1974 report, a new perspective on the health of canadians (lalonde)
what is the health field concept aimed to do
direct attention to areas of importance for sustaining a healthy population
health field concept to shift focus on other areas (4)
the biological and physiological aspects of health
environment
external factors like food safety and pollution, and the social environment
lifestyle
all other "decisions by individuals" that influence or impact their health "over which they more/less have control over"
health care organization
the nature of the health care system (the "quantity, quality, arrangement, nature, and relationships of people and resources in the provision of health care")
the environment (an aspect which individuals cannot control) might impact the "risky decisions" that individuals make
what did the Lalond report unintentionally emphasize
an individual's responsibility for their own health instead of promoting a broader consideration of the factors influencing individual health
the ottawa charter for health promotion and Epp report
when was the ottawa charter for health promotion released
1986
a resource for everyday life, not the objective of living
identified determinants of health (peace, shelter, food, income) + called for numerous actions (construction of healthy public policy, the creation of supportive environments, stronger community action, the development of personal skills, and the reorientation of health services)
when was the Epp report published
what did the epp report call on
health promotion as a response to health challenges of the day
reduce inequities in health
population health
emphasized the importance of the social determinants of health
reducing expenditures on health care by redistributing funds to areas that would promote prosperity for all
criticism of the framework of population health
neglects the unique determinants, contexts, and circumstances under which people enact health behavior (offers little opportunity for community involvement)
health promotion vs population health
health promotion strives to reduce income inequality whilst population favors producing wealth as a means of improving the health of a population (without addressing the ways in which our political and economic systems create these inequalities)
a unifying approach for the entire spectrum of health system interventions (from prevention and promotion to health protection, diagnosis, treatment and care) and integrates and balances actions between them
to improve the health of the entire population and to reduce health inequities among population groups
12 key determinants of health
income and social status, social support networks, education and literacy, employment, social environments, physical environments, personal health practices, healthy child development, biology and genetic endowment, health services, gender, culture
different approaches to understanding health (3)
biomedical, behavioral, socio-environmental
biomedical approach
illness is seen as a result of some form of biological/physiological problem
behavioral approach
health/illness is viewed as a result of individual behaviors/ actions
major limitation of biomedical and behavior approach
they do not account for the environments in which individuals get sick/ make health behavior choices
that individuals are in complete control of their choices
considers the broader structural factors that shape individuals health and health behaviors
bc it influences our responses
the upstream causes of health problems (trying to health circumstances that make people sick instead of healing people once they are sick)
key determinants of health - income and health - relationship
the higher the income, the better life expectancy
2 common measures of health in a given population
life expectancies and self-reported health
high mortality rates
inverse (as income increases, the rate of diabetes decreases)
what is levels of income inequality in a population
conclusion of studies in looking at the relationship between income inequality and health
efforts to improve health should focus on reducing income inequality
how is social capital protective of health (3)
levels of trust, civic participation, group membership
seeks to expose the structures that create inequalities
examines how the distribution of wealth and resources determines the health of a given population
nation's welfare state
the extent to which the government provides social and health services to its citizens
examples of policies and services of the nations welfare system (4)
education, housing, employment, public health resources
4 different welfare state regimes
social democratic, christian democratic, liberalism, conservative/fascist
social democratic
the firmest commitment to redistributive polices with strong support for the welfare state and broader public policies aimed at supporting the citizenry (tend to have the lowest income inequality)
characterized by lower support for redistributive polices (provide some form of social support = social security and universal health coverage) (have higher level of income inequality)
liberalism
low support for redistributive polices (levels of income inequality are higher within states)
conservative/fascist
the social groups to which people belong (families, friendship groups, work groups)
social capital
considers issues related to the social fabric (trust, civic participation, group membership)
what effect does social support within networks have on health and mental health
protective effect
cars and health - issues (4)
exercise, air pollution, accidents, worsening social cohesion
eating behavior is influence by factors related to our......environments (3)
social, physical, economic
interpersonal environment + eating behavior
what, when, and how much people eat
physical environment + eating behavior
how much and what type of food is available to eat
economic environment + eating behavior
food choices
social environment + eating behavior
eating behaviors (usage of food for cultural and symbolic means = holiday meals)
knowledge- attitudes behavior prevention model
assumes that changing an individuals knowledge will subsequently change their attitudes, fostering "better" behavior and therefore preventing ill health
weakness of knowledge- attitudes behavior prevention model
focusing solely on an individuals choice ignoring broader social, environmental, and political influences that may structure individual choice
focus of ecological models
on the environments of health behaviors
not only the individual but also contexts in which individuals make health decisions
people and places framework model
people and places framework model - people level - outlines 3 attributes
individuals, social networks, populations/communities
people and places framework model - people level - individual level
encompasses the knowledge, attitudes, skills, cognitions, and behaviors of individuals themselves
includes the characteristics of the network (size, connectedness, diversity of ties) and the nature of the network's level of social support and positive role models
people and places framework model - people level - populations/communities
encompasses concepts like social norms, cultural understandings, disparities, and sources of discrimination (income inequality and racism)
people and places framework model - place level is divided into 2 levels
local and distal
people and places framework model - place level - local
refers to the immediate environments like homes, schools, workplaces, and cities
people and places framework model - place level - distal
refers to broader places like provinces, countries, and global community
people and places framework model - first consideration
the availability of products and services in a given place and how that affects health
people and places framework model - second consideration
the physical structures of an environment (sidewalks)
people and places framework model -third consideration
people and places framework model - fourth consideration
media and cultural messages
both broader issues that may need addressing in order to promote health and also the methods by which we should address these levels
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