Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

What does health mean to individuals?

Meanings of health
- D EFINITIONS OF HEALTH
Early meanings of health
 Absence of illness or disease – any breakdown in the body system meant that it wasn’t healthy
and hence suggested you were ill
 Belief that medicine, drugs and doctors could return you to a healthy state
 This definition is too narrow and one dimensional
(eg. a person could’ve been physical healthy but suffered from depression)

World Health Organisation (WHO) defines health as:

“Health is state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity.”
 This was a more holistic approach and includes all the dimensions of health
 However, it states that one must have complete physical health etc. and therefore is unrealistic
 Also does not encompass spiritual health

- D IMENSIONS OF HEALTH

Physical Ability of human body structure to function properly

Absence of chronic pain or discomfort
Levels of fitness and energy levels
Size and weight; Mobility
Social Ability to interact with other individuals
Companionship (eg. family) and friends
Mental or Ability to process information and act properly; ability to cope, adjust and adapt
Emotional Minimising stress levels
Positive self-esteem and self-image
Thinking and communication skills
Spiritual Feeling of connection with others and society
Sense of purpose, meaning or value in life
Can involve religion (eg. Buddha or God)
Being in tune with oneself

- R ELATIVE AND DYNAMIC NATURE OF HEALTH

Relative means “in relation to…”
 Another period in time (eg. How was my health compared to last week?)
 Your potential (eg. Is this the healthiest I can be?)
 Others (eg. Are you healthier than your friends?)
 Overall, refers to how we judge our health compared to other people or other points of time in
our life

Dynamic Nature
 Refers to the constant fluctuations that occur in our level of health due to life events

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Examine the dynamic nature of health by exploring:

- THE INTERACTIONS BETWEEN THE DIMENSIONS
 If one dimension is compromised, the others may be affected as well
 Eg. Poor social health and hence an inability to communicate with others may result in a poor
mental and spiritual health.
 Eg. Poor physical health leading to obesity may result in a poor self-image and hence can affect
one’s mental health. Furthermore, obesity can also result from a sedentary lifestyle and thus
one can have poor social health with peers.

- THE CONCEPT OF GOOD HEALTH

 The idea of good health often differs from person to person  Related back to the idea of the
relative and dynamic nature of health
 Young Person  Good health may mean exercising, going out with friends, eating well
 Elderly Person  Good health may mean being able to complete everyday tasks, being able to
walk without assistance and being able to care for oneself
 Overall, good health is influenced by our social, economic and political environment

- THE HEALTH CONTINUUM

 Health is a continually changing process; highly subjective
 From a personal perspective, it can be represented as a continuum

Very poor health Optimum health

Extremely unwell Positive state of well-being

- H OW HEALTH CHANGES OVER TIME

 Linked to the relative and dynamic nature of health
 Can change at any point in time for any reason and affect other dimensions of health
 Eg. May change due an accident or poor maintenance of own health
 Changes with age

- H OW AN INDIVIDUAL ’ S CIRCUMSTANCES AFFECT THEIR HEALTH

 Heredity plays a part
 Experiences (eg. substance use/alcoholism)
 Ability to make informed health decisions - Education (eg. choosing fruit over chips)
 Ability to access health services
 Surrounding environment (eg. largely polluted area such as the city)

Perceptions of health
- PERCEPTIONS OF THEIR HEALTH – IMPLICATIONS AT AN INDIVIDUAL
LEVEL
 Has a significant influence on lifestyle choices and behaviours
 Eg. A person who drinks regularly and recognises the
detrimental effects of it is more likely to stop drinking, limit their
alcohol intake or to seek help.
 Eg. An incorrect or distorted assessment of our health status –
such as perceiving ourselves to be overweight when our weight
fits within a healthy range can lead to harmful behaviours
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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

- PERCEPTIONS OF THE HEALTH OF OTHERS (EG. PARENTS, THE ELDERLY, THE HOMELESS)
 Own ideals regarding living conditions, fitness levels and health behaviours of various groups
significantly shape our notions of how healthy people in different circumstances are likely to be
 Elderly  An elderly person who takes daily walks without the aid of a cane or person would be
considered to be quite healthy and active for their age
 Homeless  The homeless are often stereotyped to be alcoholics with poor physical, social and
mental health due to their lack of support by family members

