health education and health promotion

04/22/23OEDOJO SOEDIRHAM ([email protected]) 1

HEALTH EDUCATION HEALTH EDUCATION and HEALTH and HEALTH PROMOTIONPROMOTION

OEDOJO SOEDIRHAMOEDOJO SOEDIRHAMDEPARTMENT OF HEALTH PROMOTION AND DEPARTMENT OF HEALTH PROMOTION AND

BEHAVIORAL SCIENCESBEHAVIORAL SCIENCESFKM-UNAIR, SURABAYAFKM-UNAIR, SURABAYA


HEALTH EDUCATION and HEALTH EDUCATION and HEALTH PROMOTIONHEALTH PROMOTION

• HEALTH EDUCATION AND HEALTH HEALTH EDUCATION AND HEALTH PROMOTIONPROMOTION– introductionintroduction– Definitions and ConceptsDefinitions and Concepts– Foundation for PracticeFoundation for Practice– OthersOthers


INTRODUCTIONINTRODUCTIONOVERVIEWOVERVIEW• Everyone engaged in the tasks of promoting Everyone engaged in the tasks of promoting

health starts with a view of whathealth starts with a view of what healthhealth is.is.• However, there is a wide variety of these views, However, there is a wide variety of these views,

or concepts, of health. It is, important of the or concepts, of health. It is, important of the outset to be clear about the concepts of health outset to be clear about the concepts of health which you personally adhere to, and to recognize which you personally adhere to, and to recognize where these differ from those of your colleagues where these differ from those of your colleagues and clients. Otherwise, you may find yourself and clients. Otherwise, you may find yourself drawn into conflicts about appropriate strategies drawn into conflicts about appropriate strategies and advice that are actually due to different ideas and advice that are actually due to different ideas concerning the end goal of health.concerning the end goal of health.


• This lecture does not discuss about health only, This lecture does not discuss about health only, but also to present the process of attempting to but also to present the process of attempting to promote health that may include a whole range of promote health that may include a whole range of interventions including:interventions including:– Those which foster healthy lifestyleThose which foster healthy lifestyle– Those which encourage access to services and Those which encourage access to services and

involvement in health decisionsinvolvement in health decisions– Those which seek to promote an environment in Those which seek to promote an environment in

which the healthy choice becomes the easier which the healthy choice becomes the easier choicechoice

– Those which educate about the body and keeping Those which educate about the body and keeping healthyhealthy


• Until the 1980s most of these interventions were Until the 1980s most of these interventions were referred to as “health education” and the practice referred to as “health education” and the practice was almost exclusively located within preventive was almost exclusively located within preventive medicine or, to a lesser extent, education. In medicine or, to a lesser extent, education. In recent years, the term health promotion has recent years, the term health promotion has become widely used. This course considers become widely used. This course considers whether this change in name signifies a whether this change in name signifies a difference in ideology, policy, and practice. Using difference in ideology, policy, and practice. Using typology first suggested by Bunton and typology first suggested by Bunton and Macdonald (1992), it describes the development Macdonald (1992), it describes the development of health education and health promotion, and of health education and health promotion, and shows their interdependent. shows their interdependent.


• The 19th century public health movement The 19th century public health movement informed the health education of the earlier part informed the health education of the earlier part of the 20th century which, in turn, informed the of the 20th century which, in turn, informed the development of health promotion. It shows how development of health promotion. It shows how the debate about the meaning of health the debate about the meaning of health education and health promotion has stemmed education and health promotion has stemmed from a growing awareness that achieving “Health from a growing awareness that achieving “Health For All” requires not just changes in individual For All” requires not just changes in individual behavior, but also, social and environmental behavior, but also, social and environmental change.change.


