to prevent progression / potential future complications and disabilities from the disease)
Examples
- Screening for cervical cancer
- Monitoring and treating blood pressure
- Screening for glaucoma
What is tertiary prevention in terms of health promotion?
Aims to minimise the effects of established disease
Examples
- To maximise the remaining capabilities and functions
of an already disabled patient
- Renal transplants (to prevent renal failure and death)
- Steroids for asthma (to prevent asthma attacks)
What are some of the dilemmas of health promotion?
The ethics of interfering in people’s lives
- Potential psychological impact of health promotion
messages
- State interventions in individuals’ lives “ nanny state”
peoples rights and choices
Victim blaming
- Focusing on individual behavioural change plays
down the impact of wider socioeconomic and
environmental determinants of health
“Fallacy of empowerment”
- Does giving people the information give people the
power? No.
- Unhealthy lifestyles are not due to ignorance but due
to adverse circumstances and wider socioeconomic
determinants of health
Reinforcing negative stereotypes
- Health promotion messages have the potential to
reinforce negative stereotype associated with a
condition or group
Unequal distribution of responsibility
- Implementing healthy behaviours in the family is
often left up to the women
The prevention paradox
What is the prevention paradox?
Interventions that make a difference at population level might not have much effect on the individual
It links with lay beliefs - if people don’t see themselves as a candidate for a disease they may not take on board the health promotion messages
Awareness of anomalies and randomness of a disease (e.g. heart attacks) will also impact on views about candidacy
It is important for health promoters to engage with lay beliefs
Define evaluation
The rigorous and systematic collection of data to assess the effectiveness of a programme in achieving predetermined objectives
Why do we evaluate in relation to health promotion?
Need for evidence based interventions
Accountability - evidence gives legitimacy to
interventions and political support
Ethical obligation - Ensure no direct or indirect harm
Programme management and development
What are the three types of health promotion evaluation?
Process
Impact
Outcome
What is process evaluation?
Focus on assessing the process of programme implementation
Also referred to as “formative” or “illuminative” evaluation
Employs a wide range of mainly qualitative methods
What is impact evaluation?
Assesses the immediate effect of the intervention
Tends to be the more popular choice, as it is the easiest to do
What is outcome evaluation?
Measures more long term consequences
Measure what is achieved
Timing of evaluation can influence “outcome”
- Delay: some interventions might take a long time to
have an effect
- Decay: some interventions wear off rapidly
What are the difficulties of health promotion evaluation?
Demonstrating an attributable effect is difficult because:
- Design of the intervention
- Possible lag time to effect
- Many potential intervening or concurrent
confounding factors
- High cost of evaluation research - studies are likely to
be large scale and long term
What are some principles of health promotion?
Empowering
- Enabling individuals and communities to
assume more power over the determinants of health
Participatory
- Involving all concerned at all stages of the process
Holistic
- Fostering physical, mental, social and spiritual health
Intersectoral
- Involving the collaboration of agencies from relevant
sectors
Equitable
- Guided by concern for equity and social justice
Sustainable
- Bringing about changes that individuals and
communities can maintain once funding has ended
Multi-strategy
- Uses a variety of approaches - including policy
development, organisational change, community
development, legislation
