1. The Role of Media in Public Health
Professor SH Lee
Emeritus Professor of Community Medicine
The Chinese University of Hong Kong

2. What is Public Health?

3. Definition of Public Health
‘The science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society.’
(Acheson Report, London, 1988)

4. Public Health Movement
The New
Public Health Movement

5. “Up-stream”
Approach

6. Determinants of Health

7. Determinants of Health
Personal health practices and coping skills
Biological and genetic endowment
Environmental risk factors
Social and economic factors
Health Services

8. Personal health practices and coping skills
Smoking
Diet
Obesity
Lack of exercise
Stress
Alcohol abuse
Drug misuse
Sexual practices

9. Tobacco

10. Smoking
1994
Source: HKCOSH

11. Substance Abuse

12. Substance Abuse
Population

14. Obesity Student Survey
95/ /99

15. Biological and genetic endowment
Gender differences
Physiological, anatomical and mental capacities

16. Environmental risk factors
Physical environment
Radiation exposure
Workplace hazards
Infectious agents
Home hazards
Traffic
Product design

17. Social and Economic factors
Income and social status
Social support networks
Education
Employment and working conditions
Social disintegration
Overpopulation
Geography and Transportation

18. Health Services Accessible preventive and primary care services
Healthy child development services
Personal health services e.g.
Student health
Women health
Elderly health

19. Environmental Conditions
Genetic Influences
Health and
Medical
Services
Lifestyle
HEALTH
Social, Economic
Cultural &
Environmental Conditions
The Health Field Concept

20. The Ottawa Charter for Health Promotion and the Jakarta Declaration

21. Definition of Health Promotion

22. “A combination of health education and related organizational,
U.S. Department of Health
Education and Welfare (1979)
“A combination of health education
and related organizational,
political and economic programmes
designed to support changes
in behaviour and in the environment
that will improve health.”

23. “The process of enabling people to Increase control over the
Nutbeam (1985)
“The process of enabling people to
Increase control over the
Determinants of health and
Thereby improve their health.”

24. “The process of enabling people to increase control over their health.
WHO (1984) (1986')
“The process of enabling people to
increase control over their health.
‘and thereby to improve
their health.”

25. Health Promotion Targets towards whole population Basically healthy
Involvement of community and individual measures
Promotion of healthy lifestyle
Goal to enhance state of well being

26. Disease Prevention Activity in the medical field
Dealing with a disease or environmental threat
Protects individuals or groups of population at risk
Aims to conserve health

27. Disease Prevention Primary Prevention
Prevention of disorders before they occur
e.g. vaccination, healthy lifestyles

28. Disease Prevention Early diagnosis and treatment
Secondary Prevention
Early diagnosis and treatment
e.g. screening programmes

29. Disease Prevention Tertiary Prevention
Reducing burden of disability to
individual and society
e.g. treatment and rehabilitation

30. Five Priority Actions Of Ottawa Charter for Health Promotion
Build Healthy Public Policy
Create supportive environment for health
Strengthen community actions for health
Develop personal skills
Re-orient health services

31. Ottawa Charter for Health Promotion
An International Conference on Health Promotion
The move towards a new public health
November 17-21, 1986, Ottawa, Ontario, Canada

32. The Jakarta Declaration on Leading Health Promotion into the 21st Century (1997): Five priorities for action
Promote social responsibility for health
Increase investments for health development
Expand partnerships for health promotion
Increase community capacity and empower the individual
Secure an infrastructure for health promotion

33. Mass Media and Public Health

34. The meaning of Mass Media
Two key features:
Mass audience
Message is mediated
Source: Health Promotion – effectiveness, efficiency and equity, Keith Tones and Sylvia Telford

35. Mass Media in Health Promotion
The difference between health marketing and commercial marketing:
Health promotion, ethical and professional goals
Difference in size of budgets
Health education programmes set standard often too high

36. Mass Media in Health Promotion
The nature of the product in offer is different
The health education product frequently intangible and gratification seen only at distant future
Deep seated attitudes not easy to change

