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Introduction to Health Promotion Concepts

This document provides an overview of health promotion. It defines health as a state of complete physical, mental and social well-being, influenced by social and environmental determinants. Public health aims to prevent disease and promote health through organized community efforts, with core activities including health monitoring, disease prevention, and health education. Health promotion works to enable individuals and communities to increase control over their health by addressing both individual behaviors and social determinants of health. The Ottawa Charter outlines core strategies of health promotion including advocacy, enabling, and mediating to create healthy public policy, supportive environments, and strengthened community action.

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Dr. Abdallahi A. Yusuf
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101 views6 pages

Introduction to Health Promotion Concepts

This document provides an overview of health promotion. It defines health as a state of complete physical, mental and social well-being, influenced by social and environmental determinants. Public health aims to prevent disease and promote health through organized community efforts, with core activities including health monitoring, disease prevention, and health education. Health promotion works to enable individuals and communities to increase control over their health by addressing both individual behaviors and social determinants of health. The Ottawa Charter outlines core strategies of health promotion including advocacy, enabling, and mediating to create healthy public policy, supportive environments, and strengthened community action.

Uploaded by

Dr. Abdallahi A. Yusuf
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Dr.

Abdalle

CHAPTER ONE: INTRODUCTION TO HEALTH PROMOTION

What is Health?

In 1948, the World Health Organisation defined health as:


“A state of complete physical, mental and social wellbeing, and not merely the absence of disease
or infirmity” (WHO, 1948). While this definition is general and idealistic, it has been criticised as
being unachievable and immeasurable.
Pencheon, Guest, Melzer and Gray (2001) describe health as:
“The extent to which an individual or group is able to realise aspirations and satisfy needs, and
to change or cope with the environment.
Health is a resource for everyday life, not the objective of living; it is a positive concept,
emphasizing social and personal resources as well as physical capabilities.
Your health is related to how much you feel your potential to be a meaningful part of the society
in which you find yourself, is adequately realised”.
What determines health?
Health and wellbeing is affected by a complex mix of determinants as shown in the table below.

What is “Public Health”?

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Winshow, one of the leading figures in the history of Public Health in 1920 defined Public Health
as “The Science and Art of preventing diseases, prolonging life and promoting health and
efficiency through organized community effort”
Core activities of public health
The United States Health and Human Services Public Health Service outline ten core activities of
public health, which are:
1. Preventing epidemics
2. Protecting the environment, workplaces, food and water.
3. Promoting healthy behaviour
4. Monitoring the health status of the population
5. Mobilising community action
6. Responding to disasters
7. Assuring the quality, accessibility, and accountability of medical care
8. Reaching out to link high risk and hard to reach people to needed services
9. Researching to develop new insights and innovative solutions
10. Leading the development of sound health policy and planning. (Pencheon, et al., 2001).
Public Health Challenges Today
In more developed countries like Australia the public health challenges include issues such as:
-communicable diseases and conditions such as diabetes, asthma, mental health
factors such as obesity, physical inactivity, alcohol abuse and illicit drug use

What is Health Promotion?


There are a number of definitions of health promotion. Probably the most recognised one is the
one used by the World Health Organisation:
 The process of enabling individuals and communities to increase control over the
determinants of health and thereby improve their health.
 It has come to represent a unifying concept for those who recognise the basic need for change
in both the ways and conditions of living in order to promote health.

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 Health promotion represents a mediating strategy between people and their environments,
combining personal choice with social responsibility for health, to create a healthier future
(World Health Organisation 1986).
Another definitions is:
 Any planned combination of education and environmental supports for actions and conditions
of living conducive to the health of individuals, groups and communities (Green and Kreuter
1991).
Some further extracts below highlight important aspects of health promotion:
 Health promotion works with people not on them; it starts and ends with the local community
and is directed to the underlying as well as the immediate causes of health; it balances
concern with the individual and the environment; it emphasises the positive dimensions of
health; and it concerns and should involve all sectors of the society and the environment
(Nutbeam, 1986
 Health promotion represents a comprehensive social and political process, it not only
embraces actions directed at strengthening the skills and capabilities of individuals, but also
action directed towards changing social, environmental and economic conditions so as to
alleviate their impact on public and individual health.
 Health promotion is the process of enabling people to increase control over the determinants
of health and thereby improve their health.
 Participation is essential to sustain health promotion action (WHO, 1998).
Angela Scriven, who is an occupational therapist, describes health promotion as something that
happens at four levels.
Level Purpose Example
Primary Promoting the health of the general
population to maintain health, physiologists engaged in physical activity
prevent health damaging opportunities such as walking groups and
behaviour, prevent ill health and strength building programs to prevent
improve quality of life. chronic disease/falls etc.

women about pelvic floor exercises to


prevent incontinence issues.

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people to identify potential hazards for


falling.

foot path quality to prevent falls

training for people such as


singers/lecturers to prevent vocal cord
damage.

for children, lobbying for fluoridation of


community water supplies, advice to
minimize consumption of sweet foods and
beverages.
Secondary Promoting the health of individuals
or groups where health damaging physiologists working with obese people to
behavior has already occurred, to support weight loss through modification
change behaviour and prevent of diet and physical activity.
health moving to a chronic or
irreversible stage who smoke using brief interventions and
motivational interviewing

stress management, self esteem etc rather


than on eating for teenagers with eating
disorders.

and families of children who stutter


Dentists working with clients who
smoke using brief interventions and
motivational interviewing

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Tertiary Promoting the health of those with exercise physiologists,


chronic conditions or disability to physiotherapists and OTs working in
enhance quality of life and potential cardiac rehab programs
for healthy living
lifestyle changes for clients who have had
a stroke
Quaternary Promoting the emotional, social
and physical health and wellbeing improve the quality of life of terminally ill
of the terminally ill. patients.

