Week 3 Flashcards
Ewles & Simnett differing views of health promotion
Veiw #1 is to inform and View #2 is to raise awareness
View #1: to inform
Key aim of health promotion is to inform people about how their behaviour and lifestyle can affect their health, to ensure they understand the information, to help them explore their values and attitudes and (where appropriate) to help them change their behaviour
analysis of View #1: to inform
- reflects health education and emphasizes distributing information and knowledge to change individuals
-ignores social factors that may be key determinants of behaviour and health
-assumes high level of individual agency
-may be seen as blaming victims for their problems
View #2: to raise awareness
Key aim of health promotion is to raise awareness of the many socioeconomic policies at national and local levels that are not conducive to good health, and to work actively towards a change in those policies
examples of socioeconomic policies at national and local levels that align with view 2
employment, housing, food subsidies, advertising, transport and health services policies
analysis of view 2
- goal is to change society
- as people become more aware of the SDoH, health education became health promotion
why dont Ewles and Simnett describe view 1 as health education
health education continues to be a vital component of health pormotion - education is necessary to bring lasting social change
The Ottawa Charter for Health Promotion
result of an international conference held in ottawa in 1986 by WHO, health welfare and canadian public health association
Founding document for health romotion
The Ottawa Charter for Health Promotion
canadas federal minister of health and warfare (Jack Epp) released report in 1986 known as:
Epps Report
- Achieving Health for all: A framework for health promotion
Epps report define three strategies for promting health
- fostering public participation
- strengthening community health services
- coordinating public policy
Epps report define three mechanisms for promoting health
- self-care
- mutual aid
- healthy environments
the ottawa charter built on the ideas in the Epp report, defining 5 actions for health promotion:
- building healthy public policy
- creating supportive environments
- strengthening community action
- developing personal skills
- reorienting health services
Three roles health promoters can take:
Advocate, enablers, and Mediators
fundamental prerequisites for health:
peace, shelter, education, food, income, stable eco-system, sustainable resources, social justice and equity
Ottawa charter: Strengthen community action
- setting priorities, making decisions, planning strategies and implementing them to achieve better health
- empowerment of communities, their ownership, and control of their own destinies
- draws on existing human and material resources in the community to enhance self-help and social support
- strengthening public participation and direction of health matters
- requires full and continuous access to information, learning opportunities for health as well as funding support
Ottawa charter actions: create supportive environments
- health cannot be separated from other goals
- need to encourage reciprocal maintenance
- conservation of natural resources
- work and leisure should be a source of health
- the way society organizes work should help create a healthy society
- living and working conditions that are safe, stimulating, satisfying and enjoyable
Ottawa charter actions: Reorient health services:
- responsibility is shared to work towards a a health care system which contributes to the pursuit of health
- role of health sector must increasingly move in health promotion direction
- health services need to embrace an expanded mandate that is sensitive and respects cultural needs
- support individual needs
- open channels between health sector and broader social political economic and physical environmental components
- stronger attention to health research and changes in professional education and training
Ottawa Charter Actions: Develop Personal Skills
- supports personal and social development through providing information, education for health and enhancing life skills
- increases options available to people to excercise more control over own health
- enabling learning & coping
- action required through educational, professional, commercial and voluntary bodies within institutuions
Ottawa Charter Actions: Build Health public Policy
- health promotion goes beyond healthcare
- puts health on agenda of policymakers in all sectors and at all levels, directing them to be aware of health consequences
- combines diverse but complementary approaches including legislation, fiscal measures, taxation and organizational change
- coordinated action leads to greater equity
- requires identification of obstacles to the adoption of healthy public policies
- aim must be to make the healthier choice the easier choice
Enabling role of health promoters
- secure foundation in a supportive environment, access to information, life skills and opporitunities for making healthy choices
