PRINCIPLES OF COMMUNITY HEALTH"

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Chapter 4

Health Promotion and Risk Reduction

Health Promotion Is…

 …any combination of health education and

related organizational, economic, and

environmental supports for behavior of

individuals, groups, or communities

conducive to health (Green & Kreuter, 1991)

 …that which is motivated by the desire to

increase well-being and to reach the best

possible health potential (Parse, 1990)

Health Protection Is …(Cont.)

 … those behaviors in which one engages

with the specific intent to prevent disease,

detect disease in the early stages, or

maximize health within the constraints of

disease (Parse, 1990)

 … an important step in maintaining health

Defining Health

 The way health is defined has shifted from a

focus on the curative model, to a focus on

multidimensional aspects such as the social,

cultural, and environmental facets of life and

health (Benson, 1996)

 Health is viewed not only as an important

goal, but as a resource for living (WHO, 1986)

Healthy People 2020 …

 … is the health promotion initiative for the

nation.

 … challenges individuals, communities, and

professionals … to take specific steps to

ensure that good health, as well as long life,

are enjoyed by all. – U.S. Department of Health and

Human Services, 2012

Healthy People 2020 …

(Cont.)

 Broad goals

 Attain high-quality, longer lives free of preventable

disease, disability, injury, and premature death.

 Achieve high equity, eliminate disparities, and

improve the health of all groups.

 Create social and physical environments that

promote good health for all.

 Promote quality of life, healthy development, and

healthy behaviors across all life stages.

Determinants of Health

 Biology

 Behaviors

 Social environment

 Physical environment

 Policies and

interventions

 Access to high-quality

health care

Figure 4-1

From U.S. Department of Health

and Human Services.

Theories in Health Promotion

 Pender’s Health Promotion Model (HPM)

 Health Belief Model (HBM)

 Transtheoretical Model (TTM)

 Theory of Reasoned Action (TRA)

Risk and Health

 Risk is “the probability that a specific event

will occur in a given time frame” (Oleckno,

2002).

 A risk factor is an exposure that is associated

with a disease (Friis & Sellers, 2004).

Risk Assessment is a systematic way of

distinguishing the risks posed by potentially

harmful exposures.

Steps in Risk Assessment

 Hazard identification

 Risk description

 Exposure assessment

 Risk estimation

Risk Assessment

 Modifiable risks

 Individual has control

 Examples: smoking, lifestyle,

eating habits, activities

 Nonmodifiable risks

 Individual has little or no control

 Examples: genetics, gender,

age, environmental exposure

 Risk Reduction …

 … is a proactive process

 … enables individuals to react to

actual or potential threats to their

health

 Risk communication …

 … is the process of informing the

public regarding threats

 … is affected by perceptions,

process, and actions

Tobacco and Health Risk

 Leading cause of preventable death

 Most common in less educated populations

and those living below poverty level

 Most common form of chemical dependency

 Tobacco in all forms is harmful.

Health Promotion Activities

 Look for teachable moments

 Assess client’s tobacco use

 Explore willingness to quit

 Refer to cessation programs

 Encourage attempts to quit

Alcohol Consumption and Health

 Third leading lifestyle-related

cause of death for the nation

 Short-term use causes acute

risks

 Long-term effects have major

impact on health and social

issues

 Influenced by legal drinking age

 # 1 used and abused drug among

U.S. youth

Health Promotion Activities (Cont.)

 Prevent underage drinking

 Assist with enforcement of legal drinking age

 Identify individuals and groups at risk of

abuse and dependence

 Educate adults and youth on dangers of

alcohol

 Requires a community-wide effort to address

the problem on several fronts

Diet and Health

 Diet—one of most modifiable risk

factors

 Imbalance of caloric intake and

physical activity

 Complex interplay among

metabolism, genetics, behavior,

environment, culture, and

socioeconomic status

 Geographic areas, age, ethnicity all

influence weight

Health Promotion Activities (Cont.)

 Special populations have different nutritional

needs

 For individualized plans, see

http://myplate.gov/

 Educate clients about:

 Balancing caloric intake and physical activity

 Servings vs. portion control

 Eating away from home affects “portion distortion”

 Using social media and mobile applications to help

Physical Activity and Health

 Physical activity serves both

health promotion and

disease prevention

purposes

 Leisure activities are

influenced by level of

education, gender, age,

economic level, geography

 One’s environment plays a

significant role in activity

level

Health Promotion Activities (Cont.)

 Support and develop

“walkable” neighborhoods and

cities

 Determine recommended

exercise levels for individuals

 Visit

http://www.cdc.gov/physicalacti

vity/data/facts.html

Sleep and Health

 Sleep is an essential component of

chronic disease prevention and

health promotion

 Requirements change with age and

life circumstances

 Regulated by waking time and

circadian rhythms

 Hormones during sleep affect

memory, blood pressure, and kidney

function.

Health Promotion Activities (Cont.)

 Sleep assessment is important

 Identify disorders that may affect

daily activities

 Keep sleep log

 Practice sleep hygiene

 Establish environment that

promotes sleep

 Avoid food and activities that

interfere with sleep