The Implications of Health in the Context of Health Promotion - Essay Example

? The Implications of Health in the Context of Health Promotion By ID Number Module and Number Date of Submission The Implications of Health in the Context of Health Promotion Introduction In health promotion, the World Health Organisation’s (WHO) definition of health has become one of the most commonly used official interpretations of the term. The WHO defines health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity” (Laverack, 2007, p.31). However, this positive interpretation of health does not include other dimensions such as the emotional and spiritual dimensions. Health is more than a physical state or an individual phenomenon. Good health requires the interactivity of human beings, social capital and social support. Consequently, inequity in personal relationships or in social environments adversely impact on an individual’s health (Talbot and Verrinder, 2009). Health promotion is “the process of enabling people to take control over the determinants of their health” (Wills, 2009, p.64), for improved health outcomes. Health promotion involves a complex social and political process. Besides strengthening the skills and capabilities of individuals, it also implements changes in their social, economic and environmental conditions for enhancing individual and public health (Wills, 2009). Thesis Statement: The purpose of this paper is to critically examine the meaning of health in the context of health promotion. The Concept of Health in Health Promotion Health promotion as a concept and set of practical strategies works as a guide in addressing the main health challenges affecting developing and developed nations, “including communicable and non-communicable diseases, and issues related to human development and health” (HPA, 2009). Health promotion is a process that enables people to take action. Thus, health promotion is not conducted on people; it is carried out by the people, either as individuals or groups, and the health beneficiaries are the same people undertaking health promotion. The purpose of this process is to reinforce the skills and capabilities of individuals to take action, and strengthen the “capacity of groups or communities to act collectively to exert control over the determinants of health and achieve positive change” (HPA, 2009) in health outcomes. The concept of health is a disputed one, with different meanings for various people. Scott-Samuel and Springett (2007) argue that the popular conceptualisation of health is influenced by culture, socio-economic position, and life history. These factors are dynamically related to media and professional discourses, and with subjective definitions. Further, “the values underpinning the health promotion process are explicitly those of participation, enablement and empowerment, equity and social justice” (Scott-Samuel and Springett, 2007, p.212). Moreover, the target of health improvement is defined differently depending on the perspectives about health and its measurement. According to Scott-Samuel and Springett (2007), health promotion in England has been steadily disappearing from public health since 1997. This is true for the term ‘public health’ as well as the principles and the discipline it represents. Thus, the term ‘health promotion’ was substituted by the inadequately defined terms ‘health development’ and/ or ‘health improvement’. White and Wills (2010) add that results from the last survey of health promotion practice conducted in 2005, reveal that the specialised health promotion workforce was unevenly distributed and poorly supported. On the other hand, Scott-Samuel and Springett (2007) state that taking into consideration the significant increase in health-promoting policies and programmes in the last fifteen years, the decline in health promotion could signify a welcome mainstreaming of the process. However the authors’ findings from a detailed historical and contemporary review of health promotion and public health theory and practice, reveal that it is not in fact, the case. They assert that health promotion in England portrays a dominant absorption and dilution by an increasingly overriding public health discourse. The growing contemporary emphasis on well-being may indicate a possible revival of health promotion in England (Scott-Samuel and Springett, 2007). White and Wills (2010) examine the future of health promotion in England. Since the last survey of health promotion practice, there has been a large-scale reorganisation of primary care trusts, and a separation between provider functions and commissioning. The findings from a survey conducted in 2008-2009 on practitioners reveal that a dominant influence on the nature of health promotion activity is organisational structure. The split between commissioning and provider functions of primary care trusts has “‘presented huge challenges to practitioners irrespective of the arm in which they are placed” (White and Wills, 2010, p.44). The reason is that one of the key strengths of health promotion has always been its ability to encompass both strategic and operational dimensions, and provide an integrated approach to address the causes of ill health. Members of the specialised health promotion workforce have suffered a loss of identity and critical mass, with increasing reduction and fragmentation of the discipline. This trend may worsen in the future, due to further reorganisation and reductions in public sector spending by the new coalition government (White and Wills, 2010). Thus, “the future for specialised health promotion in England does not look promising”, argue White and Wills (2010, p.46). Reducing costs through prevention both in the short, medium as well as long terms is not advocated by key decision makers. Thus, some public health services such as providing free swimming for children and people over sixty years may be terminated. However, one area which is rapidly improving and has a potential for revival is community engagement and the involvement of ‘lay’ people in public health. With their expertise in this area, the specialised health promotion workforce could offer one way of using their skills and experience as promoters and facilitators. However, there is widespread scepticism that it may only mean substituting voluntary work for essential public services (White and Wills, 2010). Dunne and Furlong (2012) state that the current economic climate requires that public spending is undertaken in the most efficient manner. For achieving beneficial outcomes from health promotion, evaluations of interventions have to be provided. “Without evidence, funding could be jeopardised, and the capacity to deliver high quality health promotion will be weakened” (Dunne and Furlong, 2012, p.110). Thus, when the main policy driver is funding related to evidence, health promotion should fully undertake rigourous evaluation processes and evidence-based practice. Health promotion to