Health Promotion

• Health Promotion - is a range of activities and interventions to enable people to take greater control over their health. Activities may be directed at individuals, families, communities or whole populations.
• HEALTH EDUCATION - involves activities to facilitate health-related learning and behavior change.
• PUBLIC HEALTH - involves activities based on a biomedical understanding of health, focused on the identification of health-related needs and population-based actions such as immunization and screening.
• DISEASE PREVENTION  - includes activities at primary, secondary and tertiary levels to prevent the onset of disease or to reduce or ameliorate its effects.
• The process of attempting to promote health may include a whole range of interventions, including those which:

  • foster and enable healthy lifestyles
  • encourage access to services and involvement in health decisions  
  • seek to promote an environment in which the healthy choice becomes the easier choice
  • educate about the body and keeping healthy. 
• “Health promotion represents a comprehensive social and political process.
• Health promotion is the process of enabling people to take control over the determinants of their health and thereby improve their health.” – Nutbeam (1998)
• In 1920 the Winslow Professor of Public Health at Yale University described public health as: The Science and Art of preventing disease, prolonging life, and promoting health and efficiency through organized community effort for
• PUBLIC HEALTH

  • The sanitation of the environment;
  • The control of communicable diseases;
  • The organization of medical and nursing services for the early diagnosis and preventative treatment of disease;
  • The development of social machinery to ensure everyone a standard of living adequate for the maintenance of health, so organizing these benefits so as to enable every citizen to enjoy his birthright of health and longevity. 
• LEVELS OF PREVENTION: PRIMARY PREVENTION, SECONDARY PREVENTION, TERTIARY PREVENTION
• Secondary prevention seeks to change health-damaging behavior to shorten episodes of illness and prevent the progression of ill health.
• Primary prevention seeks to avoid the onset of ill health through the detection of high-risk groups and the provision of advice and counseling.
•  Examples of secondary prevention include education about medication, and advice on healthy eating for diabetics and relaxation for cardiac patients.
• Tertiary prevention seeks to limit disability or complications arising from a chronic or irreversible condition and enhance quality of life.
• Examples of primary prevention include immunization and cervical cytology, as well as health education in schools and workplaces. 
•  Examples of tertiary prevention include education about the use of disability aid and rehabilitation therapy.
• The WHO has moved the definition of health promotion away from prevention of specific diseases or the detection of risk groups towards the health and well-being of whole populations.
• CRITIQUES:

  • Health education is simply advertising admonitions.
  • Health promotion does not work.
  • Health promotion fails to address poverty.
  • Health promotion is a means of social control.
• The WHO identifies three ways in which practitioners can promote health through their work: advocacy, enablement and mediation. 
• Advocacy in health promotion is the process of defending or promoting a cause.
• ADVOCACY -  It may also mean action to gain political commitment, policy support, social acceptance and support systems for a particular goal or cause. 
• Enabling means health promotion practitioners taking action in partnership with others to promote health by identifying needs and developing networks and resources in the community; assisting people to develop knowledge and skills; and helping people identify and address the determinants of their own health.
• Enablement is an essential core skill for health promoters, since it requires them to act as a catalyst and then stand aside, giving control to the community. 
• Health promoters mediate between different interests by providing evidence and advice to local groups and influencing local and national policy through lobbying, media campaigns and participation in working groups.
• MODEL - a simplified description or graphic representation of reality (processes, organizations, beings).
• Models are often used to hypothesize the outcomes of specific inputs or processes.
• THEORY - an idea or proposition, often using general principles, used to explain something specific.
• MEDICAL MODEL - this model uses medical concepts of health and sickness rooted in physical or psychological changes that can be measured and quantified.
• Social Model - This model uses sociological concepts to theorize about health and illness. Health is normal social functioning, whereas illness is any impairment (physical or psychological) of social functioning.
• Empowerment - The act of acquiring power and the ability to make decisions and take control over one’s life.
• Medical or Preventive – to prevent disease
• Behavior Change – to encourage people to adopt healthy behaviors.
• Educational – to ensure that people are well informed and able to make health choices.
• Empowerment – to help people to acquire the skills and confidence to take control over their health.
• Social Change – to change policies and environments in order to facilitate healthy choices
• MEDICAL APPROACH - This approach focuses on activity which aims to reduce morbidity and premature mortality. Activity is targeted towards whole populations or high-risk groups. This kind of health promotion seeks to increase medical interventions which will prevent ill health and premature death. The approach is frequently portrayed as having three levels of intervention.
• Epidemiology - the study of the pattern of diseases in society.
• Medical Approach - It is an expert-led, or top-down, type of intervention. This kind of activity reinforces the authority of medical and health professionals, who are recognized as having the expert knowledge needed to achieve the desired results.
• THE MEDICAL APPROACH • Methods – Immunization and Screening • Evaluation - reduction in disease rates and associated mortality
• BEHAVIOR CHANGE - The approach is popular because it views health as a property of individuals. It is then possible to assume that people can make real improvements to their health by choosing to change their lifestyle. It also assumes that if people do not take responsible action to look after themselves, then they are to blame for the consequences.