Health Promotion and Disease Prevention 2 CHAPTER Health Promotion and Disease Prevention

Definition of Health Health: state of physical, mental, and social well-being and not merely absence of disease or infirmity (WHO, 1986) Updated WHO definition (2008)included characteristics, behaviors, and physical, social, and economic environment

Health-Illness Continuum Care in the acute care settings is usually directed to resolving immediate health problems. In the community, care focuses on maximizing individual potential for self-care. The client assumes responsibility for health care decisions and care provision, with the client’s ability to function the primary concern.

Health Promotion Versus Disease or Injury Prevention? Health promotion: activities to help individuals change their lifestyle to move toward a state of optimal health (a balance of physical, emotional, social, spiritual, and intellectual health)

Health Promotion Versus Disease or Injury Prevention? Disease prevention: activities undertaken to avoid the occurrence of a disease or injury and minimize the consequences. Intended to prevent future illness. Health protection: environmental or regulatory measures that confer protection on population groups

Community Characteristics Groups of people Share common interest Interact with one another Function collectively within defined social structure

Defining Aspects Social system or institutions Identity Commitment Common norms and values

Defining Aspects Common history or interests Common symbols Social interactions Intentional action

Population Health Arose from limitations in individual-oriented care for improving the health of population groups Defined as highest possible level of health in the population Distribution of health among members of the population

Two Approaches to Population Health Descriptive approach Focuses on the health status of a population Utilizes specific summary indicators of health Distribution of health indicators in that population

Two Approaches to Population Health (continued) Analytic approach: Broad factors influencing health Identifies factors contributing to health indicators Direct interventions to improve health status

Characteristics of Healthy Communities Ability to foster dialogue among residents Promote community leadership Engage in action based on a shared vision Embrace diversity among residents

Characteristics of Healthy Communities (continued) Assess both needs and assets Link residents to community resources Foster a sense of responsibility and cohesion Change and adapt to changing circumstances Manage conflict effectively

Characteristics of Healthy Communities (continued) Safe transportation, schools, and neighborhoods Clean air and environment Well-equipped parks, open spaces, and organized recreation High-quality mixed income housing

Characteristics of Healthy Communities (continued) Well-stocked grocery stores with nutritious food offerings Clean streets that are easy to navigate Well-kept homes

Characteristics of Healthy Communities (continued) Organized multicultural community programs, social services, neighborhood councils, or other opportunities for participation in community life Available and accessible primary care (Robert Wood Johnson Foundation, 2009)

Population Health Trends Historical Control of epidemics and communicable diseases: Sanitation Quarantine Mid-1900s Disease prevention Immunization Personal behavior changes

Population Health Trends (continued) Present Population health Social justice Healthy environments Access to resources needed for health

Three Levels of Population Health Care Primary prevention Secondary prevention Tertiary prevention

Primary Prevention Promote general optimal health and prevent illness Actions occur prior to illness or disease Increase resistance to illness Decrease or eliminate the causes of health problems Foster a healthy environment

Primary Prevention Generalized health promotion and specific protection against disease. It precedes disease or dysfunction and is applied to generally healthy individuals or groups.

Examples Health education about: Accident and poisoning prevention Standards of nutrition and of growth and development for each stage of life Exercise requirement Stress management Protection against occupational hazards

Examples Cont Immunization Risk assessment for specific disease Family planning services and marriage counseling Environmental sanitation and provision of adequate housing, recreation and work conditions

Secondary Prevention Early identification and treatment of existing health problems Actions take place after problem has occurred Screening, early diagnosis, and treatment Develop programs to diagnose and treat at community level

Secondary Prevention Emphasizes early detection of disease, prompt intervention, and health maintenance for individuals experiencing health problems. It includes prevention of complications and disabilities

Examples Screening surveys and procedures of any type. Encouraging regular medical and dental checkups Teaching self-examination for breast and testicular cancer Assessing the growth and development of children

Examples Cont Nursing assessments and care provided in home, hospital, or other agency to prevent complications. for example Maintaining skin integrity Turning, positioning, and exercising clients Ensuring adequate rest, food, and fluid intake Promoting fecal and urinary elimination Administering medical therapies such as medications.

Tertiary Prevention Return client to highest level of function Prevent recurring health problems Prevent further deterioration of health; examples: Maintenance health programs

Tertiary Prevention begins after an illness, when a defect or disability is fixed, stabilized, or irreversible. Its focus is to help rehabilitate individuals and restore them to an optimum level of functioning within the constraints of the disability.

Examples Referring a client who has had a colostomy to a support group Teaching a client who has diabetes to identify and prevent complications, or insulin administration at home. Referring a client with a spinal cord injury to a rehabilitation center to receive training that will maximize use of remaining abilities.

Resources Population Reference Bureau This database contains data on 136 population, health, and environment variables for more than 220 countries, 28 world regions and sub-regions, and the world as a whole. U.S. Agency for International Development's Global Health Website USAID programs in global health represent the commitment and determination of the US government to prevent suffering, save lives, and create a brighter future for families in the developing world.