L12- Social factors in health promotion Flashcards
examples of health promotion in the UK
- Change for life
- Start for life
- Couch to 5k
- Be clear on cancer
5 types of health promotion in action
- Medical or preventative
- Behaviour change
- Educational
- Empowerment
- Social change
medical or preventative
- Clinical approach to promoting health
* E.g. giving advice on the benefits of stopping smoking
behaviour change
.g. using shocking images and clever catch phrases
• Very brief advice on smoking (for doctors- so they can take part in the intervention)
• Motivational interviewing
educational
Giving people the facts on the easiest way to give up an unhealthy behaviour
empowerment
- Make people feel in control of stopping whatever unhealthy behaviour they want to quit
- E.g. smoke free app
social change
- Not acceptable to smoke in many places- social sanction around smoking
- Seen less often- less socially acceptable
sociological perspectives
structural
surveillance
consumption critiques
structural critiques
material conditions that give rise to ill health are marginalised
o Focus on individual responsibility may miss the point
surveillance critiques
monitoring and regulating population- is that okay??
consumption critiques
lifestyle choices not just seen as health risks but also tied up with identity construction
dilemas of health promotion
1) should we intervene in peoples lives?
2) Victim-blaming: whos fault is poor health?
3) Fallacy of empowerment
4) Reinforcing negative stereotypes
5) Unequal distribution of responsibility
1) should we intervene in peoples lives?
- Potential psychological impact of health promotion messages.
- State intervention in individuals like ‘Nanny’ state —> rights and choice
2) Victim-blaming: Who’s fault is poor health?
Health promotion often focuses on individual behavioural change
- Structural and socioeconomic changes are not often factored in
- Plays down the impact of wider socioeconomic an environmental determinant of health
- E.g. housing conditions, water and air quality, workplace conditions, roads, green spaces
- All of the above influence the perceptions individuals have on their health and the choices they make
3) The fallacy of empowerment
- Giving people generic information about unhealthy behaviours will not necessarily make them do it
- Info does not give automatic power to act on healthier choices
o e.g. cost of doing a healthy behaviour
o e.g. join a gym if inactive - Unhealthy lifestyles almost never due to ignorance, but due to adverse circumstances and wider socio-economic determinants of health
o e.g. mums who don’t breast feed because they need to earn money and work
4) Reinforcing negative stereotypes
- Health promotion can reinforce negative stereotypes associated with a condition or group
o e.g. leaflets aimed at HIV prevention in drug users
5) Unequal distribution of responsibility
- Implementing healthy behaviours in the family is often left up to the women
- Example: healthy eating advice and the responsibility to their family to eat more fresh fruit etc
- Women are often left to implement promotions that require work in the home as we know women still do
the prevention paradox
Interventions that make a diff at population level might not have much effect on the individual
lay beliefs and the prevention paradox
- 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 will also impact on views about candidacy
- Importance of health promoters engaging with lay beliefs
- e.g. anti-vaxxers do not understand why we vaccinate for diseases that don’t exist in the UK anymore- lack of understanding of heard immunity
why evaluate health promotion
- We need evidence based interventions
- Properly conducted evaluation studies can provide necessary evidence
- Accountability
- Evidence also gives legitimacy to interventions and political support
- Ethical obligation
- The imperative to ensure there is no direct or indirect harm
- Programme management and development
types of health promotion evaluation
process eval
impact
outcome
process evaluation
- Assessing the process of programme implementation
* Employ wide range of mainly qualitative methods
impact
- Assess the immediate effects of the intervention
* Popular choice- easiest to do
Outcome
Measure more long-term consequences ◦Measures what is achieved:
• Improvement in clients lives
• Reduction of symptoms
• Level of harm reduction
• Timing of eval can influence outcome: delay- sometime interventions might take a long time to have an effect
• Decay: some interventions wear off rapidly
difficulties with evaluation
Demonstrating an attributable effect is difficult because:
- Design of the intervention
- 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
