1. Promoting Health
Deborah Gowell
Week 2

2. Aims & Objectives Aims Health Promotion
Individual health – community health
Theory to practice
Psychosocial approach to health promotion
Objectives – to gain an understanding on:
What health promotion is and some of the key aspects
Why focus has changed from individuals to community
Why it is important to know the theory
The importance of a psychosocial approach

3. Review What did we do last week?
What were the main points in WHO definition of health?
Briefly sum up what you thought about this definition

4. Background on Health Promotion
A young discipline
A more practical aspect of health
Draws from psychology and sociology

5. Key features of health promotion
Prevention
Empowerment

6. McKinlay (1979) Upstream story
‘There I am standing by the shore of a swiftly flowing river and I hear the 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 I jump into the river, reach him, pull him to shore, apply artificial respiration, and then just as he begins to breather, another cry for help. So back in the river again, without end, goes the sequence. You know I am so busy jumping in, pulling them to shore, applying artificial respirations, that I have no time to see who the hell is upstream pushing them all in’

7. Prevention: Lalonde Report (1974)
Technological medicine and hospital-based services were not reducing the burden of ill health
The major causes of mortality in developed countries are non-communicable diseases such as heart disease, cancer and respiratory illness, whose cause can be attributed to behaviours such as smoking and nutrition
There is a growing elderly population, which is associated with an increased demand for care, although most older people remain independent and living in the community
Curative medicine involves escalating costs with no guarantee of effectiveness
People’s expectations of health services outstrip capacity

8. Prevention Caplan (1969)
Primary prevention: avoid ill health and disease, target high risk groups, health education, immunization
Secondary prevention: lessen ill health, early detection and treatment, health education, screening, therapy
Tertiary prevention: improving the quality of ill health, limiting the disability or complications arising from irreversible conditions, health education

9. Empowerment A core principle of health promotion
Empowering the community
Empowerment interventions, focused on minority groups – women, youth, chronic disease suffers, poor

10. Activity You need to promote one area of health to your service users
Group 1: dental hygiene
Group 2: regular exercise
Group 3: healthy diet
Group 4: accessing health services
How do you empower your service user, what steps would you take?

11. Shifting focus on health promotion
1970’s onus for health changed from public health to the responsibility of the individual
More recently focus is on community health rather than individual health

12. Theory into practice
You do not need a license to practice health promotion
But may be part of your responsibilities
Putting theory into practice is inapplicable to most practitioners
Many practitioners adopt a common sense approach

13. Theory into Practice Discuss: Why is it important?
Do you consider health promotion as part of your role?

14. Because…. You can make informed decisions rather than reactive ones
Basing your decisions on empirical evidence rather than anecdotal or common sense
Gives you confidence in dealing with a situation and the choice you have made
Deepen your understanding and knowledge
Gives credibility to your decision when faced with confrontation
Will give your practice more credibility
You are studying on a degree course!!!

15. Promoting health to people with Learning Disabilities
Face extra challenges in normal day to day life
A relatively new concept
Change concepts of what is ‘normal’
Now integrating into local community
Inclusive rather than exclusive
The right to be treated the same
There is recognition of spiritual, legal, political, sexual rights
And now recognition of the right to live a long and healthy life

16. What is your current practice for promoting health?
Discuss in groups
What training did you receive?
What support do you get?
What do you do to encourage healthy behaviours?

17. How to promote health to people with learning disabilities
Deliver information in a way they can understand to help make informed decisions
May not be aware they have access to health services
May not understand the consequences a decision has on their health
Find ways of including people into the community
Share experiences with others on things that been successful

18. Area’s that need health promotion
Many fall into the category of poor health, obesity, poor oral health
CHD 2nd highest cause of death – lack of exercise, hypertension, obesity
Many dental issues – poor diet, poor dental hygiene, less likely to visit a dentist, may need general anaesthetic
More prone to diabetes – poor diet, lifestyles, being inactive
Constipation – less mobile, inadequate hydration, poor diet, medication

19. Psychosocial approach to health promotion
Question – why do women live longer than men, but have more illness?

20. Discussion
Why don’t some health promotion campaigns work?

21. What 5 core questions should health promoters be asking?
Please discuss and write down your answers with your group

22. Core questions by Naidoo & Wills (2001)
What affects people’s health status?
What might influence the decisions that people make about their health?
How do social conditions affect individual and population health?
How can social conditions be changed to promote people’s health?

23. Summary Aspects of health promotion – prevention, empowerment
Shifting focus from public health to individual to community
Putting theory into practice
Health promotion for learning disabilities
Psychosocial health promotion
Next week: health promotion models