This written rationale will identify and explain the necessity for the promotion of public health and physical activity. It will demonstrate an understanding of the role, function and settings of public health and physical activity promotion by national, regional and local agencies. It will also analyse and evaluate the health related models and approaches to public health and physical activity promotion.
What is Health?
There are many definitions for Health. Health means different things to different people, if someone doesn’t drink and smoke then they believe that they are healthy, or if they eat a good balanced diet for example. The main most known definition of health is from the World Health Organization. World Health Organisation states:
‘Health is a state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity. Health is a dynamic condition resulting from a body’s constant adjustment and adaptation in response to stresses and changes in the environment for maintaining an inner equilibrium called homeostasis.’
World Health Organisation (2003)
This definition however has not been amended since 1948.
What is Health Promotion?
Health promotion involves doing things to prevent disease and to improve individual and communities health. Health promotion offers solutions to many of the health problems facing society such as obesity, lack of exercise and smoking though developing skills and knowledge, community action, supportive environments, healthy public policy and health services. Health promotion helps individuals or communities to increase control over and improve their health and wellbeing. Curtin University (2012) states that ‘with a significant proportion of ill-health related to choices about nutrition, exercise, the use of legal and illegal substances, interpersonal relationships and other social behaviours, health promotion can help us make choices that support well-being.’
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The features of health promotion are that it is based on a holistic view of health; it uses participatory approaches it focuses on the determinants and addressing of health not just health problems and conditions. These include the social, behavioural, environmental and economic conditions that are the root cause of poor health, wellbeing and illness such as education, income, employment, working conditions, social status. Health promotion builds on existing strengths and assets and it uses multiple, complementary strategies to promote health for the individual, community and population level.
Why is health promotion needed?
There are fears that the recent generation and their children’s generation will age less successfully than the current older one – no surprise given that, although rates of cigarette smoking are falling, more people are drinking heavily, only a minority of adults exercise often enough to maintain good health and obesity rates have greatly increased over the last 20 years.
Obesity is a main health issue which can lead to other health problems such as diabetes, high cholesterol, hypertension, joint pain, Nursing Times (2009) states that ‘these health issues can be prevented or delayed by lifestyle measures. A health promotion package would enable adults of all ages to lead happier and healthier lives.’
Around two-thirds of the England population are overweight or obese. Obesity has grown by almost 400% in the last 25 years and on present trends will soon surpass smoking as the greatest cause of premature loss of life. (NHS Dudley, 2012)
Obesity is associated with many health problems including coronary heart disease, diabetes, kidney failure, osteoarthritis, back pain and psychological damage. The strong association between obesity and cancer has only recently come to light. (Dodds, 2009)
Dodds (2009) estimates the economic costs of obesity conservatively at £3.3-3.7 billion per year and of obesity plus overweight at £6.6-7.4 billion.
Health promotion for obesity is especially important because it can help lower the risks of many other health conditions which then cuts down the economic costs in the future by educating people about the correct food and exercise and also behaviour change techniques.
Why do we need to Promote Mental Health?
Mental health promotion does remain the most underdeveloped area of health promotion even though there is an increasing recognition that ‘there is no health without mental health’ Christodoul (2009).
Positive mental health involves self-esteem, being able to solve problems and the ability to adapt to stress. The need for positive mental health promotion is beneficial and relevant for everyone. It is important to stress to policy makers and professionals to understand that mental health and mental wellbeing are issues of everyday life. Therefore positive mental health demands the co-ordinated action by all concerned; through the media, the government, local authorities, industry, voluntary organisation and through health and social and economic sectors.
Most of the time when people think of mental health they look at it in a negative way, however it could be argued that this is not the case.
‘Mental health is not just the absence of mental illness. It is defined as a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.’
(Mental Health Ireland 2013)
Mental Health is about how people feel about themselves, how they feel about others and how they are able to meet the demands of life.
Mental health promotion is important because mental health contributes to all aspects of human life, it has important, less important and essential values for the individual, society and culture. Mental health has a shared relationship with the wellbeing and productivity of a society and its members. Mental health is essential for the wellbeing and functioning of all individuals.
Mental health is essential for the well-being and functioning of individuals.
Good mental health is an important resource for individuals, families, communities, and nations.
Mental health, as an indivisible part of general health, contributes to the functions of society, and has an effect on overall productivity.
Mental health concerns everyone as it is generated in our everyday lives in homes, schools, workplaces, and in leisure activities.
Positive mental health contributes to the social, human, and economic capital of every society.
