UNIT 3 HEALTH & HUMAN DEVELOPMENT AOS 2 Promoting Health in Australia

UNIT 3 AOS 2 – Promoting health in Australia In this area of study students examine different models of health and health promotion. They investigate the roles and responsibilities of governments in addressing health needs and promoting health for all through the provision of a national health system and health promotion initiatives. Students examine the role of government and non-government organisations in providing programs and support for the promotion of healthy eating.

UNIT 3 AOS 2 – Promoting health in Australia KEY KNOWLEDGE Models of health and health promotion including: Biomedical model of health Social model of health The Ottawa Charter for Health Promotion KEY SKILLS Analyse the different approaches to health and health promotion.

UNIT 3 AOS 2 – Promoting health in Australia Key questions What is the biomedical model of health? What is the social model of health? What is the focus of each model? What are the advantages and disadvantages of each model? Why is the biomedical model more expensive? Why is it important to have both the biomedical model and the social model of health if we are to improve health status? What are the differences between the two models? Where does the Ottawa Charter fit in here? What is health promotion? The Ottawa Charter - What are the three basic strategies for health promotion which are enabling, mediating, and advocacy.

APPROACHES TO HEALTH CARE As the understanding of health status and its contributing determinants have developed over many years, so have the approaches intended to improve health. In order to assess the adequacy and effectiveness of Australia’s health care system it’s important to understand the nature and role of each approach to health care

Approaches to health care in Australia Australia’s health care system Social model Health promotion – Ottawa charter Biomedical model

APPROACHES TO HEALTH CARE ❶ Why is it important to have an understanding of the nature and role of different approaches to health care? It is necessary to have an understanding of the different approaches to health care so we can assess the adequacy and effectiveness of Australia’s health system.

Approaches to health care in Australia Biomedical Model of Health

THE BIOMEDICAL MODEL OF HEALTH Definition of the Biomedical Model of Health (Study Design) ‘Focuses on the physical or biological aspects of disease and illness. It is a medical model of care practiced by doctors and/or health professionals and is associated with the diagnosis, cure and treatment of disease.’

Biomedical Model ❷The following questions relate to the biomedical model of health 1. Outline what the biomedical model involves. The biomedical model involves trying to diagnose and treat illness and conditions once symptoms are present. 2. What does it centre around and give some examples? The biomedical model centres around doctors, health professionals and hospitals who administer treatment Examples: surgery, medication and x-rays

Biomedical Model ❷ 3. Who is the focus of the biomedical model of health and what is it attempting to achieve? Individuals are the focus in this model, which concentrates on disease, illness and disability and attempts to return physical health of the person to a pre-illness state

Biomedical Model ❷ 4. Explain the statement, “this form of intervention focuses on the biological determinants of health”. The biomedical model does not concentrate on the reasons for illness but centres around the condition itself and the treatment is considered the solution. The biological determinants are addressed in this model – factors relating to the body that impact on health. Example: Diabetes. The doctor would concentrate on: Blood sugar levels Cholesterol levels Treatment: Insulin injections

APPROACHES TO HEALTH CARE ❷ 5. Why is medical science and technologies pivotal in the biomedical model of health? Medical science is pivotal to the biomedical model as technologies are used in the treatment and diagnosis of illness. There is pressure to accurately diagnose illness and find cures. Many medical sciences and technologies have occurred because of the biomedical model

THE BIOMEDICAL MODEL OF HEALTH Examples include the use of: Medical technologies (eg: xrays, ultrasounds etc) Laboratory testing Professional health workers (eg: Doctors, Nurses etc)

THE BIOMEDICAL MODEL OF HEALTH Medication (eg: antibiotics) Hospitalisation Surgery Diagnosis

FEATURES of THE BIOMEDICAL MODEL OF HEALTH It involves trying to diagnose and treat illnesses and conditions once symptoms are present. It centres around doctors, health professionals and hospitals, who administer treatment. Focuses on INDIVIDUALS Concentrates on disease, illness or disability Attempts to return the physical health of the person to a pre-illness state.