• The development of health educationThe development of health education– The origins of health education lie in the 19th The origins of health education lie in the 19th

century when epidemic disease eventually led to century when epidemic disease eventually led to pressure for sanitary reform for the overcrowded pressure for sanitary reform for the overcrowded industrial towns. Alongside the public health industrial towns. Alongside the public health movement emerged the idea of educating the movement emerged the idea of educating the public for the good of its health. The Medical public for the good of its health. The Medical Officers of Health appointed to each town under the Officers of Health appointed to each town under the Public Health legislation of 1848 frequently Public Health legislation of 1848 frequently disseminated everyday health advice on disseminated everyday health advice on safeguards against “contagion”. safeguards against “contagion”. (Voluntary associations (Voluntary associations were also formed including the London Statistical were also formed including the London Statistical Society,1839; the Health of Towns Association,1842; and the Society,1839; the Health of Towns Association,1842; and the Sanitary Institute, 1876).Sanitary Institute, 1876).


– The Temperance Movement held Band of Hope The Temperance Movement held Band of Hope mass meetings, through schools and churches mass meetings, through schools and churches lectured to young people on the virtue of lectured to young people on the virtue of abstinence. By the 1920s health education abstinence. By the 1920s health education had become associated with diarrhoea, dirt, had become associated with diarrhoea, dirt, spitting and venereal disease. The evidence spitting and venereal disease. The evidence that between 10% and 20% of soldiers in the that between 10% and 20% of soldiers in the First World War had contracted venereal First World War had contracted venereal disease led to propaganda, one-off lectures disease led to propaganda, one-off lectures and the first use of “shock-horror” techniques and the first use of “shock-horror” techniques in which soldiers were shown lurid pictures of in which soldiers were shown lurid pictures of diseased genitals to dissuade them from diseased genitals to dissuade them from having sex.having sex.


• Changing patterns of morbidity and mortality Changing patterns of morbidity and mortality shifted attention away from disease to personal shifted attention away from disease to personal behavior. The Central Council for Health behavior. The Central Council for Health Education was established in 1972, paid for by Education was established in 1972, paid for by local authority public health departments and local authority public health departments and public health doctors formed the majority of its public health doctors formed the majority of its membership. An extract from some of the tasks membership. An extract from some of the tasks listed as important reflects an emphasis on listed as important reflects an emphasis on information, and education to bring about change information, and education to bring about change in personal habits and behavior”in personal habits and behavior”


• The provision of better and cheaper posters and The provision of better and cheaper posters and leafletsleaflets

• The provision of exhibits for exhibitionThe provision of exhibits for exhibition• The production of readable monthly bulletinThe production of readable monthly bulletin• The provision of a panel of lectures who really The provision of a panel of lectures who really

could lecture and hold an audiencecould lecture and hold an audience


• The Central Council was principally The Central Council was principally concerned with propaganda and concerned with propaganda and instruction. During the Second World War instruction. During the Second World War it delivered 3799 lectures on sex it delivered 3799 lectures on sex education and venereal disease which education and venereal disease which were attended by 340,000 people.were attended by 340,000 people.

• But, according to Sutherland (1979) the But, according to Sutherland (1979) the two principal functions or aims of the two principal functions or aims of the Central Council for Health education were:Central Council for Health education were:


• First First to promote and encourage educationto promote and encourage education … in … in the science and art of healthy living [and, the science and art of healthy living [and, secondsecond], ], to coordinate the work of all statutory to coordinate the work of all statutory bodies in carrying out their powers and duties bodies in carrying out their powers and duties under the Public Health Actsunder the Public Health Acts … relating to the … relating to the promotion … of Public Health.promotion … of Public Health.


• Unfortunately, health education confined itself in Unfortunately, health education confined itself in the main to the first, largely lifestyle, function and the main to the first, largely lifestyle, function and neglected the second, largely structuralist, issue. neglected the second, largely structuralist, issue. Health promotion in the last 20 years or so has Health promotion in the last 20 years or so has attempted to fill that gap. It is worth noting, attempted to fill that gap. It is worth noting, however, that health in turn did not develop in a however, that health in turn did not develop in a vacuum but emerged as a consequence of the vacuum but emerged as a consequence of the public health measures of the late 19th and early public health measures of the late 19th and early 20th centuries.20th centuries.


