* Identifies and examines why individuals give different meanings to health * Explains how a range of health behaviors affect an individual’s health * Describes how an individual’s health is determined by a range of factors * Evaluates aspects of health over which individuals can exert some control * Describes factors that contribute to effective health promotion * Proposes actions that can improve and maintain an individual’s health * Forms opinions about health-promoting actions based on a critical examination of relevant information * Uses a range of sources to draw conclusions about health and physical activity concepts
Meanings of Health
* Definitions of health
* Dimensions of health
* Relative and dynamic nature of health
Definitions of health:There are many interpretations of what ‘health’ means. The W.H.O. originally defined health as a state of complete physical, mental and social well-being and not merely the absence of disease.The concept of heath is diverse and means different things to different people. This diversity can be recognized by considering the different meanings of health that have developed over time.Early meanings of health, it was generally viewed as the opposite of illness. This view of health suggested that if one is ill, medicine, drugs and doctors were able to return you in a healthy state. World Health Organization’s definition of health, ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. A weakness of this definition is that it fails to acknowledge that a person’s state of health is always changing.| Dimensions of health:A person’s level of health is the result of an interaction between different dimensions. A balance between all four dimensions is essential to produce general well-being and satisfaction. Physical health – the wellness of the body and the absence of chronic pain or discomfort. It is largely determined by lifestyle and behaviour.
Perceptions of health
* Personal perceptions of health
* Perceptions of health of others
* Implications of different perceptions of health
* Perceptions of health as social constructs
* Impact of the media, peers and family
People’s perceptions of health can be highly subjective.
Perception refers to the way something is seen or viewed by an individual or group.
Personal perceptions of health
* Highly subjective
* Most likely be based on what we have learned about health, along with our own experiences or on those of people we know. * Influenced by a range of factors, including:
* Personal interpretation of health
* Our behaviours and lifestyle
* Our past level of health
* Attitudes about health conveyed by peers, family and the media * The value we place on the importance of being healthy * Beliefs about our capacity to achieve good health
Perceptions of health of others
* Different ways of seeing and interpreting the living conditions, fitness levels and health behaviours of various groups significantly shape the notions of healthy people in different circumstances are likely to be. * Stereotypical beliefs about particular groups in the community may limit our ideas about their likely health status
Implications of different perceptions of health
* Implications at an individual level
* On an individual level, people’s perceptions of their health have a significant influence on their lifestyle choices and behaviours relating to health. * For example, a person who recognizes that they are experiencing symptoms of depression is more likely to seek support or undergo counseling than someone who is unfamiliar with the symptoms of depression or disregards or dismisses these symptoms. * Being able to accurately assess our level of health assists us to be proactive about our health and take appropriate action to address health concerns. * Incorrect or distorted assessment of our health status could lead to health behaviours that are likely to harm our overall health and well-being. (Anorexia, due to wrong perceptions) * A stereotype is a simplified and fixed image, opinion or concept to which people may feel expected to conform * Differing perceptions of health may also contribute to varying expectations of people’s capabilities and levels of responsibility for managing their health. * The differing expectations that come with people’s different perceptions of health are therefore likely to impact on the degree of support that individuals provide to others. * Implications at the policy level
* Statistics of ill health are often gathered to measure the health of individuals, communities and nations. * At a societal level the perceptions of the health status of Australians held by various levels of government, health professionals, non-government policy, expenditure and action, and impact on the agenda set by various organizations. * Epidemiology – the study and analysis of trends of illness and disease evident in the figures of mortality, morbidity and life expectancy. * Mortality – the number of deaths in a given population from a particular cause and/or over a period of time * Morbidity – the incidence or level of illness or sickness in a given population * Life expectancy – is the average number of years of life remaining to a person at a particular age, based on current death rates. * Conflicting perceptions often arise about the areas of health that should be given highest priority, leading to competing demands for the finite resources allocated by the various levels of government.
Perceptions of health as social constructs
* A social construct is a concept that recognizes that people have different views based on their social circumstances and ways of seeing, interpreting, interrelating and interacting with the environment * A number of factors that are likely to play a role in our social construct of health; * Socioeconomic status
* Geographical location
* Cultural background
* Level of education
* Community values and expectations
* These facts then have an influence on the expectations we form about our health potential, the understanding we develop of what good health involves, the ability we have to act on information and exert control over our own health, the value we place on the importance of continually working to improve our health, our choices about whether we use health products and services and how they are used and how we respond to challenges to our health and well-being.
