Empowerment, health promotion and schools Glenn Laverack 4 th European conference on health promoting schools

Health Promotion and Empowerment The Ottawa Charter, WHO, 1986 says that ‘Health promotion is the process of enabling people to increase control over, and to improve, their health’. The Bangkok Charter, WHO, 2005 says that ‘Health promotion is the process of enabling people to increase control over the determinants of health and thereby to improve their health.’

Equity, Education and Health A health promoting school is one that constantly strengthens its capacity as a healthy setting for living, learning and working (WHO, 2013). Equity, as applied to education and health, is a often a normative judgment of what is fair. Inequities are preventable through interventions such as healthy policy in schools.

Empowerment Personal Organisational Family Community/ collective

Personal Empowerment The goal of personal empowerment is to increase feelings of value and a sense of mastery. Personal empowerment integrates perceptions of individual control, a proactive and a critical approach to life (Zimmerman, 1995). Education, skills development, counselling, activities to build self-confidence.

Collective Empowerment Collective (community) empowerment is (David Werner, 1988): ‘a process by which people (including children) that are disadvantaged (suffer from an inequity) work together to increase control over the events that influence their lives’. These events are often social, political and economic.

The Continuum of Collective Empowerment (Laverack, 2004) Personal action Small groups Community organisations Partnerships Action for social, political and economic change

Social change  Values, stigma, societal norms (gay rights, violence). Political change  Policy & legislation (Substance abuse, bullying) Economic change  Policy & legislation (child welfare and family tax benefits)

Empowerment & school children Empowerment approaches view children as social actors who act on the world around them. Empowerment approaches engage with children about their worlds, involving them in decision making and action about issues that are important to them.

What age in years? What age do school children begin to understand the social world in a concrete and abstract way such that they can fully engage with the concept of empowerment and the underlying, often political, causes of their powerlessness?

There is not a definitive ‘youngest’ age at which children can be engaged to help them to empower themselves collectively. And so, as a guide to empowerment and school children, give or take a year, depending on the individual and the context, the age of 14 years can be used in health promotion.

Education and empowerment Is education enough to enable others to collectively empower themselves?

Education and empowerment Empowerment interventions have been successful in schools using the education principles of ‘critical consciousness’ as developed by Paulo Freire. A methodology of listening and dialogue and importantly helping people to become politically aware and to take action.

The Alcohol and Substance Abuse Prevention Programme The Programme sought to empower youth involved in high-risk behaviours to make healthier choices and to play active political roles in society. A ‘Students Against Drunk Driving (SADD)’ chapter was started when one of the students was killed in a drink related driving accident.

The approach brought small groups of high school students to the settings of a hospital emergency centre and a county detention centre to interact with patients and detainees who had drink and drug-related problems. After listening the students engaged in a dialogue about their experiences and decided on actions. The students took a leadership role and organized events to raise the issues of drug abuse and drink driving in their communities. They lobbied local authorities to introduce policies to prevent substance abuse (Wallerstein and Bernstein, 1988).

StudentVoice (UK) is for school students, representing their views and providing training to help start their own campaigns. School Students Against War (UK) is an active group organised and maintained by School and FE students. Canada 2012: 500 students ran two protests in support of their teachers who wanted to avoid doing extra- curricular activities in South Carleton. India 2013: A large number of school girls protest in Jammu against the perpetrators of the Delhi gang-rape incident.

Empowerment principles 1.Identify your own power base - you cannot help others to empower themselves without first understanding your own power base. 2.Facilitate others to identify their own power base and then mapping and prioritising their concerns. 3.Enable others to build their capacity to find the solutions to their prioritised concerns.