Intro to Health Education and Promotion_POH705_Week 11.pptx

Health Promotion and Education POH705 Dr. Jasmin Bhawra School of Occupational and Public Health Toronto Metropolitan University Week 1 1  Course Description This course introduces theories, issues, and strategies related...

Health Promotion and Education POH705 Dr. Jasmin Bhawra School of Occupational and Public Health Toronto Metropolitan University Week 1 1  Course Description This course introduces theories, issues, and strategies related to health education and promotion. Theories exploring individual and group health behaviour, as well as adult learning styles, will be explored and analyzed. The determinants of health will underpin the theories discussed in this course. Students will learn the key components of health education and promotion, and critically analyze and evaluate health programs. 2  Course Expectations Course material to be posted on D2L – Textbook available online through the library – Articles to be posted in weekly folders – Check the weekly announcements for updates Arrive on time and be prepared to stay until the end of lecture – You are expected to attend the section that you are enrolled in – Slides will have fill-in-the blanks – you are responsible for getting missed notes from your peers Prepare for class by completing readings 3  Email – Do! Personal issue – note your full name, the – Note that accommodations course code, and a clear need to be set up ASAP with email subject the Accommodations Office – I – Always use professional only approve these after they language have been processed To set up an appointment For questions about course (but do try to come to office material – contact the TA hours) first Missed midterm or exam Expect a reply within 48 – Medical documentation needs hours to be sent to the School and approved before a rewrite is scheduled – A rewrite will not be provided without documentation Be clear about who you are 4  TA Contact Details Jackie Quesnel MSc Candidate in the School of Occupational and Public Health [email protected] 5  Email – Please Don’t Send an email instead of coming to office hours Send questions about missed classes or materials – please connect with one of your peers To ask questions about content already covered in the course outline To ask if you can come to my office hours – these are drop-in sessions To ask what is on the midterm or exam, or when marks will be posted 6  Office Hours Drop-in office hours to be held on Mondays via Zoom – You will be placed in a waiting room upon entry, and let in once we finish with the previous student Office hours will start next week – Hours to be posted weekly 7  Course Evaluation Midterm Exam 1 on October 2 (Wed section) and October 4 (Fri section) – 35% Midterm Exam 2 on November 6 (Wed section) and November 8 (Fri section) – 35% Midterms will be held in-person during class time – Attend your correct course section Final Exam, date TBD – 30% 8  Course Evaluation Keep up with the course material – There is an assessment every 3-4 classes Midterms will test: – Lecture slides – Assigned readings/resources – Content discussed in class 9  Today’s Lesson Objectives Provide a brief history of health education Understand the role of health education & health promotion Identify how health education has contributed to improvements in population health Unpack the definition of ‘health’ and how we can measure it 10  Health Education – Then and Now Our knowledge of health and communication strategies have changed over time – Science and technology have evolved – Changes in preferences for mode of communication What has changed? 11  What do you think is the biggest difference in how health information was communicated between now and the early 1900s? 12 13 We're more likely to see information shared like this: 14  Sharing Health Information Books and other printed resources Media (TV, newspaper, online)​ Social media ​ Choosing an effective medium requires_knowing your audience_______________________ What are the pros and cons of media use for health information?​ 15  The Growth of Health Education in Canada The Beginnings – 17th/early 18th century British and French colonization and the fur trade introduced several communicable diseases: Smallpox, measles, TB Led to the creation of sanitary reforms, boards of health and public health legislation (quarantine) Link between unsanitary conditions and disease, which led to advances in science First vaccine developed for smallpox (1796) Mandatory smallpox vaccinations in Canada 16 Source: https://www.cpha.ca/history-e-book  The Sanitary Movement – late 18 /early 19 century th th Public health evolves Post-Confederation (1867) Municipal infrastructures including water and sewage systems to control disease spread Scientific discoveries on the transmission and prevention of infectious disease = bacterial revolution! Changed how the public thinks about health – Importance of personal and public hygiene (sanitation) Recognition of the need for public health statistics to track morbidity and mortality Census and Statistics Act, Public Health Acts and Public health laboratories Awareness that public education fundamental to fight infectious disease 17 Source: https://www.cpha.ca/history-e-book  Social Transformation and World War I Houseflies, public drinking cups, and STDs were of particular concern Spanish influenza (1918) leads to creation of a Federal Department of Health Immunization, child and maternal health, and pasteurization programs Improved confidence in public health in 1920s with dedicated initiative for public health Creation of Canada Public Health Association Creation of school of hygiene which provided training to public health professionals Growing recognition on the threat of TB to Indigenous Peoples 18 – Source: https://www.cpha.ca/history-e-book Knowledge is power! Shift to an emphasis on information and education to bring about change in ____personal habits___________ and behaviour Use of: Better and cheaper posters Exhibits Monthly bulletins Lectures 19 Knowledge is power! Public education on the risk of sharing Risk of flies for disease 20 drinking cups and food safety Public education a traveling exhibits with signs, charts, and public demonstrations and lectures at fairs, public gatherings, and railway stations 21  Increasing awareness about injury caused by occupational exposures or accidents led to the development of workplace health and safety legislation 22 Sex ed in schools 23  The debate about sex ed continues https://www.macleans.ca/opinion/the-politics-b hind-ontarios-sex-ed-curriculum/ https://www.cbc.ca/news/canada/toronto/studen t-walkout-protest-ontario-sex-ed-changes-1.4833 