TEST 1 Flashcards
What is health?
A state of complete physical, mental and social wellbeing & not merely the absence of disease or infirmity (physical or mental weakness).
What are the five common concepts of health as identified by Blaxter (1990)
- ‘Health as not-ill’ - health is the absence of symptoms or medical input; widely used by all groups
- ‘health as physical fitness’ - health as having energy + strength; mostly used by younger men.
- ‘health as social relationships’; mostly used by women
- ‘health as function’ - health as the ability to carry out tasks + activities; mostly used by older people of both sexes.
- ‘health as psychosocial well-being’; less used by young men, most used by higher socio-economic groups.
What is lay concepts of health?
o What makes a person healthy
o People from various cultural backgrounds define health differently
o Health can be defined as:
- Absence of disease
- A dimension of strength
- Functional fitnessWhat is physical health?
Concerns the body (i.e., fitness, no disease)
What is mental health?
Positive sense of purpose & an underlying belief in one’s own worth (feeling good)
What is emotional health?
ability to feel, recognize + give a voice to feelings + to develop + sustain relationships.
What is social health?
sense of having support available from family + friends
What is spiritual health?
recognition + ability to put into practice moral or religious principles or beliefs + the feelings of having a purpose in life or a meaningful life.
What is sexual health?
acceptance + ability to engage in satisfactory expression of one’s sexuality.
What influences the individual dimensions of health?
- Societal health: the link between health & the way a society is structured
- Environmental health: physical environment & climate change
- Global health:
What is health promotion?
The process of enabling people to increase control + to improve their health.
How does health promotion aim to help people live healthy lives?
Health promotion aims to help people live healthy lives by:
o Increasing people’s knowledge & awareness
o Enabling them to take actions to improve their health
o Ensuring that the circumstances allow them to make healthy choices
How can you make the healthiest choice the easiest choice?
You can make the healthiest choice the easiest choice by:
- Health education
- Developing personal skills
- Strengthening community action
- Reorienting health services
- Building healthy public policy
- Creating supportive environments
When did the emergence of health promotion as a concept distinct from traditional public health practice or disease prevention take place
20th century
What year was the earliest published reference to health promotion taken place? and by who?
1920’s by Winslow.
Who further refined the concept of health promotion and when?
Harry Sigerist in the 1940’s
In the 1940’s, what did Harry Sigerist call for?
Sigerist called for the coordinated efforts of politicians, labour, industry, education & health care to ensure that these prerequisites for good health were within reach of everyone (intersectoral collaboration).
When was the specialized agency of the United Nations founded?
April 1948
What did the medical care act (Canada health act) ensure for all Canadian citizens? and who passed it into law?
Universal access to health care, passed into law by Trudeau govt.
When was the first Canada-wide media campaign promoting healthy lifestyles launched? And what was the (false) argument?
ParticipACTION was launched in 1972. The (false) argument was that the average 60 year old Swede was more physically fit & active than the average 30 year old Canadian.
Who is Mara Lalonde?
Minister of health.
in 1974, in spite of the holistic nature of the report, what was still emphasized?
the importance of lifestyle & personal responsibility were still emphasized.
In 1978, how did the Canadian government respond to the Lalonde report?
By establishing a Health Promotion Directorate within the federal department of national health & welfare
What is the directorate? and what was it organized around?
The first technical structure devoted to health promotion in the world.
It was organized around the health field concept of lifestyle, with a focus on areas such as smoking & nutrition.
When was the very 1st WHO international conference held? Where? What did it result in?
1986, in Ottawa, it resulted in the creation of 1986 Ottawa Charter for health promotion.
What were the three main strategies identified to promote health?
o Advocate: for healthier environments (e.g., social environmental)
o Enable: more optimal health by reducing health inequalities
o Mediate: across differing sector; in other words, encourage inter-sectoral collaboration (e.g., industry, media, government).
What are the 5 action areas identified by the Ottawa charter for health promotion?
- Build healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Re-orient health service (from treatment only to include prevention)
In 1997, what was reaffirmed at the 4th international conference on health promotion in Jakarta?
The commitment to social justice, equity & sustainability.
What was identified as the greatest threat to health by the Jakarta declaration?
Poverty.
When was the public health agency of Canada founded?
2004.
What is the Centre for health promotion (CHP) responsible for?
- The centre is responsible for implementing policies & programs that enhance the conditions within which healthy development takes place.
What does the centre for health promotion (CHP) address?
o The centre acts through programs addressing:
- Healthy child development - Families - Aging - Lifestyles - Public information & education Issues related to rural health - Support of the voluntary sector
What are the three approaches to health promotion
- Biomedical
- Behaviour change
- Socio-environmental
How does the biomedical approach view health?