* Social economic status
* A measure of an individual’s place in society, based on their income, education, employment and other economic factors such as house or car ownership. * People from a lower socioeconomic background generally have poorer health outcomes than those who are well off. This includes shorter lives, suffer more illnesses and have more risk factors for ill health present in their lives. More likely to perceive their health as fair or poor and feel they have less control of their own destiny. * Geographic location
* Broadly divided into urban, rural and remote.
* Rural and remote areas have high death rates and generally experience harsher living conditions. * In comparison to urban dwellers, people in rural and remote areas have relatively poor access to health services and recreational facilities. * Cultural background
* Population groups with similar ethnic backgrounds or cultural heritage may have vastly different explanations or meanings for health and well being to other racial groups. * The values and beliefs of the dominant culture act as a powerful influence on ideas constructed about health. * Alternative medicine – refers to various medical methods and practices that are not recognized as being conventional or traditional approaches to medicine.
Perceiving health as a social construct allows us to consider the broad social and cultural factors that impact on an individual’s behaviour. When we view health as a social construct it allows us to: * Explain why certain people choose to behave in particular ways * Understand how social norms are established in cultural subgroups * Realize how our concept of health can take on different meanings in particular social contexts.
Impact of the media, peers and family
* The media
* Television, radio, magazines, movies, newspapers and the internet * Significant role in disseminating health-related information. * Stories in the media also influence people’s perceptions through the depth of information they provide, the way this information is presented and the frequency of this presentation * Influential in shaping attitudes, values and behaviour relating to what good health looks like and means * Misleading messages in the media about health can contribute to misconceptions or distorted perceptions of health * Sustained media coverage of particular health issues can lead to increased public awareness and prompt government action * Peers
* When group members share similar ideas about what good health means and place comparable value on the importance of good health it is easier for the individual to behave in ways that will enhance their health and well-being. * This is especially the case amongst young people.
* Social pressures along with the desire to fit in, may contribute to decisions being made that are likely to negatively affect their health. * However, when a peer group recognizes these behaviours are unhealthy and liable to cause significant immediate or future harm, they are likely to discourage others from engaging in these activities. * Family
* Parents are role models, the ideas in which they communicate about what health means and the values they convey about the importance of good health have a strong effect on the perceptions that we develop. * The living conditions of families, along with other socioeconomic factors such as income, education and employment, also have a bearing on our ideas about health. * Socioeconomic disadvantage - refers to significant limitations to opportunity that can be experienced as a result of factors relating to social and economic circumstances, such as lower education, poorer education, unemployment, limited access to services, inadequate housing or lack of social networks.
Health Behaviours of Young People
* The positive health status of young people
* Protective behaviours and risk behaviours
* The positive health status of young people
* The health of most young Australians is generally good. However, young indigenous Australians, young people living in regional and remote areas and young people who suffer socioeconomic disadvantage have poorer levels of health in comparison to their peers. * The high incidence of mental health disorders, injuries and communicable diseases such as Chlamydia, meningitis and hepatitis C among young people are also areas of concern. * Protective behaviours and risk behaviours
* Protective behaviours – are those health behaviours that are likely to enhance a person’s level of health * Risk behaviours – are those health behaviours that have been found to contribute to the development of health problems or poorer levels of health.
* Exercise at least 60 minutes every day.
* Limit time spent on the computer, watching television and playing video games. Benefits: improved cardiovascular fitness, maintenance of healthy weight, increased self-confidence, development of friendships, reduction in stress levels.
* Balanced diet of fruit, veg, protein, fats and carbs.
* Fatty foods lead to weight gain, high blood pressure and bone density
* Teenagers experiment with drugs, alcohol.
* Smoking leads to cancer
* Binge drinking can result in alcohol poisoning, impair brain function. Leads to many deaths in car crashes.
Causes social harms too; guilt, embarrassment, relationship conflict and legal problems Liver diseases
* Engaging in unsafe sex increases the risk of STI’s
* Chlamydia, HIV/AIDS, genital warts
* Protective behaviours: use protection; condom, the pill, diaphragm.
The Determinants of Health
* The individual factors
* Sociocultural factors
* Socioeconomic factors
* Environmental factors
Health determinants are the individual, socioeconomic, sociocultural and environmental factors that can have a positive or negative influence on the health of individuals or populations.
