Public and Occupational Health

الصحة العامة والمهنية

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Quiz!!

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Natural history of disease

Primordial Prevention

Primary Prevention

Secondary Prevention

Tertiary Prevention

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Fact

• Health and disease are determined by dynamic interactions among biological,

psychological, behavioural, and social factors or variables.

Social Ecology Model-Visual

Social Ecology Model-Visual

Broad Conditions and Policies

• Institutions

• Religious policies and relations

• Educational policies

• Economic conditions

• Broad social conditions

• Income inequality

• Urbanization

• State level policies

• Global systems

• Trade agreements

Living and Working Conditions

• Employment status

• Occupational hazards

• SES

• Environment

• Transportation

• Water and sanitation

• Housing

• Park facilities

• Public health, health, and social services

Interpersonal or Social

• Family networks and dynamics

• Community factors

• Social cohesion

• Environmental factors

• Crime

• Others

Individual or Intrapersonal Level

• Biological or innate characteristics: age, sex

• Social characteristics: Education level

• Individual behavior

The Social and Behavioral Sciences:

Core Concepts

• Anthropology

• Sociology

• Demography

• Psychology

• Behavioural sciences

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• The Health Belief Model (HBM) is an

intrapersonal (within the individual, knowledge and

beliefs) theory used in health promotion to design

intervention and prevention programs.

The HBM assumes that behavior change occurs

with the existence of three ideas at the same time:

• An individual recognizes that there is enough reason to make a health

concern relevant (perceived susceptibility and severity)

• That person understands he or she may be vulnerable to a disease or

negative health outcome. (perceived threat)

• Lastly the individual must realize that behavior change can be

beneficial and the benefits of that change will outweigh any costs of

doing so. (perceived benefits and barriers)

Perceived Susceptibility

• Within the health field susceptibility refers to the risk a person has to a

particular disease or health outcome.

Perceived Severity

• Most people are familiar with the word severity as how serious a situation or

action can be.

Perceived Threat

• Susceptibility as stated before displayed how someone acknowledged that

their behavior could lead to a specific disease.

Perceived Benefit

• Benefit that are realized by the individual.

Environmental Factors

• Environmental factors can add to the threat of disease

Cues to Action

• Lastly cues to action are reasons why an individual realizes he could be

threatened by serious disease.

Health Promotion and Health public Policy

• One goal of a healthy public policy is health

promotion

• Each individual plays a role in achieving the

goals of healthy public policy

Concept of Health Promotion

• Enabling people to increase control over, and to

improve, their own health

Health Promotion

• The process of enabling people to increase control

over, and to improve, their health.

• To reach a state of complete physical, mental and social well-being, an

individual or group must be able to identify and to realize aspirations, to

satisfy needs, and to change or cope with the environment.

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Social policies

• The Ottawa Charter for Health Promotion (1985) – claims that health is influenced by a wide range of policy decisions. The Charter made it clear that health policy is not simply the responsibility of health departments.

Ottawa Charter of health Promotion

Areas of Health Promotion Action (Ottawa)

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Five integrated action areas for health

promotion

• Healthy public policies.

• Supportive environments.

• Community action.

• Personal skills.

• Re-orienting health services.

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Examples of Tobacco Control Actions

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Social policies

• The Bangkok Charter for Health Promotion in a Globalized World (2005) states that health promotion depends on empowering all sectors and addressing the global influences on health.

Bangkok Charter for Health Promotion

• Advocate for health based on human rights and solidarity;

• Invest in sustainable policies, actions and infrastructure to address the determinants of health;

• Build capacity for policy development, leadership, health promotion practice, knowledge transfer and research, and health literacy;

• Regulate and legislate to ensure a high level of protection from harm and enable equal opportunity for health and well being for all people;

• Build alliances with public, private, nongovernmental and international organizations and civil society to create sustainable actions.

Social policies

• The Shanghai Declaration in 2016

• “Promoting health in the Sustainable Development Goals: Health for all and all for health”

• The Shanghai Declaration recognizes health and well-being as essential to achieving sustainable development. It reaffirms health as a universal right, an essential resource for everyday living, a shared social goal, and a political priority for all countries.

Shanghai Declaration

• Good governance is crucial for health

• Cities and communities are critical settings for health

• Health literacy empowers and drives equity

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• Enhancing health literacy, through improved access to information, enables

people to make more informed decisions about their health and the health

of their families, and empowers them to advocate more effectively to their

political leaders and policy-makers. It also promotes accountability by

deepening people’s understanding of the health impact of policies and

political decisions.

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The road to Shanghai: from Ottawa

(1986) to Shanghai (2016)

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The Four Key Commitments

• Central to the global development agenda

• A core responsibility for all of government

• A key focus of communities and civil society

• A requirement for good corporate practice

Investments in health promotion have wide ranging

benefits that impact different sectors of society:

• Sustainable development

• Interconnectedness:

• Leaving no one behind

• Productivity

• Gender and other social relations

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• "Health is created and lived by people within the

settings of their everyday life; where they learn,

work, play, and love."

The Ottawa Charter, 1986

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A Health Promoting School

• A Health Promoting School is a school is one that

considers the broad health needs of all school

community members and is constantly strengthening its

capacity as a healthy setting for living, learning and

working.

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Health Promoting School Framework

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Health Promoting School

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Health Promoting School (1)

• promotes the health and wellbeing of students, school staff, families and

community members

• provides a safe and supportive environment

• upholds social justice and equity concepts

• implements practices that respect an individuals wellbeing and dignity,

provides opportunities for success and acknowledges efforts, intentions and

personal achievements.

• involves student participation and empowerment

• collaborates with parents and local community and helps them understand

how the community can contribute to (or undermine) positive health

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Health Promoting School (2)

• integrates health into the school's ongoing activities, curriculum and assessment standards

• links health and education issues and systems

• engages with health and education officials, health providers, teachers, parents and community to strive to improve health outcomes

• sets realistic goals built on accurate data and sound scientific evidence

• seeks continuous improvement through ongoing monitoring and evaluation.

• implements policies to sustain a healthy environment and support ongoing improvements to the school environment, education and services.

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Healthy Cities programme

• The Healthy Cities programme is the best-known example of a successful

Healthy Settings approach. Initiated by WHO in 1986, Healthy Cities have

spread rapidly across the world.

• A Healthy City aims to:

• create a health-supportive environment,

• achieve a good quality of life,

• provide basic sanitation and hygiene needs,

• supply access to health care.

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Healthy cities movement; addresses:

• The need to address inequality in health and urban poverty

• The need for vulnerable groups

• Participatory governance

• The social, economic and environmental determinants of health

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Health Cities

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Task: What is a healthy village ?? With focus on

Syria

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Learning Objective

األهداف التعليمية

• Define Health Promotion

• List the main initiatives of Health

promotion

• Give examples of health

promoting programme

• Understand Health Belief Model

تعزيز الصحة تعريف •

عرض مبادرات تعزيز الصحة •

إعطاء امثلة من البرامج المعززة •

للصحة

فهم طراز المعتقد الصحي •

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Resources

• Somerville et al. 2018 -- (Chapters 29 and 30)

• WHO website

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Your Questions!!