HEALTH

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HEALTH

• HEALTH PROMOTION

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What are your answers?

• I feel healthy when..
• I am healthy because.
• To stay healthy I need
• I become healthy when
• (A person) affected my health when
• (An event) affected my health when
• ( A situation) affected my health when
• ..is responsible for my health.

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HEALTH

• Value an ideal that has importance to an
  individual, group or society. They are developed
  through life experiences
• Beliefs are mental convictions (trust in another
  person). Values influence our beliefs.
• Behaviours represent or demonstrate our values
  and beliefs

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Canadian Society

• Values equality, individual rights, health and
  well being, quality of life and human dignity
• This is demonstrated in the Canadian health care
  system by the principle of universality. Equal
  access to health care and illness care to all
  Canadians regardless of where they live and their
  socio-economic status.

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Personal Values

• Our values and beliefs affect our health
  behaviours. Everyone has different health
  priorities (diet, exercise, stress maintenance,
  hygiene).
• Our professional values build on our personal
  values. The more one experiences in nursing the
  more ones values are alter, reshaped and
  reordered.
• Our behaviours will also change as seen in our
  personal strategies for health and in our care of
  clients.

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Models of Health

• Clinical model - absence of signs symptoms
• Role performance model successful performance
  of valued roles and tasks
• Adaptive model flexible adjusting to change
  through growth expansion and creativity
• Eudaimonistic model self-actualized, fulfilled,
  exuberant well being

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HEALTH (PENDER, 1996)

• Stability-oriented maintenance of equilibrium
  in physical functional and social norms
• Actualization-oriented high level wellness,
  actualizing ones own potential
• Health includes affect, attitude, activity,
  aspirations accomplishments and is seen as
  interactions between the person the
  environment.

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HEALTH (Labonte, 1993)

• Vital, full of energy
• Good social relationships
• Sense of control over ones life living
  conditions
• Doing things you enjoy
• Sense of purpose to your life
• Connectedness to community

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HISTORICAL APPPROACH TO HEALTH IN CANADA
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• MEDICAL 20th century
• Disease / body breakdown
• Focus on treatment of disease infirmity (Tx
  fix it)
• Scientific advances, hospital construction,
  national health insurance could resolve most of
  societys health problems
• Health promotion focused on treatment of
  physiological risk factors (hypertension, obesity)

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BEHAVIOURAL APPROACH

• Lalonde Report (1974)
• Lifestyle, environment, human biology, Health
  care organizations
• Health promotion to decrease behavioural risk
  factors (Participaction)
• Integrating knowledge from the social sciences to
  motivate people/HP strategies
• Placing responsibility for health on the
  individual

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Social Environmental

• Ottawa Charter (1986)
• The Epp (1986) Report
• Increasing awareness of the effect of
  socio-environmental factors on health
• People dont choose poor health, quite often
  their environment poses obstacles and barriers

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 Why is Jason in the hospital?Because he has
a bad infection in his leg.But why does he
have an infection?Because he has a cut on his
leg and it got infected.But why does he have a
cut on his leg?Because he was playing in the
junk yard next to his apartment building and
there was some sharp, jagged steel there that he
fell on.But why does he live in that
neighbourhood?Because his parents cant afford
a nicer place to live.But why cant his
parents afford a nicer place to live?Because
his Dad is unemployed and his Mom is sick.But
why is his Dad unemployed?Because he doesnt
have much education and he cant find a job.But
why.? 
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Ottawa Charter

• Prerequisites for health peace, shelter,
  education, food, income, stable ecosystem,
  sustainable resources, social justice, equity.
• Advocacy for health at all levels and areas
• Enable people by providing opportunities and
  resources
• Mediate coordinated action by governments, social
  economic sectors, and volunteer organizations

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WHO Definition of Health

• Health is viewed as the extent to which an
  individual or group is able , on the one hand, to
  realize aspirations and satisfy needs and on the
  other hand, to change or cope with the
  environment. Health is seen as a resource for
  everyday living not the object of living. Health
  is a positive concept emphasizing social and
  personal resources as well as physical capacities.

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Epp Report Achieving Health For All A Framework
For Health Promotion

• Health Challenges
• Reducing inequities, increasing prevention, and
  enhancing coping
• Mechanisms
• Self-care, mutual aid, healthy environments
• Strategies
• Fostering public participation, strengthening
  community health services, coordinating healthy
  public policy

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Strategies for population Health (1994)

• Three more determinants of health are added
  Gender, culture and social environments.
• Determinants are viewed at both the individual
  level AND the population level

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Determinants of Health

• Income Social Status
• Social Supports Networks
• Education
• Employment/Working Conditions
• Social Environments
• Physical Environments
• Personal Health Practices Coping Skills
• Healthy child Development
• Biology and Genetic Endowment
• Health Services
• Gender
• Culture

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Income Social Status

• Health Status improves at each step up the income
  and social hierarchy. High income determines
  living conditions such as safe housing and
  ability to buy sufficient good food. The
  healthiest populations are those in societies,
  which are prosperous and have equitable
  distribution of wealth.

