1. KAROLINSKA INSTITUTET Institutionen för folkhälsovetenskap Avd för socialmedicin 19 September 2007 Bo J A Haglund professor (See also http://www.phs.ki.se/socmed/postdoc/OH-presentations.html)

2. Is Health Promotion more like Pool or Polo?

3. Pool or Water polo Pool or Water polo One person, one opponent Level playing surface Highly defined playing strategy, predictable outcomes No background noise Action occurs above ground under spotlights Team game multiple opponents Constantly changing playing environment Fast moving, constantly changing game plan Considerable background noise Much action occurs below the surface

4. Framework for Health Promotion Activities, after Ewles & Simnet 1999

5. Definition of Competencies Competencies are made up of attributes such as knowledge, abilities, skills and attitudes. They can be broad and complex or specific and simple

6. 1.Följa (Monitor) hälsoläget för att identifiera samhällets hälsoproblem 2.Diagnostisera och undersöka hälsoproblem och hälsorisker i samhället (Samhällsanalyser) (Community analyses) 3.Informera, utbilda, och maktmobilsera (empower) befolkningen om hälsofrågor (Information) 4.Mobilisera olika partner i samhället vilka kan identifiera och åtgärda hälsoproblemen. (Mobilisation) 5.Utveckla policies och planer som stöder individuella och samhälleliga ansträngningar som kan påverka hälsan. ( Create policies and planning) 6.Förstärk lagar och regler som skyddar hälsa och förstärker säkerhet ( Laws for protection of health and safety) 7.Stöd människors behov av hälsoservice och försäkra att vård ges till alla behövande (Health servicies to those needed) 8.Utveckla en kompetent arbetskraft för folkhälsoarbete och vård (capacity building) 9.Utvärdera effekter, tillgänglighet och kvalitet i vård och folkhälsoarbete. (Evaluate) 10. Utveckla forskning som kan ge nya insikter och innovativa lösningar på folkhälsoproblem ( R&D for new insights and innovative solutions) Nelson, J. Essien, J., Loudermilk, R. and Cohen, D. (2002). The Public Health Competency Handbook: Optimizing Individual & Organization Performance for the Public’s Health. Atlanta, GA: Center for Public Health Practice of the Rollins School of Public Health. USA report (CDC) on Public Health Core Competencies

7. REVIEW OF COMPETENCIES FOR AUSTRALIAN HEALTH PROMOTION 2002

8. The study identifies broad consensus around a list of 82 competencies under the eight broad headings of: Needs Assessment Planning Implementation Communication Knowledge Organisation and management Evaluation and research Use of technology

9. The health promotion concept health promotion is generally seen by those who have defined it as involving a diverse set of actions focused on the individual or environment which through increasing control, ultimately leads to improved health or well being (Rootman et al 2001).

10. The health promotion concept health promotion activities involve the process of enabling or empowering individuals or communities. Therefore, the absence of empowering activities should be a signal that an intervention does not fall within the rubric of health promotion. Attempts to encourage public participation are critical to the process of empowerment

11. Settings approach Health is created and lived by people within the settings of their everyday life: where they learn, work, play and love? It is in these settings - at school, at work, in our neighborhoods - that we live our lives and it is these contexts or settings, which need to be made more conducive to health

12. Settings approach c. Healthy cities Healthy workplaces Healthy schools Healthy universities Healthy hospitals Healthy prisons Underlying principle: equity and social justice !

13. Health Promotion. Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Public Health functions

14. The health promotion concept health promotion is generally seen by those who have defined it as involving a diverse set of actions focused on the individual or environment which through increasing control, ultimately leads to improved health or well being (Rootman et al 2001).

15. The health promotion concept health promotion activities involve the process of enabling or empowering individuals or communities. Therefore, the absence of empowering activities should be a signal that an intervention does not fall within the rubric of health promotion. Attempts to encourage public participation are critical to the process of empowerment

16. The health promotion concept Definitions of health promotion fall into two clusters--clusters that are not mutually exclusive. The first cluster focuses on the environment--for example, "to improve social and environmental living conditions..." the second focuses on the individual, for example to "choose new lifestyles...". Most however, recognize the need to focus on both the individual and the environment

17. Key strategies for HP Five key strategies for health promotion were identified at Ottawa (1986) build healthy public policy create supportive environments strengthen community action develop personal skills reorient health services

18. Settings approach Health is created and lived by people within the settings of their everyday life: where they learn, work, play and love? It is in these settings - at school, at work, in our neighborhoods - that we live our lives and it is these contexts or settings, which need to be made more conducive to health

19. Settings approach c. Healthy cities Healthy workplaces Healthy schools Healthy universities Healthy hospitals Healthy prisons Underlying principle: equity and social justice !

20. 7 Principles of Health Promotion Empowering: Health promotion initiatives should enable individuals and communities to assume more power over the personal, socio-economic and environmental factors that affect their health. Participatory: Health promotion initiatives should involve those concerned in all stages of planning, implementing and evaluation. Holistic: Health promotion initiatives should foster physical, mental, social and spiritual health. Intersectoral: Health promotion initiatives should involve the collaboration of agencies from relevant sectors

21. 7 Principles of Health Promotion Equitable: Health promotion initiatives should be guided by a concern for equity and social justice. Sustainability: Health promotion initiatives should bring about changes that individuals and communities can maintain one initial funding has ended. Multi-strategy: Health promotion initiatives should use a variety of approaches, including policy development, organisational change, community development, legislation, advocacy, education and communication, in combination with one anothe

22. Definition of Health Promotion Health Promotion based on Ottawa Charter altered by Stachtchenko and Jenicek (1990) with the adding of safety reads as follows: “the process of enabling [individuals and communities] to increase control over [the determinants of health and safety] and [thereby] improve their health.”

23. Defintion of HP Staff in the Department of Health Promotion at Curtin University in Western Australia have agreed to adopt a description of health promotion that is based on the two most widely used definitions formulated by European and North American sources (Green and Kreuter 1999; WHO 1986; WHO 1997). The following definition of health promotion was adopted for the project: “Health promotion can be regarded as a combination of educational, organisational, economic and political actions designed with consumer participation, to enable individuals, groups and whole communities to increase control over, and to improve their health through attitudinal, behavioural, social and environmental changes”

24. Manpower Competence Methods materials Invest in Money and goodwill Theory and evidence Organisation network Leadership Healthy lifestyle Societal Context History The news Trends Demography Eonomy Cluture Politics etc Gain and respect Knowleldge and insight Policy strategy Social cohesion (Soc. Capital) Services Healthy environment and climate Health Literacy Human Biology Genetics Vitality Policy: Law, Rules, finance Equity = Equal access And opportunity Community Setting development Organisation Development Advocacy Lobby Policy-devel. Intersectoral action Information education Quality of life somatic psychic social Interventions Intervention-results DeterminantsHealthOrganise Health Promotion Framework After Hans Saan and Willy de Haes, NIGZ Social support

25. Review CollectJudge Evidence-process Research integrated Do EvaluatePlan Work-process PublishImplement