Typically views health as the absence of disease or disorders.
What is the target population of the biomedical approach?
general population or high-risk groups (depends on the mode of prevention).
What are the three levels of intervention?
- Primary Prevention
- Secondary Prevention
- Tertiary prevention
What does the primary prevention include?
includes everyone (the entire pop, all ages, all backgrounds)
What does the secondary prevention include?
includes individuals at risk for particular problem or disease (ie for flu prevention it’s the older elderly and younger kids 5 & under)
What does the tertiary prevention include?
includes individuals who are already sick. (ie builds immunity to keep getting flu shot each year).
What does Immunization require?
requires a certain level of uptake for it to be effective at the population-level (herd immunity)
What is screening effective for?
effective for conditions that have a long pre-clincial phase so that earlier treatment will improve outcomes.
What is the long-term evaluation of the biomedical approach?
significant reduction in rates of diseases & associated mortality
What is the short-term evaluation of the biomedical approach?
significant increase in the proportion of population being screened or immunized
How does the behaviour change approach view health?
Typically views health as the product of an individual making health lifestyle choice
What is the aim of the behaviour change approach?
encourage individuals to adopt behaviours that are found to improve health (diet)
What assumption is the behaviour change approach based on?
o Health can improve by choosing healthier lifestyle behaviours
o If people do not take responsible action to look after themselves, they are responsible for the consequences.
Why is the behaviour change approach a traditional approach to health?
Because it is expert-led, top down approach.
What does it mean that the traditional approach is an expert-led, top down approach?
- Health messages created by health professionals shared by broad population health campaigns encourage ppl to adopt healthier lifestyle behaviours.
What are health campaigns?
Goal-oriented attempts to inform, persuade or motivate behaviours change in a large, well-defined audience.
What is the aim of the health education approach?
To provide knowledge & information, but also the necessary skills so that people can make an informed choice about their health behaviour.
Why is education different than health communication?
Education is different than health communication because it does not encourage change in a particular direction
What are assumptions that are underlying the health education approach?
Assumptions underlying the health education approach are:
- By increasing knowledge, there will be a change in attitudes which may lead to a change in behaviour
- Each person makes their own informed choice.
What three aspects of adult learning is the health education approach based on in?
- Knowledge (information and understanding)
- Attitudes
- Behaviour (skills)
How does the socio-environmental approach view health?
This approach views health as the product of social, economic & environmental determinants that provide incentives & barriers that facilitate or impede the health of individuals & communities
Why is the socio-environmental approach more of a less traditional approach to health promotion?
- More bottom-up approach
- Can be initiated at grassroots level by community members &/or their advocates
- Take social context into account
What are the four key points of the indigenous wellness framework?
- Purpose
- Hope
- Meaning
- Belonging
What are the three types of influences that stress can have on health?
- Pathogenic
- Neutral
- Salutary
What does the term salutogensis mean and who is it coined by?
How people make sense of and manage stressful events to survive, adapt and overcome difficult experiences. Coined by Antonoysky
What are the three main component of the quality of life perspective as defined by centre of health promotion at the uni of Toronto?
- Being (who one is)
- Belonging (connections)
- Becoming (goals, hopes, aspirations)
What is included in the “being” component of the quality of life perspective?
- Physical being – hygiene, nutrition, exercise
- Psychological being – cognitions, mood
- Spiritual being – values, standard of conduct.
What is included in the “belonging” component of the quality of life perspective?
- Physical belonging – home, workplace, school
- Social belonging – intimate others, family, friends
- Community belonging – employment, community events, cultural events.
What is included in the “becoming” component of the quality of life perspective?
- Practical becoming - health or social needs, domestic activities
- Leisure becoming - relaxation & stress reduction activities
- Growth becoming – activities that maintain or improve knowledge and skills, adapting to change
What is theory?
- systematically organized knowledge
- applicable in a relatively wide variety of circumstances
- devised to analyze, predict or otherwise explain the nature or behaviour of a specific set of phenomena that could be used as the basis for action.
Why do we need theory?
- extremely important to understand WHY people behave the way they do if in order to effectively design an intervention
- theories provide explanations regarding why an intervention is necessary, how to intervene and how to evaluate success
- different theories are used as the field of health promotion has become to complex for any one single theory to provide adequate guidance.
What is the most commonly used theory to explain individual behaviour?
Health Belief Model (HBM)
Who developed the health belief model (HBM) and when?
Rosenstock, Hochbaum and Kegels developed HBM in the 1950’s.
What does the health belief model predict?