Spirituality it can make a significant contribution to mental health promotion and mental health influences spiritual life.
(World Health Organization, p.21 2004)
Mental health can be regarded as an individual resource, which contributes to a person’s quality of life; an aspect of good mental health is the capacity for mutually satisfying and enduring relationships.
The role of Health Promotion.
Health Promotion staff work at numerous different levels from working with groups and communities, face to face contact with individuals, to more strategic work such as policy development. Working as a health promotion specialist is much more than persuading and advising individuals to make lifestyle changes, it also includes the following:
Project management- this involves managing particular health promotion projects to make sure they are delivered to a high standard, effective and that they are ethical.
Personal development – developing personal, emotional and social skills and abilities of everyone to give them the opportunity to maximise their health and build a health promoting attitude to use for those around them.
Community development – encouraging and developing communities to become healthier such as neighbourhoods, cultural communities and communities of interest.
Organisational development – encouraging organisations to become more health promoting such as schools, work places and hospitals.
Partnership development – building partnerships with key people, communities and organisations who can influence health promotion and to help partnerships to be better educated to promote health.
Health information – developing ways of providing the correct information about people’s health, what social and behavioural factors can affect their health and what can be done to improve their health.
Strategy Development – developing a planned approach to improving health and to make sure that local, regional and national polices that could affect the public’s health do so in a health promoting way.
(NHS careers, 2012)
Health promotion specialists also work in a range of different settings and locations such as sport and fitness centres, communities, health centres, local authority buildings, hospitals, offices and schools.
National Health Promotion
National health promotion includes many different programmes and schemes backed by the government the NHS, the Department of Health and some charities. Some are list below:
Change 4 life – this involves eat well, move more, live longer government campaign. This involves a website.
NHS Life Check- this is a free online service from the NHS that asks people a series of questions about their lifestyle and gives them personalised results.
Take on life, one step at a time – this is a website from Healthier Scotland with information about healthy eating and physical activity.
NHS Health – the UKs health improvement agency for improving the health of the nation.
Health at Work Programme from the British Heart Foundation – this involves promoting health and wellbeing in the workplace.
Healthcare Promotions – this is a free service for healthcare professionals which is used to help raise awareness across the UK on a range of health issues.
Alcohol Focus UK – this is a UK national charity that works towards reducing the harm caused by alcohol.
Down Your Drink – this is a website made to help people work out wether they are drinking too much and if so what they can do about it.
Drink Aware – this aims to promote responsible drinking and find innovative ways to challenge the national drinking culture to help reduce alcohol misuse and minimise alcohol-related harm.
Fastforward – Fast Forward is a national voluntary organisation that was created to give young people the skills, education and support to live healthier lives.
Hope UK – Works with communities throughout the UK to prevent drug and alcohol-related harm to children and young people.
Life Education Centres – the aims of Life Education Centres are to help children make healthy choices by providing services appropriate to the needs of primary school children.
Frank – this is a national drug information website providing confidential advice about taking drugs.
(Patient.co.uk 2012)
Regional Health Promotion – Derbyshire
Derbyshire health promotion service offers a range of free health and well-being programs, advice and support to the local community and businesses of Derbyshire. All programs are run and delivered by health specialists. Some of the health promotion programs are listed below:
Waist Wise – this is a weight management program with separate courses for men and women
Derbyshire Stop Smoking Service – this is a specialist support program to help people quit smoking.
Health Referral Program – this is an exercise and activity scheme for individuals who want to improve their health by becoming more active.
Children and Young People’s Health Promotion Program – this is a local program to improve the health and wellbeing of children and young people in Derbyshire.
Working Well – this involves a range of programs to help local businesses to improve the health, well-being and safety of their workforce and work place.
Living with Long-term Conditions Program- this is a self-management program to help people with long-term conditions to improve their health and well-being.
Marketing and Resource Service – this is a range of health and well-being marketing resources for use in the community and education projects
(Derbyshire Community Health Service, 2012)
It is essential that Derbyshire are working on tackling obesity by using health promotion as National Obesity Surgery Centre (2010) states that ‘Obesity has hit an all time high in Derbyshire with 25% of people now in this category.’
Health officials said this cost the NHS £7m more in 2009 than in 2008. As obesity increases millions more will be spent each year. In 2008 89 people in Derbyshire had weight loss surgery such as gastric banding. Female patients outnumbered males, with 75 women receiving gastric bands compared to 14 men. Overall there were only slightly more obese women than men. 72,000 women compared to 70,000 men. The figures have been revealed after statistics showed that eight times more people in England have been admitted to hospital due to obesity than ten years ago.
