Introduction to Health Promotion

Question 1

What are the top-down and bottom-up approaches in health promotion?

Answer 1

Top-down:
Authorative - priorities set by those with power and/or resources to make decisions and impose ideas of what should be done

Bottom-up:
Negotiated - priorities set by the people themselves, identifying issues they perceive as relevant

Question 2

What are the 5 approaches to health promotion?

Describe them all

Answer 2

Medical/preventative approach

• Reducing morbidity or mortality by targeting risk groups or risk behaviours with medical interventions e.g.: immunisations, surgery
• This doesn’t promote positive health however, and it removes health decision from lay people

Behaviour change approach

• To increase individual’s knowledge about causes of health and illness; Provision of info on health risks and hazards; Persuade individuals to make change e.g.: campaigns to persuade people to make healthier choices
• However this does not take into account social determinants

Educational approach

• To provide knowledge and information and develop necessary skills so people can make an informed choice about their health behaviour e.g.: provision of leaflets/booklets
• Increasing knowledge does not necessarily lead to changes in behaviour

Empowerment approach

• To increase control over one’s physical, social and internal environments; helps people identify their own concerns - gain skills and confidence to act upon them e.g.: participatory learning; group work
• However, it is only assumed that rational choices are healthy choices, not guaranteed; is it cost effective?

Social change approach

• To modify social, economics and physical structures which generate ill health; change society, not the individual; healthier choice becomes the easier choice e.g.: changes to policy and legalisation
• However, most healthcare professionals have limited role in developing policy

Question 3

What is health promotion?

Answer 3

The process of enabling people to increase control over, and to improve, their health

.. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and realise their aspirations, to satisfy their needs, and to change or cope with the environment.

Question 4

What are the three main current health challenges?

Answer 4

Smoking
Obesity
Alcohol

Question 5

Difference between upstream and downstream influences on health

Answer 5

Upstream - what causes the problem; global forces, political priorities, social values; unequal distribution of power, money and resources

Downstream - what effect does it lead to; inequalities in the distribution of health and well-being;

Question 6

Describe the 5 tier public health impact pyramid

Answer 6

Counseling & Education
- Eat healthy, be physically active

Clinical Interventions
- Rx for high blood pressure, high cholesterol, diabetes

Long-lasting Protective Interventions
- Immunisations, brief intervention, cessation treament, colonoscopy,

Changing the Context (to make individuals’ default decisions healthy)
- Fluoridation, 0g trans fat, folic acid fortification, iodization, smoke free laws, tobacco tax

Socioeconomic Factors
- Poverty, education, housing, inequality