health promotion and primary prevention Flashcards
Once again, describe the levels of prevention.
primary - preventing disease/injury before it occurs
secondary - reducing impact of disease/ injury and screening
tertiary - long-term management of condition to minimise disability and improve symptoms/quality of life
Define Health Promotion.
‘the process of enabling people to increase control over, and to improve their health.’ - WHO
Give examples of health promotion.
- drink driving campaigns
- tobacco controls
- immunisation programmes
- screening programmes (e.g. breast/bowel cancer)
- water fluoridation
- self management of disease
- healthy eating campaigns
What are the three approaches to health promotion?
- medical
- behavioural
- socio-environmental
What health problems would be tackled by each of the three approaches to health promotion?
medical: high BP, CVD, mental health issues
behavioural: smoking, poor diet, alcohol abuse
socio-economic: poverty, pollution, isolation, loneliness
What are examples of unhealthy behaviours we want to prevent in the population?
- smoking
- alcohol abuse
- sedentary lifestyle
- substance misuse
- poor diet
- unsafe driving
- risky leisure pursuits
What are examples of healthy behaviours we want to promote in the population?
- fruit+veg consumption - balanced diet
- condom use
- exercise
- sun protection
- attending screening
- immunisation
- dental health checks
- self management of disease
- seat belts/ helmets
Describes the levels of the intervention ladder from the greatest level of intervention into peoples’ healthcare to the least.
- eliminate choice completely
- restrict choice
- guide choices through changing default policy
- guide change through incentives
- guide change through disincentives
- enable choice
- provide information
- do nothing or simply monitor current situation
Name 6 health promotion strategies.
- health communication
- health education
- self-help/mutual aid
- organisational change
- community development and mobilisation
- policy/legislation
Give examples of health communication strategies for health promotion.
providing info to large audiences:
- tv adverts
- leaflets
- billboards
- front of cigarette packet labels
- food labelling
Give examples of health education strategies for health promotion.
education on how to manage a disease or condition:
- 1:1 or group sessions
- school based education
- healthcare workers and community support
Give examples of self help/mutual aid strategies for health promotion.
opportunities for ppl who share common experiences to support each other:
- alcoholics anonymous
- weight management
- cv rehabilitation
Give examples of organisational change strategies for health promotion.
creating environments for ppl to make healthy choices in:
- school healthy eating policy
- no smoking policy in hospitals/smoking ban
- workplace exercise programmes
- workplace shower facilities
Give examples of community development/mobilisation strategies for health promotion.
North Karelia study:
- in Finland in 1970s
- 1960s had high rates of CVD mortality
- in 1970, local concerns and petitions
- 1972 - launch of local project to reduce smoking and improve diet
- this was done through NHS, schools, non-government organisations, media, food industry
- effect was reducing rates of CVD mortality
What is the difference between policy and legislation?
policy = plan of action to guide people to stick to legislation legislation = rules enforced by the law
What is the difference between interventionists and libertarians?
interventionists believe the state should create freedom for individuals and level out inequalities
libertarians feel that intervention should be limited and place a strong emphasis on individual freedom. often opposed to state law
Give examples of legislation/policy strategies for health promotion.
- Licensing Act (1872): restricted pub opening times and stopped children from drinking spirits in pub
- Seatbelt wearing mandatory (1983)
- Smoke-free public places (2006-07)
- Healthy School Meals
- NY Trans-fat ban (2006-08):banned trans fats in restaurants
What are the pros and cons of a unhealthy food tax?
pros:
- decrease intake of unhealthy foods
- decrease incidence of disease related to intake of unhealthy foods
- generate funds through tax to help healthcare for obesity related to disease
cons:
- where to draw the line
- food industry is powerful
- lack of current evidence that taxing will have an effect
- penalising lower s-e groups
describe the role of the doctor in health promotion.
- consider health promotion in all consultations
- ask about lifestyle
- offer advice and appropriate referral if necessary
- empower patients to manage chronic disease and offer appropriate support
- undertake public health research
- contribute to national reports
- advocacy and lobbying
compare the high risk approach and population approach to health promotion.
high risk:
- target few ‘high risk’ individuals
- large benefit to those at risk
- limited effect at population level
- e.g. CV screening in primary care
population:
- target population as a whole
- small changes at individual level
- substantial population benefit
- e.g. North Karelia project