FEATURES of THE BIOMEDICAL MODEL OF HEALTH 6. The reasons for illness are not the centre of the biomedical model; rather the condition itself is the focus and treatments are considered the solution 7. This form of intervention focuses on biological determinants (behavioural and social generally excluded) 8. Medical science and technologies are central in the biomedical model 9. The biomedical model has played a large role in prolonging life expectancy in Australia 11. It receives the majority of health care funding

Advantages and Disadvantages of the BMH It creates advances in technology and research Many common problems can now be effectively treated Extends Life Expectancy Improves quality of life It relies on professional health workers and technology (-costly $) Not every condition can be treated Does NOT promote good health It is very expensive – is it affordable? The broader determinants of health are neglected

Key skills – exam practice There are many biomedical approaches to health and dental care. Identify one biomedical approach to health care and explain how it could assist in the maintenance of dental health in children. VCAA: Written exam 2003

Key skills – exam practice There are many biomedical approaches to health and dental care. Identify one biomedical approach to health care and explain how it could assist in the maintenance of dental health in children. VCAA: Written exam 2003 One mark was available for naming an appropriate biomedical approach to health care and one mark for the explanation of how it could assist in the maintenance of dental health in children. One student wrote: One biomedical approach to health care in association with dental health in children would be having fillings put in the child’ tooth or teeth when there are holes found. This assists in the maintenance of dental health of children as it allows the holes in the teeth to be filled, ensuring that the teeth will be safe from holes becoming any bigger which will ensure there are less of a chance of there becoming more serious dental problems. Key skills – exam practice

THE SOCIAL MODEL OF HEALTH

THE SOCIAL MODEL OF HEALTH Definition: A conceptual framework which improvements in health and well-being are achieved by directing efforts towards addressing the social, economic and environmental determinants of health. The model is based on the understanding that in order for health gains to occur, social, economic and environmental determinants must be addressed. VCAA Study Design P 36

THE SOCIAL MODEL OF HEALTH 2. Why was the social model of health developed in the late 1970’s – 80’s It was created in response to increasing rates of lifestyle-related diseases, especially CVD. The Social Model of Health is an approach to health that attempts to address the broader influences of health rather than disease and injury

THE SOCIAL MODEL OF HEALTH The Social Model of Health is based on an understanding that, in order for health to improve the social, economic and environmental factors need to be addressed. 3. Outline the importance of factors such as SES, access to health care and social connectedness in bringing about improved health status. If these determinants are addressed, many diseases and illnesses can be prevented. Policies, education and health promotion activities are key aspects of the social model of health.

Relationship between the determinants of health and health status Social Economic Environmental RURAL AND REMOTE SOCIAL EXCLUSION ACCESS TO HEALTH CARE FOOD SECURITY STRESS MEDIA POVERTY EARLY LIFE EXPERIENCES SES UNEMPLOYMENT EDUCATION INCOME POLLUTION SANITATION SAFE WATER WORK PLACE SAFETY NEIGHBOURHOOD SAFETY Behavioural TOBACCO PHYSICAL ALCOHOL DRIG USE SUN PROTECTION ACTIVITY If all these causes can be addressed many diseases and illnesses can be prevented altogether

Advantages and Disadvantages of the SMH Addresses the broader determinants of health Focuses on factors such as SES, social exclusion, access to health care. These impact significantly on the health of individuals and populations If causes of poor health can be addressed many diseases and illnesses can be prevented Focuses on community groups rather than individual – community is more effective Not everyone has access to education, health promotion activities Doesn’t address ALL causes of illness The SMH may be adopted, however someone may get the disease Still rely on BMH to treat a disease Cannot prevent, treat or cure all diseases and illnesses

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH

The Social Model of Health Acronym i Intersectorial Collaboration b Broader Determinants of health are addressed e Empowers individuals and communities a Acts to enable access to appropriate and affordable health care r Reduce social inequities

Description of the principles of the SMH 5 Key principles of the Social Model of Health Principle Description of the principles of the SMH i Intersectorial Collaboration The broader determinants of health must be addressed. Social factors – gender, culture, SES, race, location, physical environment - these must be addressed to improve health status and health outcomes

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Involves Inter- sectorial Collaboration Only by involving all interested and concerned groups can the social determinants be adequately addressed The social and environmental determinants of health cannot be addressed by the health sector alone Collaboration or Working together