- IMPLICATIONS OF DIFFERENT PERCEPTIONS OF HEALTH

 Individual Level  See above
 Can also reinforce stereotypes (eg. ideal body type; women will be reluctant to participate in
sports such as boxing due to the perception that women are weak and delicate)
 Impact at a National Level  Influence health policy and the expectations of our national and
state health services
 Policy level  Drives health policies and expenditure
 Statistics show rates of mortality, morbidity, life expectancy and years of life lost to premature
mortality as well as causes of hospitalisation
 Conflicting perceptions by the government leads to inadequate funds/support in areas of need
 Analysis of trends identify areas of need, determine risk factors, target prevention strategies or
intervention strategies towards specific populations/groups

- P ERCEPTIONS OF HEALTH AS SOCIAL CONSTRUCTS

 Social Construct: Concept that recognises that
people have different views based on their social
circumstances and ways of seeing, interpreting,
interrelating and interacting with their environment
 Allows us to:
- Explain why certain people choose to behave in
particular ways
- Understand how social norms are established in
cultural subgroups
- Realise how our concept of health can take on
different meanings in particular social contexts

- IMPACT OF THE MEDIA, PEERS AND FAMILY

Media TV, radio, magazines, movies, newspapers Positive:
and internet News stories on binge drinking, TV
advertisements on skin cancer and smoking
Disseminates health-related information to seek to raise awareness and increase the
the nation public’s understanding of these issues.

Can shape attitudes and behaviours Negative:

regarding what good health looks like Magazines, TV and movies portray the ideal
body image to be slim/muscular/athletic
Often results in misleading messages and has a significant effect on people’s
assessments of their own health

Peers Have a significant impact on our health Positive:

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

behaviours When young people recognise that positive

mental health is important for one’s well-
Peer pressure can lead to negative health being, they are more likely to support
choices friends in need

However, peers can also recognise Negative:

unhealthy behaviours and discourage them On the other hand, mental health problems
may be seen as a sign of weakness and thus
makes it harder for an individual to seek
help from peers
Family Probably the most significant influence Positive:
Belief that participation in sport and
Parents are often role models physical activity is important for good
health will see that parents encourage their
Have a strong influence on the perceptions children to be active and support their
we develop throughout our life involvement in regular physical activity

Poor socioeconomic disadvantage is often Negative:

determined by the parent and thus can Parents who are smokers and/or periodic
determine what services are available drug users will most likely have children
who are engaged in similar behaviours

Examine perceptions of health by exploring questions such as:

- How healthy am I? How healthy do other people think I am?
- How healthy do I think other people are?
- Why would my perceptions of health be similar or different to others?
- How might an individual’s perception of health affect their wellbeing?

Determine the degree to which perception of health are socially constructed

Health behaviours of young people
- THE POSITIVE HEALTH STATUS OF YOUNG PEOPLE
Young Indigenous Australians
 Higher rates of death, injury and some chronic diseases
 More likely to experience health risk factors (eg. obesity, physical inactivity, smoking,
imprisonment etc.)
 Over 50% live in remote areas or very remote areas
 Less likely to rate their health as excellent or very good
 However, the gap between the non-indigenous and indigenous groups is closing

Young Australians – Indications of Good Health

 Continually improving  Reductions in morbidity and mortality
 Reduction in chronic diseases
 Percentage of road accidents has decreased
 Decrease in risk behaviours - involvement with smoking and illicit drugs
 Increase in use of protective behaviours – use of sexual contraception
 Over 90% of young people rate their health as excellent, very good or good

Males/Females – Disease, disability and injury

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

 Anxiety and Depression: Females – 32% and Males – 17%

 Accidents that lead to injury (eg. transport accidents, falls etc.): Males – 71%
 HOWEVER, females have a significantly higher report of self-harm
 Suicidal rates are higher in males
 Eating disorders (incl. anorexia and bulimia) are higher in females
 Diabetes is much higher in females

Areas where health is NOT improving

 Mental health is an ongoing concern
 It is the greatest contributor to the burden of disease for young Australians
 Young people are increasingly sexually active
 Thus, STIs are somewhat increasing
 Reports show chlamydia cases have increased x5

- P ROTECTIVE BEHAVIOURS AND RISK BEHAVIOURS

Risk Behaviours Protective Behaviours
Mental  Unemployment  Drug Abuse  Maintaining a healthy lifestyle
Health  Divorce  Disability  Stress management
Issues  Level of Education  Obesity  Remaining drug free

 Family support

Physical  Injury  Obesity  Family + Peer Support

Inactivity  Socioeconomic  Increasing age and  Cultural Factors
Status weight  One hour of moderate to vigorous
physical activity every day
Drug use  Drug Abuse  DUI of drugs  Using legal drugs responsibly

