Health Promotion

1. Health Promotion Ali H. Abbas

2. What is health? • Health can be hard to define, as it is one of those words that can mean many different things to different people. It is often looked at in two main ways: A. a positive or wellness approach, where health is viewed as an asset or the ability to do something. B. a more negative approach, which focuses on the absence of illness and diseases.

3. The dimensions of health.

4. Influences on health There are many factors can influence on health such as Poor health, illness, disease and early death have many causes. Some are genetic, some may be the consequence of age and degeneration and some may be due to people’s lifestyle choices but it is also known that some social groups have much higher rates of illness and early death than others. The causes of these inequalities lie in wider structures in society. These factors are termed the social determinants of health and include: • A. living conditions B. employment (or unemployment); • C. education; D. housing.

5. Introduction • Health, in the abstract refers to a person’s physical, mental, and spiritual state; it can be positive (as being in good health) or negative (as being in poor health). Health is extolled as a “dynamic state of well-being” (Bircher, 2005,) and, in a classic article from 1997, Sarrachi describes health as a “basic and universal human right”

6. Definition • Definition of Health • The World Health Organization defines Health ” as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”.

7. Other definitions • the condition of an organism or one of its parts in which it performs its vital functions normally or properly, the state of being sound in body or mind. • The state of the organism when it functions optimally without evidence of disease or abnormality. • A state of dynamic balance in which an individual's or a group's capacity to cope with all the circumstances  of living is at an optimal level.

10. Wellness and Illness • wellness: “It is a more active state, oriented toward maximizing the potential of the individual, regardless of his or her state of health”. • “Illness”: Most people have a medical view of illness as a disease, which is a pathology affecting an organ or body system. Traditional definitions would encompass traumatic injury and psychiatric disorders as well.

11. Concepts of Health • Health is a relative not an absolute concept. • A person can move from one category to the other from sick- well again in an absolute sense. So both health and illness are relative and exist in varying degrees.

13. Degrees of illness • A person with terminal cancer or end stage of renal disease is classified as “very ill”. While one recovering from • a surgery (cholecystectomy) is “less ill” another one with infections like mononuclessis as “mildly ill”.

14. Degrees of Wellness • A person with chronic arthritis may be classified as “mildly well” if functions minimally with his disease, while an old person who is functioning at an optimal level of wellness is classified as “well”.

16. Health – Focused Individual • In nursing, we consider both the physical and psychological needs of each individual patient. • Maslow (1968) developed a hierarchy of basic human needs to consider which needs of a person are the most important and more basic than others.

17. Levels of Needs The five levels of needs with being most basic are as follow- • Physiological needs • Safety & security needs • Love & belonging needs • Self – esteem needs • Self – actualization needs

19. Health – Focused Family Friedman & associates (2003) identified the importance of family – centered nursing care based on 4 rationales • Family is composed of interdependent members who affect one another. • A strong relationship exist between family & health status of its members. • Levels of health of each member within a family can be significantly improved through health promotion activities. • Illness of one family member may suggest the possibility of the same problem in others.

20. Health – Focused Community • Community based is centered on individual and family health care needs. • The health care provided within a community must be culturally competent and family – centered. • Health - focused community are employed in different kinds of practice settings, including home health care, primary health centers, schools, occupational etc.. • Disease prevention involves all activities that avoiding the occurrence of illness or injury. E.g. Immunization, enforcement of seat belt use.

21. Health Protection Health Protection is a term used to encompass a set of activities within the Public Health function. It involves: • Ensuring the safety and quality of food, water, air and the general environment • Preventing the transmission of communicable diseases • Managing outbreaks and the other incidents which threaten the public health.

22. Con… • The profile of Health Protection has increased significantly in recent years with issues such as immunization, food borne infections, pandemic flu, healthcare associated infection and communicable diseases regularly being in the public eye. The quality of public protection from hazards demands a workforce, educated and trained to the highest standards.

23. Con…. Disease protection involves all efforts to shield the people from illness and from harmful effects of elements in the environment. E.g. • Physical agents such as cigarette smoking • Chemical agents such as dust & fumes • Psychological agents such as stress

24. Health education • It is a process that informs, motivates, and helps people to adopt and maintain healthy practices and lifestyles, enables them to make informed decisions, to cope more effectively with temporary or long term alterations in health and lifestyle, & to assume greater responsibility for health.

25. What is health promotion? • Much of nursing is about treatment and restoring a patient to health. Sometimes this is referred to as “downstream” actions as they do not address why a person has become ill in the first place. Health promotion is principally about “going upstream” and initiating care to prevent people becoming ill in the first place. Nurses have a key role in minimizing the impact of illness, promoting health and function (capabilities),

26. Con… • and helping people maintain their roles at home, at work, at leisure and in their communities. Figure shows the key areas for nurse involvement in public health and health promotion: promotion of health and health education; protection from harm; and the prevention of ill health underpinned by the assessment of health needs (RCN, 2012).

28. Health promotion • refers to all activities that maintain , enhance and increase the community’s level of wellness e.g. recreational facilities in the community, adequate nutrition, safe water, encourage healthy lifestyle, family planning services.

29. Con… • Health promotion is concerned with developing sets of strategies that seek to foster conditions that allow populations to be healthy and to make healthy choices (World Health Organization, 2001).

30. Con… A landmark international WHO conference on health promotion was held in Ottawa, in Canada, in 1986 and it published the key document, the Ottawa Charter for Health Promotion, which continues to guide health promotion practice today. The following WHO (1986) definition was part of that document and combines these two elements of improving health and having more control over it: “Health promotion is the process of enabling people to increase control over and to improve their health (including the determinants of health).”

31. Con… • The Ottawa Charter provides five action areas that are central to the conceptual framework of health promotion: • 1. Build healthy public policy. • 2. Create supportive environments. • 3. Develop personal skills. • 4. Reorient health services. • 5. Strengthen community action (WHO, 1986; Nutbeam, 1998).

32. The health promotion role of most nurses will be to: • provide health information and advice about healthy lifestyles; • promote every encounter between a nurse and a patient or client as a health promotion encounter; • develop personal skills for their clients and patients that are empowering and enable people to feel more confident and competent in managing their health; • enable access and use of the health care system; • encourage social change and addressing inequalities.

33. Thank you for All