Current Approaches to Health Promotion

Individual (e.g., medical screening, lifestyle messages)

Current Approaches to Health Promotion Setting (e.g. workplace, school, community

centre, etc.)

• Setting is seen as a place to reach people. • Usually has a lifestyle emphasis as opposed

to reorganizing the workplace to increase control and health.

• Can involve increasing control by participants of local conditions.

Current Approaches to Health Promotion

Community Mobilization (e.g. heart health, smoking cessation)

• Usually involves focus on an expert-decided problem or issue.

• Assumed to be an equal partnership between community and experts or authorities.

Current Approaches to Health PromotionCommunity Development (e.g.

participatory research )

• Usually involves focus on a community-decided problem or issue.

• Control is assumed to rest with the community and its members rather than with experts or authorities

Current Approaches to Health Promotion

Healthy Cities/Healthy Communities

• Focus on municipal governance• Broad definition of health and its

determinants• Citizen participation is important• Careful monitoring of progress

Healthy Communities in OntarioBasic Princples I

Health is a state of complete physical, mental and social well-being.– Social, environmental and economic factors are important

determinants of human health and are inter-related. – People cannot achieve their fullest potential unless they are

able to take control of those things which determine their well-being.

– All sectors of the community are inter-related and share their knowledge, expertise and perspectives, working together to create a healthy community.

•

Healthy Communities in OntarioBasic Principles II

A Healthy Community process involves:– wide community participation– broad involvement of all sectors of the

community– local government commitment– creation of healthy public policies

•

Healthy Communities in OntarioBasic Principles III

• Qualities of a Healthy Community include:– clean and safe physical environment– peace, equity and social justice – adequate access to food, water, shelter,

income, safety, work and recreation for all– adequate access to health care services– opportunities for learning and skill

development

Current Approaches to Health Promotion

Health Protection (e.g., pollution control, seat belts)

Current Approaches to Health Promotion

Political/Economic (e.g., Canadian policy documents)

Canadian Government Statements on Health and Health Promotion I

All policies which have a direct bearing on health need to be coordinated. The list is long and includes, among others, income security, employment, education, housing, business, agriculture, transportation, justice and technology.

-- Achieving Health For All: A Framework for Health Promotion, J. Epp. Ottawa: Health and Welfare Canada, 1986.

Canadian Government Statements on Health and Health Promotion II

There is strong evidence indicating that factors outside the health care system significantly affect health. These “determinants of health” include income and social status, social support networks, education, employment and working conditions, physical environments, social environments, biology and genetic endowment, personal health practices and coping skills, healthy child development, health services, gender and culture.

-- Taking Action on Population Health: A Position Paper for Health Promotion and Programs Branch Staff. Ottawa: Health Canada, 1998.

Canadian Government Statements on Health and Health Promotion III

In the case of poverty, unemployment, stress, and violence, the influence on health is direct, negative and often shocking for a country as wealthy and as highly regarded as Canada.

-- The Statistical Report on the Health of Canadians. Ottawa: Health Canada, 1998.

Reflection: The Role of Values in Health Promotion

• Does choice of health promotion model and approach by an individual, organization, or government reflect particular individual and societal values?

• David Seedhouse argues that every health promotion activity has an underlying political ideology:

All health promotion ‑‑ even the most routine and mundane ‑‑ is based on one political philosophy or another.

Class Exercise: How Should We Reduce the Incidence of Heart Disease?

• You have been chosen to reduce the incidence of heart disease among Canadians.

• You have also been provided with limitless resources and total power.

Class Exercise: How Should We Reduce the Incidence of Heart Disease?

• What would you do?

• What grounds (evidence) do you have for choosing this approach?

• Where did you get this evidence from? • What does your choice say about you and the way

you and others think about the causes of heart disease and how it can be reduced?