 Poly-drug use  Violence  Abstinence

 Experimentation  Alternative interests

 Assertive behaviour to protect

from peer pressure
Road Injury  Speeding  Risk taking  Zero tolerance

 Fatigue  Drunk driving  Stop, revive and survive

 Inexperience
Eating  Poor self image  Assertive dieting  Accepting differences in body
Disorders  Adopting  Allowing media to shapes and sizes
inappropriate role shape your  Do not aim for perfection
models perception of  Ability to sort misleading info and
health messages from the media
 Following the Dietary Guidelines
for Children and Adolescents
Obesity  Overeating Low levels of
  Same as eating disorders
 Poor food choices physical activity
 Poor nutritional  High levels of  Manage calorie intake
knowledge passive recreation  Snack on fruits
Unplanned  Use of drugs  Promiscuity  Abstinence
Pregnancy  Unprotected sex  Lack of sexual  Appropriate use of contraception
knowledge  Education regarding sexual health

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Explore current research and information to:

- IDENTIFY THE PREVALENCE OF AND TRENDS IN THE HEALTH BEHAVIOURS OF YOUNG PEOPLE
- CHALLENGE THE ACCURACY OF THE SOCIETAL PERCEPTIONS OF THE HEALTH BEHAVIOURS OF YOUNG PEOPLE

Issue Prevalence of and Trends Accuracy of Perceptions

Weight Control More prevalent amongst girls Perception: Young people are becomingly
88% of teens perceived themselves increasingly overweight and unhealthy
to be overweight though only 20%
were actually overweight Statistics show that teenagers are having
Cases of obesity, blood problems trouble with weight control
(eg. high cholesterol) and chronic
diseases (eg. diabetes type 2) are
steadily increasing
Nutrition 40% of girls skip breakfast Perceptions: Younger generations have
Most young girls have poor nutrition poor nutrition leading to eating disorders
– fad diets, believing carbs and
proteins have too much fat etc. Evidence shows that young people are
Though rate of obesity is increasing skipping meals or are eating the wrong
amounts of each of the food groups
Mental Health Peaks at ages 14-29 Perception: Mostly focus on negative
2007 survey says that 1 in 5 issues, creating a stigma
experienced a mental disorder
Statistics show that this issue is still
prevalent in today’s society
Road Safety 20% of all drivers in fatal crashes Perception: Young people are far worse
Most common: than previous generations; over-
- Speeding – 32%, most were male represented in fatal crash statistics
- Drinking – 21%
- Fatigue – 25% Trend in 1980-2007 shows a significant
% shown are of the young drivers drop in the total mortality rate
involved in fatal crashes
Substance Use * Stats from 1995 - 2007 Perception: Teenagers are involved in
Alcohol: Decreased by 3% binge drinking and taking drugs
Tobacco: Decreased from 15% to 7%
Cannabis: Statistics show that there has been a
- Male – 23% decrease decrease in such behaviours though since
- Female – 20% to 13% 2007, it may have increased/decreased
Sexual and Increased in the previous decade Perception was that young people had a
Reproductive - 1 in 4 of Yr 10 and 1 in 2 of Yr 12 higher participation in sexual behaviours
Health have reported to have had sexual Supported by evidence collated
intercourse

Identify protective and risk behaviours for health issues relevant to young people and
predict how risk decreases or increases when multiple factors interact
Protective Behaviours: Health behaviours that are likely to enhance a person’s level of health

Risk Behaviours: Health behaviours that have been found to contribute to the development of
health problems or poorer levels of health
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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Multiple Factors Interacting:

 Risk Decreases: Strong family connections such as eating together at the table often leads to a
higher intake of healthier and fresh foods (eg. lean meat, fruits and vegetables) which then
leads to a lower incidence of eating disorders and a reduced likelihood of drug use.

 Risk Increases: Many of the young people involved in road accidents are often DUI of alcohol or
illegal drugs. Similarly, those with high levels of stress would usually undertake smoking, alcohol
use as well as illicit drug use.

What influences the health of individuals?

