Robert Hall; Week 1 MED2031; Health Promotion
Determinants of health are broad features of society, socioeconomic characteristics, health behaviours and biomedical factors as well as individual psychological and physical makeup. Causal pathways are not well understood, usually environment to risk factors to asymptomatic pre disease to disease then complex disease. Health determinants can be equity and social justice, societal resources, physical environment which can lead to intermediate outcomes like living conditions, learning opportunities, community development, community norms, social cohesion and health promotion, all of which lead to health outcomes.
Health promotion is the process of enabling people to increase control over, and to improve their health. Is comprehensive on an individual and social level. Differs from disease prevention. Heatlh promotion focuses on upstream determinants and downstream determinants of health.
Ottawa Charter looks at strengthening community action, developing personal skills, building healthy public policy, creating supportive environments, reorienting health services and 'enable, mediate, advocate'.
Whitehead studies to strengthen individuals, looked at by an individual level (health literacy, life skills education, counselling), strengthening communities by horizontal social development (neighbourhood renewal, community development), vertical social development (inclusive social welfare, increasing community participation). Looks to improve living and working conditions by limiting exposure to health damaging physical and social environments, healthy macro-policy by limiting exposure to damaging macroeconomic and cultural environments.
Improving early childhood development and environmental health (housing and sanitation) are important to address health outcomes, as well as increasing and improving employment, universal health care and universal social and income protection.