* The individual factors
* Those factors unique to each person that can determine their level of health * Knowledge and skills
* Social cultural factors
* Relate to the society in which the people live and the cultural practices and expectations that exist within these communities * Family
* Socioeconomic Factors
* Relate to a person’s level of income, education and employment. * Education
* Environmental Factors
* Those things present in the environment in which people live and work that can affect their health in a positive or negative way * Geographic location
* Access to health services
* Access to technology
| Determinants| Examples of POSITIVE influence on health| Examples of NEGATIVE influence on health| Individual Factors| Knowledge and Skills| ‘I know it’s unhealthy to smoke, therefore I won’t.”| Person unaware of the effects smoking has on their health. Why not smoke them. BEING UNAWARE| | Attitudes| Eager to seek help if knows they have a mental illness| Stubborn and naïve about speed in a car. Speeding can lead to death| | Genetics| Breast cancer in medical history. Takes great awareness in getting regular check-ups.| Not knowing heart disease runs in the family| | | | |
Sociocultural factors| Family| Family encourage physical activity + exercise| Take away/fast food for dinner every night| | Peers| Large and supportive friend network| Smoking, underage drinking. Peer pressure| | Media | Awareness of HIV/AIDS and other STIs| Stereotypical perception of health. Unrealistic images of what’s being healthy| | Religion| Catholics believe no sex before marriage: prevention of STI’s| Vegetarian: low on iron.| | Culture| Great support network| Language barriers prevent access to information| | | | |
Socioeconomic factors| Education| Great knowledge of health issues – prevention| Sucked into risk behaviours| | Employment| Income to live off| Work can be stressful or dangerous E.G. miners| | Income| Spend on health related opportunities Example: the gym| If limited, discourages health investments| | | | |
Environmental factors| Geographical location| In the city, access to a variety of sources| Rural: less access to services| | Access to health services| Prevent certain unless,| Rural: higher death rates. Takes longer for ambulances to reach them| | Access to technology| Internet support Example, Beyond Blue| Self diagnosis on internet |
The Degree of Control Individual can Exert over their Health * Modifiable and non-modifiable health determinants
* Changing influence of determinants through different life stages
Modifiable Health Determinants
* Those determinants that can be changed or controlled so they have a different level of influence on our health. * Modifiable:
* Control over self-efficiency (belief in the ability to bring about change) greater self-efficiency, greater levels of perseverance and persistence * Health campaigns such as ‘speeding’ can change behaviour.
Non-modifiable Health Determinants
* Are determinants that cannot be changed or altered
* Non modifiable:
* Parents influence these (geographic location and socioeconomic circumstances) * Teenagers; media has a great influence and peers
Changing influence of determinants through different life stages * Social norms describe the behaviours, beliefs and values that are expected or seen
Health As A Social Construct
* Recognizes the interrelationship of determinants
* Challenging the notion that health is solely an individual’s responsibility
The Social Construct of health recognizes that people have different vies of health based on their social circumstances and ways of seeing, interpreting, interrelating and interacting with their environment
* Statistics on the health status of Australians shows that groups commonly suffering from poorer levels of health often experience a higher number of negative health determinants in their lives. For Example:
Aboriginal and Torres Strait Island people who suffer much more ill health than other Australians are more likely to; Be in most disadvantaged SOCIOECONOMIC group.
Poorer levels of EDUCATIONAL achievement
Higher rates of UNEMPLOYMENT
Lower rates of HOME OWNERSHIP and live in inadequate
SMOKING, ALCOHOL CONSUMPTION, OBESITY etc present in their lives more risk factors for ill health
Challenging the notion that health is solely an individual’s responsibility * Poor health is not just a matter of not knowing any better * Biological, social, economic and environmental factors can present considerable barriers to an individual’s health * Viewing health as a social construct helps explain:
* Why certain groups behave in certain ways
* How behaviour can be associated with social and cultural meanings * What the priorities of certain groups are in terms of health and well being * Predisposing, enabling, reinforcing factors
Responsibility for Health Promotion
* Community groups and schools
* Non-government organizations
* International organizations
* Idea is to improve people’s health by aiming to enable people to take control of their health, to improve their health and prevent illness. * AIMS TO PREVENT RAHTER THAN CURE.