The determinants of health
- INDIVIDUAL FACTORS (EG. KNOWLEDGE AND SKILLS, ATTITUDES AND GENETICS)
Knowledge Health literacy: Ability to understand and Informed individual would have
and Skills interpret health information and use it to greater knowledge regarding
promote and maintain good health obesity to make positive lifestyle
A person’s knowledge and understanding of and healthy food choices to
protective and risk behaviours has a large reduce their risk of over-eating.
influence on their ability to make informed
health decisions.
Attitudes Self-efficacy: Belief in our ability to be able to While a person may be informed
carry out a particular task of the dangers of smoking,
Attitudes possessed can strongly influence a attitudes influenced by peers,
person’s behaviours. family and the media can result in
Attitudes are often usually influenced by a poor health choices being made.
person’s knowledge of a particular issue.
Genetics Contributes to body type, appearance etc. Can play a role in determining
One cannot determine their own genetic make- individual’s potential for good
up but can certainly engage in activities to fully health (eg. greater life
utilise skills they may have inherited or to expectancy) or also susceptibility
minimise contracting other health disorders to contracting diseases (eg. more
Determines predisposition to certain diseases likely to have sun-burns if you
or health problems have fair-skin)

- SOCIOCULTURAL FACTORS (EG. FAMILY, PEERS, MEDIA, RELIGION, CULTURE)

Family Children may imitate parent’s health Emotional: Love and care
Can influence all dimensions of health Social and spiritual: Support in tough times
Provide family expectations Physical: Provide us with food and shelter
Main source of health information
Peers Starting to have freedom over own health Peers may contribute to a healthy social
choices and perhaps spiritual health but can
Have a large impact on ability to make promote poor health choices.
decisions (ie. peer pressure) Eg. Hard to maintain a social relationship if
Seek to establish their identity and feel a all your peers are smoking and you’re not.
sense of belonging Thus, has a negative influence on health.
Media Pervades all aspects of modern life While it can inform individuals of particular
Consists of magazines, newspapers, radio issues such as skin cancer, can also portray
and TV false images. Eg. “Ideal body types” leads

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Can influence: Values and attitudes, to mental disorders – esp. in young females
expectations of societal forms and health
promotion
Religion Particularly valuable in times of stress or Certain religions forbid consumption of
grief particular food
Can affect all dimensions of health as it Negative: Hindu – No beef  Anaemia
often dictates what you can and can’t do Positive: Islam – No alcohol
Culture Affected by gender, ethnicity, age and Asians: Low-fat foods such as rice, fish, lean
interest groups (eg. beach culture) meats and green-leafy vegetables;
Can influence what dominates a person’s Promote good health and be less
diet among other things susceptible to obesity and diabetes
Beach culture: Singlets/shirt-less;
Can lead to sunburns and skin cancer

- SOCIOECONOMIC FACTORS (EG. EMPLOYMENT, EDUCATION, INCOME)

Employment Financial independence, sense of Unemployed: Low self-esteem and lack of
control, self-confidence and social confidence  Leads to anxiety and
contact depression
Type of occupation can also affect Limited access to fresh foods  Poor
your health physical health
Education Indirectly affects health through Educated person: Less likely to be caught
association with more rewarding drink driving  Aware of the
employment repercussions that follow
Influences a person’s knowledge and Can help to decrease stress levels; better
understanding of protective and risk diet and food choices
behaviours
Income Better food, housing, recreation and Good education  Higher paying job
health care; Leads to positive Hence, more funds can be spent on
psychological wellbeing health-related services (eg. better health
Closely related to other factors such as insurance) and healthier food options
employment and education

- ENVIRONMENTAL FACTORS (EG. GEOGRAPHICAL LOCATION, ACCESS TO HEALTH SERVICES AND TECHNOLOGY)
Geographica Urban: Cities Urban: Greater access to health services
l Location Remote/Rural: Countryside or and advantages (eg. fluoridated tap water)
isolated areas However, more susceptible to noise and air
pollution
Access to Remote/Rural: Limited access to If a person has an accident that involves a
Health health services and medical bone fracture, may have to rely on medical
Services treatment support over the phone/radio or await
helicopters to receive medical treatment
Technology Research, up to date medical Poor physical health due to excessive TV
equipment, access to information on watching, increased use of mobile phones
the internet and playing video games; leads to a
Increase in the use and complexity sedentary lifestyle  Obesity
of technology

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Analyse how an individual’s health can be determined by a range of factors acting in

various combinations
The degree of control individuals can exert over their health
- MODIFIABLE AND NON-MODIFIABLE HEALTH DETERMINANTS

Modifiable Determinants that can be changed Our attitudes towards our health can change
and controlled; have different level of as experiences shape them and also through
influence on health education.

Self-efficacy: Refers to our belief to The influence of sociocultural factors also

bring about change differs as we grow older and as we decide
upon how to interpret the information at our
disposal
Non- Genetics: Cannot be altered We cannot change the characteristics given
modifiable to us (eg. colour of skin) and the factors of
Environmental Factors: Some people the surrounding environment (eg. pollution
can’t choose the environmental levels) are often not up to us.
factors surrounding them
HOWEVER, other factors can be employed to
minimise the impact of these non-modifiable
determinants on our health.

