Module 1 Flashcards
Ottawa Charter
The process of enabling people to increase control over and to improve, their health
Empowerment
“Process through which people gain greater control over the decisions and actions affecting their health.”
Empowerment & Health
Theory and Practice of Community Change, identifies three conditions that contribute to empowerment by Nina Wallerstein: social networks, community participation & community competence
Positive Health Impacts of Empowerment
increased levels of social support, enhanced coping capacities, increased life satisfaction and decreased susceptibility to illness.
Example of Empowerment
A local health center adapts it’s services to meet the language and cultural needs of the growing South Asian population in the community
Inclusion
- Excluded people cannot access health, social or economic benefits of full participation in society
- Excluded by poverty, ill health, gender, race, disability or lack of education
- HPWs work with marginalized groups in the community who face systemic barriers to good health
- E.g. A health clinic promotes acceptance of different perspectives, viewpoints and lifestyles
Respect
- Diverse viewpoints, cultures and perspectives
- Builds sustainable relationships
- Basis for action to achieve shared goals
- E.g. A public health team accounts for the 12 determinants of health in planning the delivery of accessible health service
Holistic view on Health
A state of complete physical, mental and social well-being rather than a mere absence of disease or infirmity.
- Health= resource for everyday life
- Physical health is one resource contributing to health along with other social and personal resources
Focus on Participatory Approaches
- Addressing health issues by doing things with people rather than for them
- Supporting people to get greater control over the conditions that affect their health (IMPORTANT!)
- Includes values such as empowerment, social justice and equity, inclusion and respect
Focus of SDoHs
-range of social, economic and environmental factors which determine the health status of individuals or populations
Building on existing strengths & assets
- Community leaders
- Existing programs and services
- Strong social networks
- Community institutions and events that bring people together
Use of Multiple Complementary Strategies
- comprehensive approach
- addresses diff levels of audiences including individuals, networks, organizations or society as a whole
Ottawa Charter Action Areas
a) Build healthy public policy
b) Create supportive environments
c) Strengthen community action
d) Develop personal skills
e) Re-orient health services
Complementary Strategies
- Health communication
- Health education
- Self-help/mutual aid
- Organizational change
- Community development and mobilization
- advocacy
- Policy change
- Intersectional collaboration
Multidisciplinary Nature
HP includes elements from…
- Psychology
- Sociology
- Nursing
- Social work
- Community organizing
- Planning and education
HP Settings
- Understand health behaviour and decide on appropriate health promotion interventions
- When, where & how to build supportive environments that encourage health?
Home & Family
Influences and shapes our…
- Attitudes and beliefs towards health
- Practices
- Behaviors
- Coping mechanisms (stress & illness)
- Health behaviour
- Who we are as individuals?
- primary target of HP
Internal vs External Factors
- internal factors= cultural norms, values ad traditions
- external factors= employment status and neighborhood safety
School
- children spend lots of time here
- Most formative/ impressionable years
- Peer relationships that influence attitudes and behaviors are formed (+ & - effects)
- Build confidence & self esteem
- Opp effect when bullying, ostracism or peer pressure occur
School allows for learning about…
- Nutrition
- Physical activity
- Sexual health and behaviour
- Substance use
Workplace
- tech innovations, globalization, mechanization of manual labor and increased controls on environmental workplace hazards have changed HP
- Focus move to social and mental aspects of health
- Identify root causes of ill health
- Develop equitable, safe and supportive environments
- Support good organizational management through policy development
Physical factors that can affect the workplace
air quality, hazardous exposures and injuries are still concerning
Health care institutions
large, established organizations primarily directed towards the provision of medical care, including acute care, long-term care, rehab and psychiatric care
Tech advances in Health care leads to…
- increasing chronic disease rates and budget pressures
- Inspired interest in helping patients to better manage health and become less reliant on the health care system
