What is health promotion?

means focusing not just on preventing disease but also on people’s social & mental health. Includes preventive activities, education, community-based social action, creation of healthy environments & policy change.

WHO “Health for all by the year 2000” 5 key steps:

1. Population perspective 2. Action on determinants of health 3. Uses diverse but complementary approaches 4. Requires effective public participation 5. Activity is based in the health & social fields

1985 WHO - Targets for health for all: the health policy for Europe

Health is dependent on: Peace & freedom from the fear of war Equal opportunity for all & social justice Satisfaction of basic needs including food & income, safe water & adequate sanitation, acceptable housing, secure work & a satisfying role in society Political commitment & public support Stable eco-system & sustainable resource use

1986 - Ottawa Charter for Health Promotion focussed on:

Advocacy, Enablement and Mediation

The Ottawa Charter achieves its 3 core values by 5 key actions:

Strengthening Community Action, Building Healthy Public Policy, Creating Supportive Environments, Developing Personal Skills, and Reorienting Health Services

approaches to health promotion

Medical or preventive Behaviour changes Educational Empowerment Social changes

Objectives of health promotion

prevention of disease, to ensure that people are well informed & able to make good health choices, to help people to acquire the skills & confidence to take greater control over their health, to change policies & environments in order to facilitate healthy choices

Approach 1) Medical/preventive

reduce risk of disease, premature death, illness or disability, or any other undesirable health event

Primary prevention

prevention of onset of disease via risk education

Secondary prevention

preventing progression of disease once it’s established

Tertiary prevention

reducing further disability & suffering in those already ill, preventing recurrence of an illness, improving quality of life even if disease is incurable, e.g. rehabilitation, patient education, palliative care

Pros of preventative medicine

Cheaper to treat illness/disease in early stages, can be very effective

Cons of preventative medicine

can be criticised for ignoring social & environmental dimensions of health, Relies on having infrastructure capable of delivering,

Approach 2) Behaviour change

encourage individuals to adopt health behaviours key to improving health

Pros of behaviour change

Grants people agency, expert-led

Cons

it assumes if people do not take responsible action to look after themselves then they are to blame for the consequences, change may only become apparent over a long period of time, also it may be difficult to isolate any change as attributable to a health promotion intervention

Approach 3) Educational

provide knowledge & information & to develop necessary skills so that people can make an informed choice about their health behaviour

Health education can be provided via -

provided via Leaflets & booklets, Visual displays, One to one advice, Group discussion, Role playing activities, Media campaigns, classroom interventions

Pros of education

Helps to empower people to make good choices

Cons of education

Information alone is not enough, people must be willing

Approach 4) Empowerment

to help people to identify their own concerns & gain the skills & confidence to act upon them

Self empowerment

counselling & client centred approaches are aimed at increasing people’s control over their own lives

Community empowerment

community development is a way of working which seeks to create active participating communities who are empowered & able to challenge & change the world around them

Pros of empowerment

bottom up strategy where individuals take control of their health,

Approach 5) Social Change

to bring about changes in physical, social & economic environment which will have health promoting effect - focus is at policy or environmental level

Challenges of social change

Need to make the healthy choice the easier choice - often a healthy choice is available but to make it a realistic option for most people requires changes in its cost, availability or accessibility