- THE CHANGING INFLUENCE OF DETERMINANTS THROUGH DIFFERENT LIFE STAGES

Babies and  Main influence is their family – in particular parents
young children  Do not have much control own health determinants
 Sociocultural factors are not large influences
 Religion usually reflects the parent’s choice
Adolescents and  Social pressures and yearning for a sense of belonging and to conform
young adults influences decisions
 Family still provides for basic needs though they can still make their own
food choices
 Peers and media have a large influence on individuals
 Can decrease ability to make healthy choices and can promote drugs,
alcohol and smoking
 Individual will decide upon their identity and religion
Working adult  Now independent and usually have a family of their own
 Work can lead to high levels of stress and take a toll on health
 May result in little time to socialise with others
 While media is not a large influence, may still influence body image
Elderly  Less attention from family  Loneliness
 Physical health deteriorates
 Typically a sedentary lifestyle
 Not largely influences by media as they do not access it

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Assess the degree of control individuals have over their health, by exploring questions
such as:
- how much control do individuals have over the determinants?
- What can individuals do to modify the determinants they have little control over?
- How does the level of influence of the determinants change over time?

Health as a social construct

- RECOGNISES THE INTERRELATIONSHIP OF DETERMINANTS
 The factors do not make their impact as isolated factors
 Conceptual framework for determinants of health demonstrates the links between all the
determinants and highlights the complexity of these relationships

Socioeconomic Largely determines where a person Person living in a poorer area may be
Status lives (acc. to what they can afford) influenced by peers that getting a higher
and thus their access to health education (eg. University) is less
services, physical choices, nutritional important than obtaining a job for
choices and job satisfaction economic security.
Sociocultural Influences the way a person has Influence of the media has a strong effect
Factors been raised and the set of values on the choices an individual will make. Eg.
they have established for the media will often falsely portray the
themselves as they mature ideal body image to be lean and fair
(females) and muscular (males). This may
lead to poor nutritional choices or can
lead to mental health disorders.
Environmental Can influence other determinants Being brought up in a coastal
Factors such as employment opportunities environment increases the likelihood that
and cultural factors a person may adopt surfing culture; may
also lead to risk of skin cancer.

- CHALLENGES THE NOTION THAT HEALTH IS SOLELY AN INDIVIDUAL’S RESPONSIBILITY

Example: Obesity
 Not all health issues can be solely controlled by an individual
 Thus, must look at the social construct of health

Predisposing Factors: Existing factors already influenced by others

Eg. If a child’s parents are overweight and lead a sedentary lifestyle, this may result in the child
being overweight as well.

Enabling Factors: Factors that support the behaviours occurring

Eg. The prevalence of junk food advertising by the media, the close availability of fast food outlets
and inadequate exercising facilities such as cycling and walking paths, may contribute to this health
issue occurring.

Reinforcing Factors: Factors that help the behaviours to continue

Eg. A lack of ability to cook healthy meals as well as a low income may lead to poor food choices
and one may opt for canned and frozen foods instead of the more expensive fresh food. Also, an
absence of suitable role models to encourage healthy eating and exercising may continue to
enforce unhealthy eating.

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Investigate how the determinants of health explain why some individuals and groups
have better or worse health than others
See tables above for examples

What strategies help to promote the health of individuals?

What is health promotion?
 Aims to achieve better health for everyone
 Process of preventing ill health and advancing the health of individuals and the community
 Focuses on the actions that prevent poor health from occurring or recurring
 Idea of prevention vs. cure
 Advancing the health of individuals and the community through planned interventions

WHO Definition: The process of enabling people to increase control over their health and
improve their health

 Promoting lifestyle behaviours that reduce the chance of diseases developing

 Recognises social determinants, lifestyle factors that contribute to health promotion
 Seeks to address the support for behavioural change

Responsibility for health promotion

- INDIVIDUALS
 Empowerment: Awareness of the choices they have and can make decisions relying on others
or expecting other to make decisions for them
 Ability to make decisions about, or have personal control over their life
 Need to encourage ourselves to participate in activities that improve our level of health
 Best achieved when:
- Provided with accurate and relevant information
- Given the opportunity to be involved in decision making about our own and community’s
health
- Develop personal skills that will aid us to adopt or maintain positive health behaviours
 Other individuals promote health (eg. doctors, dentists, dieticians and other professionals)
- Increase awareness of risk behaviours
- Provide information as to how to lead a healthier lifestyle