• This lecture does not to conclude which one come This lecture does not to conclude which one come first, whether health education or health first, whether health education or health promotion. Rather, to give information about promotion. Rather, to give information about what is “inside” of those two. Is there any real what is “inside” of those two. Is there any real different, both in concept and in practice?different, both in concept and in practice?

• What do you think about these two tables below, What do you think about these two tables below, which one is more useful for you as public health which one is more useful for you as public health worker?worker?


LEADING CAUSES OF DEATH IN THE UNITED STATES, 2000LEADING CAUSES OF DEATH IN THE UNITED STATES, 2000

2.32.3SEPTICEMIASEPTICEMIA1.51.5KIDNEY DISEASESKIDNEY DISEASES2.12.1ALZHEIMERALZHEIMER’’S DISEASES DISEASE2.72.7INFLUENZA AND PNEUMONIAINFLUENZA AND PNEUMONIA3.03.0DIABETESDIABETES4.14.1ACCIDENTS (UNINTENTIONAL INJURIES)ACCIDENTS (UNINTENTIONAL INJURIES)5.15.1CHRONIC LOWER RESPIRATORY DISEASESCHRONIC LOWER RESPIRATORY DISEASES7.07.0CEREBROVASCULAR DISEASESCEREBROVASCULAR DISEASES

23.023.0MALIGNANT NEOPLASMS (CANCER)MALIGNANT NEOPLASMS (CANCER)29.629.6DISEASES OF HEARTDISEASES OF HEART

TABLE 1:


ACTUAL CAUSES OF DEATH IN THE UNITED STATES, ACTUAL CAUSES OF DEATH IN THE UNITED STATES, 20002000

0.70.7ILLICIT DRUG USEILLICIT DRUG USE0.80.8SEXUAL BEHAVIORSEXUAL BEHAVIOR1.21.2FIREARMSFIREARMS1.81.8MOTOR VEHICLEMOTOR VEHICLE2.32.3TOXIC AGENTSTOXIC AGENTS3.13.1MICROBIAL AGENTSMICROBIAL AGENTS3.53.5ALCOHOL CONSUMPTIONSALCOHOL CONSUMPTIONS

15.215.2POOR DIET AND PHYSICAL ACTIVITIESPOOR DIET AND PHYSICAL ACTIVITIES18.118.1TOBACCOTOBACCO

TABLE 2:


Definitions and ConceptsDefinitions and Concepts

What is:What is:

HEALTH ?HEALTH ?

Health in the River of Health in the River of LifeLife


• The river as a metaphor of health The river as a metaphor of health development has often been used. development has often been used. According to Antonovsky, it is not enough According to Antonovsky, it is not enough to promote health by avoiding stress or by to promote health by avoiding stress or by building bridges keeping people from building bridges keeping people from falling into the river. falling into the river. Instead people have Instead people have to learn to swim to learn to swim (Antonovsky 1987).(Antonovsky 1987).


• The river of life is a simple way to The river of life is a simple way to demonstrate the characteristics of demonstrate the characteristics of medicine (care and treatment) and public medicine (care and treatment) and public health (prevention and promotion) shifting health (prevention and promotion) shifting the perspective and the focus from the perspective and the focus from medicine to public health and health medicine to public health and health promotion towards population health.promotion towards population health.


• Cure or treatment of diseasesCure or treatment of diseases• The curative perspective on health means The curative perspective on health means

that we ‘save people from drowning’ using that we ‘save people from drowning’ using expensive high technology and well-expensive high technology and well-educated professionals. Up stream educated professionals. Up stream thinking would offer people support and thinking would offer people support and interventions at an earlier stage.interventions at an earlier stage.