improve the health conditions of the weaker sections of society, and for empowering the economically challenged is termed as health equity promotion. For this purpose, both social conditions and human rights are considered. Several of the foundational concepts of health equity and human rights are similar, though the two fields have different languages, perspectives, and tools for action. Braveman (2010) identifies connections between human rights and health equity, with specific emphasis on the implications of current knowledge of the ways in which social conditions tend to impact health and health inequalities, and the scale on which health equity is evaluated. To determine the role played by social conditions in health, two factors are taken into consideration. First, the concept that social conditions along with other modifiable determinants of health are required for health equity; and second is the right to a standard of living adequate for health. All human rights are undividable as well as mutually interdependent. Human rights related to civil, political, economic, and social dimensions, as well as the right to education, covertly but clearly support the requirement for addressing the social and political determinants of health, thus forming a part of the concept of health equity (Braveman, 2010). The concept of health equity is supported by the human right to attain the highest standard of health possible; this is because the “reference group for equity comparisons should be one that has optimal conditions for health” (Braveman, 2010, p.31). Further, the human rights principles of non-discrimination and equality also reinforce the concept of health equity. This takes place through identifying groups among whom health status and health determinants including social conditions, reveal an absence of health equity; and by interpreting discrimination not only to include “intentional bias, but also actions with unintentionally discriminatory effects” (Braveman, 2010, p.31). At the same time, health equity makes significant contributions to human rights, with research on health inequalities providing evidence supporting social conditions as determinants of health (Braveman, 2010). Further, it indicates the implementation of the right to health, using the elusive means of measurement and accountability. Human rights principles and health equity concepts form powerful instruments for mutual strengthening by building shared values and by guiding analysis and strengthening measurement of both concepts (Braveman, 2010). Conducting health research and implementing evidence-based practice are vital in the field of health promotion. Piggin (2012) investigates the approach to turning of health research into health promotion. Important decisions on health “can alter between public health policy formulation and eventual marketing implementation” (Piggin, 2012, p.296). The author examines the major United Kingdom social marketing campaign ‘Change4Life’, and investigates how the health promotion process produces at different times, varying ideas about the reasons and solutions to the obesity epidemic. Through studying various research, policy, marketing strategy and marketing messages between 2008 and 2011, the author finds that claims regarding the causes keep changing throughout the research, policy and Change4Life marketing process. The original consumer research being critical, an urgent review was required when it was found to be directly contradicted in the campaign. This was also due to the importance of the health issues being addressed, and the amount of funding dedicated to Change4Life. Thus, the utility of social marketing is evident, in causal claims in health promotion (Piggin, 2012). Conclusion This paper has critically examined the context of health in health promotion in England. The apparent decline of health promotion as a discipline in England, and its future prospects were discussed. Further, the importance promoting health equity, and the role of social conditions, human rights, and the empowerment of community in health equity promotion were determined. It is evident that health is an essential requirement, consisting of social as well as personal resources composed of physical, mental, spiritual, material and economic resources. Moreover, the fulfillment of basic human rights is also important. These components of health are essential for leading individually, socially, and economically productive lives. Thus, HPA (2009) states that the key aim of health promotion should be to meet these fundamental needs. The research evidence indicates that the role and relevance of health promotion can be enhanced by reinforcing community action, and creating supportive environments for health, promoted by soundly formulated public policy. This is reiterated by HPA (2009), who add that health services are required to be reoriented towards health promotion. Thus, health promotion will include social, environmental and economic conditions, as well as the determinants related to individual health behaviours. Health promotion is a powerful strategy for social development, particularly in correcting inequalities in health among different sections of the population. It also embodies principles for implementing strategies to develop conditions for optimising the health of populations, and to promote the importance of making healthy choices. It is concluded that health promotion should include the multiple implications of health, and should support change and social justice. Bibliography Braveman, P. 2010. Social conditions, health equity, and human rights. Health and Human Rights, 12(2), pp.31-48. Dunne, A. and Furlong, C. 2012. Funding linked to evidence: What future for health promotion? Perspectives in Public Health, 132(3), pp.109-110. HPA (Health Promotion Agency). 2009. What is health promotion? http://www.healthpromotionagency.org.uk/Healthpromotion/Health/section2.htm [Accessed 5 December 2012]. Laverack, G. 2007. Health promotion practice: Building empowered communities. London: McGraw-Hill International. Piggin, J. 2012. Turning health research into health promotion: A study of causality and ‘critical’ insights in a United Kingdom health campaign. Health Policy, 107(2-3), pp. 296-303. Scott-Samuel, A. and Springett, J. 2007. Hegemony or health promotion? Prospects for reviving England’s lost discipline. The Journal of the Royal Society for the Promotion of Health. 127(5), pp.211-214. Talbot, L. and Verrinder, G. 2009. Promoting health: The primary health care approach. Edition 4. The United Kingdom: Elsevier. Wills, J. 2009. Health promotion: Not drowning but waving? In Jenny Douglas, Sarah Earle, Stephen Handsley, Linda J. Jones, Cathy E. Lloyd, and Sue Spurr, eds. A reader in promoting public health. Edition 2. London: Sage, pp.62-67. White, J. and Wills, J. 2010. What’s the future for health promotion in England? The views of practitioners. Perspectives in Public Health, 131(1), pp.44-47. Read More