Session 1 - Public Health; Past Present & Future

Introductions and Icebreaker

Ground Rules! Listen to others and value the diversity of opinions in the group Be constructive Value the differences; there are no rights or wrongs, no good or bad Be open and honest Keep to agreed time, especially start and finish Mobile phones! (extracted from, Working with Groups. General Improvement Skills. Modernisation Agency)

Outline of Session Explore the concept of health and different models of health Discuss the history of public health Identify what are health inequalities and discuss the influence of public health policy within the ‘New Public Health’ Explain how public health attempts to tackle health inequalities Explore how public health can be put into practice

Group Work Definitions of Health

Is health achievable? The word ‘health’ is derived from the old English word for heal which means ‘whole’, signalling that health concerns the whole person and his or her integrity, soundness or well-being. -ve – absence of disease +ve – state of well-being

3 Predominant models of health Biomedical model Lay model of health Social model of health

Medical Model of Health The absence of disease and illness Medical treatment can restore health

Lay concepts of health Health is a positive concept Differs depending on e.g. age, culture, ethnicity Example 1-.Older people - wholeness, inner strength & ability to cope. Example 2 - Young people – fitness, energy & strength Example 3 - Middle class vs working class

Social Model of Health – Dahlgren & Whitehead Social Ecological Theory Age, sex and constitutional factors Agriculture and food production Education Work environment Living and working conditions Unemployment Water & sanitation Health care services Housing

Coffee

Public Health The science and art of preventing disease, prolonging life and promoting health through the organised effects and informed choices of society, organisations, public and private, communities and individuals” (Wanless 2002) Public Health Policy Time Line

Who is this?

Health Inequalities Main measures of health inequality: Infant mortality statistics Mortality statistics Morbidity statistics – including chronic disease management Life Expectancy at Birth

Title

Title

How public health can help tackle health inequalities – Zola’s River Analogy ‘You know’, he said, ‘sometimes it feels like this. There I am standing by the sort of a swiftly flowing river and I hear a 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 back in the river again, reaching, pulling, applying, breathing and then another yell. I am so busy jumping in, pulling them to shore, applying artificial respiration, that I have no time to see who the hell is upstream pushing them in’ (Zola 1972)

Group Work In small groups choose a public health topic e.g. obesity, falls, and identify what interventions and policies that they would implement that would be considered upstream & downstream in nature

The Principles that run through all Public Health Work The elements of public health practice are; Assessing the health needs of a population. Working with local people to identify needs. Identifying groups most in need of health care and most likely to benefit from health care; identifying health inequalities and working to improve the health of the socially excluded. Determining the social, economic and environmental factors that impinge on health. Planning and implementing programmes that promotes and protect health, both within the health sector and with other sectors to address the wider threats [determinants](eg. Housing, transport). Assessing the impact of interventions on the health of the population. (Wanless, 2004; Hall and Elliman, 2004)