The Ottawa Charter of Health Promotion


A social view of health:
“implies that we must intervene to change those aspects of the environment which are promoting
ill health, rather than to continue to simply deal with illness after it appears, or continue to extort
individuals to change their attitudes and lifestyles when, in fact, the environment in which they live
and work gives them little choice or support for making such changes” (South Australian Health
Commission 1988:3, cited in Wass, 2000).
According to the Ottawa Charter, the core activities of health promotion are:
1) Advocating: to make political, economic, social, cultural, environmental, behavioural and
biological conditions favourable for health.
2) Enabling: to make people achieve the fullest health potential, addressing in particular, issues
of equity – i.e. providing access to information, life skills and a supportive environment.
3) Mediating: with government and non-government agencies, industry and media to achieve
coordinated action.
The Five Principles of the Ottawa Charter
1. Build Healthy Public Policy:
Examples:
 Smoke free policies
 compulsory wearing of helmets
 seatbelt legislation.
2. Create Supportive environments:

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Examples:
 Create user friendly accessible breast feeding areas in public areas
 create user friendly, accessible counseling services at schools and places where young
people gather.
 Shade creation in schools.
3. Strengthen Community Action:
Examples:
 Create consumer organisations such as Nursing Mothers Association of Australia,
 encourage the development of support groups and community demands for support
services.
4. Develop Personal Skills:
Examples:
 Education programs.
 Skill development.
5. Reorient Health Services:
Examples:
 Train staff to prevent, and recognise and manage early warning signs of disease.
 Implement the policies of a Breast Feeding Promoting Hospital so that staff encourage
new mothers to breast-feed.

Common questions

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'Health Promotion' involves empowering communities to increase control over their health determinants, recognizing the need for lifestyle and environmental changes, and integrating personal choice with social responsibility . Contrarily, 'Public Health' is defined as the science of preventing diseases and promoting health through organized community efforts such as policy development and health monitoring . Both fields aim at improving health but differ in their methods and scopes, with health promotion emphasizing empowerment and public health focusing on systemic action.

The five principles of the Ottawa Charter for Health Promotion are building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services . These principles aim to improve public health outcomes by creating a comprehensive framework that addresses health determinants through policy, community engagement, skill development, and restructuring health services to be more preventative and supportive.

The document describes four levels of health promotion: Primary, Secondary, Tertiary, and Quaternary. Primary aims at preventing health issues in the general population, Secondary targets changing behaviors in those with risk factors, Tertiary focuses on enhancing quality of life in individuals with chronic conditions, and Quaternary aims to promote wellbeing in the terminally ill . Each level addresses different stages in health to effectively manage and prevent various health outcomes.

The World Health Organization's definition of health from 1948 describes it as "a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity" . This definition is broad and idealistic, focusing on complete wellness rather than just the absence of disease. However, later perspectives, such as that from Pencheon et al. (2001), describe health as the ability to realize aspirations, satisfy needs, and handle the environment, emphasizing health as a resource for everyday life, rather than the ultimate goal . This perspective is more practical and resource-oriented, focusing on adaptability rather than an unachievable ideal.

Community action plays a vital role in health promotion by mobilizing local resources and engagement to address the broader determinants of health. It encourages the formation of support groups and consumer organizations, which foster an inclusive and collective approach to health improvements. This grassroots involvement is crucial for sustaining health promotion efforts and achieving long-term positive health changes .

Developed countries like Australia face public health challenges that include an increase in non-communicable diseases such as diabetes and asthma, lifestyle-related risk factors like obesity and alcohol abuse, new health threats such as biothreats and climate change, and issues regarding the elderly's functional capacity . These challenges differ from those in developing countries, which often focus more on infectious diseases and malnutrition, pointing to a greater need in developed countries to address lifestyle and chronic disease prevention.

The document highlights a complex mix of determinants affecting health and wellbeing, including physical, mental, social, and environmental factors . This comprehensive approach underscores health as being influenced by a wide array of factors rather than a single dimension, requiring integrated and multifaceted strategies such as community engagement, addressing social inequalities, and environmental adjustments to achieve true well-being.

Health promotion as described in the document balances personal choice and social responsibility by acting as a mediating strategy between individuals and their environments. It involves enabling people to gain control over health determinants by integrating personal change with societal support, thereby creating a healthier future through coordination of social and personal factors . This approach emphasizes collective and individual efforts in fostering a supportive health environment.

The Ottawa Charter proposes a shift in addressing health issues by advocating for changes in environmental and societal conditions that promote ill health, rather than solely focusing on treating illnesses after they manifest or attempting to alter individual lifestyles in non-supportive environments. This approach involves advocating for conducive health conditions, enabling access to health resources, and mediating across sectors to drive coordinated action .

The core activities of public health put forth by the United States Health and Human Services Public Health Service include preventing epidemics, protecting the environment, workplaces, food, and water, promoting healthy behavior, monitoring the health status of the population, mobilizing community action, responding to disasters, assuring quality medical care, linking high-risk individuals to necessary services, researching for new health insights and solutions, and developing health policy and planning .

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