NS1220

Health Belief Model

1. Perceived seriousness 2. Perceived susceptibility 3. Perceived benefits of action 4. Perceived barriers

Ottawa Charter - 5 Action area

1. Building healthy public policy 2. Creating supportive environments 3. Strengthen community actions 4. Developing personal skills 5. Reorient health services

3 pillars of sustainability

1. Environmental 2. Social equity 3. Economic demands

For services to be considered PHC they must fulfill which principles?

1. Equity, 2. Universal access 3. sustainability 4. cultural appropriateness 5. be provided at little or no cost to the consumer.

Measure of health and wealth

1. GDP 2. Life expectancy 3. Infant mortality 4. Morbidity 5. Mortality 6. Maternal mortality 7. birth rates

Environmental factors that have contributed to infectious and chronic disease

1. Global warming (drought, flooding, severe storm, extremes in temperature). 2. Ozone depletion and UV radiation exposure 3. Globalisation 4. Increased population mobility - international travel - transportation of food 5. Increased urbanisation and industrialisation 6. Increased international trade 7. Air pollution 8. Water pollution

Goals of community development

1. Improvement of quality of life through resolution of a shared problem 2. Reduction in the level of inequalities caused by the Social determinants of illness such as poverty 3. Exercise and enhance democratic principles through peoples shared rolls in decisions that affect them in their communities. 4. Enabling people to achieve their potential as individuals 5. Creation of a sense of community

Healthcare as a contributor to environmental waste

1. Infectious waste - blood by-products, swabs, bandages 2. Pathological waste - body parts and contaminated carcasses 3. Sharps - syringes, needles, disposable scalpels 4. Chemicals - mercury, solvents and disinfectants 5. Pharmaceuticals - expired, unused contaminated drugs, vaccines and sera 6. Genotoxic waste - highly hazardous eg cytotoxic drugs 7. Radioactive waste - eg glassware contaminated with radioactive diagnostic material 8. Heavy metals waste - broken mercury thermometers

Policy development and analysis steps

1. Issue identification 2. Stake holder consultation 3. Statement of intentions aims and objectives 4. Policy instruments 5. Evaluation Planning

4 Types of Environment

1. Natural - ecological 2. Built - spaces and buildings 3. Work - in which people can spend 40+hrs / wk 4. Living - eat, sleep, play

How medical waste effects human health

1. Radiation burns 2. Sharp inflicted injuries 3. Poisoning and pollution through the release of pharmaceutical products in particular antibiotics and cytotoxic drugs 4. Poisoning and pollutions through waste water 5. Poisoning and Pollution by toxic elements or compounds such as mercury or dioxins that are released during incineration

How health care workers can influence policy

1. Social advocacy and lobbying 2. Collaboration across sectors 3. Individual speaking through wider networks and not in isolation 4. Effective use of the media

Four models of health education

1. Traditional medical model 2. Client-centred model 3. The behaviour-change model 4. The empowerment model

Future challenges in health promotion

1. degradation of habitats 2. aging population 3. rising violence 4. increase in private enterprise profit driven 5. communication (social media) 6. changes in work patterns 7. changes in family structures (not as strong as used to be)

Advocate aims

1. protect human rights 2. ensure better quality of life 3. challenge stereotypes and stigma 4. overcome barriers which restrict opportunity 5. aim for empowerment of disadvantaged 6. be responsive to and emphasis individual needs

Know the development of the Ottawa Charter for health promotion

1986 Ottawa conference first series of global health promotion conferences, providing profile to the newly emerging concept of health promotion. Advocate Mediate Enable.

Social Determinants of Health List

: Income & social status : Education : Physical environment : Social Support networks : Food : Gender : Transport : Unemployment : Addiction : Early life : Stress : Work : Social exclusion

Stake holder consultation

A democratic process that provides for accountability from the government. Consultation provides transparency. A policy is likely to have more legitimacy if stakeholder have a degree of ownership. Consultation broadens the input and increases expertise.

Illness

A disease or period of sickness affecting the body or mind.

Mortality

A measure of the number of deaths in a defined population

What is an advocate

A person who represents and works with a person or group of people who may need support and encourgment to exercise their rights, in order to ensure their rights are upheld.

Advocacy

About promoting and supporting changes that will improve the health of the community. 1. Expose and redress unjust or unsafe practices 2. Promote accountable, transparent and responsive government. 3. Encourage, influence and inform public debate on issues effecting legal and democratic rights. 4. Promote the development of law that reflects the public's interest 5. Develop and assist community organisations with a public interest focus to pursue the interest of the communities they represent 6. Develop models to respond to systemic unmet needs.

