Public health and health promotion

Introduction New public health includes public health and health promotion seen as two complementary areas of practice. Origin: Health promotion emerged in 70s, 80s as a force to prevent ill health, differentiating it from public health purpose of disease prevention. Health promotion develops a unique discipline. WHO established core principles of health promotion in Now, health promotion is regarded as a new branch of modern public health.

Health promotion in KSA 1.Public oral health programs (prevention and control of oral diseases) 2.1st Saudi and 4th Gulf Conference for Health Promotion in March School health (Smoking – AIDS – Dates and milk)

A framework to understand concept of HP Health promotion Definitions ModelsTheoriesStrategiesApplication WHO origins

Definition Process of enabling people to increase control over health determinants thereby improve their health. (WHO, 1986) Health promotion works to enable people to increase control over their health and its determinants by developing personal skills, embracing community action, and fostering appropriate public policies, health services and supportive environment.

It is not directed against any particular disease, but is intended to strengthen the host through a variety of approaches: health education, environmental modification, nutritional intervention, life style and behavioral changes.

Seven core definitions central to concept of health promotion Health Health Promotion Health for all Pubic Health Primary Health Care Disease Prevention Health Education

Other glossary A revised glossary added to the list: burden of disease, capacity building, evidence-based health promotion, global health, health impact assessment, self efficacy, sustainable health promotion actions and wellness, social marketing.

Health promotion interventions 1. Health education: one of the most cost effective interventions, can prevent many diseases with little or no medical intervention. Extension to all people of benefits of medical, psychological and related knowledge is essential to fullest attainment of health. (WHO) Targets of educational efforts may include public, patients, priority groups, health providers, community leaders, decision makers.

2. Environmental modifications: A comprehensive approach to HP requires environmental modifications e.g. provision of safe water, installation of sanitary latrines, control of insects and rodents, improvement of housing. History has shown that many infectious diseases have been successfully controlled in developed countries prior to development of specific vaccines or chemotherapeutic agents. Environmental interventions are non-clinical and do not involve physicians.

3. Nutritional interventions: These comprise food distribution and nutrition improvement of vulnerable groups. E.g. child feeding programs, food fortification, nutrition education. 4. Life style and behavioral changes: Each health worker acting is acting as an educator more than a therapist. Health education is a basic element of all health activities to change views, behavior and habits of people.

Importance of health promotion Tackling the major health determinants. Contributing to positive health development. Applicable in all sectors of society, public, private or voluntary. Raising awareness and supporting benefits of activity in early years, schools and communities, and encourages physical activities. Guiding global, national and community health policies, thus contributing to reducing health risks e.g. alcohol, eating habits, physical inactivity.

Models of health promotion 4 strategies: persuasion, personal counselling, legislative action, community development. (Beattie’s model) Combine prevention, health education, health protection. (Tannahill’s model) Pre-contemplation, contemplation, readiness for action, action and maintenance. (Transtheoretical model) Motivation to change depending on concern about perceived susceptibility and severity outweighed by belief in benefits and effectiveness. (Becker’s health belief model)

Strategies of health promotion ( summary of UK strategies and policies) Health of nation (1992): CHD, cancer, mental illness, sexual health, accidents. New NHS (1997): HIMPs. Saving lives: healthier nation(1999): focus on wider determinants of health. National Service frameworks (1999): CHD, MH, older people, diabetes, children.

NHS plan (2000): developing primary care, screening, smoking sessasion services, new initiatives: diet, cancer, heart disease, mental health, sure start. Choosing health (2004): healthy choices, reduce inequalities. Our health (2006): new directions for community services. Essence of care benchmarks for promoting health (2006): 9 benchmarks include empowerment, engagement and partnership. Our NHS, our future (2006): fair, personalized, effective and safe care.

Assignment Students of CLN & HE Choose a health promotion school in Riyadh. Describe its strategy in health promotion.