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Social Supports Networks

• Support from families friend and communities is
  associated with better health. The importance of
  effective responses to stress and having the
  support of family and friends provides a caring
  and supportive relationship that seems to act as
  buffer against health problems

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Education

• Health status improves with the level of
  education.
• Education increases the opportunities for income
  and job security, and equips people with a sense
  of control over life circumstances key factors
  that influence health

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Employment/Working Conditions

• Unemployment, underemployment and stressful work
  are associated with poorer health.
• People who have more control over their work
  circumstances and fewer stress related demands of
  the job are healthier and often live longer than
  those in stressful or riskier work and
  activities.

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Social Environments

• The array of values and norms of society
  influence in varying ways the health and
  well-being of individuals and populations.
• In addition, social stability, recognition of
  diversity, safety, good working relationships and
  cohesive communities provide a supportive society
  that reduces or avoids many potential risks to
  good health. Studies have shown that low
  availability of emotional support and low social
  participation have a negative impact on health
  and well-being.

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Physical Environments

• Physical factors in the natural environment (e.g.
  air, water quality) are key influences on health.
  Factors in the human built environment such as
  housing, workplace safety, community and road
  design are also important influences.

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Personal Health Practices Coping Skills

• Social environments that enable and support
  healthy choices and lifestyles, as well as
  peoples knowledge, intentions, behaviours and
  coping skills for dealing with life in healthy
  ways, are key influences on health.
• Through research in areas such as heart disease
  and disadvantaged childhood, there is more
  evidence that powerful biochemical and
  physiological pathways link the individual
  socio-economic experience to vascular conditions
  and other health events.

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Healthy child Development

• The effect of prenatal and early childhood
  experiences on subsequent health, well-being,
  coping skills and competence is very powerful.
• Children born in low income families are more
  likely than those born to high income families to
  have low birth weights, to eat less nutritious
  foods and to have more difficulty in school

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Biology and Genetic Endowment

• The basic biology and organic makeup of the human
  body are fundamental determinant of health.
• Genetic endowment provides an inherited
  predisposition to a wide range of individual
  responses that affect health status. Although
  socio-economic and environmental factors are
  important determinants of overall health, in some
  circumstances genetic endowments appears to
  predispose certain individuals to particular
  diseases or health problems.

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Health Services

• Health services, particularly those designed to
  maintain and promote health, to prevent disease,
  and to restore health and function contribute to
  population health.

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Gender

• Gender refers to the array of society-determined
  roles, personality traits, attitudes, behaviours,
  values, relative power and influences that
  society ascribes to the two sexes on a
  differential basis.
• Gendered norms influence the health systems
  practices and priorities. Many health issues are
  a function of gender based social status or
  roles. Women for example are more vulnerable to
  gender based sexual or physical violence, low
  income, lone parenthood, gender based causes of
  exposure to health risks and threats (e.G.
  Accidents STDs, suicide, smoking, substance
  abuse prescription drugs, physical inactivity).
  Measures to address gender inequity and gender
  bias within and beyond the health system will
  improve population health.

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Culture

• Some persons or groups may face additional health
  risks due to a socio-economic environment, which
  is largely determined by dominant cultural values
  that contribute to the perpetuation of conditions
  such as marginalization, stigmatization, loss or
  devaluation of language and culture and lack of
  access to culturally appropriate health care and
  services.

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Health Promotion

• Increasing the level of well being and self
  actualization
• Disease Prevention
• Decreasing the probability of experiencing health
  problems

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Levels of Prevention

• Primary Prevention protection of disease before
  the occurrence of Signs Symptoms
• Secondary Prevention activities that promote
  early detection of disease so that prompt
  treatment can halt or decrease it.
• Tertiary Prevention activities that minimize the
  residual disability from the disease and help to
  live productively

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Health Promotion Strategies

• Build Healthy Public Policy
• Create Supportive Environments
• Strengthen Community Action
• Develop Personal Skills
• Reorient Service

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People must

• Develop an understanding of the complex factors
  influencing health.
• Consider the root causes of health situations.
• Consider a variety of strategies.
• Realize enhancement of health takes EVERYONE not
  just health professionals.