Statement of intentions, aims and objectives

Aims are broad statements that are general statement of intent. Objective elaborate and restate the goals in operational terms, from that you set priorities.

Client-centred model

Allows for active participation however still practicioner drive (gym instructor sets the plan after you answer questions)

Building healthy public policy

An explicit concern for health and equity in all areas of policy and by an accountability for health impact, with aims to create supportive environments to enable people to lead healthy lives and the building of policies particularly in non-health sectors to support health. HPP is central to the promotion of health and has been the central tenet of public health and health promotion since the 1980's.

Healthy Public Policy

An explicit concern for health and equity in all areas of policy and by an accountability for health impact. With aims to create supportive environments to enable people to lead healthy lives and the building of policies particularly in non health sectors to support health. Broader Social determinants of health Multi-sectorial in scope Central to the promotion of health Ecological in perspective Participatory in strategy

Downstream Interventions

Are characterised by efforts to modify the individuals perception of health or deal with the health issue / disease directly. These interventions can be called Selective Primary Health Approaches. Eg: Targeted antibiotics, transplants.

community empowerment

Bottoms up approach. Grass roots driven. Empowers communities. People how are affected most are integral to the process. People are entitled to have control over issued that affect their lives.

Population Health

Can be defined as the health of groups, families or communities. Can be defined by location, gender, age (biological) social criteria such as SES or cultural criteria.

Re-orient Health Services

Changing health services attitudes to the way they operate and deliver their services. Move towards health promotion rather then concentrating on cure.

What is Social Justice?

Collective expression of equity. Social Justice is an ethical concept based on human rights, equity, and fairness. In PHC social justice must supersede individual goals and must inform international health enhancement goals.

Origins of Health Promotion

Come from the Ottawa Charter (1986). Birthplace of health promotion to advocate and mediate not dictate and blame. 1980's addressing communicable diseases however there was a corresponding increase of non-communicable diseases.

Community engagement

Community development works through engagement with the community. Engagement looks at working with groups within the community. Including those experiencing disadvantage to increase their inclusion. Therefore it's a planned process with specific purpose of working with identified groups of people to address issues effecting their well being

The empowerment model

Consistent with principles of public health and health promotion Sensitives to person's needs, participation, autonomy encouraged. Involves family and significant others.

Sustainability and how it relates to the environment and health "Action for Change"

Continuation of aspects of health promotion such as issues, programs, changes or partnership; sustainable development is development that meets the needs of the present without compromising the ability of future generations to meet their own needs. Sustainability requires the reconcilliation of the 3 pillars of sustainability 1. Environmental - reduction of fluro carbons / decreased degregation of ozone layer / decreasing uv impact to slow down ocean warming / reduction of the use of persistant organic pollutants such as deoxins 2. Social equity 3. Economic demands

Benefits of social marketing

Create groundswell in community Short memorable message Sense of ownership in community

Infant mortality

Death rates of children under 5 years

Strengthening Community Action

Empowerment of communities Community involved in - setting priorities, making decisions, planning strategies and implementation. Uses community's existing resources to enhance self-help and social supports.

Where does education fit into the Ottawa Charter for health promotion

Developing personal skills

Tertiary Prevention

Downstreaming Therapeutic and rehabilitative once disease is firmly established. Eg. physio, OT, speech, nursing care. management of diabetes and chronic heart disease.

Millenium Development Goals

Eight goals adopted by international leaders in 2000, to be achieved by 2015. Provide concrete numerical benchmarks for tackling extreme poverty in it's many dimensions. 1. Eradicate extreme poverty and hunger 2. Universal primary education 3. Gender equality - empowerment of women 4. Child mortality reduction 5. Maternal health improvement 6. Combat HIV aids and other diseases 7. Environmental sustainibilty 8. Global partnership

What social justice action is at the heart of the Ottawa Charter particularly "Strengthen Community Action"?

Empowerment

Describe / define Equity

Everybody gets the same quality of service, which fits their individual needs. - being fair or impartial - an ethical value - sharing available resources - closely related to human rights

Upstream Interventions

Focuses on correcting the problem before it has happened. They are designed to alter the precursors of poor health. These intervention are also know as Comprehensive Primary Health Care Approaches. Eg:preventative vaccinations, diet, exercise, primary prophylaxis

Issue Identification

Generally a report Statistics will tell if there is a increase in problem

GDP

Gross Domestic Produce. The market value of all officially recognised final goods and serviced produced with a country in a given period of time.

