Assignment assessment criteria Academic report Title: Delivering health promotion LO 4. Understand the role of different strategies in the delivery of health promotion initiatives Explain the meaning and role of health promotion (4.1) An evaluation of the role of health education in health promotion. (AC 4.2) An explanation of the preventative approach to health promotion. (AC 4.3) An explanation of the ‘behaviour change’ approach to health promotion. (AC 4.4) An assessment of the role of empowerment in health promotion. (AC 4.5) Explain the role of a range of people and organisations that may contribute to health promotion activities (5.1) Evaluate the value and limitations of health promotion activities in a range of situations (5.2)

Assignment mapping The assessment criteria cannot be dealt with in turn as they are intertwined within health promotion. The aim is to explain health promotion (4.1) Then address the three key areas in turn - 4.2, 4.3 and 4.4 will be covered. In assessing the strategies in turn a range of people will be examined then 5. 1 will be covered. In evaluating empowerment 4.5 will be addressed and then by your overall evaluation 5.2 will be covered.

Explain the meaning and role of health promotion (4.1) Health promotion is a key element of public health practice and involves a combination of health education, prevention and behaviour change. Many have a role in health promotion which will involve the co-operation and involvement of many people and agencies from the State in social policy, to health workers, professional groups, community-based workers and volunteers as well as individuals themselves.

Health promotion is a global issue The starting point for any discussion of health promotion is the Ottawa Charter, which in 1986 set out the concept of health promotion (WHO, 1986). The Ottawa Charter also reaffirmed the importance of community participation and introduced the goal of empowerment

Health promotion (definition) Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social wellbeing, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to wellbeing. (Ottawa Charter, 1886)

The rationale behind health promotion (UK) The scope for prevention of ill health and promotion of health shows that the leading cause of death for people living in England and Wales is circulatory disease (such as heart disease and strokes), which accounted for approximately one-third (32 per cent) of deaths during 2010. Twenty-nine per cent of all deaths registered in 2010 were attributed to cancer and in 2009 lung cancer was the most common cancer for both men and women. (Office for National Statistics, 2009).

UK focus Quality of life and cost to the NHS Chronic illnesses, as well as injuries, mental illness, oral health and substance abuse represent a considerable burden both on the quality of life of individuals and also the cost of treatment for the health services. Epidemiology shows that much of the current burden of disease can be prevented or alleviated by appropriate action. As well as improving people’s life expectancy and quality of life, there is also an argument that ‘prevention is cheaper than cure’ and health promoting interventions may save health care costs. The promotion of a healthy lifestyle is now a key element of health policy-White Paper Healthy Lives, Healthy People: Our Strategy for Public Health in England

The Government’s role in health promotion Advocacy - Agenda setting and public policy -How health is perceived and tackled by governments Pledge to improve health. Service improvement (NHS) Strengthening community and individual action. Promoting behaviour change. Health Promotion aims to tackle the causes of poor health and the approach should be: responsive – owned by communities and shaped by their needs. resourced – with ring-fenced funding and incentives to improve. rigorous – professionally led, focused on evidence, efficiency and effectiveness. resilient – strengthening protection against current and future threats to health. (HM Government, 2010)

Service improvement - Reorienting Health Services (NHS role) The responsibility is shared among individuals, community groups, health professionals, health agencies and governments. They must work together towards a health-care system that contributes to the pursuit of health. Reorienting health services with attention to health research as well as changes in professional education and training. Leading to a change of attitude and organisation of health services, which refocuses on the total needs of the individual as a whole person.

Three key areas Three areas of action: Health education – this is a general strategy in communication directed at everyone i.e. individuals, families and communities to provide knowledge and raise awareness on health related behaviour. The preventative approach – This is a specific strategy directed at target groups. (i.e. over 50s or 60s – flu jab) This approach is to prevent onset, (primary) deter continuance (secondary) and alleviate symptoms(tertiary). Behavioural change- This is an individual strategy to target individuals at risk (smokers, obesity, diabetes) with the aim of altering behaviour in engagement, referral and advice.

Who can be involved in health promotion

Smoking Activity Education approach General Individual approach specific risk Preventative approach Specific target groups

Applying health promotion in the three key areas Health topic Health education Raising awareness Preventative approach Service improvement Behaviour change approach Target risk Tobacco smoking Promotion of increased awareness of the risks of smoking, the benefits of quitting and practical skills in resisting peer pressure, refusing cigarettes and different ways of stopping smoking. Prevent non-smokers from starting Developing anti-smoking within primary care, stop smoking clinics, availability of stop-smoking aids (e.g. nicotine patches) Make smoking socially unacceptable No smoking policy in all public places Cigarette sales less accessible –Promotion of non-smoking as a social norm – Limiting and challenging tobacco advertisments and sports sponsorships Enforcement of controls on tobacco promotion, sales to young people and smoking in public places; subsidies for stop-smoking aids . Encourage people to seek early detection and treatment of smoking related disorders Persuade smokers to stop Behaviour changes from smoking to not smoking