- people cannot achieve fullest health potential unless they are able to take control of those things which determine health
Mediating role of Health Promoters
- health promotion demands coordinated by governments, sectors, non-governmental and voluntary organizations, local authorities, industry and the media
- all people involved as individuals, families and communities
- professional and social groups and health personnel have responsibility to mediate between differing interests in society for pursuit of health
- programs should be adapted
Advocate health promoter role
-good health is a major resource
-making conditions favourable through advocacy for health
5 approaches to health promotion
- Medical
- Behaviour Change
- Educational
- Empowerment
- Social Change
Medical approach
- concerned with preventing ill health and premature death through medical intervention
- including primary, secondary and tertiary prevention
- popular because they can be seen as a quick fix and high status of medical field in society
Example medical change approach
- ex. giving vaccinations to people at risk of infection
Behaviour change approach
- aims to encourage people to adopt healthy behaviours
- ignores social, political, and economic forces that constrain individual behaviour
- seen as ascribing fault to individuals who may be powerless to change behaviour
ex behaviour change approach
media campaign encouraging people to wear N95 mask when indoors
educational approach
- increase knowledge and skills so people can make informed decisions about behaviour
- differs from behavioural in that it doesnt attempt to motivate chnge in particular direction
example educational appraoch
ex. creation and distribution of flyers about a disease
Empowerment approach
- helps marginalized people and communities understand their situation and gain control over it by developing skills and confidence to act to improve it
- empowerment requires health promoters to step aside once hte community is sufficiently empowered
example empowerment approach
brazillian educator who taught people to understand and address powerlessness
Social Change Approach
- focuses on policies to bring about changes to physical, social or economic environment
- types of policy changes sought through the social change approach can be seen as ideologically-driven and reflecting political interests
example social change approach
ex. advocating carbon pricing system to address climate change
4 models of health promotion
- Caplan and Holland’s four paradigms (1990)
- Beattie’s model of practice (1991)
- Tannahill and Downie’s descriptive model (1996)
- Tones and Tilford’s empowerment model (2001)
Caplan and Holland’s four paradigms:
- Traditional
- Humanist
- Radical Humanist
- Radical Structuralist
Caplan and Hollands paradigms propose:
- two dimesions along which paradigms or approaches to health promotion differ:
- the nature of desired societal change, which can involve social regulation or radical change
- the nature of knowledge, which can be subjective or objective
Traditional paradigm
-social regulation and objective knowledge
-typical expert-led approach under medical and behaviour change approaches
Humanist Paradigm
-social regulation and subjective knowledge
-educational approach in which people learn to develop and use personal resources and skills
Radical Humanist Paradigm
- radical change and subjective knowledge
-empowerment-based approach to health promotion where people and communities act to understand and address the determinants of their health
Radical Structuralist Paradigm
-radical change and objective knowledge
-social change approach in which social ands structural determinants are identified and addressed
Beatties model of practice proposes:
- two dimesions upon which health promotion practice differs:
- the focus of intervention, which can be individual or collective
- the mode of thought and intervention, which can be objective and authoritative or negotiated and subjective
Combinations of meatties domesions:
roughly correspond to actions articulated in the ottawa charter
Beatties model: health persuation
individual intervention & authoritative/objective knowledge
Beatties model: legislative action
involves collective intervention & authoritative/objective knowledge
Beatties Model: personal couunselling
involves individual intervention & negotiated/participatory knowledge
Beatties model: Community development
collective intervention & negotiated/participatory knowlefge
4 combinations of Beatties dimensions
- Health persuasion
- Legislative action
- Personal counselling
- Community development
How does health persuasion of Beattie’s model correspong to Ottawa charter
developing personal skills
How does legislative action of beatties model correspond to ottawa charter
building healthy public policy
How does Personal counselling of beatties model correspond to the ottawa charter
developing personal skills
How does community development of beatties model correspong to the ottawa charter
strengthening community action & create supportive environments
what part of the ottawa charter is beatties model missing
re-oirenting health services