• Health protection/disease preventionHealth protection/disease prevention• This stage can be divided in two phases, This stage can be divided in two phases,

i.e. the protective and the preventive. The i.e. the protective and the preventive. The protective perspective means that the protective perspective means that the interventions are limiting the risks of interventions are limiting the risks of disease. The efforts and interventions are disease. The efforts and interventions are population-based and passive.population-based and passive.


• In the metaphor of the river, the In the metaphor of the river, the interventions are aimed at preventing interventions are aimed at preventing people from falling into the river by people from falling into the river by ‘building fences’. The preventive ‘building fences’. The preventive perspective aims at preventing diseases perspective aims at preventing diseases by active interventions characterized by by active interventions characterized by an empowering attitude where people are an empowering attitude where people are actively involved.actively involved.


• People are here ‘supplied with a life vest’. People are here ‘supplied with a life vest’. The rationale is to reduce the negative The rationale is to reduce the negative effects and risks thus maintaining the effects and risks thus maintaining the health of the public. The interventions are health of the public. The interventions are both population-directed (protective) and both population-directed (protective) and individual-based (preventive).individual-based (preventive).


• Health education/health promotionHealth education/health promotion• This stage consists both of health This stage consists both of health

education and health promotion. Health education and health promotion. Health education has a long tradition in public education has a long tradition in public health practice. Originally, it was a health practice. Originally, it was a question of the professionals informing question of the professionals informing people of health risks and giving advice people of health risks and giving advice how people should live their lives. how people should live their lives.


• Today it is based on a dialogue, involving Today it is based on a dialogue, involving people in their own lives, making their own people in their own lives, making their own decisions supported by the professionals. decisions supported by the professionals. People are, in general, more actively People are, in general, more actively involved than in the previous stages. The involved than in the previous stages. The interventions are directed towards both interventions are directed towards both individuals and groups. Improved health individuals and groups. Improved health literacy is the key outcome of health literacy is the key outcome of health education (Nutbeam, 2000). education (Nutbeam, 2000).


• Returning to the river, the efforts here aim Returning to the river, the efforts here aim at ‘teaching people how to swim’. In health at ‘teaching people how to swim’. In health promotion, health is seen as a human promotion, health is seen as a human right. The focus is on the co-ordination of right. The focus is on the co-ordination of activities between professions and activities between professions and professionals in societies. This is a positive professionals in societies. This is a positive concept emphasizing social and personal concept emphasizing social and personal resources as well as physical capacities. resources as well as physical capacities.


• The responsibility of health promotion The responsibility of health promotion action extends far beyond the health action extends far beyond the health sector and health behavior to wellbeing sector and health behavior to wellbeing and QoL. It is a humanistic approach and QoL. It is a humanistic approach having the human being, human rights at having the human being, human rights at focus again. The individual becomes an focus again. The individual becomes an active and participating subject. active and participating subject.


• The task for the professionals is to support and The task for the professionals is to support and provide options, enabling people to make sound provide options, enabling people to make sound choices, point out the key determinants of health, choices, point out the key determinants of health, to make people aware of them and able to use to make people aware of them and able to use them (Lindström and Eriksson, 2006). Health them (Lindström and Eriksson, 2006). Health education is here replaced by learning about education is here replaced by learning about health referring to the reciprocity of a health health referring to the reciprocity of a health dialogue. The salutogenic perspective can be dialogue. The salutogenic perspective can be applied in all these stages.applied in all these stages.


• Improving health Improving health perception/wellbeing/quality of lifeperception/wellbeing/quality of life

• Going up-streams towards the source the last stage Going up-streams towards the source the last stage deals with health perception and QoL. The ultimate deals with health perception and QoL. The ultimate objective of health promotion activities is to create objective of health promotion activities is to create prerequisites for a good life. Perceived good health is prerequisites for a good life. Perceived good health is a determinant for QoL. The salutogenic framework a determinant for QoL. The salutogenic framework can create a fusion of the complexity of health and can create a fusion of the complexity of health and QoL development (Eriksson and Lindström, 2006, QoL development (Eriksson and Lindström, 2006, 2007).2007).


