Lecture 2 Flashcards
Discuss what the Ottowa charter is
The Ottowa charter was developed by the world health organisation. It aims to promote health by increasing people’s control over their own health by providing health information. The fundamental conditions for health include: peace, shelter, food, education, sustained resources etc. The government have also tried to promote health behaviour by releasing a white paper about it in 2010.
Why did the UK Government produce a white paper on health promotion?
What are the basic points discussed in the white paper?
Because the UK is the most obese nation in Europe, it has the worst stats for STDs, health inequalities between the rich and poor are growing and many people die from smoking each year.
Improving maternal health is crucial, work improves physical and mental health and that deaths during the winter needs to be reduced. Individuals need to feel empowered and financial incentives are very beneficial.
Discuss health promotion and ideology
Health promotion can be driven by ideologies; a set of political beliefs of a group. Ideologies usually claim that good health is a universal objective, the idea of healthiness is agreed by everyone and that there is a scientific consensus about what behaviours facilitate health. However, science should drive health promotion not ideologies as they aren’t empirical.
What do health psychologists do?
They study: why people seek professional help about their health, why healthcare professionals do/don’t recommend preventative procedures, the interaction between the patient and professional and the links between perception, behaviour and functioning.
What are the 5 different approaches to health promotion?
Medical, educational, behavioural, social and empowerment.
Discuss the medical approach of health promotion
It aims to reduce morbidity, target risk groups and increase interventions that prevent death/illness. There are three levels; primary prevention (modifying risk factors), secondary prevention (detecting an illness whilst it’s still asymptomatic) and tertiary prevention (rehabilitation and treatment). This approach is extremely popular as it uses scientific methods, it’s cost efficient, it uses top-down approaches and it has good success rates. For example, screening has come from the medical approach; examining those statistically at risk for an illness. There are a few types of screening: opportunistic, population and self screening. Primary screening explores one’s risk and secondary explores the actual disease. Self screening is extremely useful for breast and testicular cancer. Neonates get their eyes, hips and intestines screened to ensure they don’t have any infectious diseases. We know this approach works by looking at reductions in disease rates.
Discuss the medical approach in relation to social studies
Social studies have revealed that screening is very expensive but it can also lead to false positives, aka over-diagnosis which causes unnecessary interventions. It can also cause social harm as it can lead to foetal termination for example.
Discuss Gotzsche’s study
Screening was shown to have no effect on the mortality rates of women with breast cancer. Also, some women were diagnosed even though their condition was not causing any harm. Furthermore, if screening is supposed to reduce mortality rates by 15% then that means over-diagnosis would be at 30%. The false positives also have great social impacts like anxiety about ‘illness’.
List 4 criticisms of the medical approach
It’s not always cost-effective, it doesn’t try to promote positive health, it ignores social and psychological costs, it depends purely on medical knowledge alone.
Discuss the educational approach of health promotion
The educational approach aims to give knowledge, ensure understanding of health issues and enable well-informed decisions to be made. This approach does not aim to persuade or motivate change, it just aims to inform. However, they do help one carry out new health practises that are offered. They give advice in the client’s best interests but it’s down to the client to make their own decision on their health behaviour. Lashley found that fear campaigns do not have any effect on health promotion. They provide information via leaflets, campaigns, group discussions, counselling and educational programmes. The issue with this approach is that it’s used informally and opportunistically and it doesn’t explore whether their approaches leads to behavioural change.
Discuss the behavioural approach to health promotion
It aims to encourage individuals to adopt healthy behaviour. Health is a property of the individual and can be improved by changing one’s lifestyle, the consequences for the lack of change are their own fault. The stages of change model can be applied to this. The issues with this approach is that it assumes there’s a direct link between attitudes and behaviour, it blames the individual and it’s hard to assess what causes the behavioural change.
Discuss the empowerment approach of health promotion
This approach aims to empower people into making healthy life choices. Unlike the other approaches, this one is bottom up. The health promoter is a facilitator as they help people identify their personal concerns, they start the process of change and then withdraw from the situation and they have the skills to make change happen. The client is empowered by learning to recognise their powerlessness, feeling strong enough for change and feeling capable to change. Group work, problem solving and assertiveness training are all techniques to help empowerment. This can happen on a community level, the same process occurs but with a group of people. The issues with this approach is that outcomes are difficult to measure and it assumes that rational decisions are healthy decisions.
Discuss the social approach to health promotion
This approach recognises that the socio-economic environment has a big impact on health. It focuses on changing society rather than the individual on an environmental/policy level. It targets physical, social and economic aspects of society by changing costs and availability of health promoting resources. Individuals work together to change the health issues they face in society. The issues with this approach is that most health care professionals aren’t qualified to change policies and it is often vulnerable to lack of funding.
