International Perspectives on the Promotion of Health - Essay Example

?Introduction: Health promotion is a very important which needs due attention of the governments and the international health agencies such as the World Health Organization. The Bangkok Charter established and adopted by the World Health Organization identifies the commitments, pledges and actions which are essential for the promotion of health globally. So the Bangkok Charter plays the pivotal role for the promotion of health internationally and also provides the guidelines necessary for the promotion of health locally. The charter establishes various policies through which various countries within a particular region can join hands and work together for the improvement of health and health quality. Public Health Promotion is a very extensive and wide-spread phenomenon with far reaching consequences therefore it involves various important factors which include housing, food security, employment and quality working conditions. Health can only be ensured if the people of a country are provided with the essentials of life and are fed well. Another factor that has added to the deteriorating situation of health is the workplace stress and employment worries, so job security and a healthy working environment is very much necessary for the ensuring health of the people. The next important thing is the educating the people about the importance of adopting various strategies for ensuring health. Therefore promotion of health is a very complicated process in which the various other factors which affect the lives of the individuals also need to be studied. This is the reason that the Bangkok Charter has identified the following groups and organizations as critical in the promotion and achievement of health: 1. Governments and Politicians 2. Civil Society 3. The Private Sector 4. International Organizations 5. Public Health Community Factors Influencing Public Health Promotion: Provision of health in the its best form is the right of each and every individual living on this earth and is necessary for improving the quality of life and living standard of individuals and nations. Health promotion enables people to identify the possibilities and opportunities available to them for leading a healthy life and by gaining all this knowledge about maintaining health they are in a better position to safeguard their health and utilize the facilities made available to them by the government and the other health promotion agencies. The various important factors which influence health on an international, national and local level include: 1. Social and Economic changes occurring at national and international level which affect the lives of the people 2. Increasing inequalities between the economic progress and technological advancement between countries and between different regions of the same country 3. Inequalities of financial status of people living within the region of a country 4. Clinical factors which include the standard of education in a country and also the manufacturing standards of medicine 5. New patterns of resource consumption in the changing global scenario which are dictated by technological advancement 6. Commercialization of the health institutes and the pharmaceutical industries has also affected the health of people 7. Global changes in environment which have took place due to the increase in carbon content in environment resulting in global warming 8. Enhancement of provision of knowledge through advancement in communication technology 9. Rapid urbanization and movement of people from rural to urban areas Environmental factors determining the health of people include the air quality, water and sanitation, weather conditions and the geographic conditions of a region. The environmental conditions if favorable for the people living in an area cause a positive impact on the health. For example if the air quality is good, this implies that the diseases and disorders caused due to air pollutants and air borne bacteria will not affect the population. Similarly, millions of people are affected each year by the water borne diseases. An estimated 3.575 million people die because of the diseases spread through water especially poor drinking water (‘Water Facts’). Hence water quality of a region is also an important factor governing the health and well being of people. Extreme weather conditions also have an adverse affect on the health of the population. The people living in deserts and extreme hot places will suffer more from sun strokes and dehydration. Similarly those living in cold climate are more likely to suffer from frost bites, cold and flu etc. The tropical countries have heavy rainfall throughout the year which results in spread of more water borne diseases than in any other place in the world. Another less acknowledged effect of the environment is the dust and pollen quantity in the atmosphere caused by the forests around a certain area. A high ratio of dust and pollen caused by various trees can result in respiratory troubles and allergic reactions. To contain the harmful impacts of environment, people are advised to take necessary precautionary measures on one hand and save the environment on the other by adopting sustainable practices in the use of natural resources. Social and Economic considerations are also important towards determining the overall health of a population. It is observed that the better the socio – economic conditions of a society, the better their health is. This seems logical because wealthy and affluent societies can spent more on their health care and hence have better living conditions than the poor. Moreover, the people with good economic conditions also spend more on their education. An educated society has good habits of personal hygiene which has a positive impact on their health. This is why we observe that more epidemics are spread in the poor third world countries around the world than in the developed and educated societies (‘Epidemics: an increasing burden for the world’, 2009). The overall living conditions in the third world countries are unhygienic because of their economic conditions. Most of the houses domesticate cattle for their daily needs. These cattle living in small closed houses