• It is necessary to learn how to reflect on the It is necessary to learn how to reflect on the options of ones life situation, such as what options of ones life situation, such as what generates health, what improves QoL and what generates health, what improves QoL and what develops SOC. Traditionally, the difference develops SOC. Traditionally, the difference between the biomedical model and public health between the biomedical model and public health has been described through a metaphor of a river has been described through a metaphor of a river moving from the down river approach where moving from the down river approach where people already are struck by disease up streams people already are struck by disease up streams through the stages described above.through the stages described above.


• However, to explain the shift of paradigm of the However, to explain the shift of paradigm of the salutogenic framework, the metaphor of the river salutogenic framework, the metaphor of the river is different. This is Health in the River of Life. is different. This is Health in the River of Life. Here the river flows vertically across your view. Here the river flows vertically across your view. Along the front side of the river, there is a Along the front side of the river, there is a waterfall continuously following the whole stretch waterfall continuously following the whole stretch of the river. This means the main flow and of the river. This means the main flow and direction of the river is not down the waterfall.direction of the river is not down the waterfall.


• At birth, we are dropped into the river and float At birth, we are dropped into the river and float with the stream. The main direction is life not with the stream. The main direction is life not death and disease in the waterfall. Some are born death and disease in the waterfall. Some are born close to the opposite side of the river where one close to the opposite side of the river where one can float at ease and the opportunities for life are can float at ease and the opportunities for life are good and there are many resources at disposal, good and there are many resources at disposal, like in a welfare state. Some are born close to like in a welfare state. Some are born close to the waterfall, at dis-ease, where the struggle for the waterfall, at dis-ease, where the struggle for survival is harder and the risk of going over the survival is harder and the risk of going over the rim is much greater.rim is much greater.


• The river is full of risks and resources. The river is full of risks and resources. However, the outcome is largely based on However, the outcome is largely based on our ability to identify and use the our ability to identify and use the resources to improve our options for resources to improve our options for health and life.health and life.




• BIOMEDICALBIOMEDICAL• PSYCHOLOGICALPSYCHOLOGICAL• SOCIOLOGICAL SOCIOLOGICAL (SOCIOCULTURAL)(SOCIOCULTURAL)


Definitions and ConceptsDefinitions and Concepts• BIOMEDICALBIOMEDICAL

• Focuses solely on the individual’s Focuses solely on the individual’s physiological statephysiological state

• Health is defined simply as the absence Health is defined simply as the absence of disease or physiological malfunctionof disease or physiological malfunction

• It is NOT positive state; but the It is NOT positive state; but the absence of a negative stateabsence of a negative state


Definitions and ConceptsDefinitions and Concepts• PSYCHOLOGICALPSYCHOLOGICAL

• Asserts that individual constantly make Asserts that individual constantly make subjective evaluations of their own subjective evaluations of their own healthhealth

• Originally, this assessment was Originally, this assessment was assumed to focus solely on a general assumed to focus solely on a general feeling of overall well-beingfeeling of overall well-being

• Psychological wellness includesPsychological wellness includes– Pleasurable involvementPleasurable involvement– Long-term satisfactionLong-term satisfaction– The absence of negative affectThe absence of negative affect


Definitions and ConceptsDefinitions and Concepts• SOCIOLOGICAL SOCIOLOGICAL

(SOCIOCULTURAL)(SOCIOCULTURAL)• Emphasizes on the social and cultural Emphasizes on the social and cultural

aspects of health and illnessaspects of health and illness• Focuses on the individual’s capacity to Focuses on the individual’s capacity to

perform roles and tasks and perform roles and tasks and acknowledges that there are social acknowledges that there are social differences in defining healthdifferences in defining health


Definitions and ConceptsDefinitions and Concepts• Health promotion is the process of Health promotion is the process of

enabling people to increase control over, enabling people to increase control over, and to improve, their health.and to improve, their health.