- COMMUNITY GROUPS/SCHOOLS
 Schools provide health promotion in a variety of ways
 Organise immunisation programs
 Provide healthy food programs through the school canteen
 Educate through a variety of curriculum deliveries (ie. PDHPE)
 Sun safety policies (eg. “no hat, no play”)
 Anti-bullying policies and how to deal with bullying behaviours

 Community Groups often focus their health promotion on particular groups or causes
 Examples: Alcoholics, young mother’s groups and drug use

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

- NON-GOVERNMENT ORGANISATIONS
 NGOs usually focus on a particular health issue
 Promote at local, national and international levels
 Examples: Cancer Council, Asthma Australia and Heart Foundation
 Cancer Council: Pink Ribbon Day to raise public awareness of Breast Cancer
 Heart Foundation: Encourages increased physical activity to combat heart disease
Jump Rope for Heart highlights importance of PA and of heart health
 Inspire Foundation: Manage the ReachOut website; offer up-to-date information, support and
resources to young people regarding mental health to develop a sense of resilience

- GOVERNMENT
 Commonwealth (Federal) Government:
- Planning and forming policies identifying health priorities
- Allocate funding for health promotion, special projects, research and NGOs
- Introducing regulation and legislation for the maintenance of health
- National health promotion (eg. Health Action Australia)
- Example: National Tobacco Campaign
Cancer Council + National Heart Foundation + Australian Medical Association

 State Government
- Delivering specific health promotion and disease prevention programs
- Forming laws around alcohol and the road (eg. P-platers)

 Local Government
- Implement state-controlled programs at a community level
- Maintenance and provision of health services (eg. maintenance of local parks – promote PA)
- Local public libraries provide drug use information
- Council may provide venues for support groups to meet

- INTERNATIONAL ORGANISATIONS (EG. WHO, UNITED NATIONS)

 World Health Organisation; established in 1948
- Specialised agency of the UN that acts as the coordinating authority on international public
health issues
- Coordinates policies and directions in health promotion for member countries of the UN

- Provide leadership on health issues causing significant worldwide concern

eg. 2004 – WHO devised the Global Strategy on Diet, Physical Activity and Health
Effort to reduce the worldwide incidence of death and chronic diseases related to poor diet
and inactivity

- Set international health standard for essential elements of promoting good health
eg. Water and air quality; food safety standards

- Helps countries address public health concerns; monitor disease outbreaks

- Assess performance of health systems around the world; promote health research

- 1986 – Organised the First International Conference on Health Promotion

- Conference saw the production and acceptance of the Ottawa Charter

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Describe the various health promotion roles and responsibilities adopted by individuals,
groups and governments
See above

Health promotion approaches and strategies

- LIFESTYLE/BEHAVIOURAL APPROACHES (EG. QUIT SMOKING PROGRAMS, HEALTH EDUCATION)
 Aims to reduce or prevent the incidence of risk behaviours that contribute to poor health
 Directed at improving:
- Eating habits - Unsafe sexual activity
- Physical activity - Substance abuse
- Smoking

 Health promotion programs include:

- Health education programs - Promotion of self-help/self-care
- Social marketing campaigns practices

 Examples include:
- Web-based services (eg. ReachOut, Quit)
- Physical activity initiatives targeting school-aged children to reduce sedentary behaviour
- Road safety campaigns to change attitudes towards unsafe driving behaviours (eg. speeding)

- PREVENTATIVE MEDICAL APPROACHES (EG. CHILDHOOD IMMUNISATION, CANCER SCREENING)

 Primary Prevention: Targets whole populations, including those without obvious risk factors
 Prevent an illness from ever occurring
- Infectious diseases: Childhood immunisation programs
- CVD: Annual doctor check of cholesterol
Sport and healthy canteen at school (ie. education)
- Cancer: Education on self-examination for cancer

 Secondary Prevention: Targets sections of the population that report increased risk
 Try to reduce the likelihood that a disease will develop; early stage intervention
- Cancer: Free mammograms for women over 50 years old
BP and diabetes checks at the chemist
Bowel (colorectal) cancer kits for people over 50
Breast and pap smear screening

 Tertiary Prevention: Targets people already affected by disease

 Prevent chronic ill health occurring through the use of effective rehabilitation that stops a
disease from recurring once it has been diagnosed and treated
- Injuries and asthma: Rehabilitation and return to work programs for people injured at work
Asthma management plans; promoting effective management plans

- PUBLIC HEALTH APPROACHES (EG. HEALTH-PROMOTING SCHOOLS AND WORKPLACES)

Health Promoting Schools
 Regard the health of their students and those in the school community as top priority

