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WHAT
IS HEALTH PROMOTION?
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Health
promotion is a broad field encompassing educational, social,
economic, and political efforts to improve the health of a
population. Health education, health protection, and disease
prevention form the essential triad of health promotion. Health
promotion is practiced in a variety of settings schools, churches,
worksites, health care facilities, voluntary health agencies,
health maintenance organizations, correctional institutions,
private clubs, and self-help groups-by practitioners of varied
backgrounds and occupations- physicians, nurses, exercise
scientists, nutritionists, social workers, physical
therapists, and health educators. Health promotion workers put
health on the agenda of policy makers, directing them to be aware
of the health consequences of their decisions and to accept
their responsibilities for public health
(Monash Health Promotion Unit,1999). It
has
unified
a number of separate, even disparate, fields of study under
one umbrella and now forms an important part of the health
services of most industrially developed countries (Macdonald &
Bunton, 1992).
Healthy People 2000 (U .S. Department of Health and Human
Services,
1991),
a
publication
that
guided the nation's health promotion efforts for nearly a
decade, contained the words, ?Health promotion and disease
prevention comprise perhaps our best opportunity to reduce the
ever- increasing portion of our resources which we spend to treat
preventable illness and functional impairment."
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Two
of the most commonly quoted definitions of health promotion are
A planned combination of educational) political) regulatory) and
organizational supports for actions and conditions of living conducive
to the health of individuals) groups) or communities (Green &
Kreuter) 1999).
The process of enabling people to increase control over and to
improve their health. . . a commitment to dealing with the challenges of
reducing inequities) extending the scope of prevention) and helping
people to cope with their circumstances. . . creating environments
conducive to health) in which people are better able to take care of
themselves (World Health Organization) 1986) .
The definitions imply a broad spectrum of interventions. Health
promotion attempts to promote adaptations and adjustments in individuals
and
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communities
to encourage maintenance and improvement of the health of whole
populations, usually by applying wellness principles to
organizations and institutions. These adaptations and adjust-
ments may be attitudinal, environmental, or behavioral, but all
are directed toward sustaining or increasing the level of well-
being, self -actualization, and fulfillment (Teague & McGhee,
1992) . It is also appropriate for health promotion tQ3function on
an economic level, given that larger gaps between the haves and
have nots correlate strikingly with increased mortality rates
among the have nots. The gap between rich and poor children is
greater in the United States than in any other industrialized
country (Seffrin, 1997)-one reason that reducing health
disparities has become a national goal (U.S. Department of Health
and Human Services, 2000) .
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The
Working Group on Concepts and Principles in Health Promotion
(1987) listed the basic characteristics of health promotion as
1. Enabling people to take control over,
and responsibility for, their health as an important component of
everyday life-both as spontaneous and as organized action for
health
2. Requiring the close cooperation of
sectors beyond the health services, reflecting the diversity of
conditions that influence health
3.Combining diverse, but complementary,
methods or approaches, including communication, education,
legislation, fiscal measures, organizational changes, community
development, and spontaneous local activities against health
hazards
4. Encouraging effective and concrete
public participation, encompassing the development of individual
and collective problem-solving and decision -
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making
skills and involving health professionals in education and health
advocacy, particularly those in primary care
Health promotion is arena-based in the
sense that it seeks to deal with whole populations and their needs
and strengths. Health promotion is less effective when it attempts
to lessen the effects of a specific disease or condition. Rather
than take the "disease of the month" approach, health
promoters seek to improve health by improving the overall
condition of the target population.
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