What is new about New Public Health

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What is new about New Public Health?

• Signild Vallgårda
• Institute of Public Health University of
  Copenhagen

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New public health is about health promotion
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Health promotion is the process of enabling
people to increase control over, and to improve,
their health. Ottawa declaration, 1986
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To reach a state of complete physical mental and
social wellbeing, an individual or group must be
able to identify and to realize aspirations, to
satisfy needs, and to change or cope with the
environment. Ottawa declaration, 1986
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Health promotionassumptions

• The goal is improved health complete physical
  mental and social wellbeing rather than avoiding
  disease
• Methods imply less governing more decisions by
  the individual citizen

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Is it new?The medical ideas of the old greeks
implied the efforts to promote health by
achieving a balance through diet, rest, the right
environments etc.
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People should be informed about how much health
and strength depends on well prepared food, and
orderliness, cleanliness, frugality and industry,
and weakness and disease is caused by bad food,
disorder, filthiness, idleness and strong
drinking of aquavit and coffee. Plan for
Fattigvæsenet for København fra 1799
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the preventive and healthpreserving work cannot
be carried through without the cooperation of
each indiviodual in society, and a prerequisite
for this cooperation is an understanding of the
means and goals of teh workJohannes Frandsen,
1939
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the personal guidance and influence, which does
not only give knowledge, but which - - also
gives and understanding of the importance of
using this knowledge, creates the mentality and
thereby nurses the urge to actually follow the
advices. Poul Bonnevie 1951
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The goal promoting health is not new
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New conceptshealth promotion, new public
healthNew governing technologiesempowerment,
enablement, motivating dialogue
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Exercise of powerA makes B do something B would
not otherwise have done
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Exercise of power it incites, it induces, it
seduces, it makes easier or more difficult in
the extreme it constrains or forbids absolutely
it is nevertheless always a way of acting upon an
acting subject or acting subjects by virtue of
their acting or being capable of action
Foucault 1982
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Empowerment as an exercise of powerThe goal
is to shape people by giving them new properties
the ability to act The goal is also to make
them use this ability to improve their health
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The second paradox is implicit in the
expression empowering people to make healthy
choices. But empowered people do not always make
the choices you believe they should. Evans RG.
Health for all wealth for some
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Motivational interviewing has as its goal to
promote behavioural changes by stimulating the
patient to analyse her feelings In the dilemma
between actual behaviour and health wishes.
Dansk selskab for almen medicin, 2001
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a non-directive guidance based on an
interaction, with the purpose to change or modify
behaviour Mabeck et al 2001
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Emphasize readily very strongly, what the
patient does to preserve her health Dansk
selskab for almen medicin, 2001
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New public health Not a stronger focus on
health nor on non-directivenessNew more
concealed governing technologies