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Health promotion
is the process of enabling people to exert control over the
determinants of health and thereby improve their health. As
a concept and set of practical strategies it remains an essential
guide in addressing the major health challenges faced by developing
and developed nations, including communicable and non-communicable
diseases, and issues related to human development and health.
Health promotion
is a process directed towards enabling people to take action.
Thus, health promotion is not something that is done on or
to people; it is done by, with and for people either as individuals
or as groups. The purpose of this activity is to strengthen
the skills and capabilities of individuals to take action
and the capacity of groups or communities to act collectively
to exert control over the determinants of health and achieve
positive change.
Role
and relevance of health promotion
In tackling the determinants of health, health promotion will
include combinations of the strategies first described in
the Ottawa charter, namely developing personal skills, strengthening
community action, and creating supportive environments for
health, backed by healthy public policy. Special attention
is also given to the need to reorient health services towards
health promotion.
Thus, health
promotion will include actions directed at both the determinants
of health that are outside the immediate control of individuals,
including social, economic and environmental conditions, and
the determinants within the more immediate control of individuals,
including individual health behaviours.
Health promotion
is a powerfully relevant strategy for social development -
in particular as an important set of strategies to address
the factors influencing inequalities in health. Health promotion
also encompasses the principles that underlie a series of
strategies that seek to foster conditions that allow populations
to be healthy and to make healthy choices. The range of strategies
draws upon multiple fields of thought including anthropology,
epidemiology, sociology, psychology and other behavioural
sciences, public health, political science, education and
communication, to name a few, and their respective methodologies.
Health
promotion and determinants of health
Health is a resource for life that enables people to lead
individually, socially and economically productive lives.
It is a positive concept emphasising social and personal resources
(physical, mental and spiritual).
It has long been
acknowledged that there are certain prerequisites for health
that include peace, adequate economic resources (and their
distribution), food and shelter, clean water, a stable ecosystem,
sustainable resource use, and access to basic human rights.
The challenge to meet these fundamental needs must remain
a core goal for all action directed towards health, social
and economic development.
Recognition of
these prerequisites highlights the inextricable links between
social and economic conditions, structural changes, the physical
environment, individual lifestyles and health. These links
provide the key to an holistic understanding of health, and
are meaningful to people's lives as they experience them.
There are obvious
inherent challenges in achieving the goal of reduced inequities.
Virtually all societies struggle with this problem. Achieving
complete equality in health status among all who live in Northern
Ireland could be viewed as an unrealistic goal. But achieving
'equitable' or fair access to the opportunities and supportive
environments all people need to be healthy is both a laudable
and achievable goal in a caring, civilized society. The United
Nations report on human development suggests that efforts
to reduce relative poverty, and to increase opportunities
in education, employment, wages and participation in political
and economic spheres are the key strategies for reducing inequities
and, therefore, improving the health and wellbeing of those
who live here.
Challenges
for health promotion
The fact that health promotion refers to a collection of strategies
that can be applied to many health and development issues
also means that these strategies must operate within the context
of something else. 'Empowerment', 'advocacy', 'communications',
'education', 'social mobilisation', 'community participation',
and so on, all buzz-words of health promotion adherents, have
little meaning in a vacuum. Nor are these components of health
promotion ends in themselves, but means to achieve healthier
and fuller lives.
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