Understand the link between the environments, its changes and human health

Has been central to indigenous populations throughout the world. In the relentless quest for economic wealth, we have increasingly abused our own life-support system Air/Water/Land contamination/safe food supplies.

The term SDoH describe which factors that have an influence on health.

Health care interventions, The interactions between human biology, lifestyle, the physical and social environments.

How is health education central to health promotion

Health education is the "HOW" of enabling. Core strategy for promotion of health and prevention of disease. Any combination of learning experiences Just one strategy of health promotion Equipping people with skills Not telling them what to do.

How does health promotion relate to primary health care

Health promotion and illness prevention are based on the principles of Primary Health Care. WHO: Health promotion as a process of enabling people to increase control over, and to improve, their health. Involves population as a whole. Directed towards action on the determinants or causes of health. Combines diverse but complimentary approaches Aims at effective public participation. Is not a medical service. Multimodal

Secondary Prevention

Intervention Focus on early detection and swift treatment of disease. To cure, slow progress or reduce impact Eg Screening

Empowerment

Is a social action process that promotes the participation of people, communities and organisations towards goals of increased individual and community control, political efficacy (ability to produce a desired or intended result), improved quality of community life and social justice.

Health Literacy

Is the degree to which people have the capacity to obtain, process and understand basic health information and services, needed to make appropriate health decisions.

Public Health

Is the science and art of 1. preventing disease, 2. prolonging life, 3. promoting physical health and focuses 4. focuses on the health of populations 5. directs lifestyle changes as well as social and environmental changes 6. Seeks to address the SDoH Public Health accepts the collective burden to provide basic services for all (involves prevention level) eg: immunisation for all @ no cost

Why does Healthy Public Policy sit outside the circle

It encompasses all.

Health Education

It is a strategy in health promotion designed to help individuals and communities improve their health by increasing their knowledge or influencing their attitudes. Empowerment is the core of health education.

non-communicable disease

Lifestyle disease 1. Obesity 2. diabetes 3. some cancers 4. hypertension 5. renal and heart disease

Describe how health needs are identified by the community

Measure of health Statistics Asking the community

Awesomeness

Michelle and Jacinta

Understand how social marketing is applied to health

Multimodal approach is most effective. * Mass media * Strategic message placment * Interpersonal * Social media * Edutainment

Traditional medical model

Necessary for acute medical emergencies. Physician is in charge of health not the patient

Evaluation planning

Need to evaluate for: ccountability reporting performance management governence

hashtag

Nursing care der !!!!

GDP per capita

Often considered an indicator of a countries standard of living

What does PHC emphasize?

PHC emphasizes the importance of working with people / communities to enable them to make decisions about their needs and how best to address them.

What is PHC's underpinning philosophy or care?

PHC is a philosophy of care intended to redress inequalities in health by recognising that well being is dependent on a broad range of social, political, economic and environmental factors.

Alma Atta prerequisites for health

Peace Shelter Education Social Security Social Relations Social Justice Equity Food Income Empowerment of women A stable ecosystem Sustainable resource use Respect for human rights

Power v's empowerment

Power is knowledge, to empower you need to give away your knowledge.

Describe what Primary Health Care is:

Primary Health Care is and approach or a model of care aimed at reducing health inequities and ensuring equity, equality and social justice in health.

6 P's of social marketing

Product Price Place & Distribution Promotion Policy Partnerships

How a health care worker can assist a community to make change

Provide resources Assist with skills development Assisting with research Planning action Supporting localism Supporting community member

Developing Personal Skills

Providing information, education for health and enhancing life skills. Enabling people to exercise more control over their own health and environments. eg. quit smoking (inner strength to do it)

Difference between Public and Population Health

Public Health: strategies @ all levels to address the SDoH Population Health: targets the SDoH of a particular population

What does equality refer to?

Refers to a similarity of statuses or sameness in the provision of services. Everybody gets exactly the same service without regard to individual differences.

What are the Social Determinants of Health mostly responsible for?

SDoH are mostly responsible for health inequities - the unfair and avoidable differences seen within and between countries.

Key steps in successful social marketing campaign

SMART Know your audience Identify key message appropriate mode of communicating message newsworthiness

Social marketing vs commercial marketing

Social marketing designed to influence behaviours Commercial marketing used to make profit

Community

Social system bound by geographical location or common interest. Can include groups with conflicting interest.

