Public health and health promotion interventions Flashcards
what are the indicators of health
Life expectancy at birth. Deprivation and mortality. Employment/occupation. Deprivation and behaviour – e.g. smoking and drinking. Age& Gender. Education
what are the causes of mortality and disease risk factor
Underweight. Overweight. Smoking. Alcohol consumption. Hypertension. Sexual behaviour, i.e. unsafe sex. Iron deficiency. Cholesterol. Low intake of fruit and vegetables. Physical inactivity
what are the wider determinants of health
These influence the causes/risk factors for disease and mortality: General socioeconomic, cultural and economic conditions. Living and working conditions. Social and community influences. Individual lifestyle factors. Age, sex and hereditary factors
what do approaches to health promotion take into account
The broad definition of health. The scope of prevention. Limitation of health services. Role of individuals, groups and governments
what does health promotion involve
Clinical intervention: Biomedical prevention; screening, immunisation.
Health education: Traditional e.g. education about smoking etc.
Health public policy: Legal, fiscal and social measures - Makes individual healthy choices easier - E.g. seatbelt legislation, smoking ban.
Community development - Individuals/groups setting their own agenda
what is the Tannahill Model
A simple and practical framework which advocates 3 health promotion approaches: 1. Health Education- influences knowledge 2. Health protection- legislative, fiscal and social measures 3. Prevention- medical interventions to reduce risk
what are the four levels of prevention
primordial, primary, secondary and tertiary
what is primordial prevention
Prevention of factors promoting the emergence of lifestyles, behaviours, exposure patterns which contribute to increased risk of disease
what is primary prevention
Actions to prevent the onset of disease, Limit exposure to risk factors, Includes health promotion and specific protection e.g. vaccines
what is secondary prevention
To halt progression once the illness is already started; early diagnosis and treatment
what is tertiary prevention
Rehabilitation to minimise residual disability and complications
what are the 2 main approaches to disease prevention
high risk and population
what is high risk disease prevention
Identifying those in special need (target rescue operation), e.g. screening among SCA patients - Controlling exposure or providing protection against effect of exposure
what are the pros of high risk disease prevention
Effective (high motivation of individual and physician) - Efficient (cost-effective use of resources) - Appropriate to individual - Easy to evaluate
what are the cons of high risk disease prevention
Palliative and temporary (misses a large amount of disease) - Risk prediction not accurate - Limited potential- misses out on info about relatives and friends - Hard to change individual behaviours
what is population disease prevention
recognition that the occurrence of common diseases and exposures reflects the behaviour and circumstances of society - Idea that small changes lead to a bigger influence
what is the prevention paradox
many people exposed to a small risk may generate more disease than the few exposed to a large risk. therefore, when many people receive a small benefit the total benefit may be large. however, individual convenience may be high to the many when benefit may only be to a few
what are the pros of population disease prevention
Equitable (attributable risk may be high where risk is low if a lot of people are exposed to that low risk) - Radical - Large potential for population - Behaviourally appropriate
what are the cons of population disease prevention
small advantage to individual. poor motivation of subject. poor motivation of physician. benefit:risk ratio worrisome
where can health promotion operate
internationally. nationally. locally (GP, hospitals, local authority, police, schools etc). individual
who can health promotion impact on
population, community, the individual
health promotion role of doctors working with individuals
smoking cessation guidelines. motivational interviewing. support for cessation. prescription of nicotine replacement therapy (NRT). referral to specialist services
what wider health promotion
advocacy e.g higher taxes, nrt on prescription, ban on tobacco advertising, smoke-free public and work places by: writing, letters to the press, influencing to decision makers
give an example of a current public health initiative
the wanless report. wanless 1,2 and 3. the disease burden. fully engaged scenario. focus on prevention and the wider determinants of health. cost effectiveness of actions to improve health and reduce inequalities
the marmot review
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 a healthy standard of living for all. Create and develop healthy and sustainable places and communities. Strengthen the role and impact of ill health prevention
what are the key public health programmes
smoking cessation, alcohol harm reduction strategy, sexual health- national chlamydia screening programme, tackling teenage pregnancy, tackling obesity, immunisation programmes
commission on social determinants of health
improve the conditions of daily life – the circumstances in which people are born, grow, live, work, and age. Tackle the inequitable distribution of power, money, and resources – the structural drivers of those conditions of daily life – globally, nationally, and locally. Measure the problem, evaluate action, expand the knowledge base, develop a workforce that is trained in the social determinants of health, and raise public awareness about the social determinants of health.
three key policy documents regarding health promotion
Ottawa Charter
Jakarta Declaration
Bangkok Charter
