1. Promoting Health Health Education Versus Health Promotion
Psychosocial factors which influence health
Individual health or community health

2. Health Education
Health education – often seen as the giving of information and advice.
Until the mid-1980s it was practitioners such as nurses and doctors who gave the advice.
Then, because of an awareness that individuals make health choices which contribute to the development of disease, information was given through persuasion, mass communication techniques and education
Does the giving of advice always work? Why?
Apart from TV adverts, what other forms does health education take?
What information and advice can you think of that has been given to us during your life time?
Think of health education that has had an impact on your. Has it changed your behaviour?
We have known since I was a child that smoking is dangerous, and yet many people still smoke. Does the offering of information and advice actually help? Does it change behaviour?
Watch these adverts – discuss whether they work on you. Do they work on others? What sort of health promotion does work?
Watch these adverts and decide who the advert is aimed at, what information advice they are giving, whether the information is good/correct/ambiguous/ and whether you think it will work.

3. Health Promotion
The World Health Organisation has moved the definition of health promotion away from prevention of specific diseases or the detection of risk groups towards the health and well-being of whole populations.
Instead of experts and professionals diagnosing problems, the people themselves define health issues of relevance to them in their local community.
Health is not seen as the responsibility of the individual alone, health is viewed as a collective responsibility of society
Which model does health education go with (medical)

4. Health Promotion
“Health promotion incorporates all measures deliberately designed to promote health and handle disease… A major feature of health promotion is undoubtedly the importance of ‘healthy public policy’ with its potential for achieving social change via legislation, fiscal, economic and other forms of environmental engineering” Tones 1990

5. National Targets Saving Lives – Our Healthier Nation 1999
Government national action plan for the UK to tackle the problem of poor health in everyone and in particular the health of the worst off.
It addresses the ‘4 big killers’ faced by people in the UK today: Cancer – to reduce the death rate in people under 75 by at least a fifth Heart Disease – to reduce the death rate in people under 75 by at least two fifths Accidents – to reduce the death rate by at least a fifth and serious injury by at least a tenth Suicide – to reduce the death rate from suicide and undetermined injury by at least a fifth. (lung disease has also now been identified as a major health problem)

6. 21st Century. The public health White Paper – Choosing Health: Making Healthy Choices Easier, 2004
This strategy follows on from Saving Lives: Our Healthier Nation.
It too aims to tackle health inequalities, but it also recognises that people should be empowered to make changes in their own lives.

7. Choosing Health: Making Healthy Choices Easier, 2004
The Strategy recognises that we are individuals

8. The Strategy has 3 underpinning principles
Informed choice: although with two important qualifications: - Protect children & - Do not allow one person’s choice to adversely affect another, eg passive smoking
Personalisation: support tailored to the needs of individuals
Smoking cessation – how many choices are there now for giving up? What can you get for giving up?
Nicotine replacement, zyoban, 1-1 support, patches, group therapy etc etc etc. It’s personal to you. What other examples of personalisation can you think of?
Working together: real progress depends on effective partnerships across communities

9. The Main Priorities of the Strategy
Reduce the number of people who smoke
Reduce obesity and improve diet and nutrition
Increase exercise
Encourage and support sensible drinking
Improve sexual health
Improve mental health

10. Psychosocial Factors – Health Inequalities
Both the government health strategies recognised health inequalities due to psychosocial factors.
What psychosocial factors do you think impact on health behaviours?
Have you seen a difference in your workplace between the health of different socioeconomic groups?
Psychosocial factors:
Age, income, social class, gender, sexuality, housing, employment, race, peer pressure.

11. McKinlay (1979), in persuading us of the need to refocus upstream
‘There I am standing by the shore of a swiftly flowing river and I hear the cry of a drowning man. So I jump into the river, put my arms around him, pull him to shore and apply artificial respiration. Just when he begins to breathe, there is another cry for help. So I jump into the river, reach him, pull him to shore, apply artificial respiration, and then just as he begins to breathe, another cry for help. So back in the river again, without end goes the sequence. You know I am so busy jumping in, pulling them to shore, and applying artificial respiration, that I have no time to see who the hell is upstream pushing them all in.’
The concept of refocusing upstream is a powerful and persuasive argument for health promotion. It can help us to reorient our thinking from a belief that medical care can or will, solve most health problems towards prevention.

12. Health Promotion
What examples in your work are there of short-term problem-specific activity?
What would a reorientation upstream involve?
Who or what do you think is pushing people in?
What problems are there in your work of people being ill – lots of them and causing a problem?
If you looked upstream, what would you do to stop them from falling in?
What things are there that are PUSHING them in?