along with humans are major cause of spread of disease mainly stimulated because of socio – economic factors. Other factors include gender disparity especially affecting pregnant women, ethnic disparity observed even in the developed countries towards immigrants etc. (‘Women Health Surveillance Report’, 2004). To contain these adverse impacts of socio – economic conditions, awareness should be increased among the people and primary education should be promoted. Although economic progress is a long term target, but it can be achieved if the international community supports the under developed countries and promote the respect for basic human rights. Technological advances in the fields of medicine and surgery play very important role in the health care of a society. The life expectancy has risen remarkably in the last few decades with developed countries having the highest figures in this regard. The average expected ages of citizens in USA, Canada, UK and Japan are 78.7, 81.2, 80.1 and 82.9 years respectively compared with 50.1years in Somalia, 55.7 years in Ethiopia and 44.3 years in Afghanistan (World Bank). Moreover, the data from World Bank shows a continuous rise in the life expectancy for the developed nations. The above figures show that the technological advances, along with other factors, have resulted in good health of the people. A few decades back, millions of deaths were caused by epidemics such as malaria, cholera, plague, typhus, smallpox, measles etc. Now these diseases do not seem to pose any threat because of the treatments that have been discovered and the prevention measures that have been taken thanks to the technological progress. Even the modern day epidemics such as AIDS and Hepatitis etc. do not such a widespread damage as in the past because of the awareness brought by the researchers of the field. However, the fruits of these technological advancements should be made universal by avoiding commercialization of the health care sector. Lifestyles of people also have a significant impact on their health. Our habits of socializing, eating and working define our fitness levels. Many of the heart diseases heard today are caused by obesity (Eckel, 1997) which in turn is caused by the careless eating habits of the people. A study conducted by Canadian Population Health Initiative show that the overweight children and adults eat much less vegetables and fruit as compared to those physically fit (‘Analysis in Brief’, 2009: 6). Moreover, smoking and drinking alcohol has bad effects on the health of an individual. Conversely, the societies free from these evils are free from the diseases as well (Muslim societies specifically). Somewhat similar is the case with the spread of AIDS. The epidemic is rampant in societies where lack of awareness and moral values persist (African countries and India). On the other hand western societies are free from it because of the awareness and prevention measures being taken and Muslim societies are generally free because of the strict moral conduct being followed. There is an urgent need of increasing awareness among the masses to control the spread of these epidemics. Moreover, the habits of personal hygiene and good eating habits should be promoted among the people especially in the rich and affluent societies. The politics of a certain region also influence the health policies of governments. Developed countries lay great emphasis on health care considering it a responsibility of the state to provide facilities to each citizen. This results in better health conditions in the society especially in the less income groups. However, in most of the second and third world countries (Gulf countries, India, Far Eastern countries etc.) government usually does not provide enough funds for the health care of the population and hence quality health care is only available in private sectors at high prices. This situation can be changed only through the commitment on the part of governments of less developed countries to contain their lavish lifestyles and spend more on their people and to eradicate the evil of corruption. Rapid urbanization has occurred in the recent past especially in the developing countries of Latin America and South Asia. This has resulted in migration of large number of rural citizens to urban areas where they are forced to live in deplorable conditions due to lack of enough facilities in the cities. In the slums where these immigrants dwell, there are no health and sanitation facilities, potable water is not available and overcrowding leads to rapid spread of diseases. Better urban planning on the part of governments is hence necessary to avert the threat posed by rapid urbanization. With globalization comes increased coordination among countries of the world to solve the issues and challenges faced by the humanity. Such coordination, usually carried out from the platform of international organizations such as WHO, UNICEF, UNDP, and UNHCR, helps the challenged populations of underdeveloped countries in terms of aid, technology transfer in medicine and surgery, exchange of medicine students and practitioners etc. Millennium Development Goals (MDGs) set in this regard by UNDP is a remarkable step in this regard. The goals lay great emphasis on the better health and nutrition of the poor in all the countries around the world. Although most of the targets set in the goals are yet to be realized, significant progress is made by many signatory countries towards the set targets. International Approach to Public Health: The global effort for health promotion is being led by the charters of the World Health Organization which include the Ottawa Charter of the promotion of Health and the Bangkok Charter for Health Promotion in a Globalized World. In addition to providing aid and technical assistance to the various countries for the promotion of health, the WHO charters urge the member states and all other states of the international community to adopt the recommendations of the charter for promoting health nationally and locally as well and ask for assistance from the international agencies when it is required. In the following paragraphs the approaches to health promotion adopted by some of the countries of the world have been discussed. Health