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Involves Inter- sectorial Collaboration Employment, Education Finance Social Security Environment Sanitation Determinants of health Government departments Non-government organisations Private sector Health sector Vic Health Nutrition Australia BeyondBlue Hospitals Doctors Research Medicare PBS Water supply Energy supply Transport Manufacturers

5 Key principles of the Social Model of Health Description of the principles of the SMH B Broader Determinants of health are addressed Health is determined by a broad range of social, environmental and economic factors and not just biomedical factors. Differences in health status and health outcomes are linked to social factors including gender, culture, race and ethnicity, SES, working conditions, unemployment, housing, location and physical environment

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Addresses the Broader Determinants of health Addressing the broader determinant of health is a key aspect of the social model of health. Behavioural Determinants These need to be addressed to improve health These are often influenced by other broader determinants of health such as: Social determinants Economic determinants Environmental determinants Gender: Culture: Race: Ethnicity SES: Unemployment: working conditions Location: Physical environment: housing

5 Key principles of the Social Model of Health Description of the principles of the SMH E Empowers individuals and communities Empowering individuals and communities with health knowledge and skills means that they are in a position to make positive changes to their health

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Empowers individuals and communities Empowering individuals and communities with health knowledge and skills means that they are in a position to make positive changes to their health People have the right to participate in decision-making about their health and to access skills and resources they need to change factors which influence their health.

5 Key principles of the Social Model of Health Description of the principles of the SMH A Acts to enable access to appropriate and affordable health care Health services should be affordable and available according to people’s needs. Health information should be available to all in accessible and appropriate formats

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Acts to enable access to health care The social model of health acts to enable all people to have access to appropriate health care regardless of their social situation Health services should be affordable and available according to people’s needs. Health information should be available to all in accessible and appropriate formats

5 Key principles of the Social Model of Health Description of the principles of the SMH R Reduce social inequities Equity is a key principle for health service delivery. The SMH acts to reduce inequities that are related to factors such as gender, culture, race, SES, location and physical environment.

THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH Acts to Reduce Social Inequities The social model of health aims to promote equity for all people and to achieve this, the social determinants be adequately addressed Gender, Culture, Race, Socioeconomic Status, Location Physical Environment.

APPLYING THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH TO A HELATH PROMOTION PROGRAM Hungry for victory - Rumbalara Football and Netball Club The overall purpose of this program was to promote healthy eating in the context of improving sporting performance. This program targeted a group of 40 footballers at the Rumbalara Football and Netball Club in the under-17 years and under-14 years competitions, who took part in a nutrition program. This involved a series of nutrition workshops, a mentoring program for younger players and a breakfast program where players and opposition teams were provided with a healthy breakfast prior to matches. Four nutrition workshops were also conducted where participants received information about nutrition and were encouraged to tailor their eating habits towards maximising performance on the football field. Older players were encouraged to bring players along to have a healthy breakfast in order to pass on knowledge and encourage positive behaviour. The program ran for the duration of the 2006 football season. Various resources were provided such as T-shirts and drink bottles bearing the hungry for victory logo. The health promotion program was community-directed, state-funded and involved university researchers. It was conducted within the Koori community of the Goulburn-Murray Region of Northern Victoria

APPLYING THE PRINCIPLES OF THE SOCIAL MODEL OF HEALTH TO A HELATH PROMOTION PROGRAM Case Study 2 “Feedin' the mob” Feedin' the mob is a nutrition, physical activity and healthy lifestyle project for Aboriginal and Torres Strait Islander people in the City of Whittlesea Victoria. Based at Plenty Valley Community Health, Feedin' the mob is funded by the Federal Government and supported by Council through its Healthy communities initiative. Feedin' the mob gets the community involved in activities that draw on local culture to teach the benefits of healthy eating and lifestyle. The target audience are teenagers, parents and carers, people living with chronic illness and Elders. The project includes a community garden, cooking classes and information-sharing about chronic disease prevention.