- E.g. Greening of hospital procedures, community engagement, patient counselling, clinical rehabilitation and corporate/community wellness programs
Community
- Theory in a Nutshell: A Practitioner’s Guide to Commonly used Theories and Models in Health Promotion
- Contemporary HP practice= communities that are viewed as dynamic systems with capabilities that can be influenced and supported in ways that improve health
- Offers resources, social support and tools for health
- Could reinforce inequalities in society (excluding marginalized and disadvantaged people)
Population Health
-John Last- “health of the population, measured by health status indicators”
-Influenced by physical, biological, behavioral, social, cultural and economic factors
-Subset of the population
Primary Interventions:
-Societal-level
-Aim to affect the health of entire populations
-E.g. Increasing tobacco taxes, regulation of sodium levels & bicycle helmet laws
-Mass population
-Aim to lower the average level of risk in a population
-Mass-immunization or education campaign (sun-safety or condom use)
-Beneficial to population, less impact on individual level
-High-risk
-Focuses on individuals/ groups that are most susceptible to a health problem or behaviour
-Involves screening to determine risk status
-Benefits individuals rather than population
-E.g. breast cancer screening, HIV testing or School bullying interventions
Disease Prevention
- Alternative to HP
- Preventing chronic diseases (heart disease, cancer, stroke or diabetes) that contribute to premature mortality
Primordial Prevention
- Eliminates predisposing risk factors
- E.g. environmental controls, maternal deprivation or illiteracy
Primary Prevention
- Strategies to prevent disease
- E.g. immunization
Secondary Prevention
-Uses screening procedures to detect and treat serious disease as soon as possible
Tertiary Prevention
- Aimed at stopping the progression of established disease
- E.g. heart attack-> patient undergoes cardiac rehab to prevent relapse
HP & DP
- HP focuses on assets & strengths
- Commitment to participatory approaches
- Moves beyond biological factors to focus on social, economic and environmental causes of health & illness
- Disease prevention is applying to health promotion features & values
Harm Reduction
- “Any program or policy designed to reduce harm w/out requiring the cessation of a practice or addiction”
- E.g. needle exchange programs or condom distribution
- focuses on high-risk behaviour
The American Journal of Health Promotion
“health promo is the art and science of helping people discover the synergies between their core passions and optimal health, enhancing their motivation to strive for optimal health. Optimal health is a dynamic balance of physical, emotional, social and spiritual and intellectual health. Lifestyle change can be facilitated through a combo of learning experiences that enhance awareness, increase motivation, and build skills and most important through the creation of opportunities that open access to environments that make positive health practices the easiest choice.”
Ottawa Charter
“The process of enabling people to increase control over, and improve their health.”
Green & Kreuter
“Any planned combination of educational regulatory and organizational supports for actions and conditions of living conducive to the health of individuals, groups and communities.”
Similarities between the diff definitions of HP
- Idea of enabling people to take control of their health
- Multi-faceted and participatory approaches
Similarities between the Ottawa Charter & AJHP
- Health as going beyond physical health to a state of well-being or optimal health
- Includes physical, mental, social, spiritual, intellectual and emotional well-being
- Enhancement of personal skills and capabilities
- Provides a definition of optimal health*
Differences with Green & Kreuter
-Role of the state (system or organization
-Role of interventions in HP and creating conducive environments and supports that enable people to achieve health
-Planned supports for individual/groups/communities
E.g. 3 health promoters working for different organizations are hired to develop programs to prevent diabetes among low-income, socially isolated seniors
•Focus on policy or organizational changes that would support health over the long term
•E.g. advocating for policies to subsidize nutritious foods or enhance walkability of streets where isolated seniors live
Differences in the Ottawa Charter
- HP is not just a responsibility of a health sector
- Health as a resource
HP Values…
- Empowerment, social justice and equity, inclusion and respect
- Focus on holistic view of health
- Participatory approaches
- Broad social determinants of health
- Building on existing strengths and assets
- Use of multiple strategies
Ottawa Charter drives HP through…
process of allowing people to increase control over and improve their health