 Positively influence the health of students by creating, promoting and support healthy practices
and environments across the school setting

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Health Promoting Workplaces

 Workplace policies, practices and activities are developed and implemented to improve the
health and well-being of all workers
 Recognises that a healthy workforce can benefit both employers and employees

 Joint efforts undertaken by employers, employees and the wider community

 Improve morale, reduce stress, decrease staff turnover, reduce absenteeism and increase
productivity
 Recognises that other non-work related factors can have an impact (eg. family welfare, home
and community conditions)

 Strategies such as flexible working conditions may be implemented to reduce the effect of these
factors on the overall well-being of employees
 Strategies include:
- Fitness and PA programs
- Provision of workplace counselling
- Free vaccinations for hepatitis B
- Health information seminars (eg. regarding stress, alcohol, self-examination for cancer)

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Determine the effectiveness of a range of health promotion strategies relevant to young

people
(eg. government interventions relating to alcohol consumption and young drivers)

DON’T TURN A NIGHT OUT INTO A NIGHTMARE

 Target Audience: 15-25 years old

 Risk behaviours: Drinking to intoxication and the associated harmful behaviours

eg. Violence, road trauma and relationship breakdowns
 Effectiveness:
- Raised awareness of harms and costs associated with drinking to intoxication
- Successfully motivated and supported the target age group
 Additional Strategies:
- Legislation to limit the opening hours of night clubs and hotels
- Situational promotion of responsible drinkers at venues

SPEEDING. NO-ONE THINKS BIG OF YOU

 Target Audience: Predominantly male drivers of 17-25 years old; also the wider community

 Risk behaviours: Speeding amongst young male drivers

 Effectiveness:
- Successfully increased the social unacceptability of speeding within the community
- Combated the stereotype and idea that speeding was a manly act
 Additional Strategies:
- Aim was to increase the social unacceptability of speeding within the community
- Thus combat the idea that speeding was a manly act
- 74% of the general population found speeding to be socially unacceptable

Note: These are not targeted towards young people but are still important health issues
 Measure Up  Obesity as a result of unhealthy eating and drinking; sedentary lifestyle

 Kids Absorb your Drinking  Shows how the attitudes of children towards alcohol and other
health issues are directly affected by parents

Propose other actions that may improve the health of young people
 Building self-concept within young people
- Self-concept: Sense of who they are and how they feel about their place in their family and
amongst society
- Hence, is closely related to their self-esteem  Mental, social and spiritual health
 Developing supportive networks and healthy relationships
- Having a close network of friends and family
- Get involved in community service
 Developing resilience and coping skills
 Developing health literacy and communication skills
- Thus, are able to discern between health information and sort misleading information
portrayed by the media
 Ability to access health services
 Develop cooking ability to prevent to the consumption of frozen and convenient foods

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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

The Ottawa Charter as an effective health promotion framework

Framework Definition Examples

Component
Developing  Enhancing life skills by Provision of Information/Education:
Personal Skills supporting social and personal - Mandatory PDHPE for K-10 curriculum
development through education - Food Technology  Nutrition and
and provision of information preparation of healthy meals
- Online information (eg. Quit)
 Increases options available to - Information brochures at medical centres
exercise more control over their
own health and environments Media Influence
- Campaigns on the harmful consequences
of drug use/alcohol etc.
Creative  Creating social and physical Social Environment
Supportive environments to increase - School counsellors/welfare programs
Environments people’s abilities to make - Quitline support (smoking) available in
positive health choices various languages

 Incl. workplaces, support groups, Physical Environment

health services, schools, the - Creating 40km/h zones around schools
media and family - Local councils building recreational
 Thus targets where people live facilities (eg. bike paths and walking
tracks; shaded playgrounds)
- Healthy canteens in schools
Strengthening  Empowerment of communities - Health-promoting schools (see above)
Community to identify and implement - Lions Club Driver Reviver Stations
Actions actions to address health - Local community programs (eg. walking
concerns groups/sports clubs)
 Thus enhance self-help and social
support
Reorienting  Can take place in a number of - NSW Health: Immunisations in schools
Health Services settings: schools, workplaces and - Local police: Working in schools to
community health centres support road safety and cyber bullying
 Responsibility is shared among - Heart Foundation: Jump Rope for Heart
individuals, community groups, - BreastScreen NSW: Provision of free
health professionals, health mammograms for women aged 50-69
service institutions and
governments
Building  Policy makers in all sectors, at all - Nutrition content on food labels
Healthy Public levels of government - Reduced taxes on low-alcohol beer to
Policy  Includes legislation, taxation and promote their consumption
organisation change - Legalisation to ban smoking in public
 Make decisions and provide places, workplaces, pubs and clubs
resources –including - School policies related to sun safety
infrastructure - (funding through - OHS and WHS
taxes) for healthy choices
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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Describe the historical significance of the Ottawa Charter for Health Promotion
Formation of the Ottawa Charter
 First came into existence at the First International Health Promotion Conference in Ottawa,
Canada, 21st November 1986
 Created to address the growing health concerns that had emerged in the 20 th century
- Most prominent issues: AIDS and obesity
 Main motive was to respond to the increasing expectations for a contemporary health
movement around the world
 Forged in an age of technology (ie. phones and television)
 Enabled it to be broadcasted on an international scale; easy access of information to the public

