What is Health Promotion?
Health promotion creates opportunities for individuals, communities and populations to understand the determinants (influences) of their health and wellbeing and what they can do to improve them.
Health promotion values
Empowerment
Empowerment is a process through which people gain greater control over the decisions and actions that affect their health.
Social Justice and Equity
Social justice in society implies that rules are just and fair and resources are shared equitably within the community. Equity is concerned with creating equal opportunities for health and with bringing differences in health status down to the lowest level as possible.
Inclusion
Health promotion practice emphasises inclusion by working with members of marginalised groups in the community who face barriers to good health. This ensures that everyone has access to the resources needed to maintain good health as well as a voice in the decisions affecting their health.
Respect
Health promotion embodies and respects a diverse range of cultures and perspectives on health and wellness.
Features of health promotion
- based on a holistic view of health
- uses participatory approaches
- focuses on addressing the determinants of health, not just health problems. These include the social, behavioural, economic and environmental conditions that are the root causes of health and illness such as income, social status, education, employment and working conditions.
- builds on existing strengths and assets
- uses multiple, complementary strategies to promote health at the individual (downstream), community and population (upstream) level.
For common terms used in health promotion visit the World Health Organisation – Health Promotion Glossary
Ottawa Charter for Health Promotion
http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf
The Ottawa Charter is the main framework used in health promotion to guide programs and interventions. It supports the view that effective health promotion includes a range of strategies and a focus on the following five priority action areas:
Used collectively in any population setting, the action areas can achieve positive health outcomes.
Build healthy public policy
- Health Promotion goes beyond health care.
- It puts health on the agenda of policy makers in all sectors to be aware of the consequences of their decisions and accept their responsibilities for health.
- Healthy public policies aim to achieve greater equity. For example, free and universal education, legislation, taxation and welfare.
- The aim is to make the healthier choice the easier choice for people and also for policy makers.
For example: Healthy Food and Drink Choices for Staff and Visitors in SA Health Facilities Policy; SA Health Smoke-free Policy; Seatbelt laws; 30-Year Plan for Greater Adelaide; and Health in All Policies.
Create supportive environments for health
- Social, economic and physical environmental factors are important in shaping people’s experiences of health.
- Health promotion creates living and working conditions that are safe, satisfying and enjoyable.
For example: Hospitals and community services that are accredited as Baby Friendly Health Initiative organisations; the South Australian Active Living Coalition aims to ensure that active living is a way of life where physical activity is part of our daily routine.
Strengthen community action for health
- Community development strategies increase the ability of communities to achieve change in their physical and social environments. This occurs through participation in collective decision making and action on issues that impact on their health and wellbeing.
- Greater power and control remains with the community themselves.
For example: Community Centres SA play a vital role in the empowerment and development of individuals and communities across South Australia; Obesity Prevention and Lifestyle (OPAL) program is about everyone in the community working together to create all kinds of ways to enjoy healthy eating and to have fun being active; Community Foodies aims to build the capacity of communities to make healthier food choices by training and supporting volunteer community members ('Foodies') to act as agents for change.
Develop personal skills
- Acknowledges the role of behaviour and lifestyles in promoting health and how people can be supported to build skills that will help them make positive changes.
- Provides information, health education and helps people to develop the skills they need in order to increase options available for people to increase control over their own health and environments, and to make healthy choices
For example: The Quitline® provides information and advice on how to help people quit smoking.
Re-orient health services
- Health promotion is everybody’s business.
- Health systems need to shift their focus from primary care (eg hospital-based treating illness) towards a system that is community-based, more user-friendly and receptive to client needs, which focuses on health and wellbeing for illness prevention.
For example: Building health promotion skills of primary health care workers to help move the system towards an increased focus on prevention; Children's Centres for Early Childhood Development and Parenting bring together care, education, health, community development activities and family services for families and their young children from birth to eight years of age.
Approaches to promoting health
There are a range of different approaches to improving health outcomes. In many instances a combination of approaches for the same health issue works well. How people focus on the health issues and view the causes and remedies as well as their scope of influence will impact on the types of actions undertaken.
The continuum of health promotion approaches
As seen in the diagram above, health promotion can occur at any point along a continuum, from those that focus on individuals and communities through to interventions that improve the health or living conditions of whole populations.
At the individual (downstream) level people may be identified or treated for a condition based on targeted strategies such as screening for early signs of disease such as breast screening, pap smears, blood pressure screenings.
Strategies in the middle of the continuum focus on behaviours that are generally risk factors for disease for groups of people. Many public health campaigns aim to influence behaviours such as reducing smoking, increasing physical activity and healthy eating.
At the population (upstream) level, health promotion works to address the determinants (influences) of health which relate to the conditions under which we live. Health promotion means implementing actions that positively impact on the health of communities and populations generally. For example:
- the provision of healthy water for everyone,
- ensuring a healthy and affordable food supply,
- providing a safe, efficient and accessible transport system for all,
- ensuring jobs for all who want to work and an equitable income distribution.
References
Baum, F 2002, The new public health, 2nd edn, Oxford University Press, Victoria.
Keleher, H, MacDougall, C & Murphy, B 2007, Understanding health promotion, Oxford University Press, Melbourne, Victoria.
Ontario Health Promotion Resource System (OHPRS), HP-101 Health promotion on-line course, http://www.ohprs.ca/hp101/main.htm
World Health Organisation (WHO) 1986, Ottawa charter for health promotion, WHO, Geneva, http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf
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