S5) Health Promotion

Question 1

What are determinants of health?

Answer 1

Determinants of health are a range of factors that have a powerful and cumulative effect on the health of populations, communities and individuals

Question 2

Identify some determinants of health

Answer 2

• The physical environment,
• The social and economic environment,
• Our individual genetics, characteristics and behaviours

Question 3

Why are determinants of health important?

Answer 3

• The context of people’s lives determine their health so blaming/rewarding people for their health is inappropriate
• Individuals are unlikely to be able to directly control many of the determinants of health

Question 4

What is health promotion?

Answer 4

Health promotion is the process of enabling people to increase control over and to improve their health

Question 5

There are certain principles of health promotion. Describe the following:

• Empowering
• Participatory
• Holistic
• Intersectoral

Answer 5

• Empowering: enabling individuals and communities to assume more power over the determinants of health

- Participatory: involving all concerned at all stages of the process

- Holistic: fostering physical, mental, social and spiritual health

- Intersectoral: involving the collaboration of agencies from relevant sectors

Question 6

There are certain principles of health promotion. Describe the following:

• Equitable
• Sustainable
• Multi-strategy

Answer 6

• Equitable: guided by a concern for equity and social justice

- Sustainable: bringing about changes that individuals and communities can maintain once funding has ended

- Multi-strategy: uses a variety of approaches e.g. policy and community development & organisational change

Question 7

Distinguish between health promotion and public health

Answer 7

• Public Health tends to emphasise the ends
• Health Promotion places more value on means to achieve the ends

Question 8

What are the 5 approaches enforced in health promotion?

Answer 8

• Medical / preventive
• Behaviour change
• Educational
• Empowerment
• Social change

Question 9

What are the aims and approaches of Primary Prevention?

Answer 9

• Aim: to prevent the onset of disease or injury – by reducing exposure to risk factors
• Approaches: immunisation, reducing risk factors from health-related behaviours, etc

Question 10

What is the aim of Secondary Prevention?

Provide some examples

Answer 10

Aim: to detect and treat a disease (or its risk factors) at an early stage to prevent progression / potential future complications and disabilities from the disease

E.g. screening for cervical cancer, monitoring and treating blood pressure

Question 11

What is the aim of Tertiary Prevention?

Provide some examples

Answer 11

Aim: to minimise the effects of established disease

E.g. steroids for asthma, renal transplants, maximise the remaining capabilities and functions of an already disabled patient

Question 12

One of the dilemmas raised by health promotion involve the ‘ethics of interfering in people’s lives’.

Explain this

Answer 12

• Potential psychological impact of health promotion messages
• State interventions in individuals’ lives

Question 13

One of the dilemmas raised by health promotion involve the ‘victim blaming’.

Explain this

Answer 13

Focusing on individual behavioural change plays down the impact of wider socioeconomic & environmental determinants of health

E.g. high costs of ‘healthy living’, housing conditions, water and air quality, etc

Question 14

One of the dilemmas raised by health promotion involve the ‘fallacy of empowerment’.

Explain this

Answer 14

• Giving people information doesn’t give them the power
• ‘Unhealthy’ lifestyles aren’t due to ignorance but due to adverse circumstances and wider socio-economic determinants of health

Question 15

One of the dilemmas raised by health promotion involve the ‘reinforcing of negative stereotypes’.

Explain this

Answer 15

Health promotion messages have the potential to reinforce negative stereotypes associated with a condition or group

E.g. Leaflets aimed at HIV prevention in drug users can reinforce that drug users should only blame themselves

Question 16

One of the dilemmas raised by health promotion involve the ‘Unequal distribution of responsibility’.

Explain this

Answer 16

Implementing healthy behaviours in the family is often left up to women

E.g Healthy eating advice and the responsibility – eat more fresh fruit, less processed food, etc.

Question 17

Explain the relevance of lay beliefs to health promotion interventions

Answer 17

• If people don’t see themselves as a ‘candidate’ for a disease they won’t co-operate with health promotion
• Awareness of anomalies and randomness of a disease (e.g. heart attacks) also impacts views about candidacy

Question 18

What is evaluation?

Answer 18

Evaluation is the rigorous & systematic collection of data to assess the effectiveness of a programme in achieving predetermined objectives

Question 19

Why should one evaluate?

Answer 19

• Need for evidence-based interventions
• Accountability
• Ethical obligation
• Programme management and development

Question 20

What is process evaluation?

Answer 20

Process evaluation focuses on assessing the process of programme implementation (uses qualitative methods)

Question 21

What is impact evaluation?

Answer 21

Impact evaluation assesses the immediate effects of intervention

Question 22

What is outcome evaluation?

Answer 22

Outcome evaluation measures more long-term consequences

Question 23

Illustrate how the timing of evaluation can influence the ‘outcome’

Answer 23

• Delay: some interventions might take a long time to have an effect
• Decay: some interventions wear off rapidly

Question 24

Why could it be difficult to demonstrate an attributable effect?

Answer 24

• Design of the intervention
• Possible lag time to effect
• Potential confounding factors
• High cost of evaluation research