Promotion in Japan is a subject which is related to the historical, sociological, technological and cultural developments that took place in Japan after the Second World War. The history of Health Promotion in Japan goes back to 1950s and 60s when educating the general public about the health was given much importance but health promotion was adopted as a public policy in 1978. Health Promotion in Japan is different from the rest of the world because it gives more importance to medical checks and preventive measures through regular family counseling, fitness movements and community health development program. But despite all these efforts a comprehensive national health promotion is still to be established and the reason behind this is that the governmental agencies are trying to carry out all the health promotion programs all by themselves and there exists a lack of cooperation between the international agencies, the Non Governmental Organizations and the government. Next is the example of the health promotion campaign in a poor country like Sudan, where such campaigns and programs hardly exist because of the various financial and economic constraints. Moreover the previous record and the history of various diseases have not been established and there are no reliable benchmarks specific to the country about various risk factors and their contribution to the overall burden of the diseases. Moreover in addition to the absence of a baseline the technological aspects of the health promotion programs cannot be accommodated in a country like Sudan (Njogu, 2005). The solution is to start from a basic level and seek guidance and support from the international health promotion bodies and other countries which have maintained exemplary standards in the health promotion. Health Promotion in Australia is given due importance and that is why the situation of health in the country has very much improved during the past years and it is one of the world’s 15 healthiest countries (forbes.com). The Australian Health Promotion Association was incorporated in 1988 which has established various subsidiary Health Promotion bodies in the various states of the country which include the Victorian Health Promotion Foundation which is formed by funds generated from enforcing tax on tobacco. However there are a few areas in which Health Promotion in Australia still needs to make progress, these include extending these programs to remote areas in central parts of the country as well (Willis, Reynolds and Helen, 2008). Canada has gained international reputation for its work in the area of health promotion because it has based its Health Promotion campaigns on various community action projects and community movements regarding promotion of health. Canada has played a commendable role in the promotion of health at the international scenario as well and the First International Conference of Health Promotion was held in Ottawa in 1986 and issued a charter which still serves as the guideline for all the subsequent conferences, programs and campaigns which took place for the promotion of health. The government of Canada continued to expand its spending on the Health Promotion to establish high standards of health in the country. Currently Health Promotion exists in thirteen different systems which include the federal health system; this has resulted in diversity in the promotion of health across the country (O’Neill, 2007). The Public Health Promotion Agency of Canada which was established in 2004 is carrying out various Health Promotion programs throughout the country and the various provinces have established their own Health Promotion agencies and institutions as well which include the Ministry of Health Promotion in Ontario. Canada has also been placed in the 15 healthiest countries of the world by forbes.com. Health Promotion in the United Kingdom has also been established for the last 8 years and the main focus of the Health Promotion programs is on the areas with the highest health needs. The Royal Society for the Promotion of Health merged with the Royal Institute of Public Health in 2008 and started working together for health promotion by dividing the duties of the programs between the various national health promotion agencies. The Royal Society for Public Health focuses on the advocacy of health promotion and its workforce. The Institute of Health Promotion and Education is there for making the people aware about the health promotion campaigns and the importance of adopting various practices which are important for leading a healthy life. In addition to this the UK health promotion policy gives importance to educating the people working in the field of Health Promotion for effective working, Faculty of Public Health focuses on educating people and training the professionals and also formulates and establishes professional standards (Green and Tones, 2010). So the Health Promotion program in UK focuses on those areas which have the highest health needs and carries out its Health Promotion activities through various established national and international organizations. In addition to all this, recently the role of pharmacists for health promotion has been recognized nationally and various documents have been produced to support pharmacists and to train them to play an effective role in promotion of health through communication of knowledge about medicine to the patients as well as healthy people. Sweden has set up exemplary standards in Public Health Promotion because different commissions have been working on legislation, prevention programs and financing of these health promotion programs. There are various programs for various diseases which include cardiovascular diseases, cancer, accidental injuries and other diseases were established through parliament in1985 (Tones and Tilfrod, 2001). Moreover the role of health education has also been established well in Sweden and various national bodies are working in collaboration with the WHO for holding awareness campaigns and training sessions. The overall health of the American population has improved during the last few years because of the promotion of preventive and public health measures and the situation is further improving with time because of the increase in awareness