Health Promotion: Public Health and Health Services - Essay Example

Health Promotion: Public Health and Health Services Nutrition, education, housing, income, public health measures and health services all contribute to an increase in health status improvement. Health promotion is the science and art of enabling people to control and improve their health according to the World Health Organization. It has been one of the most important health policy developments in the past two decades. Societies are now facing new challenges as the role of governments have changed and political leadership is faced with changing demands. Welfare and health care is experiencing conflicts and crisis despite investments in the GNP (Green, 5, 1991). Health promotion is based on the idea that the basic prerequisites must have a secure foundation in order to improve health. Quality of life is an important dimension of health promotion (Hawe, 25, 1990). Social and personal development can be favorable for health. Equity in health must be achieved in order to reduce the differences in health status. Each member of the world must have access to equal health opportunities and resources. Men and women must be empowered to have the opportunities and life skills needed for a healthy lifestyle (Muir, 35, 1997). Governments, private organizations, communities and individuals must contribute to health promotion. It cannot be achieved by one individual or community. Health promotion can only be pursued if people from all walks of life are involved with it. It has to be adapted to the unique social, cultural and economic systems of various cultures. Policy makers belonging to all sectors and levels must be aware of the health consequences of their decisions. They must accept their responsibilities for health. Health promotion policies consist of diverse approaches which need to be applied and implemented by laws, taxes, structural changes and fiscal measures. It has to be coordinated by various government and private organizations that lead to healthier goods and services (NIPH, 55, 1996). Every society in the world is unique and diverse. Promoting health in different societies is linked between people and the environment. Nations must be required to take care of each other and the environment. Protecting the natural resources of the world is the collective responsibility of every nation. Changes in lifestyle and work have a direct impact on health. There is a need for living and working conditions which are safe and healthy (Potvin, 65, 2001). Local communities can play a leading role in promoting health by setting their goals, decisions and strategies to achieve a healthy lifestyle. They can play a proactive role by drawing on existing resources to enhance social support and direction of health matters. Health promotion supports the development of personal skills which help the individual in making better healthy choices. Information and education on health is vital for the development of personal skills (Sackett, 75, 1996). This helps people in making better decisions for their health and environment. It enables people to prepare for illnesses and injuries. Health services must be reoriented by ensuring that all segments of society are actively involved in the provision of clinical services, pursuit of health, support the needs of the individual and community and respects cultural needs. It also focuses on providing training to health professionals to meet the health needs of individuals (Suchman, 65, 1996). There is a considerable body of literature regarding health promotion models. They are defined as assessing health requirements and collecting information about intervention that brings about the desired effect. Health promotion models use data from information, target audience and needs of professionals to assess the health requirements. The evidence for interventions is assessed from available literature and cultural settings. Financial and human resources are identified to achieve health change. Targets are set to measure the progress (Wiggers, 75, 1998). Finally objectives, methodology and evaluation are assessed to measure the desired outcome. One of the earliest health promotion models is the Precede-Proceed planning model. This model recognizes that health has multiple determining elements. It assesses life and social problems which are the ultimate goals of health (Wimbush, 301, 2000). Motivation, attitudes and behaviors of the individual and community can support or interrupt health promotion. It also pays attention to the links between program components and outcomes. The European Quality Instrument for Health Promotion is another model developed by the European Union to achieve the goals of health promotion. It promotes a positive approach to health reinforced by participation and empowerment of individuals and communities (Davies, 61, 1998). The project analyzes health problems and its determining elements. It also selects the target group to ensure that intervention and implementation strategies and methods are outlined. Finally it evaluates the effects and quality of the strategies and methods. The model is managed by people, who have leadership, planning, documentation and communication skills vital for the success of the project. The World Health Organization has been the primary supporter and implementer of health promotion policies by its network of hospitals and schools. It strives for the establishment of health settings which are places or social contexts that allow people to pursue activities that affect health and well being. They also use the setting to improve or solve their health problems (Ebrahim, 71, 1996). There are five types of health promotion settings according to a review of the World Health Organization. The first type of model is the passive in which the problems and solutions can be controlled by the individual (GGD, 41, 1997).An example of this model is health education within schools which teaches young people to remain healthy. The active model pursues changes required to keep an environment healthy. For instance education about smoking in schools is followed by policies which limit smoking. The third type of model is the vehicle model in which the problem is understood and the solution is found from within the environment. This model slowly implements the steps required for achieving a health objective. The fourth type of model is the organic model which emphasizes the role of individuals to change the system. This is based on the assumption that actions of individuals and groups are responsible for the organizational setting. Therefore the solution is to train, motivate and develop the staff to ensure the creation of a healthy environment. Finally the comprehensive model seeks structural changes that can be influenced only by senior management and decision makers (Meyrick, 61, 1997). Research has shown that some health promotion methods are at a risk because of inappropriate assessment evidence, overemphasis on individual behavior and limited resources. Subsequently researches have made much recommendation to evaluate the performance of health promotion activities. The participation of policy makers, health professionals and organizations at the