Lecture 7: The New Public Health Dr J. Sitali MPH 541 Lecture 7: The New Public Health Dr J. Sitali

Lecture Outline Introduction The Development of health promotion. Defining health promotion. Disease prevention Health education Health promotion An integrated definition of HP Ways of promoting health

Introduction Until the 1980s most PH interventions were referred to as ‘health education’. PH was exclusive to preventive medicine. Recently the new term ‘health promotion’. No consensus on HP. But all agree PH should be about health.

The Development of health promotion HP is used in many different ways. The main features of HE. The main features of HP. HP originates from 19th century following calls for sanitary reforms to combat epidemics in overcrowded towns. HE developed alongside the pursuit of PH. Medical officers of health disseminated HE. Several associations to combat hygiene and sanitation.

Development continued Development of ‘shock-horror’ technique. Attention towards personal behavior. Emphasis on information and education. Blanket programs of education and selected priority subjects started. Medical services noted not to be improving health status. HE and prevention of disease emphasized. Behavioral approach formulated.

Development continued Change lifestyle so as to avoid lifestyle diseases. Health of the Nation strategy. Awareness that poor health linked to poverty. The ‘Black report’ on social classes and health. The role of WHO. Health for All 2000.

Defining health promotion Concept of health Different understanding of what HP is. A shift from public health to HP. Dominance of medical model of health. HP thus often seen as prevention of disease. Targeting high risk groups.

Disease Prevention Aim: to avoid disease. Primary, secondary and tertiary prevention. This is the most used understanding of HP. Disease prevention does not look beyond the risk factors or group to the origins of ill health.

Health Education Usually used to describe the work of healthcare workers. Health choices contribute to development of disease. Premise: information can lead to change for a healthy lifestyle. Modeled on Top-down approaches. In HE the HP is a facilitator. Help identify need and enable an informed choice.

Health Promotion Moved from prevention towards health and well being. The community address their concerns. All levels in society are involved. Health is a collective responsibility. HP is much broader than HE. HP incorporates all measure deliberately designed to promote health.

An Integrated Definition of HP Individual versus structural approaches. Emphasis on personal responsibilities. Health and wealth are linked: social gradient. Need to address root cause of health problems. Several methods at play. Need to eliminate health inequalities.

Ways of Promoting Health Principles underpinning HP: Advocacy Enablement Mediation

HP Action Means: Build healthy public policy. Create supportive environments. Strengthen community actions. Develop personal skill. Reorient health services. Address gender inequalities.

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