S7 - Health promotion Flashcards
what is the definition of health
health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity
- The absence of any disease or impairment
- A state that allows the individual to adequately cope with all demands of daily life (implying also the absence of disease and impairment)
- A state of balance, an equilibrium that an individual has established within himself and between himself + his social and physical environment
Note: the WHO definition of health as ‘complete wellbeing’ is no longer fit for purpose (due to rise in chronic disease)
How to measure health
- Operational definitions are needed for measurement purposes, research and evaluating interventions
- Measurement instruments should relate to health as the ability to adapt and self manage eg functional status, quality of life, sense of wellbeing
What is health promotion + definition
the process of enabling people to increase control over, and to improve their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions
* comprehensive approach to promoting health by focussing on multi sectoral approaches
* Responds to developments which have a direct or indirect bearing on health, such as inequities, evironments, cultural beliefs etc
☞ the promotion of health is affected by the differences in the definition of health
What is the Ottawa charter of health promotion and the 3 basic strategies
health is created and lived by people within the settings of their everyday life; where they learn, work, play and love
3 basic strategies
☞ advocacy for health to create the essential conditions of health
☞ enabling all people to achieve their full health potential
☞ mediating between different interests in society in the pursuit of health
What are the 5 action areas of the Ottawa charter of health promotion
- Building healthy public policy (joint working across sectors, recognition of the role of public policy in health)
- Create supportive environments for health (the role of work and leisure, protecting the natural and built environment)
- Strengthen community action for health (empower communities, improve access to opportunities)
- Develop personal skills (provide access to info + education for health, enhance life skills)
- Reorient health services (putting more focus on holistic care and health promotion)
Determinants of health
- Combination of non modifiable factors (eg age, sex and constitutional factors)
- Also individual lifestyle factors
- Social and community networks
- Living and working conditions (eg education, housing, health care, unemployment and water sanitation)
- Different factors are interlinked - complex interplay
- The context of people’s lives determine their health
Social determinants of health
these are the conditions in the environments where people are born, live, work, learn, worship, play and age
- Affect a wide range of health, functioning and QoL outcomes and risks
- Poor health outcomes are often made worse by the interaction between individuals and their social + physical environment
- Eg:
☞ economic stability
☞ social and community context
☞ neighbourhood and built environemtn
☞ health care access and quality
☞ access to education and quality
Examples of health promotion strategies
- healthy weight management
- NHS health checks
- Substance misuse services
- Smoking cessation
- Sexual health services
- Green health
- Diet and nutrition
- Physical activity
- Mental health and wellbeing
What are the 3 principles + 6 pillars of lifestyle medicine
- Acknowledge the need for action on socioeconomic determinants of health
- Proven techniques to support people to sustain lifestyle change
- Knowledge of the 6 pillars of lifestyle medicine…
☞ healthy eating
☞ mental wellbeing
☞ healthy relationships
☞ sleep
☞ physical activity
☞ minimising harmful substances
What are the levels of prevention
primary
- Prevent onset of illness
- Designed to reduce the instances of an illness in a population
- Therefore often reduce the risk of new cases appearing, and reduce duration
secondary
- Early diagnosis
- Aimed at detecting and treating pre-symptomatic disease
tertiary
- Minimise effects of established disease and prevent complications
- Aimed to reduce incidence of chronic incapacity or recurrences in a population
- Therefore reduce the functional consequences of an illness
- Includes therapy, rehabilitation or interventions designed to help the patient return to education, career and social/family/cultural life
Targeted vs universal health promotion
universal aims to reduce the risk across the whole population (likely to see bigger impact where a risk factor is common) eg the sugar tax
targeted aims to identify those most at risk ad then tailor messages + approaches for that group (that initiative is more likely to work for that specific community) eg breastfeeding for young mums
Self-management
3 core tasks
☞ medical management (eg attending appointments, adherence to meds, self-assessment for symptoms and complications)
☞ role or behavioural management (eg adapting to their life with new disease status – medication routines, regular exercise and balanced diet)
☞ emotional management (eg managing emotional and psychological consequences of having a lifelong condition)
5 key processes
☞ decision making
☞ taking action
☞ problem solving
☞ utilising resources
☞ forming partnerships with HCPs
Patient activation what is it + definition
the knowledge, skills and confidence that an individual has in managing their own health and healthcare
- individual managing their own healthcare
- ie whether they are disengaged and overwhelmed, or maintaining action (or somewhere in between)
has an important role in self-management
- knowledge abut a long term condition and its treatment is important component of patient activation + self-management
- having necessary skills + knowledge of own condition → better levels of activation
- increased activation → improved self-management behaviours
Barriers and faciliators to self-management
lower patient activation associated with
- intrusive treatment (eg dialysis)
- higher numbers of co-morbidities
- poorer QoL
higher patient activation associated with
- medication adherence
- good QoL
- fewer symptoms and co-morbidities
Predicting change - social cognitive theory
bandura
environmental factors eg social norms, access in community, influence on others
behavioural factors eg skills, practice and self-efficiacy
cognitive factors (personal factors) eg knowledge, expectations and attitudes
