1. Health Health Determinants and Health Promotion Diane B. Wilson EdD, RD Mary S. McLellan MS,RD Medical University of South Carolina

2. Developed as part of an Enhanced AHEC Community Partnership for Health Professions Workforce and Educational Reform project funded by the Health Resource and Service Administration (HRSA)

3. OBJECTIVES l Health promotion, disease prevention, wellness l Disease prevention as part of health care

4. What is Health?

5. Health is a state of complete Physical, Mental, and Social well-being and not merely the absence of disease or infirmity. WHO, 1947 The Metaphysical Context of the Universe The Secular Dimensions of Health PhysicalMental Social

6. Two Major Aspects of Health l Feeling Well l Ability to Function

7. Determinants of Health l the complex inter-relationships of s genetics s social environment s physical environment s behavior s health/illness services l that determine the level of health and sense of well-being in an individual

8. Genetics l Body Size l Special Abilities l Disease Resistance l Disease Susceptibility l Genetic Diseases l General Robustness

9. Physical Environment l Macro-environment s Food and Water s Air Pollution l Micro-environment s Home s Workplace

10. Social Environment l Religion l Race/Gender l Socioeconomic Status l Education l Occupation l Family Composition

11. Socioeconomic Status, Income and Health l Socioeconomic Status s As GDP increases, the health of a nation increases s In times of economic hardship, the incidence of disease increases

12. Health Care l Quality l Availability l “Health has improved NOT because of steps taken while we are ill, but because we are ill less often.” Thomas McKeown, 1978

13. Health Promotion l An intervention that seeks to eliminate or reduce exposures to harmful factors by modifying human behaviors; or any combination of health education and related organizational, political and economic interventions designed to facilitate behavioral and environmental adaptations that will improve or protect health l Concerned specifically with sociobehavorial processes.

14. Targets of Health Promotion l Individuals at risk of a health problem l Those who influence individuals at risk l Those who set policy s Foster the adoption of healthful changes in the environment s Improve health services s Encourage healthful personal behavior change

15. Health Promotion Objectives l Individual s Knowledge s Attitudes s Behaviors s Physiology l Organization s Policies s Practices s Programs s Facilities s Resources l Community s Policies s Practices s Programs s Facilities s Resources l Government s Policies/Programs s Facilities/Resources s Legislation/Ordinances s Regulation/Enforcement

16. Examples of HEALTHY PEOPLE 2000 Priority Areas l Health Promotion s Physical Activity and Nutrition s Tobacco s Alcohol Consumption l Preventive Services s Heart Disease and Stroke s Cancer s Health Screenings

17. Healthy People 2010 l 2 Broad Goals s Increase quality and years of healthy life s Eliminate health disparities l 4 Primary Objectives s Promote healthy behaviors s Promote healthy and safe communities s Improve systems for personal and public health s Prevent and reduce diseases and disorders

18. Disease Prevention l any intervention that seeks to reduce or eliminate diagnosable conditions; it may be applied at the individual level, as in immunization, or the community level, as in chlorination of the water supply

19. Primary Prevention l Measures taken to prevent the disease from occurring such as: s healthy lifestyle habits s Immunizations

20. Secondary Prevention l Measures undertaken to facilitate early detection s Screenings s Diagnostic tests

21. Tertiary Prevention l Measures to minimize complications or exacerbation of injury or disease. s Rehabilitation Therapy s Patient counseling

22. Discussion Time l Identify all three levels of prevention as they apply to a health problem or threat to health such as injury or vaccine preventable disease l Be sure to include consideration of all of the determinants of health!

24. Summary l There are various definitions of “health” l A number of factors determine our health, including genetics, physical factors, social factors, healthcare and lifestyle factors. l Health promotion and disease prevention are related to identifying strategies to prevent disease and injury.