37. Mass Media in Health Promotion
Ten key marketing concepts in health promotion
Market philosophy
The “four Ps” of marketing: product, price, place, promotion
Hierarchy of communication effects
Audience segmentation

38. Mass Media in Health Promotion
Understand all the relevant markets
Feedback
Interpersonal and mass communication interactions
Commercial resources
Competition
Expectations

39. Mass Media and “Public Health Advocacy”

40. ‘Public health advocacy’
Sometimes called ‘public health lobbying’
Process of over coming major structural barriers to public health goals
Such barriers could be political, economic or cultural

41. Skilled Professionals Partnerships or Coalitions Champions or Leaders
What are the components of an effective public health advocacy campaign?
Information
Health Professionals
Skilled Professionals
Partnerships or Coalitions
Champions or Leaders

42. Skills required in effective public health advocacy
Competency and understanding of subjects and roles
Political science, sociology of mass communication
Structuring of media
Health issues
Networking techniques

43. Skills required in effective public health advocacy
Community educators and organizers
Journalists
Lawyers and political analysts / advisers
Research
Evaluation

44. Does it work?
Governments (and organizations) tend to adopt policies only in activities of public headiness, using the principles that Governments (organization) should not move far from what is perceived to be public opinion

45. What are the conditions for success in public health advocacy?
A recognized constituency
Building community agreement that an issue is a priority for action and that the proposed solutions are acceptable

46. What are the conditions for success in public health advocacy?
Empowered communities
A feasible solution (a feasible solution is not necessarily based only on, for example, epidemiological evidence. Many different types of “evidence” can be used by politicians, and managers when mainly policy decisions)

47. Mass Media
The mass media, by definition, reach mass audiences, including key political and bureaucratic decision makers. If well informed about the process of news reporting, public health advocates may be in the position of influencing journalist to report issues in ways more consonant with public health objections.

48. Advocacy in Health Education and Health Promotion
Case Studies
in Public Health
Advocacy in Health Education and Health Promotion

49. Case Study 1
Smokeless
Tobacco

50. Tobacco advertising in printed media and outdoor advertising
Case Study 2
Tobacco advertising in printed media and outdoor advertising

51. Prohibition of smoking in restaurants and other public indoor premises
Case Study 3
Prohibition of smoking in restaurants and other
public indoor premises

53. The Asia Pacific Association for the Control of Tobacco
(APACT)

55. The Hong Kong Declaration APACT 2001
The Asia Pacific Association for the Control of Tobacco (APACT) recognizes that tobacco use is a major cause of death in the Asia-Pacific region:
The current pandemic of tobacco-related diseases is causing tremendous harm and an excessive burden on the economy.
Everyone, especially children, has the right to live in a tobacco-smoke free environment.

56. The Hong Kong Declaration APACT 2001
Of all the children alive today in Asia, a conservative estimate is that at least 150 million will eventually be killed by tobacco.
There is a need for an urgent effort to contain this pandemic of tobacco-related diseases as well as its terrible effects on the environment and the economy. If it is to effectively prevent young people from smoking, it must be a comprehensive programme directed at the entire community.

57. The Hong Kong Declaration APACT 2001
A comprehensive regional tobacco control policy:
An end to all tobacco advertising
Increase in taxes
Protection of youth
Regulation and control of tobacco products

58. The Hong Kong Declaration APACT 2001
A comprehensive regional tobacco control policy:
Cessation programmes
Strong public education programmes
Support WHO FCTC
Holding tobacco companies accountable

59. The Hong Kong Declaration APACT 2001
In addition, the 432 participants from 34 countries to this 6th APACT Conference on Tobacco or Health give full support to Hong Kong’s current legislative proposals, particularly the recommendations for 100% smoke-free workplaces and restaurants.