Key skills – exam practice Question 7 Outline two major characteristics of the biomedical model of health. 2 marks VCAA: Written exam 2010

Question 3 The following information is about the program LEAD (Localities Embracing and Accepting Diversity). Greater Shepparton City Council has been awarded this program by the Victorian Health Promotion Foundation (VicHealth) aimed at improving community acceptance of cultural diversity. The VicHealth Chief Executive Officer said that communities that support cultural diversity have been found to have better health outcomes. The focus is on the community as a whole, not just on people from migrant, refugee and Aboriginal communities affected directly by discrimination or racism. The responses will include a range of different approaches such as communications, community development, and supporting organisations with training and other resources. Working across settings such as education, employment, and sport and recreation, the LEAD program plans to support local organisations to • ensure that environments are safe and welcoming for people from a range of cultural backgrounds • increase understanding and empathy among different community groups • ensure fairer outcomes for all. A goal is to identify what works when it comes to reducing discrimination and promoting diversity at the local level. Adapted from: www.vichealth.vic.gov.au

6 marks 1. 2. VCAA: Written exam 2010 Describe two principles of the social model of health and explain how they are evident in this program. 1. 2. 6 marks VCAA: Written exam 2010

THE OTTAWA CHARTER FOR HEALTH PROMOTION The principle of the Ottawa Charter was founder on the Social Model of Health The Ottawa Charter outlines guidelines to help organisations and key stakeholders incorporate health promotion ideas into strategies, policies and campaigns. The Ottawa Charter was adopted by Australia as a means of promoting health

THE OTTAWA CHARTER FOR HEALTH PROMOTION The Ottawa Charter: an approach to health development by the WHO which attempts to reduce the inequalities in health. The Ottawa Charter for Health Promotion was developed from the Social Model of Health and defines health promotion as “the process of enabling people to increase control over, and improve their health. The Ottawa Charter identifies three basic strategies for health promotion which are enabling, advocacy and mediating. (study design)

THE OTTAWA CHARTER FOR HEALTH PROMOTION Focuses on prevention rather than cure Uses the causes of disease as the starting point rather than diseases themselves.

THE OTTAWA CHARTER FOR HEALTH PROMOTION The Ottawa Charter identifies certain prerequisites or basic conditions and resources that must be available if any gains in health are to occur. Peace Education Stable ecosystem Our ecosystem provides resources for health – water, air, food – balance between the landscape and plants/animas Shelter Food Social justice and equity Refers to all people being valued and receiving fair treatment Income Sustainable resources Resources such as food, water, fish, oil, timber. These must cause little or no damage to the environment - able to continue for a long time

THE OTTAWA CHARTER FOR HEALTH PROMOTION The Ottawa Charter for health promotion is a document or tool used by different organisations to improve health in the community. There are two parts to this tool that work side by side to improve health. Part 1. Three basic strategies that are supported by the 5 priority areas Part 2. The 5 priority or action areas Three (3) basic strategies Five (5) priority or action areas Advocacy Mediating Enabling Building Healthy Public Policy Create Supportive Environments Strengthen Community Action Develop Personal Skills Reorient Health Services

The Ottawa Charter for health promotion identifies three basic strategies: Basic strategies for health promotion Description 1. Advocacy Involves speaking up for groups to gain support for a particular issue or concern. some groups are able to advocate (“stick up for themselves”), other groups may need people to speak on their behalf. Examples: Mass media campaigns Lobbying politicians Organising pressure groups

The Ottawa Charter for health promotion identifies three basic strategies: Basic strategies for health promotion Description 2. Mediating Many groups in the community have their own interests and ideas on a particular health issue. Conflict can occur. To resolve the conflict reconciliation may be needed. This is where intersectorial collaboration takes place. Different groups work together to resolve the conflict. Health promotion requires the coordinated action by all levels of government, the health sector, non-government organisations, industry and media

The Ottawa Charter for health promotion identifies three basic strategies: Strategy Description 3. Enabling This approach to health care cannot be enforced upon the individual. Enabling provides the individual with the skills to take actions to promote or protect health Enabling is the process by which people gain more control over factors that influence their health; that is empowering individuals or groups to take action to promote or protect their health Examples: Providing access to information Developing skills through education Instil motivation to improve health

THE OTTAWA CHARTER FOR HEALTH PROMOTION The Ottawa Charter sets out five priority or action areas that should be taken into account when devising health promotion initiatives B - bad Building Healthy Public Policy C - cats Create Supportive Environments S - smell Strengthen Community Action D - dead Develop Personal Skills R - rats Reorient Health Services

Complete the following questions What is the relationship between the Social Model of Health and the Ottawa Charter? Describe what is meant by health promotion. The Ottawa Charter identifies certain prerequisites or basic conditions and resources that must be available if any gains in health are to occur. Identify 4 of these basic conditions Outline the 5 priority areas of the Ottawa Charter. Select one and explain what is meant by the priority area.

THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action area 1 B - bad Building Health Public Policy Relates directly to decisions made by governments in relation to laws and policies that directly affect health health sector • local councils - recreation work place policies • housing and transport school policies Examples: healthier environments – banning smoking influence behaviour – compulsory wearing of seat belts wearing hats during play at school removing the GST on unprocessed foods

THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 2 C - cats Create Supportive Environments A supportive environment is one that promotes health and assists people in making healthy lifestyle choices. Its aim is to provide a: Healthy Physical Environment: ●Where we work, live, go to school. EG Providing shaded areas in schools - ● Protect the physical environment – investing in sustainable energy production Healthy Social Environment: ●Help and support to others. EG Quitline – support to smokers wanting to quit ● Help and support from others ● Fulfilling social life

THE OTTAWA CHARTER FOR HEALTH PROMOTION Action area 3 S - smell Strengthen Community Action ● This action area is centred around the community working together to achieve a common goal ● The more people working together towards a common goal, the greater the chance of success. ● Communities work together to identify and set health priorities, and plan and implement strategies to achieve better health Example: Government immunisation scheme higher immunisation rates Doctors Media Schools Parents

THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 4 D - dead Develop Personal Skills ● Education is the key aspect of this priority area ● People gain knowledge and skills necessary to make decisions that will affect their health ● People who have knowledge and life skills have greater control over their lives and choices to enhance health Examples: Talking to people to resolve conflict rather than using violence

THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 5 R - rats Reorient Health Services ● Movement away from the biomedical model to one that promotes health and prevents ill health + ● Includes all members of the community Doctors + hospitals + individuals + community groups + health professionals + government departments ● Examples : Healthy eating to reduce impact of CVD rather than surgery Physical activity to reduce obesity and type 2 diabetes

THE OTTAWA CHARTER FOR HEALTH PROMOTION Priority or Action Area 5 R - rats Reorient Health Services ● A health system that reflects the Social Model of Health must therefore address all the determinants of health, not just disease This requires a shift towards health promotion (The process of enabling people to increase control over, and to improve their health) Doctors take on a role of educator or provide preventive health care messages not just curative care

THE OTTAWA CHARTER FOR HEALTH PROMOTION For each of the statements listed below indicate which of the 5 priority or action areas of the Ottawa Charter are represented. Legislation that bans smoking in public places QUIT campaigns advertising on billboards, stickers and TV Programs made available to school students about how to practice safe sex Introduction of condom vending machines in public places Occupational health and safety requirements for building sites Erecting sun shade at local swimming pools and sporting venues Provision of palliative care and support for AIDS sufferers Taxation subsides for sunscreen Learning how to detect changes in moles on your skin Development of a National Policy on ATSI health Providing bike tracks in the local community Establishing support groups for heart attack sufferers GP’s providing information on the risk factors for CVD

THE OTTAWA CHARTER FOR HEALTH PROMOTION Select one of the following Explain how the following priority or action areas of the Ottawa Charter for Health Promotion could be applied to address the issue of obesity in the Australian population. Building Healthy Public Policy Developing personal skills Re-orient health services 2. Explain how the following priority or action areas of the Ottawa Charter for Health Promotion could be applied to address the issue of injury due to car crashes Creating supportive Environment Strengthening community action

Explain how the five priority or action areas of the Ottawa Charter could be applied to obesity Building Health Public Policy The State Government passes a law that all children enrolled in school must participate in 30 minutes of exercise per day Creating supportive environments Local councils develop recreational facilities such as running tracks, ovals and bike tracks to encourage people to engage in physical activity Strengthening community action Interested groups such as schools, parents, local councils and sporting groups develop programs for children to participate in sporting activities throughout the week Developing personal skills Programs in schools that inform students of the importance of physical activity and balanced diet to reduce the incidence of obesity Re-orient health services Local doctor working with parents to encourage them to get their children engaged in physical activity.