Health Promotion, Health Equity, and the Social Determinants of Health

Vocabulary flashcards covering core concepts in health promotion, equity versus equality, upstream and downstream approaches, Ottawa Charter strategies, Primary Health Care principles, and social justice models.

Social Justice

The fair distribution of society's benefits, resources, and opportunities, focusing on the relative position of one social group in relationship to others and acknowledging systemic barriers that create inequities.

Health Equality

An approach where everyone is provided with the exact same resource to access care, regardless of differences in need or background.

Health Equity

An approach where everyone is provided with tailored and additional support based on individual needs so they can equitably access care.

Health Justice

An approach focused on the systemic removal of barriers and obstacles that prevent people from accessing care.

Health Disparities and Inequities

Differences in health status across population groups that are avoidable, unfair, and systematically linked to social inequalities, disadvantage, and unequal distribution of determinants of health.

Intersectionality

A theoretical lens that examines how social and structural systems (such as racism, classism, sexism, and homophobia) interact and overlap to advantage some while disadvantaging others.

Critical Social Justice

A perspective in nursing practice that addresses root power hierarchies, interrupts practices of oppression and structural violence causing human suffering, and moves beyond Eurocentric biomedical models.

Upstream Thinking

A macro-level approach targeting the social determinants of health through prevention, policy, and environmental protections to prevent harm before it occurs ('keeping people out of the river').

Downstream Thinking

A micro-level approach focused on individual clinical care, medical treatments, and mitigating the damage of a health issue after it has occurred ('pulling people out of the river').

Midstream Approach

Interventions operating at the individual and group level that address behavioral risks, individual social needs, or harm reduction strategies (e.g., safe injection sites, clean needles, smoking reduction).

Upstream, Midstream, Downstream Health Framework

A conceptual model dividing health action into upstream community conditions/impact, midstream individual social needs/impact, and downstream individual clinical care.

Health Promotion

The process of enabling people to increase control over, and to improve, their health to achieve a state of complete physical, mental, and social well-being.

Lalonde Report (1974)

A Canadian document titled 'A New Perspective on the Health of Canadians' proposing the health field concept (human biology, lifestyle, environment, health organizations); criticized for focusing excessively on lifestyle and fostering victim blaming.

Alma-Ata Declaration (1978)

A World Health Organization declaration outlining primary health care as universally accessible, scientifically sound, socially acceptable care that fosters community self-reliance and citizen participation.

Five Principles of Primary Health Care (PHC)

Accessibility, health promotion, community/public participation, appropriate technology, and intersectoral collaboration/cooperation.

Primary Care (PC)

The client's first point of entry into the health system, characterised by a narrower, professionally driven, top-down clinical focus on diagnosis, treatment, cure, and disease management.

Primary Health Care (PHC)

A comprehensive, bottom-up approach focusing on promoting health, addressing social determinants, and improving quality of life across social, cultural, economic, and environmental domains.

Prerequisites for Health (Ottawa Charter)

The foundational conditions required for health improvement: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity.

Ottawa Charter Emblem Action Areas

The visual representation of the Ottawa Charter (1986) illustrating its five core action strategies: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, and reorient health services, centered on advocate, mediate, and enable.

Building Healthy Public Policy

An Ottawa Charter strategy that ensures health considerations are on the agenda of policy decisions across all government and organizational sectors (e.g., campus smoking bans, school zone speed limits).

Strengthening Community Action

An Ottawa Charter strategy centered on bottom-up community participation where members identify priorities, plan, and direct actions to improve their own community's health.

Creating Supportive Environments

An Ottawa Charter strategy focused on designing living, working, and leisure settings (physical and social) that are safe, stimulating, satisfying, and health-enhancing.

Developing Personal Skills

An Ottawa Charter strategy that provides information, health education, and life skill enhancement to increase options and personal control over health.

Reorienting Health Services

An Ottawa Charter strategy that expands health services beyond clinical, curative, and treatment responsibilities toward total health promotion and social determinants.

Population Health Promotion Model (PHPM, 1996)

A three-dimensional Canadian model that integrates the Ottawa Charter action strategies (how), the determinants of health (what), and various levels of society and care (with whom).

Bangkok Charter for Health Promotion (2005)

A WHO charter identifying actions and pledges to address the determinants of health globally, emphasizing urbanisation, commercialization, and corporate and government accountability.

Capacity Building

Activities and processes that develop and strengthen skills, abilities, and resources among individuals and communities to navigate complex social determinants and address root causes of health issues.

Empowerment

The process of enabling individuals and communities to gain mastery and control over their lives through shared decision-making, power negotiation, and social/political change.

Intersectoral Collaboration

Coordinated action between the health sector and other sectors (such as housing, education, employment, and transportation) to address complex health determinants.