stage of evaluation is the first step towards the effectiveness of health promotion. Multiple evaluations are drawn using information gathering procedures. The capacity of individuals and organizations are evaluated to judge the performance of health promotion policies (Scott, 91, 1998). The long term impact of health promotion interventions needs to be evaluated in order to consider its effectiveness. The effectiveness of health promotion policies is a matter of dispute. However there have been effective health promotion activities. For instance tobacco use has been combated by reducing environmental exposure to tobacco smoke and increasing cessation. Marginalized segments of society have been supported by food programs. Young people have been targeted to reduce drug usage. There have been programs to prevent skin cancer by reducing exposure to UV radiation. Motor vehicle injuries have been reduced by promoting the use of child safety seat use and safety belt use. Housing and public health has been implemented by refurbishment and renovation (Speller, 631, 1997). The World Health Organization has developed the Health Promoting Hospitals Network to implement the objectives and goals of the Ottawa Charter’s health promotion policies and procedures. They strive to promote human dignity and solidarity. They acknowledge the differences in values and behavior of various population groups. The promoting hospital should improve the quality of its services. It should look after the welfare of its patients and staff. It should focus on the preventive and curative services of health. It should provide health services to facilitate the healing process. Resources should be utilized properly and efficiently. Health promoting hospitals have implemented projects, delegated the roles of departments and promoted the health of communities. Health promotion activities have been incorporated into the hospital culture (Tones, 12, 2007). The World Health Organization assesses hospitals on the basis of several tools. First of all the management policy of the hospital is analyzed. The policy must be implemented in conjunction with quality of services and improving health outcomes. Patients are assessed for their health promotion needs. All factors about disease are provided to patients. The hospital is developed with a clean and healthy workplace. The hospital also collaborates with government and private institutions on a regular basis. The World Health Organization has also developed guidelines for schools to ensure the success of health promotion principles and policies. This approach emphasizes curriculum as important in promotion of health. The school develops a health enhancing policy. Health promotion schools support children and young people in developing healthy habits and behaviors. They raise pupil achievement and promote social inclusion. They also aim to reduce the health inequalities. Research has found the effectiveness of health promotion schools. Students at such schools are more likely not to use drugs and cigarettes. They are also less likely to engage in sexual behavior which can lead to problems like teen pregnancies. International organizations are increasingly targeting workplaces, universities and prisons for promoting health activities and policies. Research has found to support the view improving employee health carries greater social and economic benefits for society. Health promotion approaches at the workplace include the participation of staff members to ensure a healthy workplace. Project management effectively assesses the needs for a healthy workplace. There is also an integration of companies’ regular management practices. Comprehensive approaches are directed towards the individual and environment (Veen, 22, 1994). Prisons and universities are also defined boundaries for health promotion activities. They have an impact on the local community. Smoking, healthy eating, nutrition, drug and substance abuse are issues which are of concern at prisons. Local health services that work in partnership with the government are effective in addressing these issues at prisons (World Health Organization, 22, 1998). The participation of the community has been the central tenet of the World Health Organization’s health promotion policy. The community consists of a spatial dimension where people belonging to various social, ethnic, religious groups live together on the basis of a common interest. The community is an asset to solve health problems. The representatives of communities must be supported to develop a healthy community. Marginalized sections of society must also be involved in health promotion policies. Financial support is vital for accessibility to health care (Morgan, 22, 2006). Community participation strategies must be designed in order to create a healthy environment. Primary care trusts must be responsive to the needs of the community. Concrete outcomes are necessary to ensure the interest of the participants of the community (Nutbeam, 32, 1998). There are three basic approaches towards health promotion which are the medical change, educational and social change models. The medical model emphasizes on disease prevention. It focuses on the biomedical model of health and compliance with diagnosis and prognosis by health professionals. The educational model views human beings as rational people who can prevent disease and improve health if they are made aware of the remedies and healthy lifestyle required to sustain a healthy life. The social model views health as being determined by social, cultural and physical factors. This model focuses on removing health disabling environments (Watson, 301, 2000). These different models influence professionals in determining the best method of treatment. In practice health promotion is based on a combination of approaches and models. It is part of the extension of health education. The best possible health outcomes for individuals and communities are ensured using a combination of approaches. It is also a reaction to the individually focused health systems that have evolved in recent decades. Health promotion has focused on equity, social justice, participation and empowerment as key elements of creating a healthy environment (Judge, 81, 1999). The Ottawa Charter for Health Promotion launched in 1986 postulated the participation of the entire population in preventing specific diseases. It also focused on the causes of health. It emphasized on the cooperation between the government and private sector in reducing health risks and promoting a healthy environment. It also called for the combination of diverse approaches for preventive and curative services. It also highlighted the importance of health professionals participating in healthcare. The charter has provided the global forum for the development of health promotion. It defines health promotion as the “process of enabling people to increase control or improve their health” (Connell, 71, 1995).This perspective recognizes that good health is essential for a productive and enjoyable life. Equity, empowerment and engagement are prerequisites for health promotion. It also considers health promotion as a process which can enable people to voluntarily change their