about the effectiveness of preventive health measures. The techniques of curative medicine and health care are rapidly being replaced by preventive health and medicine because of their effectiveness. The various organizations which are working for Health Promotion includes Centers of Disease Control and Prevention, entitled with the responsibility of promoting the mission of health improvement through disease prevention, The United States Army Center of Health Promotion and Preventive Medicine provides with technical assistance, research and training for Health Promotion programs. In addition to these organizations various nongovernmental organizations are also working in collaboration with the UN agencies for carrying out the various health promotion activities. Despite this the USA is the only developed country which does not ensure that all the citizens have coverage to some health insurance or not. The life expectancy in the USA is below the average life expectancy of the European Union. The Health Promotion in the countries like India is better as compared to most of the African countries but is still very far away from the developed countries. Only 6% of the GDP is allocated to the health sector out of which 58.7% goes towards preventive health but according to the health care scenario in the country this is a very small amount. There are no specific organizations for carrying out Health Promotion campaigns however some of the NGOs and United Nations bodies have taken the primary steps in this direction (Ramachandrudu, 1997). After carefully analyzing the situation in various countries we can clearly see that the European nations have taken very good steps for the promotion of health and that is also very evident from the results. The US despite spending much on its health care and health promotion programs is lagging behind and need to improve its strategy to implement health promotion. Developing countries like India and underdeveloped countries like the African countries should focus on the objectives established in the Bangkok charter and should seek guidance from World Health Organization and international community in this regard. National Breastfeeding Awareness Campaign: The US Department of Health and Human Services’ Office on Women Health carried out the National Breastfeeding Awareness Campaign for the promotion of breastfeeding in parents. The campaign focused on stressing breastfeeding for at least six months highlighting its advantages to the children in particular and the mothers in general. The campaign was launched in June 2004 and ended on April 2006 and was overall deemed as a success. The people were made aware of the fact that the breastfed babies have a decreased risk of death during first year of life, diabetes, ear infections, obesity and hospitalization from asthma or pneumonia. Decreased risk of breast cancer, ovarian cancer and type ii diabetes, is the advantage of breastfeeding to the mothers. Assuming a rationale behavior the campaign identified various problems and barriers to breastfeeding according to the culture of various communities living in the US also considering the psychological impacts of breastfeeding on women who have been victim of sexual assault. As solutions to these factors the National Breastfeeding Awareness Campaign used social norms theory in addition to the health benefits to convince mothers to breastfeed their children. Empowering women psychologically is very important for convincing them to breastfeed their children and this approach was used in the campaign. The results obtained after conducting various surveys after carrying out the awareness campaign indicated an overall increase in the percentage of women who showed approval to breastfeed their children (62% in 2006 as compared to 53% in 2004). People also showed more convenience in accepting breastfeeding as a good thing to be done openly in society (52% in 2006 as compared to 41% in 2004). Therefore the campaign was deemed as a success and also provided with the future line of action for the subsequent campaigns. Conclusion: Health Promotion is a very effective method for keeping people healthy as it lays more stress on preventive health rather than curative health. There are various factors involved in Health Promotion which needs to be addressed while devising health promotion programs. Various countries have adopted various different techniques for carrying out Health Promotion programs based on their own cultural, political, economic, geographic and environmental conditions. References Analysis in Brief - Comparing Activity and Fruit and Vegetable Consumption by Weight Status among Children and Youth, (2009), Canadian Institute for Health Information Declaration of Alma-Ata, (1978), Proceedings of International Conference on Primary Healthcare Eckel R. H., (1997), Obesity and Heart Disease, American Heart Association Epidemics: an increasing burden for the world, (2009), [Online], Available: http://trendsupdates.com/epidemics-an-increasing-burden-for-the-third-world [15 July 2011] Green J. and Tones K. (2010), Health Promotion: Planning and Strategies, SAGE Publications Ltd. Njogu K. (2005), Culture, Entertainment and Health Promotion in Africa, African Books Collective. Oliver A. and Exworthy M., (2003), London: The Nuffield Trust O’Neill M., (2007), Health Promotion in Canada: Critical Perspectives, Canadian Scholars’ Press. Ramachandrudu G. (1997), Health Planning in India, APH Publising. The Bangkok Charter for Health Promotion in Globalized World, (2005), Proceedings of the 6th Global Conference on Health Promotion Tones K. and Tilford S. (2001), Health Promotion: effectiveness, efficiency and equity, Nelson Thornes. Water Facts, [Online], Available: http://water.org/learn-about-the-water-crisis/facts [15 July 2011] Whitehead D., (2002), Evaluating health promotion: a model for nursing practice, Journal of Advanced Nursing, Volume 41, Issue 5, Page 490 – 498 Willis E., Reynolds L. and Helen K. (2008), Understanding the Australian Health Care System, Elsevier Australia. Women Health Surveillance Report, (2004), Ontario: Canadian Institute of Health Information World Bank, Countries and Economies, [Online], Available: http://data.worldbank.org/indicator [16 July 2011] Read More