60. Promotion of Healthy Cities
Case Study 4
Promotion
of Healthy Cities

61. How do we get a Healthy City ?
Invite expert to introduce and explain the concept of Healthy Cities and talk about experience on implementation
Seek government and community support and participation
Establish a ‘Steering Committee’ to plan and co-ordinate Healthy City programme
Identify priority health issues (through community diagnosis)
Develop an action plan
Secure potential community and funding support
Monitor and evaluation of the project

62. Healthy Cities Eight Healthy Cities in Hong Kong Tseung Kwan O
Wan Chai
Central & Western
Kwai Tsing
Tsuen Wan
Sham Shui Po
Wong Tai Sin
Tai Po

63. Tseung Kwan O District
Kwai Tsing District
Central & Western
District

64. Health Promoting Schools and Healthy Schools Award Scheme
Case Study 5
Health Promoting Schools
and Healthy Schools
Award Scheme

65. School-Based Approach
Involve Kay Personnel
School Principals
School Teachers
School-based Health Coordinators
Pupils
Parents

66. School-Based Approach
Supportive environment and policy making
Community Partnership
Participation of Parents
Networking

67. Hong Kong Healthy Schools Award Scheme Opening Ceremony
20 May 2001

69. Case Study 6
Healthy Workplace

70. Healthy Workplace

71. Healthy Workplace

72. Why Canada has been successful in Tobacco Control?
Case Study 7
Why Canada has been successful in
Tobacco Control?

73. Tobacco industry’s survival strategy Nine D’s
Deny the health consequences of smoking.
Deceive consumers about the true nature of cigarettes through marketing and PR.
Damage the credibility of industry opponents.
Direct advertising to women and youth, in addition to men, to maximize sales volume.

74. Tobacco industry’s survival strategy Nine D’s
Defeat attempts to regulate the industry or control smoking.
Delay legislation if it can’t be defeated.
Destroy legislation once it passes, either by trying to overturn the law in court, by disobeying the law, or by exploiting loopholes.
Defend lawsuits filed against the industry.
Develop new markets around the world.

75. Factors for success on Tobacco Control
Political will
Bureaucratic support and experience
Effective advocacy outside government
NO SMOKING

76. Political Will
To introduce, implement and enforce tobacco control measures
Political support from:
Minister of Health
Minister of Labour
Minister of Finance
Departments support

77. Advocacy (lobbying) Anti-smoking and health groups
Tobacco-control campaign
Collaboration between government and NG sectors

78. Use of effective advocacy techniques
Factors for success:
Health Groups offer the government solutions, not just problems
Unity is strength – advocating coalitions

79. Use of effective advocacy techniques
Factors for success:
Coalitions include:
Public support
Health organization
Provisional councils
Consumers
Religious groups
Women’s organizations
Volunteers

80. Use of effective advocacy techniques
Factors for success:
Adequate financial resources and staff
Health groups able to respond quickly
Use a wide array of tools
E.g. letters, phone calls, newspaper advertisements, meetings with government officials

84. Atypical Pneumonia Epidemic, Hong Kong
Case Study 8
Atypical Pneumonia Epidemic, Hong Kong
Impact of Community, NGOs, Professionals Involvement

86. 給我們的醫生、護士及所有醫護人員： 在這艱難的時刻，我們要關心自己， 關心身邊的人，互勵互勉。 關懷從這一分鐘開始。 面對非典型肺炎的危機，
您們表現的專業精神、毅力和勇氣，我們十分敬佩。
我們和全港市民一樣，衷心感謝您們﹗
在這艱難的時刻，我們要關心自己，
關心身邊的人，互勵互勉。
關懷從這一分鐘開始。

88. Conclusion

89. Conclusion Advocacy is a powerful strategy for promoting health
Possible to use political processes to bring about positive changes to health
Media sector has a very important role to play in health communication

90. Conclusion
There should be close working partnership between health and media professionals in promoting health
Joint education and training programmes for both the health and media sectors in health communication would greatly enhance the cooperation and communication between the two sectors

91. Conclusion
More workshops, seminars on various subjects of health should be organized and better methods of communication should be developed to enable the media sector to have easy access to health information and a good understanding of the various issues affecting health

92. Conclusion
The World Health Organization should be requested to organize more international workshops and seminars for the media in order to acquaint them the major global public health problems which can only be dealt with effectively by joint forces of all countries on a regional and global basis

95. THANK YOU