HHD- UNIT 3 AOS 2: Promoting health and wellbeing

Public health

Refers to the ways in which governments monitor, regulate and promote health status and prevent disease in the population.

• is concerned with the organisation and collective effort to improve the health status of the entire population

Changes in health from 1900 - Now

Categories of diseases

Common diseases in early 20th century vs late 20th century

OLD PUBLIC HEALTH

• Bacteria was found to be the main cause of disease and death in the early 20th century

• Living conditions were poor, clean water and sanitation was minimal, waste littered the streets (rats and mice carried disease), overcrowding in homes, food quality and storage was poor, working conditions were dangerous.

• Focus on improving the physical environment became known as the 'old' public health

• The government invested in water and sewage systems, better sanitation, improved nutrition, improved housing conditions and better work conditions (among other things!)

Initiatives associated with 'old' public health

IMPROVEMENTS IN HEALTH

• Many of the initiatives associated with 'old' public health were introduced alongside advancements in medical technology - specifically in relation to the diagnosis, treatment and monitoring of disease.

• This is often referred to as the 'biomedical' approach and will be discussed in more detail in the next lesson.

• Important to note that the discovery of vaccines themselves is not an 'old' public health initiative (it's biomedical), rather ensuring that as many people as possible received these vaccines through mass public vaccinations in schools/community settings is the 'old' public health initiative.

THE SHIFT TO HEALTH PROMOTION

The process of enabling people to increase control over and improve their health

• By the 50's-60's, people were living longer and infectious diseases were now controlled and rapidly decreasing.

• Lifestyles diseases such as CVD and cancer were quickly becoming the major cause of death, and a new approach to public health was needed.

• This was when the 'new' public health (also called the social model of health), was introduced.

• Health promotion campaigns, designed to focus on changing the behaviour of the individual in order to reduce ill health - were implemented.

Leading causes of death globally

BIOMEDICAL APPROACH TO HEALTH

Focuses on the physical or biological aspects of disease and illness.

• Focus is on the individual and the disease (not the cause) and returning the individual to their pre-illness state (contrast to the population-based focus of public health).

• It accounts for a large proportion of the health budget (over 95%).

• Often referred to as the 'quick-fix' or 'bandaid' approach

Features of the biomedical approach

EXAM tip for + & - of biomedical approach

Pros of biomedical approach

Cons of biomedical approach

read through chapter 5.4 and add to notes; what is the biomedical approach and its key features, how advancements in tech have contributed to improvements, strengths and limitations of the approach

Social model of health

• Once infectious diseases were controlled (thanks to old public health and the biomedical model), focus shifted to the lifestyle diseases and their contribution to mortality and morbidity (around 1970s)

- Although biomedical interventions could treat some cases, many ended in death.

• Another approach was needed that encouraged people to lead healthier lives.

• The social model of health (also referred to as 'new' public health) now focused on health promotion (the process of enabling people to increase control over, and improve their health through understanding the consequences of health behaviours)

• Physical, sociocultural and political environments were recognized as having an impact on health, rather than just the individual and their choices

DEFINING FEATURES (prevention, community approach, disadvantaged groups)

• The social model of health takes into account the significant role that Sociocultural factors (socioeconomic status, access to healthcare and social connectedness) plays in bringing about improved health status.

• If we can address these factors (e.g. through education.policies, and health promotion activities), than many of these diseases can be prevented.

• More of a community approach, as opposed to individual focus of biomedical approach

• Aims to improve the health status of disadvantaged groups

OTTAWA CHARTER FOR HEALTH PROMOTION

• Developed at the World Health Organisation's first International Conference on Health Promotion held in 1986 in Ottawa, Canada

• This framework aims to assist government and non-government organisations in implementing the social model of health.

• This is where the health promotion definition was created

- The process of enabling people to increase control over, and improve their health through understanding the consequences of health behaviours

Health promotion

Guidelines to how key organisations and stakeholders promote all the health promotion ideas,

Action areas of Ottawa Charter

1. Build healthy public policy

Relates directly to the decisions made by government and organisations regarding laws and policies that make it more difficult for people to undertake unhealthy behaviours and seek to make healthier choices the easier choices.

eg:

1. Banning smoking in public places, which makes the environment healthy for everyone

2. Compulsory wearing of seatbelts, which aims to directly influence behaviour

3. Increasing the tax on tobacco and alcoholic drinks, which aims to discourage unhealthy behaviour by making them more expensive

2. Create supportive environments

• Recognises the impact that the broader determinants have on health and wellbeing and health status

• Aims to promote a healthy physical and sociocultural environment for all members of the community

• A supportive environment is one that promotes health and wellbeing by being safe, stimulating, satisfying and enjoyable

3. Strengthen community action

• Focuses on building links between individuals and the community, and centres around the community working together to achieve a common goal

• Giving the community a sense of ownership of a health and wellbeing strategy and working together increases the likelihood that it will be effective

4. Develop personal skills

• Education is the main aspect of this action area. Education refers to gaining health-related knowledge and skills that allow people to make informed decisions that may indirectly affect health and wellbeing (such as talking to people to resolve conflict rather than using violence or teaching people the skills they need to cook a healthy meal).

• Education can occur in many places, including school and work settings, families, and government and non-government organisations

5. Reorient health services

Refers to changing the health system so that it promotes health and wellbeing rather than just focusing on diagnosing and treating illness, as is the case with the biomedical model

• Addressing all factors that influence health and wellbeing, not just diseases. This requires a shift towards health promotion, which includes doctors taking on the role of educator.