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HealthHealthHealth DeterminantsHealth Determinants

and Health Promotionand Health Promotion

Diane B. Wilson EdD, RD

Mary S. McLellan MS,RD

Medical University of South Carolina

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Developed as part of an Developed as part of an Enhanced AHEC Community Enhanced AHEC Community

Partnership for Health Partnership for Health Professions Workforce and Professions Workforce and Educational Reform project Educational Reform project

funded by the Health funded by the Health Resource and Service Resource and Service Administration (HRSA) Administration (HRSA)

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OBJECTIVESOBJECTIVES

Health promotion, disease prevention, wellness

Disease prevention as part of health care

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What is Health?What is Health?

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Health is a state of complete Physical, Mental, and Social well-being and not merely the absence of disease or infirmity.

WHO, 1947

The Metaphysical Context of the Universe

The Secular Dimensions of Health

Physical Mental

Social

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Two Major Aspects ofTwo Major Aspects ofHealthHealth

Feeling Well

Ability to Function

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Determinants of HealthDeterminants of Health

the complex inter-relationships of genetics social environmentphysical environmentbehaviorhealth/illness services

that determine the level of health and sense of well-being in an individual

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GeneticsGenetics

Body Size Special Abilities Disease Resistance Disease Susceptibility Genetic Diseases General Robustness

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Physical EnvironmentPhysical Environment

Macro-environmentFood and WaterAir Pollution

Micro-environmentHomeWorkplace

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Social EnvironmentSocial Environment

Religion Race/Gender Socioeconomic Status Education Occupation Family Composition

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Socioeconomic Status, Socioeconomic Status, Income and HealthIncome and Health

Socioeconomic StatusAs GDP increases, the health of a nation

increases In times of economic hardship, the

incidence of disease increases

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Health CareHealth Care

Quality Availability “Health has improved NOT because of

steps taken while we are ill, but because we are ill less often.”

Thomas McKeown, 1978

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Health Promotion Health Promotion

An intervention that seeks to eliminate or reduce exposures to harmful factors by modifying human behaviors; or any combination of health education and related organizational, political and economic interventions designed to facilitate behavioral and environmental adaptations that will improve or protect health

Concerned specifically with sociobehavorial processes.

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Targets of Health PromotionTargets of Health Promotion

Individuals at risk of a health problem Those who influence individuals at risk Those who set policy

Foster the adoption of healthful changes in the environment

Improve health servicesEncourage healthful personal behavior

change

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Health Promotion ObjectivesHealth Promotion Objectives

Individual Knowledge Attitudes Behaviors Physiology

Organization Policies Practices Programs Facilities Resources

Community Policies Practices Programs Facilities Resources

Government Policies/Programs Facilities/Resources Legislation/Ordinances Regulation/Enforcement

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Examples of HEALTHY Examples of HEALTHY PEOPLE 2000 PEOPLE 2000 Priority AreasPriority Areas

Health PromotionPhysical Activity and NutritionTobaccoAlcohol Consumption

Preventive ServicesHeart Disease and StrokeCancerHealth Screenings

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Healthy People 2010Healthy People 2010

2 Broad Goals Increase quality and years of healthy lifeEliminate health disparities

4 Primary ObjectivesPromote healthy behaviorsPromote healthy and safe communities Improve systems for personal and public healthPrevent and reduce diseases and disorders

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Disease PreventionDisease Prevention

any intervention that seeks to reduce or eliminate diagnosable conditions; it may be applied at the individual level, as in immunization, or the community level, as in chlorination of the water supply

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Primary PreventionPrimary Prevention

Measures taken to prevent the disease from occurring such as:healthy lifestyle habits Immunizations

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Secondary PreventionSecondary Prevention

Measures undertaken to facilitate early detectionScreeningsDiagnostic tests

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Tertiary PreventionTertiary Prevention

Measures to minimize complications or exacerbation of injury or disease.Rehabilitation TherapyPatient counseling

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Discussion TimeDiscussion Time

Identify all three levels of prevention as they apply to a health problem or threat to health such as injury or vaccine preventable disease

Be sure to include consideration of all of the determinants of health!

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SummarySummary

There are various definitions of “health” A number of factors determine our

health, including genetics, physical factors, social factors, healthcare and lifestyle factors.

Health promotion and disease prevention are related to identifying strategies to prevent disease and injury.