Week 1 Health and Wellness Disease vs.

. Illness Disease (objective; measurable) The pathology of a condition which can be detected by medical science - not all diseases can be cured; only managed in some cases - Its when you can see the symptoms or with diagnostic imaging Illness (subjective) More subjective feeling and no real identifiable reason behind a condition or loss of health - most are curable

Health: WHO defines the term health as being in a state of complete physical, mental, and social well-being, but not necessarily the absence of a disease or infirmity (ex. Weak at old age) - someone can have a disease but still show positive signs of physical, mental, and social-well being.

Discourse on health in Canada the evolution of health promotion Medical Emphasised on traditional medical assistance/intervention Mostly objective and focused on treating diseases The approach was emphasized on physiological risk factors: characteristics that are precursors for a disease. Problem This is not adequate in ensuring that the population remains healthy. Large investments on health care (medical interventions) did not make a huge difference on the health status of the population. Behavioural Lalonde report The 1st government document stating that a pure biomedical health care system was inadequate for promoting health. It took on a behavioural approach to health promotion The argument addressed that the access to health care was not the only DOH. It focused on health practices and activities to stay healthy (diet, stress reductions, less smoking, etc.); cannot only rely on western medicine It defined other DOHs: - lifestyle - environment - human biology - organization of health care Socio-Environmental Ottawa Charter for Health Promotion - this document took on the socio-environmental approach, recognizing explicitly that health is affected by factors that are not in control of the health care sector (social DOH). For example: - poverty, unemployment, poor housing, social inequalities, living conditions, social justice - the charter also directed other strategies like getting the community involved to ensure the responsibility of health. It was a modern approach that focused on: a) strengthening community actions b) improve healthy public policies c) create supportive environments d) develop personal skills e) reorient health services - make health care system more effective and efficient (improve access)

Lifestyle is the most significant attention where the aim was to decrease behavioural risk factors - smoking - diet - exercise - drug abuse This report suggested that individuals were responsible for their own health, by the following: a) provide greater knowledge of human biology b) improving the environment c) reduce self-imposed risks smoking, substance abuse -essentially, the Lalonde report was to inform the population about risk factors so they will lead healthier lifestyles and reduce self-imposed risks. Problem -the primary thrust of various critiques was that, the lifestyle approach led to victim-blaming for their own poor-health conditions and behaviours. It neglected other factors such as social, economic, and political context that influenced an individuals health behaviours. An awareness to further address issues in inequalities and other factors had to be looked into.

Epp Report Provided another framework that incorporated concepts from the Ottawa Charter. The report defined 3 other mechanisms to promote health: 1) self care 2) mutual aid 3) healthy environments - these mechanisms were aimed to address the many challenges that influenced Canadians like reducing inequities, increase prevention, and enhance coping. - the Epp report emphasized societys responsibility to ensure that supports are more readily available to the population and the need for support, for caregivers. Both the Ottawa Charter and Epp Report reflect the socio-environmental approach where health is seen as more than just the absence of disease (medical) and health behaviours/lifestyles (behaviour). It strived on connectedness, self-efficacy (believing in one self to achieve goals and live a more productive and happy life), and empowerment to engage in meaningful activities. Labonte categorized the major DOH in the socio-environmental approach as: 1) Socio-environmental risk conditions -phys. Environment, pollution, income, economic powerlessness 2) psychosocial risk factors - ex: self-esteem, isolation, social support

Health promotion then focuses on opening spaces for those whose voices were often left out or ignored, especially those who live their daily lives in locations where social, political, and economic context have consequences for their health.

Toronto Charter (1990s) Considered 10 social or societal DOH to explore the implications of the increasing inequalities, both socially and economically. The DOHs considers the big picture of health and examines factors of the health care system (inside/outside) that affect our health. It includes the interactions of social and economic factors, physical environment, and individual behaviour (as a consequence of these factors).

Income and social status This is the greatest determinant of health because people who live in poverty generally have poorer health and are more likely to face complications earlier on suffering more illnesses (regardless of age, sex, race, culture). Ill health may be correlated to social deprivation, influencing health through personal controls of ones life (families with lower incomes may not be able to distribute their income to essential needs such as food, housing, health services, education thereby affecting their overall health).

Social Support Networks The more support you have from friends and families, the less emotional stress youll have with coping your life. - healthier behaviours and support (ex: help with child care and financial aid).

Education Increases job opportunities, income security, skills/knowledge, access to health information and services. With more education, it may have positive influences on other health DOHs like income, physical environment, and health practices (nutrition, exercise, etc).

Employment and working conditions Jobs that arent full-time do not provide pensions and those people may suffer from job insecurities and periods of unemployment. Such conditions can be linked to higher stress levels, depression, high bp, substance abuse, and cardiovascular disease.

Physical environments Housing, indoor air quality, exposure to air contaminants for families living near industrial areas. Spending too much on rent and not enough on food, clothing, medical care

Biology and Genetic Endowment Age (physical health + stress levels decrease as we get older). - factors affecting age are questionable whether its biological aging or other DOH like socio-economic status, social support, personal health practices

Personal Health Practices/Coping skills Actions by which individuals can make choices to fulfill a healthy lifestyle - choices are influenced by socioeconomic environments Physical activity, nutrition, smoking/substance abuse - this DOH (personal health practices) is the primary focus of the behavioural approach Lalonde Report

Healthy Child Development A persons development at an early age is greatly affected by where he/she is brought up, family income, neighbourhood, education, nutritious food, relationship with parents

Health Services Gender Culture Every culture is different and ethnic factors will influence the way people interact with a health care system. - ex: language barriers, physical contact Men die more prematurely than women Women are more like to suffer from depression, stress, injuries, abuse Quality of accessible care (acute, long-term, home) and preventive services

Social Environments This is related to social supports and includes a broader community characteristic - norms and values, human rights, social security and relations. Reducing prejudice and discrimination to increase cohesiveness in the community (also as seen in the Jakarta Declaration).

Jakarta Declaration Added 4 prerequisites for health from the Ottawa Charter: 1) empowerment of Women 2) social security 3) respect for human rights 4) respect for social relations The declaration stated that poverty was the greatest threat to health It sought to promote health strategies by: promoting social responsibility for health in public and private sectors increasing investments for health for all sectors consolidating and expanding partnerships for health to all levels of government in the private sector increasing community capacity and empowering the individual securing adequate infrastructure for health promotion

Bangkok Charter emphasized human rights, as well as mental and spiritual well being as important elements to health - also focused on strong political actions