Criticisms of social marketing

Stereotyping May ignore SDoH Focus on single issue

Creating Supportive Environments

Support environments of health and offer people protection form threats to health, and enable people to expand their capabilities and develop self-reliance in health. Emcompasses where they live, work, play,homes, access to resources for health. General socioeconomic, cultural and environmental conditions within education, working environments, living conditions, water and sanitation, health care services, agriculture and food production, building and spaces. Conservation of natural resources, Health impact on rapidly changing environment.

Health Policy

Targeted A formal statement or procedure within institutions (notably government) that defines priorities and the parameters for action in response to health needs, available resources and other political pressures. Target on issues due to a report. Health policy implies a particular value and are generally government driven and usually high on electoral agenda's.

Surveillance

The collection of data, analysis, interpretation, and dissemination of health data to inform public health agencies and initiatives to monitor health, prioriitise and develop appropriate preventative strategies. Assist in planning and using data for evidence based decision making. Eg's: case detection and public health intervention, estimating impact of a disease or injury Portraying natural history of a health condition Determining distribution and spread of an illness Generating hypothesis and stimulating research Evaluating prevention and control measure Facilitating planning Outbreak detection

Principles of (good) community

The community is highly effective working group. Community facilitates healing. Community is the ideal consensual decision making body. Individual differences are celebrated. Share equal responsibility for and a commitment to maintaining spirit.

1978

The declaration of Alma Atta "Health for all by the year 2000" PHC born and strives to address inequalities between and with in nations.

Life expectancy

The expected length of life of a population

Social Gradient

The lower a persons socio-economic position the worse their health is likely to be. The SDoH are what positions a person on the Social Gradient.

Maternal mortality

The number of maternal deaths within 42 days of end of pregnancy per 100,000 women.

Lobbying

The process of the activities involved in advocating on behalf of a group issue. May be professionals employed by organisation to seek policy change

Morbidity

The rate or incidence of illness or disease

Environmental Health Justice

The right of all people to a safe, healthy, productive and sustainable environment. The populations of developing countries undergoing rapid industrialisation are at risk from the combined threats of both traditional and modern environments health hazards. "Traditional" poor housing inadequate water, sanitation. "Modern" new infectious diseases, chemicals, radio-nuclear threats.

Health

The state of complete physical, mental and social well-being and not merely the absence of disease. (WHO 1948)

Policy instruments

The technical means of achieving the policy goal. cash grants pricing (tobacco and alcohol) price controls (petrol) tax breaks restructuring Most common is a program budge to build a new service or expand upon an existing one.

Environmental Health

Those aspects of human health determined by physical, chemical, biological and social factors in the environment. Environmental health is about creating and maintaining environments which promote good public health.

Two tier health promotion program

Tier 1: conceptual foundations. 1. Evidence of the problem 2. Determinants of the problem 3. Population of interest 4. Settings 5. Outcome levels Tier 2: Technical program 1. Partnerships development and rationale 2. Vision setting 3. Goals and objectives 4. Action mapping and strategy selection 5. Implementation 6. Evaluation and dissemination

Birth rates

Total number of births per 1000 head of population per year

Behaviour-change model

Transmission of health information Encourages personal responsibility Doesn't take into account SDoH Leads to victim blaming

1948

United Nations form (post WW2) Universal Declaration of Human Rights adopted (Dec 10th) World Health Organisation is established to function as a peak body of UN to deal with international health issues and disparities.

Community action placement on River of Health

Upstream - prevention

Primary Prevention

Upstreaming Prevention of disease and conditions before onset eg's: preventing environmental exposure, improving human resistance to disease, education to diminish risk taking behaviour.... immunisation

Disease

a pathological condition of a part, organ or system of an organism resulting from various causes, such as infection, genetic defect or environmental stress and characterised by an identifiable group of signs or symptoms. It is an abnormal condition which affects the body.

Communicable Disease

bacteria, germs don't always need a mode of transmission 1. lack of clean water 2. poor sanitation 3. overcrowding 4. poor literacy 5. lack of access to health care 6. unemployment

Social Determinants of Health

conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices.

A socially just society is more likely to be a ____________ society.

healthy

Primary Health Care

is essential health care based on PRACTICAL, SCIENTIFICALLY SOUND and SOCIALLY ACCEPTABLE methods and technology. PHC is made universally ACCESSIBLE to individuals and families in the community through their FULL PARTICIPATION and at a cost the community and country can AFFORD to maintain at every stage of their development in the spirit of SELF RELIANCE and SELF DETERMINATION.

why is screening important for communicable and non-communicable disease

to detect incidence and rise of disease. (if you don't know this you shouldn't be doing nursing !! just saying)