• To reach a state of complete physical, To reach a state of complete physical, mental, and social well-being, an mental, and social well-being, an individual or group must be able to individual or group must be able to identify and to realize aspirations, to identify and to realize aspirations, to satisfy needs, and to change or cope with satisfy needs, and to change or cope with the environment.the environment.

• Health is, therefore, seen as a resource for Health is, therefore, seen as a resource for everyday life, not the objective of living.everyday life, not the objective of living.


Definitions and ConceptsDefinitions and Concepts• Health is a positive concept Health is a positive concept

emphasizing social and personal emphasizing social and personal resources, as well as physical resources, as well as physical capacities.capacities.

• Therefore, health promotion is not Therefore, health promotion is not just the responsibility of the health just the responsibility of the health sector, but goes beyond healthy life sector, but goes beyond healthy life styles to well-beingstyles to well-being


Definitions and ConceptsDefinitions and Concepts• PREREQUISITIES FOR HEALTHPREREQUISITIES FOR HEALTH

PeacePeace ShelterShelter EducationEducation FoodFood IncomeIncome A stable eco-systemA stable eco-system Sustainable resourcesSustainable resources Social justiceSocial justice EquityEquity


Definitions and ConceptsDefinitions and Concepts• HEALTH PROMOTION ACTION MEANSHEALTH PROMOTION ACTION MEANS

BUILD HEALTHY PUBLIC POLICYBUILD HEALTHY PUBLIC POLICYCREATE SUPPORTIVE ENVIRONMENTSCREATE SUPPORTIVE ENVIRONMENTSSTRENGTHEN COMMUNITY ACTIONSTRENGTHEN COMMUNITY ACTIONDEVELOP PERSONAL SKILLSDEVELOP PERSONAL SKILLSREORIENT HEALTH SERVICESREORIENT HEALTH SERVICES



These actions are These actions are interdependent, but interdependent, but healthy public policyhealthy public policy

establishes the establishes the environment that environment that

makes the other fourmakes the other four


THE FIVE MAJOR AREAS/STRATEGIES IN HEALTH PROMOTION(OTTAWA CHARTER)

1. Healthy Public PolicyHealthy public policy is a pre-requisite for

successful health promotion.A Healthy Public Policy is characterized by a

concern for health and equity and an accountability for health impact.

Health should be made a priority item on the agenda of policy-makers in all sectors.

Policy-makers should be made aware of the health consequences of their decisions. They should create pro-health policies, whether in the area of development, legislation, taxation etc.



Healthy public policy covers a combination of diverse but complementary measures and approaches such as legislation, taxation, fiscal incentives and disincentives, policy analysis and review, and organizational change

Joint action by all sectors will contribute to achieving safer and healthier goods and services, healthier public services, and cleaner and more healthy environment. The aim is to make the healthier choice the easier choice for all people. HPP should lead to the creation of a supportive environment to enable people to lead healthy live



According to the Adelaide Conference (1988), “The main aim of HPP is to create a supportive environment to enable the people to lead healthy lives. Healthy choices are thereby made possible and easier for citizens”.

All relevant government sectors like agriculture, trade, education, industry and finance need to give important consideration to health as an essential factor during their policy formulation.



2. Create Supportive Environment A supportive environment is essential for health. Supportive environments cover the physical,

social, economic, and political environment. Supportive environments encompass where

people live, work and play. This is what is envisaged by the “settings” approach.

Everyone has a role in creating supportive environments for health.



3. Strengthen Community Action: Community Participation

According to the Ottawa Charter, “health promotion works through concrete and effective community action in setting priorities, making decisions, planning strategies and implementing them to achieve better health”.

There are many ways of defining community. Factors used are geography, culture and social stratification.



Community action is any activity undertaken by a community in order to effect change (including voluntary and self-help services).