lifestyle rather than imposing upon them. It is directed towards improving the determining factors of health. The charter advocated building healthy public policy, creating supportive environments, strengthening community action and developing personal skills. It also aims to reorient health services (Pawson, 41, 1997). The World Health Organization has played an important role in health promotion. It has sponsored international conferences and promoted settings based models for health promotion. It has supported the development of healthy cities projects, schools, worksites and hospitals. The principles of the Ottawa charter have been reviewed and updated in several conferences. Future objectives of the organization have been the promotion of social responsibility for health. It has also emphasized increasing investment and expanding partnerships for health sector. It also strives to empower individuals and increase the resources of communities to address health problems. It also struggles for the creation of a healthy infrastructure that supports health promotion. The twenty first century has created many challenges and problems. Only by the development of health promotion policies, procedures and philosophies can these health problems be solved. A key element of health promotion policy is leadership which informs and motivates the population. They also offer economic incentives to encourage change. The public must be made aware of the health risks and preventing disease. Effective leadership informs the public the payoffs to healthier lifestyles and improved social conditions. They are also convinced about interventions that change lifestyles and social conditions. Leadership informs and motivates its public by communication efforts and adequate funding. Leaders are comfortable working in environments (Tones, 21, 2004). Another important approach to health promotion is incentives to facilitate change. This builds healthier lifestyles and social conditions. For instance raising taxes on tobacco and grants in aid to encourage communities to develop bike paths are examples of this approach. Health promotion practice can be divided into coercive and persuasive types. Coercive health promotion is based on laws which enforce behavior. This can to support the society and individual. Examples of this include health and safety legislation protecting employees at the workplace. Persuasive health promotion takes many forms. For instance advertisements informing people about the risks of smoking, healthy diets and screening clinics are examples of persuasive health promotion. Health promotion has also been the target of criticism. Criticism can be divided into two types, the empirical and philosophical. Empirical criticisms are based on the belief that some health promotion interventions are of dubious benefit. There is a lack of scrutiny for preventive medicine. Philosophical criticism is directed against coercive measures which are employed to enforce a desired behavior (Weiss, 31, 2002). Fiscal policies are also considered a part of health promotion activities. These policies focus on health promotion. They strive to prevent disease. These policies exempt health care goods and inputs from taxation or guarantees as a constitutional right. Research and development initiatives are also applied to health and health care goods. They carry macroeconomic benefits, equity and efficiency of health. Fiscal policies can be designed to affect sectors which contribute directly or indirectly to health outcomes. Many governments use consumer subsidies to encourage the use of beneficial products. They lower the price to ensure that consumers can access it. There are also subsidies for food which can include quotas and food stamps to increase food consumption. This can have a positive impact on health. Condoms are another item which has been subsidized by governments. They have been effective in preventing the spread of diseases like HIV/AIDS. Governments have also launched promotion and information campaigns to highlight any disease and the risks associated with it (Kubisch, 21, 1995). Governments have also provided subsidized health care to promote health. In some countries health goods are directly provided whereas in other nations the public provision of services is combined with health insurance. Governments use producer subsidies to encourage production that improves health by lowering manufacturers’ costs in situations in which the private market supply is inadequate to meet social needs. Examples include medical supplies; vaccines, food additives, and medical research. Governments sometimes subsidize the fortification of staple foods through the addition of selected micronutrients as a way of achieving broadly based nutrition improvements. Health promotion is the science and art of enabling people to control and improve their health according to the World Health Organization. It has been one of the most important health policy developments in the past two decades. Health promotion is based on the idea that the basic prerequisites must have a secure foundation in order to improve health. Quality of life is an important dimension of health promotion. Every society in the world is unique and diverse. Promoting health in different societies is linked between people and the environment. Nations must be required to take care of each other and the environment. The effectiveness of health promotion policies is a matter of dispute (Kubisch, 21, 1995). However there have been effective health promotion activities. For instance tobacco use has been combated by reducing environmental exposure to tobacco smoke and increasing cessation. . The participation of policy makers, health professionals and organizations at the stage of evaluation is the first step towards the effectiveness of health promotion. The participation of the community has been the central tenet of the World Health Organization’s health promotion policy. The community consists of a spatial dimension where people belonging to various social, ethnic, religious groups live together on the basis of a common interest. The community is an asset to solve health problems. The representatives of communities must be supported to develop a healthy community. Marginalized sections of society must also be involved in health promotion policies. Financial support is vital for accessibility to health care. Community participation strategies must be designed in order to create a healthy environment. Primary care trusts must be responsive to the needs of the community. Concrete outcomes are necessary to ensure the interest of the participants of the community. References Green LW (1991) Health promotion planning: an educational and environmental approach. Mountain View, CA: Mayfield Hawe P. (1990) Evaluating health promotion: A health worker’s guide. NSW, McLennan & Petty Pty Muir Gray JA. (1997) Evidence–based healthcare: how to make health policy and management decisions. London: Churchill Livingstone. NIPH, (1996). 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Washington DC: The Aspen Institute Wimbush E & Watson J (2000) An evaluation framework for health promotion: theory, quality and effectiveness. Evaluation 6(3): 301-32 Read More