Lecture 7 - Disease Prevention II - Health Promotion Flashcards
What is the WHO definition of health?
A resource for everyday life, not objective of living. Health is a positive concept emphasising social and personal resources, as well as physical capabilities
What is the definition of public health?
Science and art of preventing disease, prolonging life and promoting health through organised efforts of society
What is health promotion?
Process of enabling people to increase control over and to improve their health
What does health promotion represent?
Comprehensive social and political process
What actions does health promotion carry out?
Directed at strengthening skills/capabilities of individuals, Changing social/environmental/economic conditions to alleviate impact on public/individual health
What is essential to sustain health promotion action?
Participation
What does health promotion involve?
Clinical intervention (biomedical), Health education (traditional type health promotion (knowledge, attitude, behaviour, practice)), Healthy public policy (legal/fiscal/regulatory), community development (radical individuals setting their own agenda)
How can we see changes in the health of the popn?
Several determinants of health need to be addressed simultaneously
What is the Tannahill model?
Model for health promotion: Prevention, Protection and Education, all overlapping
What are the 4 types of prevention in the prevention circle in the Tannahill model?
Primordial, Primary, secondary, tertiary
Describe in more detail primordial prevention
Prevention of factors promoting emergence of lifestyle/behaviours/exposure that contribute to ^ risk of disease
Describe in more detail primary prevention
Actions preventing onset of disease, limiting exposure to RF by individual behaviour change and actions in community inc. Health promotion and specific protection
Describe in more detail secondary prevention
Halt progression once illness has established, early detection followed by prompt/effective treatment - special consideration of asymptomatic individuals
Describe in more detail tertiary prevention
Rehab of ppl with established disease to minimise residual disability/complications - qual of life action even if disease can’t be cured
What are the 2 main approaches to disease prevention?
High risk and popn
What is the high risk approach to disease prevention?
ID those in need - targeted rescue operation - then controlling exposure (reducing dust mites in house fr asthma)/providing protection against exposure (vaccination)
What is the population approach to disease prevention?
Recognition that the occurrence of common diseases and exposures reflect the behaviour and circumstances of society as a whole
What is the prevention paradox?
Many people exposed to a small risk may generate more disease than the few exposed to large risk->small benefit received by many ppl=total benefit is large BUT individual inconvenience may be high to the many when benefit may only be to a few
What are the strengths of a high risk approach?
Effective, efficient, Benefit:risk is favourable, appropriate to individual, easy to evaluate
What are the weaknesses of a high risk approach?
Palliative and temporary (large no. of disease missed), risk prediction isn’t accurate, limited potential, hard to change individual behaviours
What are the strengths of a popn approach?
Equitable (attributable risk may be high if lots of ppl exposed to low risk), Radical, large potential for popn, behavourally appropriate
What are the weaknesses of a popn approach?
Small adv to individual, poor motivation of subject/physician, benefit:risk worrisome
Where can health promotion operate?
Internationally, nationally (gov, ads, media), locally (GPs, hospitals, local authority, police, schools), individually (support groups, neighbourhood schemes, communities)
Who does health promotion impact upon?
Popn, community and individual
Give an example of Health promotion role of doctors working with individuals
Smoking cessation: NICE guidelines, motivational interviewing, support for cessation, prescription of NRT and Zyban, referral to specialist services
How do doctors play a role in broader health promotion?
Writing/speaking to politicians (lobbying), letters to the press (media advocacy), influencing decision makers
What type of wider health promotion occurs on smoking?
Higher taxes, NRT on prescription, ban on tobacco ads, smoke-free public and work places
What is the Wanless report?
Report written by banker about the unsustainable disease burden, so NHS has to operate a fully engaged scenario, focus on prevention/wider determinants of health, cost effectiveness of actions to improve health/reduce inequalities
What health priorities were chosen in the Wanless report?
Smoking, alcohol, obesity, sexual health, teen preg, MH - also choosing between better diet (food+health action plan) or activity (physical activity action plan)
What was the Marmot review?
A response to the commission on social determinants of health, stating 6 policy objectives
What were the 6 policy objectives mentioned in the Marmot review?
Give every child the best start in life, Enable all children/young ppl/adults
to max their capabilities/have
control over their lives, Create fair employment/good work for all, Ensure healthy standard of living, Create/develop healthy/sustainable
places/communities, Strengthen role and impact of ill health
prevention
What are the key public health programmes?
Smoking cessation, alcohol harm reduction strategy, sexual health, tackling teen preg/obesity, immunisation prog
Describe the smoking cessation campaign actions
Legislation, Taxation, Media campaigns, School activities, Healthy workplaces, One-to-one support, Smoking Cessation clinics, NRT, Group sessions
What is the national alcohol strategy?
End sales of cheapest alcohol, strengthen ban on irresponsible promotions in pubs/clubs, challenge alcohol industry to support local partnerships/promote+display alcohol responsibly, provide action at local level to strengthen partnerships, introduce no. of changes to improve licensing system
How is sexual health being improved?
Free National chlamydia screening programme- est. 2003 (early detection/treatment preventing disease transmission)
How is teen preg being reduced?
Info/advice/support, accessible ppl sex/reproductive health services, improving access to/use of effective contraception when needed, intervening with those most at risk, improving outcomes for teen parents and their children
How is childhood obesity being reduced?
National Child Measurement Programme: annual prog to measure height/weight of all children in reception/Y6 - Change4life campaign raising awareness of lifestyle choices
