Promoting Health & Preventing Illness

Question 1

Why are health inequalities a concern for doctors?

Answer 1

Identifies population groups who might be more vulnerable to particular illnesses/health behaviours and beliefs

Question 2

What’s the aim of tackling health inequalities?

Answer 2

Yield a more equal distribution of health between social groups: requires social determinants, tackling the social gradient

Question 3

Define disease prevention and health promotion

Answer 3

Prevention: actions aimed at eradicating/eliminating/minimising the impact of disease and disability or delaying the progress of disease and disability

Health promotion: the process of enabling people to increase control over their health and its determinants to improve their health

Question 4

Outline the 3 stages of disease prevention

Answer 4

Primary prevention: pre disease avoid it starting in the first place (immunisation/education -> public health, GP)

Secondary prevention: early stage disease to detect early and slow progression (screening -> GP/hospitals)

Tertiary prevention: symptomatic disease to limit damage from disease to reduce its progress (rehab, pain management programmes -> rehab and palliative care)

Question 5

Who can you target for primary/secondary prevention?

Answer 5

High risk individuals (stigmatise individuals) or populations (benefit is small for individuals but population for whole large)

Small reduction in average by/cholesterol of a population would produce a large reduction in incidence of CVD

Question 6

What’s the Ottawa Charter?

Answer 6

Action areas: build healthy public policy, create supportive environments, reinforce community actions, develop personal skills, reorient health services from treatment to prevention

Question 7

What are 2 models of entity of health promotion?

Answer 7

Ewles and Sminett 5 approaches

Beattie 4 quadrants

Question 8

What are the Ewles & Sminett’s 5 approaches to health promotion?

Answer 8

Medical
Behaviour change
Educational
Client centred
Societal change

Question 9

Outline Beattie’s Model of Health Promotion

Answer 9

4 quadrants:

Individual -> Collective focus of intervention along the x axis

Authoritative (top down) -> Negotiated (bottom up) mode of intervention along the y axis

Question 10

What are the 2 big reports on health inequalities and what same conclusion do they draw?

Answer 10

Marmot review 2010 & WHO Commission on Social Determinants of Health 2008

= tackling health inequalities requires tackling the determinants of social inequality (social gradient needs to be reduced)

Question 11

What are the Marmot reviews 6 policy objectives and what recommendations from the review will reduce inequalities?

Answer 11

Give every child the best start in life
Enable all children, young people and adults to maximise their capabilities and have control over their lives
Create fair employment and good work for all
Ensure healthy standard of living for all
Create and develop healthy and sustainable places and communities
Strengthen the role and impact of ill health prevention

Reduce the social gradient
Action across all social determinants
Action across all sectors
Participatory decision making at local level

Question 12

What are two approaches that the social gradient can be reduced?

Answer 12

Upstream factors: tackle wider influences on health through public policy approaches

Downstream factors: tackle health behaviours, lifestyles