What is the Ottawa Charter?

 Framework for which health promotions throughout the world are based upon
 Based on the understanding that health is socially determined
 Gives direction to health promotions through clear definitions, action plans and positive
involvement
 Health promotion strategies and programs should be adapted to the local needs and
possibilities of individual countries and regions to take into account differing social, cultural and
economic systems

Prerequisites for Health:

 Peace  Income
 Shelter  Stable ecosystem
 Education  Sustainable resources
 Food  Social justice and equity

Advocate
 Good health is important for social, economic and personal development
 Is an important dimension of quality of life
 Health promotion aims at making these conditions favourable through advocacy for health

Enable
 Reduce differences in current health status
 Ensuring equal opportunities and resources to enable all people to achieve their fullest potential
 Includes a secure foundation in a supportive environment, access to information, life skills and
opportunities for making healthy choices
 Must apply equally to women and men

Mediate
 Demands coordinated action by all concerned: governments, health sectors, NGOs, local
authorities, industry and media
 Must mediate between differing interests in society for the pursuit of health

Explain how health promotion based on the action areas of the Ottawa Charter have
contributed to positive health outcomes. For example:
- REDUCTION IN ROAD INJURIES
- REDUCTION IN TOBACCO USE
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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

Principles of social justice

 Social Justice: Value that favours the reduction or elimination of inequality
 Promotion of inclusiveness of diversity
 Establishment of environments that are supportive of all people
 Seek to ensure that individuals and groups identified as being the most disadvantaged are
provided with sufficient resources and support to empower them to improve their health

- EQUITY
 Equity: Means taking action to achieve fairness
 Allocation of resources and entitlements according to the needs of individuals and populations
 Ensuring all individuals within society have access to the same opportunities for achieving
optimal health
 Goal: Achieve equality of all outcomes

- DIVERSITY
 Variety or difference between individuals and groups of people
 Essential that we are sensitive to people’s differences
 Adapt programs to meet the needs of the whole population
 Tailor strategies to better cater for the particular needs of different groups
Eg. Initiatives targeted at people living in rural areas need to be designed and delivered
differently as compared to those aimed at urban residents
 Factors that may limit people’s ability to access information and support
- Language barriers
- Misconceptions
- Lack of cultural awareness
- Unfamiliarity with health supports and services

- SUPPORTIVE ENVIRONMENTS
 Social environment of where a person lives or works has a significant influence on that person’s
level of health and ability to make changes
 Good health is achieved in environments with:
- Regular supply of safe water and nutritious food
- Adequate supply of basic necessities (eg. clothing, shelter and transport)
- Provide opportunities for recreation and variety in daily living
- Cause less stress
- Relatively free of violence and pollution
- Low levels of poverty
 Strategies to promote better health need to address social, cultural, physical and economic
factors present in people’s lives
 Eg. Person who travels a long distance to a sedentary job may find it difficult to make time for
physical activity
 Home and work environments can create obstacles for people’s choices in becoming active
 Thus, may require changes in work practices, wider range of transport and employment options
and improved local facilities

Identify strategies where the principles of social justice have been applied to promote the
health of individuals
Medicare
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Preliminary PDHPE Core 1: Better Health for Individuals Nicole Goh

 Established to ensure access to health care for all Australians is based on the understanding that
all Australians should contribute to the cost of health care
 Payment is determined according to their ability to pay
 Financed through progressive income tax and an income related to medicine levy

 It provides access to:

- Free treatment as a public patient (people that pay Medicare) in a public hospital
- Free on subsided treatment by medical practitioners including GP’s specialist/participating
optometrists or dentists

 Medicare also runs the pharmaceutical Benefits Scheme, which provides subsided access to
medicine, including a safety net for those who have expensive pharmaceutical needs

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