* Individuals must be empowered with knowledge, skills, access and social and economic supports * For example, providing information for quitting smoking; the ‘nicotine ads’ * Shows how patches affect people and show where they are available
Community and Schools
* School is where young people form beliefs and values
* PDHPE and co-curricular are responsible for health promotion * Health literacy, nutrition, physical activity guidelines. * For example,
* A school implementing hats being worn outside to reduce sunburn and skin cancer * Bullying is not tolerated
* Activities like ‘jump rope for heart’
* Community – women help groups, migrant help centers
* Generally focus on a particular health issue and aim to raise awareness, provide information, find raise for research and support those affected * For example, The Red Cross and Beyond Blue
* Plays greatest role in developing, implementing and finding health promotion in Australia * Federal: create national health policies (illegal drugs, schooling etc), provide money for funding * National health promotion; healthy spaces and places, national Skin Cancer Awareness * Skin: Also implement own laws. For example – P plate laws * Different ad campaigns as targeting something that may happen more of in NSW than in WA; speeding * Local: Responsibility of ensuring state laws are implemented * For example – Fencing around pools, available paths for pedestrians, safe play equipment in parks, libraries.
* WHO – major international organization responsible for global health promotion * They set international standards such as water quality and food safety * WHO also advocates governments to change for the better and help people understand the social, environmental and economic influences on health
Health Promotion Approaches and Strategies
* Lifestyle/behavioral approaches
* Preventative medical approaches
* Public health approaches
Lifestyle and Behavioural Approaches
Lifestyle Approach: aims to reduce or prevent incidence of risk behaviours that contribute to poor health * For example, poor diet, no exercise, smoking, unsafe sex, drug and alcohol abuse * Major causes of death in Australia are due to disease as a result of this * Social marketing used to prevent
* Health Promotion Programs: Campaigns encouraging physical activity, quit-smoking campaigns, road safety
Preventative Medical Approaches
* Use medical treatments or interventions to promote health * Use of medical interventions
* Primary: Aims to stop illness occurring: Example: VACCINATIONS * Secondary: identifies groups at risk and aims to reduce this likelihood of happening OR slow down spread of illness. Example: PAP TEST or BLOOD PRESSURE LEADING TO CVD. * Tertiary: Aims at reducing likelihood recurring or best treating the illness. Example: ASTHMA OR DIABETES.
Public Health Approaches
* Things out of the individual’s control
* Looks at changing the environment to make it easier to make healthy decisions * Encourages individuals being affected to get actively involved. * Health Promoting Schools
* Work to protect and promote the health of the students. It includes curriculum, school organizations and partnership with the local community * Health Promoting Workplaces
* Workplaces that put strategies, policies and practices in place to have a happy, safe, productive and mutually respective environment.
The Ottawa Charter as an Effective Health Promotion Framework * Developing Personal Skills
* Creating Supportive Environments
* Strengthening community actions
* Reorienting health services
* Building healthy public policy
Developing Personal Skills
* Support the development of an individual aims to educate, provide information on health and enhancing skills * For example: decision-making, communication.
* Empowering people to make healthy decisions through skills and education.
Creating Supportive Environments
* Makes making the healthy decision the easy decision (within the supportive environments) * For example: school canteens that sell healthy food encourage healthy eating patterns
Strengthening Community Action
* Enabling the community to control the process; gives opportunity to create and implement actions that address their healthy concerns. * For example: Active After School Communities
* Schools, workplaces, local governments getting involved
Reorienting Health Services
* Using current health services for prevention rather than cure. * Requires change in attitude
* Jump Rope for Heart
Building Healthy Public Policy
* Relates to the decisions made at all levels of government and by organizations that work towards health improvement – creating supportive environment * For example, fencing around pools, no hat; no play, not allowed to buy alcohol after certain amount of drinks at a pub.
Principles of Social Justice
* Supportive environment
Is the allocation of resources according to the needs of individuals and populations, the goal being able to achieve equality of outcomes.
Is variety, or difference, between individuals and groups of people
Good health is achieved in environments that:
* Are relatively free of violence, pollution with a regular supply of water and nutritious foods * Adequate supply of necessities; clothing, shelter and transport. * Provide opportunities for recreation and variety in daily living * Cause less stress
* Free of factors that cause isolation and alienation
* Low levels of poverty
* Provide safe and interesting work
- Strategies need to address the SOCIAL, CULTURAL, PHYSICAL AND ECONOMIC factors present in people’s lives.