The model predicts that individuals will act to change their behavior if they believe that:
- they are susceptible to a condition/problem
- perceived severity: consequences of the condition/disease are serious.
- they have agency – they can carry out the recommended actions to deal with the problem, and those actions are beneficial
- the benefits of taking action, outweigh the costs or barriers.
What was the HBM expanded to include?
- Self-efficacy: perceived ability to carry out the recommended action (self-confidence)
- Cues to action: these are strategies to activate readiness to change behaviour.
What is the theory of planned behaviour (TPB) and who is it developed by?
- Based on the assumption that intention to act is the key determinant of behaviour.
- All other factors affecting behaviour are mediated through behavioural intention.
- Developed by Aizen in the 1980’s
What are behaviour intentions thought to be influenced by?
- attitudes towards behaviour
- subjective norms
- perceived behavioural control
What is the trans theoretical model (TTM)? Who is it developed by?
- Uses stages of change to integrate processes & principles of change across major theories of intervention.
- James Prochaska
What is the Precontemplation stage?
No intention to take action within the next 6 months.
What is the Contemplation stage?
Individual intends to take action within the next 6 months.
What is the Preparation stage?
Individual intends to take action within the next 30 days & has taken some behavioural steps in this direction.
What is the action stage?
The individual has changed overt behaviour for less than 6 months.
What is the maintenance stage?
Individual has changed overt behaviour for more than 6 months
What is the termination stage?
The individual may not need to continue the behaviour so you stop or you can continue the maintenance stage. (does not always apply, but sometimes it does.)
What is decisional balance?
relative weighting of the benefits (pros) & costs (cons) of changing.
What is self-efficacy?
confidence you can engage in new healthy behaviour across different challenging situations vs temptation to engage in unhealthy behaviour.
What is involved in the processes of change?
- consciousness raising:
- self-revaluation:
- helping relationships:
- reinforcement management:
- stimulus control:
What are the three distinct models for practice within the Rothman’s framework?
- social planning
- locality (community) development
- social action
What is social planning within Rothman’s framework?
A rational, deliberately planned task-oriented method of problem solving, usually by an outside party, to address community concerns.
- The outside change agent(s) gather facts about community problems & recommends the most appropriate solutions.
What is locality (community) planning within Rothman’s framework?
A more process-oriented approach that attempts to build a sense of group identity within community.
- a wide variety of community people should be involved in planning, implementation and evaluation.
- Community workers organize a broad cross-section of people into small, task-oriented groups to identify and resolve shared problems.
What is social action within Rothman’s framework?
A more radical approach, which aims to address imbalances of power between marginalized & dominant community groups.
- Main assumption: A disadvantaged/disenfranchised segment of the population needs to be organized in order to make demands on the larger community for increased resources or improved treatment.
What is the major theme in the intersectionality framework?
Emphasis on power differences between group & individuals.
What does the intersectionality framework highlight
the “interaction between gender, race, and other categories of differences in individual lives, social practices, institutional arrangements and cultural ideologies and the outcomes of these interactions in terms of power”
What are the key assumptions in the intersectionality framework
- pursuit of social justice is the main objective.
- concept of identity does not assume shared or similar perspectives
- recognition that categories of difference (e.g., age, gender, sexual identity) are complex, fluid and flexible.
- Power is a central theme.
What is an important component of the intersectionality framework?
Reflexive practice is an important component of this framework: because it requires us (no matter who we are) to think about ourselves and the world around us and makes us become more aware about why we are thinking the way we are.
What is the community organization framework?
The process by which community groups identify common problems or goals, mobilize resources and develop and implement strategies to achieve goals.
What is a key concept in the organization framework?
- Empowerment is a key concept:
- enabling individuals and communities to take more control over their lives and their environment.
What are the five key concepts of the community organization framework?
- empowerment
- critical consciousness
- community capacity
- issue selection
- participation & relevance
What is the definition of empowerment and how it it applied?
- Social definition process for people to gain mastery over the lives & communities.
- Applied by community members assuming greater power or expanding their power to create desired changes.
What is the definition of critical consciousness and how it it applied?
- Consciousness based on reflection & action in making change.
- Applied by people engaging in a dialogue that links root causes to community action.
What is community capacity and how is it applied?
Characteristics affecting the community’s ability to identify, mobilize and address problems.
Members participate actively in the life of their community through leadership, social networks and access to power.
What is Issue Selection and how is it applied?
Identifying winnable & specific targets or goals of change that unify & build community strength.
Issues identified through community participation; goals chosen as part of a larger strategy.
What is participation and relevance and how is it applied?
Organizing starts “where the people are” & engages all members as equals.
- Members create their own agenda based on felt needs, shared power and awareness of resources.
