Promoting Health Deborah Gowell Week 2

Aims & Objectives Aims Health Promotion Individual health – community health Theory to practice Psychosocial approach to health promotion Objectives – to gain an understanding on: What health promotion is and some of the key aspects Why focus has changed from individuals to community Why it is important to know the theory The importance of a psychosocial approach

Review What did we do last week? What were the main points in WHO definition of health? Briefly sum up what you thought about this definition

Background on Health Promotion A young discipline A more practical aspect of health Draws from psychology and sociology

Key features of health promotion Prevention Empowerment

McKinlay (1979) Upstream story ‘There I am standing by the shore of a swiftly flowing river and I hear the cry of a drowning man. So I jump into the river, put my arms around him, pull him to shore and apply artificial respiration. Just when he begins to breathe, there is another cry for help. So I jump into the river, reach him, pull him to shore, apply artificial respiration, and then just as he begins to breather, another cry for help. So back in the river again, without end, goes the sequence. You know I am so busy jumping in, pulling them to shore, applying artificial respirations, that I have no time to see who the hell is upstream pushing them all in’

Prevention: Lalonde Report (1974) Technological medicine and hospital-based services were not reducing the burden of ill health The major causes of mortality in developed countries are non-communicable diseases such as heart disease, cancer and respiratory illness, whose cause can be attributed to behaviours such as smoking and nutrition There is a growing elderly population, which is associated with an increased demand for care, although most older people remain independent and living in the community Curative medicine involves escalating costs with no guarantee of effectiveness People’s expectations of health services outstrip capacity

Prevention Caplan (1969) Primary prevention: avoid ill health and disease, target high risk groups, health education, immunization Secondary prevention: lessen ill health, early detection and treatment, health education, screening, therapy Tertiary prevention: improving the quality of ill health, limiting the disability or complications arising from irreversible conditions, health education

Empowerment A core principle of health promotion Empowering the community Empowerment interventions, focused on minority groups – women, youth, chronic disease suffers, poor

Activity You need to promote one area of health to your service users Group 1: dental hygiene Group 2: regular exercise Group 3: healthy diet Group 4: accessing health services How do you empower your service user, what steps would you take?

Shifting focus on health promotion 1970’s onus for health changed from public health to the responsibility of the individual More recently focus is on community health rather than individual health

Theory into practice You do not need a license to practice health promotion But may be part of your responsibilities Putting theory into practice is inapplicable to most practitioners Many practitioners adopt a common sense approach

Theory into Practice Discuss: Why is it important? Do you consider health promotion as part of your role?

Because…. You can make informed decisions rather than reactive ones Basing your decisions on empirical evidence rather than anecdotal or common sense Gives you confidence in dealing with a situation and the choice you have made Deepen your understanding and knowledge Gives credibility to your decision when faced with confrontation Will give your practice more credibility You are studying on a degree course!!!

Promoting health to people with Learning Disabilities Face extra challenges in normal day to day life A relatively new concept Change concepts of what is ‘normal’ Now integrating into local community Inclusive rather than exclusive The right to be treated the same There is recognition of spiritual, legal, political, sexual rights And now recognition of the right to live a long and healthy life

What is your current practice for promoting health? Discuss in groups What training did you receive? What support do you get? What do you do to encourage healthy behaviours?

How to promote health to people with learning disabilities Deliver information in a way they can understand to help make informed decisions May not be aware they have access to health services May not understand the consequences a decision has on their health Find ways of including people into the community Share experiences with others on things that been successful

Area’s that need health promotion Many fall into the category of poor health, obesity, poor oral health CHD 2nd highest cause of death – lack of exercise, hypertension, obesity Many dental issues – poor diet, poor dental hygiene, less likely to visit a dentist, may need general anaesthetic More prone to diabetes – poor diet, lifestyles, being inactive Constipation – less mobile, inadequate hydration, poor diet, medication

Psychosocial approach to health promotion Question – why do women live longer than men, but have more illness?

Discussion Why don’t some health promotion campaigns work?

What 5 core questions should health promoters be asking? Please discuss and write down your answers with your group

Core questions by Naidoo & Wills (2001) What affects people’s health status? What might influence the decisions that people make about their health? How do social conditions affect individual and population health? How can social conditions be changed to promote people’s health?

Summary Aspects of health promotion – prevention, empowerment Shifting focus from public health to individual to community Putting theory into practice Health promotion for learning disabilities Psychosocial health promotion Next week: health promotion models