Community participation covers a spectrum of activities

At the low end, it may be token participation in the form of consultation or endorsing plans drawn up by the health authorities. At the high end, it may be in the form of ‘people power’ where they have full say in identifying needs, setting priorities, planning strategies and activities and implementing the program.



Full community participation occurs when communities participate in equal partnership with health professionals as stakeholders in setting the health agenda.

• A Definition (Rifkin et al. 1988)Community participation is a social process

whereby groups with shared needs living in a defined geographic area actively pursue identification of their needs, take decisions and establish mechanisms to meet these needs



According to the Jakarta Declaration (1997), “health promotion improves both the ability of individuals to take action, and the capacity of groups, organizations or communities to influence the determinants of health”.

Empowerment is an important strategy, based on the notion that health is significantly affected by the extent to which one has control or power over one’s life.



4. Develop Personal Skills Strategies for empowering the community include

leadership training, learning opportunities for health, and access to resources including material and funding

Empowerment helps people to identify their own needs and concerns, and gain the power, skills and confidence to act upon them. It is a bottom-up strategy which requires the health promoter to act as a facilitator and catalyst for change.



Skills which can promote an individual’s health include those pertaining to identifying, selecting and applying healthy options in daily life.

Health education is life-long, so that people can develop the relevant skills to meet the health challenges of all stages of life, and to be able to cope with chronic illness and disabilities.

Health education should be conducted in all settings.



5. Reorient Health Services Shift of emphasis from provision of curative

services. Health care system must be equitable and client-

centered. May necessitate reengineering and organizational

change, especially in the areas of professional education and training, management, recruitment and deployment of health personnel, and planning, development and delivery of services,

Health Promotion TheoryHealth Promotion Theory

• Why study health promotion theory?Why study health promotion theory?• Although it is clear why public health Although it is clear why public health

practitioners and students of public health practitioners and students of public health should learn about how to devise and implement should learn about how to devise and implement health promotion interventions, it may be less health promotion interventions, it may be less obvious why it is necessary to spend time obvious why it is necessary to spend time learning about the theory of health promotion. learning about the theory of health promotion. As this book makes clear, health promotion is far As this book makes clear, health promotion is far from straightforward.from straightforward.


Health Promotion TheoryHealth Promotion Theory

• Why study health promotion theory?Why study health promotion theory?• Unless public health practitioners explore and Unless public health practitioners explore and

understand the theory underpinning health understand the theory underpinning health promotion, there is a real risk, at best, of promotion, there is a real risk, at best, of establishing ineffective interventions and, at establishing ineffective interventions and, at worst, of antagonizing and even harming the worst, of antagonizing and even harming the very people you are seeking to help.very people you are seeking to help.


SECTION 1SECTION 1Philosophy and theory of health promotionPhilosophy and theory of health promotion

• Health promotion is probably the most ethical, Health promotion is probably the most ethical, effective, efficient and sustainable approach to effective, efficient and sustainable approach to achieving good health. It was defined initially by achieving good health. It was defined initially by the World Health Organization in 1986, but the the World Health Organization in 1986, but the definition has since been refined to take account definition has since been refined to take account of new health challenges and a better of new health challenges and a better understanding of the economic, environmental understanding of the economic, environmental and social determinants of health and disease.and social determinants of health and disease.


• Health is the most sought after subject on the Health is the most sought after subject on the World Wide Web. The problem of definition is World Wide Web. The problem of definition is confusing because terms such as health (and confusing because terms such as health (and education and promotion) are widely used in education and promotion) are widely used in everyday language and, as such, are used to everyday language and, as such, are used to mean very different things in different contexts. mean very different things in different contexts. These are essentially contested concepts, as These are essentially contested concepts, as they are used and abused, in the familial sense, they are used and abused, in the familial sense, in everyday language.in everyday language.


health education and health promotion

Documents

concepts of health

health decisionsthose

health of t

meaning of health education

term health promotion

public health legislation

everyday health advice

end goal of health