Concepts and Policies of Health

Promotion, Public Health and

Health Education.

NUR7066-C
 Session aim
Objective:
To deconstruct health promotion as a public health instrument, explore concepts associated with health
promotion and discuss key health promotion policies and principles.

Learning outcomes:
At the end of the session, you will be able to:
1. Distinguish and critically discuss the difference between public health and health promotion and
recognise how perspectives of health differ across populations and the consequent implications for
promoting health.
2. Distinguish and critically reflect on the different approaches to promoting health and changing
behaviour.
3. Critically discuss and evaluate the key health promotion principles congruent with promoting health
in a multicultural and global space.
Public health and health promotion

 Public health is the science and art of preventing disease, prolonging life and promoting health through
the organised efforts of society (Acheson, 1988).

 Health promotion is a range of activities and interventions to enable people to take greater control
over their health. Activities may be directed at individuals, families, communities or whole populations’
(Naidoo and Wills, 2016).

 Public health includes health protection, health prevention and health promotion.

 Health promotion (also referred to as health improvement) is a speciality within Public Health.
Spheres of health promotion

Health
Education

Prevention Health
Protection

A Model of health promotion

 • Prevention –Reducing the risk of disease, premature
Spheres of death, illness or disability or any other undesirable health
event. E.g. vaccination, pollution control and sanitary

health measures
• Health Education – Seeks to prevent ill-health and
promote health by enabling people to understand, follow
promotion and sustain particular actions and choices. Involved
imparting knowledge, changing attitudes and altering
behaviour. E.g. harmful effects of smoking
• Health Protection – Usually involve the use of legislation
to secure health goals; e.g. legislation to maintain pure
water supply
• Health and well-being are seen as interdependent
• Prevention is as important as cure
• Long-term solutions are as important as treatment
Connection between health promotion and
public health
Defining public health as the science and art of promoting and protecting health and wellbeing, preventing ill
health and prolonging life through the organised efforts of the society underlies the following approach to
public health:

 Population based.

 Collective responsibility for health.

 Recognition of the key role of the state.

 Emphasis on partnership.

Health promotion is not simply advertising health. By promotion in the health context we mean improving
health: advancing, supporting, encouraging and placing it higher on personal and public agenda (Ewles &
Simnett, 2004).
What is
Health Promotion?

“Health promotion works through concrete and effective community action

in setting priorities, making decisions, planning strategies, and implementing
them to achieve better health. At the heart of this is the process of
empowerment to communities, their ownership and control of their
destinies.”
(WHO, 1986)
 Health Promotion

Health promotion is the process of enabling people to

increase control over the determinants of health and
thereby improve their health. Participation is essential
to sustain health promotion action.
Basic strategies for health
promotion
The Ottawa Charter identifies three basic strategies for
health promotion, namely:
• Advocacy for health to create the essential
conditions for health indicated above
• Enabling all people to achieve their full health
potential
• Mediating between the different interests in society
in the pursuit of health
• Link to Otawa Charter:
https://www.who.int/teams/health-promotion/enhance
d-wellbeing/first-global-conference
• First International Conference on Health Promotion,
meeting in Ottawa this 21st day of November 1986
• The fundamental conditions and resources for health are:
• peace,
• shelter,
• education,
• food,
• income,
• a stable eco-system,
• sustainable resources,
• social justice, and equity.
• Improvement in health requires a secure foundation in
these basic prerequisites.
5 priority Health Promotion action
Areas

1. Building healthy public policy

2. Creating supportive
environments
3. Strengthening community
actions
4. Developing personal skills
5. Reorientating health services

(Ottawa Charter - WHO Europe Region Health Cities Project)

 Principles of health promotion
 Equitable (guided by a concern for equity and social justice).

 Empowering ( enable individuals and communities to assume

more control over the factors that affect their health).

 Participatory ( involving all concerned at all stages).

 Inter-sectoral (involving the collaboration of all relevant

agencies).

 Holistic ( fostering physical, mental, social, spiritual and

sexual well-being).

Importantly, health promotion interventions must be evidence-

based, transparent, professional and offering value for money.
Videos to watch
What is public health
• https://www.youtube.com/watch?v=t_eWESXTnic
• https://youtu.be/oy1CAMObRzc
Health protection
• https://youtu.be/RgnCUrdZ688
• https://youtu.be/NCtedekBCyI
Health improvement
• https://youtu.be/0JPe-U4iLMA
Social Determinants of health
• https://youtu.be/8PH4JYfF4Ns
 • General widespread awareness of health
issues
• Influence of mass media
• Multi sectoral approaches
Issues for • Contextual strategies

consideration • Active community participation

• Access and affordability
• Socio-cultural sensitivity (acceptance)
• Political/ Institutional support
• Understanding of wider determinants of
health
  Obesity and Healthy Eating -https://www.gov.uk/health-and-social-
care/healthy-eating
Links to  Smoking- https://www.gov.uk/health-and-social-care/smoking
 Cancer research and treatment:
policies on https://www.gov.uk/health-and-social-care/cancer-research-and-tre
atment
key public  Children's health:
health issues https://www.gov.uk/childcare-parenting/childrens-health-and-welfar
e

 Drug misuse and dependency:

https://www.gov.uk/health-and-social-care/drug-misuse-and-depen
dency

 Harmful drinking:
https://www.gov.uk/health-and-social-care/harmful-drinking
 FURTHER READING
1. Donaldson LJ and Donaldson RJ (2000): Essential Public Health (2 nd edn). Newbury, Petroc Press:115
2. WHO (1986): Ottawa Charter for health promotion: An international conference on Health Promotion – the move towards a new public health. Ottawa, WHO
3. Alma-ata declaration- https://www.who.int/publications/i/item/WHO-EURO-1978-3938-43697-61471
4. Tannahill A (1985): What is health promotion? Health Education Journal, 44:167-8
5. DOH (2008): Healthy Weight, Healthy Lives: a cross-government strategy for England.
6. University of California news release 2009: maintaining or increasing physical activity slows cognitive decline in elders.
7. Green, J., Tones, K., Cross, R. and Woodall, J. (2015) Health promotion planning and strategies 3rd ed. London: Sage Publications Ltd.
8. Marmot, M. and Wilkinson R. G. (1999) Social determinants of health. Oxford: University Press.
9. Naidoo, J. and Wills, J. (2009) Foundations for health promotion. 3rd ed. Oxford: Saunders.
10.Naidoo, J. and Wills, J.(2016) Foundations for health promotion. 4th eds. London: Elsevier Publications Ltd.
11.Raeburn, J. and MacFarlane, S. (2003) ‘Putting the public into public health: towards a more people-centred approach’. In R. Beaglehole (ed.), Global Public
Health: A New Era. Oxford: Oxford University Press.
12. Snelling, A., M. (2014) Introduction to health promotion. 1st ed. San Francisco: John Wiley and Sons.

Websites

1. Department of Health:

http://www.dh.gov.uk/en/Publichealth/Healthinequalities/index.htm

2. WHO:

http://www.who.int/healthpromotion/conferences/previous/ottawa/en/

3. CABE:

Future health: sustainable places for health and well-being. Commission for Architecture and the Built environment (CABE)