Health promotion Flashcards
Public health domains
Health promotion
Health protection
Health care
Indicators of health
Life expectancy
Measure of standard of life
Measure of conditions in which people live
North-South divide
Those in south live longer
Upstream determinants
life circumstances i.e. housing, education
Downstream determinants
risk factors: ethnicity, gender, alcohol consumption, familial history, obesity, stress
Major wider factors contributing to health
Financial status
Employment
Education
Housing
Leading risk factors contributing to health
Tobacco High BP Alcohol Cholesterol Overweight
Health promotion
enabling people to increase control over & to improve their health
Focus of health promotion
Health rather than disease
Health promotion involves:
Clinical intervention
Health education
Healthy public policy
Community development
What is clinical intervention in health promotion?
Biomedical screening
Immunisation
What is health education in health promotion?
Traditional health promotion e.g. smoking cessation, healthy eating
What is healthy public policy in health promotion?
Legal/ social measures to make healthy choices easier e.g. sugar tax
Policies/ infrastructure to address wider determinants of health
What is community development in health promotion?
Partnerships with groups to create sustainable actions
What are the 3 components needed for good health promotion (Tannahill model)
Prevention: intervention to reduce risk
Protection: legal/ social measures
Education: knowledge/ attitudes
How many levels of prevention are there?
4
Primordial prevention
Prevention of factors promoting the emergence of lifestyles, behaviours, exposure patterns which contribute to increased risk of disease.
Primary prevention
Actions to prevent onset of disease.
Limit exposure to risk factors by individual behaviour change/ actions in community.
Examples of primary prevention
Health education
Prescriptive diets
Vaccination
Secondary prevention
Halt progression once illness is already established.
Early detection, prompt, effective treatment.
Tertiary prevention
Rehab of people with established disease to minimise residual disability & complications.
2 main approaches to disease prevention
High risk
Population
High risk disease prevention
identifying those in special need “targeted rescue operation” then controlling exposure or providing protection against effect of exposure
Population disease prevention
begins with recognition that the occurrence of common diseases & exposures reflects the behaviour & circumstances of society as a whole
Prevention paradox
- Many people exposed to a small risk may generate more disease than the few exposed to a large risk SO when many people receive a small benefit the total benefit may be large
- However, individual inconvenience may be high to many when benefit may only be to a few.
- Low risk effecting a lot of people leads to a large number of cases.
Strengths of a high risk approach in disease prevention
Effective (high motivation of individual & physician)
Efficient (cost-effective use of resources)
Benefit: risk ratio is favourable
Appropriate to individual
Easy to evaluate
Weaknesses of a high risk approach in disease prevention
Palliative & temporary (misses a large amount of disease)
Risk prediction – not accurate
Limited potential – misses out on spill over of info
Hard to change individual behaviours
Strengths of a population approach in disease prevention
Equitable (Attributable risk may be high where risk is low if a lot of people are exposed to that low risk)
Radical
Large potential for population
Behaviourally appropriate
Weaknesses of a population approach in disease prevention
Small advantage to individual
Poor motivation of subject
Poor motivation of physician
Benefit: risk ratio worrisome
Where can health promotion operate?
Internationally
Nationally (government, advertising, media)
Locally (GP, hospitals, Local Authority, Police, Schools etc)
Individually (support groups, neighbourhood schemes, communities)