(National Obesity Surgery Centre 2010)
This is just another set of statistics highlighting the problem of obesity is on the increase and is in desperate need of tackling. This is why Health Promotion is crucial in areas of the world.
Local Health Promotion – Chesterfield
The health of the community in Chesterfield in general is wore than the England average, there are health issues within Chesterfield which are by gender, level of deprivation and ethnicity. Almost seven out of ten local people describe their health as good/very good, which is said to be low compared with others. Chesterfield also has a high rate of teenage pregnancies and alcohol related admissions to hospital. More people in Chesterfield are admitted to hospital for alcohol related harm than anywhere else in Derbyshire and the rate is higher than the national average.
(Chesterfield Borough Council, 2009)
Chesterfield is currently focusing and providing opportunities for young people to take part in activities. Queen’s Park Sports Centre has a synthetic pitch and provides free use for supervised activities for 10 hours each week. There is a health programme called swim free which means under 16s can swim for free, also the new Healthy Living Centre at Staveley is now open. The Council also won funding to develop play facilities in the deprived area of Barrow Hill in Chesterfield. Chesterfield Borough Council (2012) reports that ‘Last year, the number of children taking part in sports development activity increased from 1,255 to 1,541.’ These activities of health promotion are decreasing the chances of obesity by providing physical activity activities which is crucial when trying to loose or maintain a correct body weight.
Strengths and Weaknesses of Health Promotion
Weaknesses
Issues relating to funding and lack of resources are a major problem when coming to health promotion.
Lack of staffing – funding issues
Losing out to direct care – health promotion being seen as not important so staff such as nurses will be dealing with health promotion on top of dealing with direct care of patients.
Lack of understanding of health promotion – Godden (2008) states that ‘staff and management can sometimes be identified as lacking in understanding of health promotion.’ Godden also found that a lack of skills and knowledge amongst staff as a weakness and several members of staff at the NHS suggested that there was an unjustified assumption that anyone can just do health promotion without appropriate training.
Some sectors do not understand or recognise health promotion and neither does the community.
Strengths
Cutting down cost for the economy by tackling health problems such as obesity, cardiovascular disease and cancer
Community togetherness getting together as groups in the community
Making new friends
Cut down levels of depression with health promotion based on physical activity – physical activity decreases the symptoms of depression. Physical activity releases endorphins, which may improve an individual’s mood, exercise the immune systems chemicals that increases depression, due to body temperature increasing during exercise this produces a calming effect. Exercise also increases confidence and helps distractions of negative thoughts. Exercising may offer more opportunities to socialize and offers people a healthy way to cope with depression.
Morin (2011) states that ’33 percent of adults do not engage in any form of leisure time physical activity. Increasing physical activity improves depression. This is why health promotion for exercise is beneficial for everyone and will cut down the cost on the NHS prescriptions of antidepressants’
Behavioural Modifications in Health Promotion
There many theories and models that are used in Health Promotion, however it depends what the focus of change of behaviour that is being worked out. For tackling obesity and to promote healthy eating the following theories may be found helpful.
The stages of change model would assess the readiness of the community to change
Learning theory, diffusion of innovations theory and communication theory would inform behavioural interventions to help people to make healthy food choices
Community development theory would help in enabling the community to address barriers to having a healthy diet (for example through setting up a food co-operative)
Policy theory would help with how to influence political processes (e.g. getting the council to set aside land for allotments).
The Health Belief Model can also play a good role in health promotion. This model predicts and explains the health behaviours people decide to undertake, the Health Belief Model supposes that a person believes they can avoid a negative condition such as obesity, that an individual will expect positive results if they take recommended actions to avoid negative health conditions and that people believe that they can successfully take recommended health steps towards leading a positive healthy life. This model will also assist towards cutting costs on the NHS for all types of health problems.
(Kansas State University College of Human Ecology, 2006)
Is Health Promotion a good thing?
Health Promotion is Prevention. Health Promotion is the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries.
Yes, Health Promotion is a good thing because it saves money and improves peoples quality of Life. If a community is healthy then it is spending less money on health care; meaning better economic productivity and improved quality of life for everybody. Health Promotion doesn’t only help the adult population but it also helps children thrive. If a child is healthy then it will grow up to be a healthy adult, a healthy child attends school more often and performs better as a whole meaning they will be educated on health and fitness and hopefully carry it on through to their children too.
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