097 24  25 ce: Health Promotion and Disease Prevention Directorate Source: TCI Health Promotions & Advo  Coughs and Sneezes (British Parliament, 1945) 26 Modern example 27  Health Education Identified as part of a “new” public health movement in the 1980’s – Led to formalized approaches to health education Identified that changes needed to be made in the way health issues were addressed – Placed the onus of health onus of health on individuals (e.g. blaming the victim) Participation was a key organization promoting healthier lifestyles across Canada -To ensure physical activity is a priority on the national agenda; - To inspire Canadians to move more and inspire society to make it easier to do so http://www.youtube.com/watch?v=t1p6K0xGKd0 https://www.bodybreak.com/ 28  Ottawa Charter for Health Promotion Created in 1986, organized by WHO and CPHA Presents strategies for global progress in health promotion Goal: ‘health for all by 2000’ – Definition of health changed – Views health as a product of daily life – Identifies core values of Health Promotion – Proposes 3 strategies and 5 action areas 29  Ottawa Charter for Health Promotion Core values: Enablement, mediation, advocacy Five action areas: 1. Building healthy public policy (e.g. smoking legislation) 2. Creating supportive environments (e.g. creating bike lanes, parks) 3. Strengthening community action (e.g. support/working groups) 4. Developing personal skills (e.g. health literacy skills) 5. Re-orienting health services (e.g. focusing on prevention instead of treatment) 30  Definition: Health Education The process of ___assisting_________ individuals, acting separately or collectively, to make ______informed decisions______________ about matters affecting their personal health and that of others Attempts to ___close the gap______________ between what is known about optimum health practice and that which is actually practiced 31  Health Education Consciously constructed _opportunities for learning___A involving some form of communication designed to improve health literacy, including improving knowledge and developing life skills which are conducive to individual and community health. Ontario Health Promotion, 2009 32 Health Education Attempts to Answer… Why do people behave as they do? How does what they do affect their health? What causes them to change their health- related behaviour? How can messages be targeted to particular groups? How can organizations change their focus and ways of working? 33  Factors affecting the delivery of Health Education messages Family pattern trends Technology Economic trends Health Medical Political trends Education discoveries Scientific discoveries Societal values Employment patterns 34  Health Education Theories Attempt to understand: – Why some parents refuse health interventions (e.g. vaccinations for their children) – Why some people think they are at risk of disease and others do not – How people prioritize health issues 35 Health Education attempts to… Create a change in: Quality of Life: “I e.g. want to feel better & healthier improve Behaviour: I buy veggies and grow them vegetation in my yard to increase consumption Skills: “Imy canintake” grow veggies in my yard” Attitude: “I want to increase my veggie intake because veggies are important for my health” Knowledge: “Increasing veggie intake will increase my daily nutrient intake” Awareness: aware of dietary guidelines that you should eat 4-5 36  Health Education vs. Promotion The Ottawa Charter for Health Promotion defined health promotion as: The process of __enabling________ people to increase control over, and improve, their health…a commitment to dealing with the challenges of reducing inequities__________, extending the scope of prevention, helping people to cope with their circumstances…and creating _environments_____________ conducive to health, in which people are better able to take care of themselves. World Health Organization, 1986 These concepts are often used interchangeably. However, Health Promotion considers the broader social context and emphasizes the SDOH, whereas Health Education is facet/strategy used in Health Promotion. 37  HEALTH PROMOTION H H Ad c ea po eal vo om lth lic thy ca m y p cy un ng lth tion ub ic at ial ti ea ca lic io i ty t oc ke H du n n S ar un me m E m p om lo C ev e d 38 Public Health 39 In addition to changes in health education and promotion, the causes of illness have also significantly changed over time... 40  Causes of Illness 1900-2000 Why do we see this shift? Death rate Chronic diseases Infectious diseases Year Increased public education on healthy behaviours and practices Changes to the buit envrionment, sanitation, and immunization Shift to “lifestyle-related” (i.e., preventable) diseases – complex (i.e., 41 industry, food environment, etc.) Major Epidemics of the Mo dern Era Review year 2000 to 2022 at this link: https://www.cfr.org/timeline/major-epidemics-mo dern-era – 2002 to 2003: Severe Acute Respiratory Syndrome (SARS) – 2005: WHO releases new rules to boost defenses against global health challenges – 2009 to 2010: New influenza pandemic (H1N1) – 2012: Middle East Respiratory Syndrome (MERS) – 2014: Rise in Polio cases – 2014 to 2016: Ebola – 2015: Dengue – 2015 to 2016: Zika virus – 2018 to 2020: Ebola returns – 2019 to present: COVID-19 – 2022 to present: Monkeypox 42  Global Burden of Disease 43 Max Roser, Hannah Ritchie and Fiona Spooner (2021) - "Burden of Disease". Published online at OurWorldInData.org. Retrieved from:  Life Expectancy by Province Government of Canada, S. C. (2021, April 13). Life expectancy and other elements of the complete life table, three-year estimates, Canada, all44 provinces except Prince Edward Island. https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310011401  Life Expectancy 45 https://www150.statcan.gc.ca/n1/pub/82-624-x/2014001/article/14009-eng.htm  46 ce: https://ourworldindata.org/life-expectancy  What does this data and history tell The causes of illnessus?​ and life expectancy have ____drastically changed__________________o ver time The public has continuously been given ___information_________ about the latest health concerns Source: Jacob Wentz/WUSF Public Med But... there has always been a general _____lack of interest_________ _________________ 47  Leading causes of death in 2020 Malignant neoplasms 1 Diseases of heart 2 COVID 19 3 Accidents (unintentional injuries) 4 Cerebrovascular diseases 5 Chronic lower respiratory diseases 6 Diabetes mellitus 7 Influenza and pneumonia 8 Alzheimer's disease 9 Chronic liver disease and cirrhosis 10 rce: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310039401 48 The World Health Organization (WHO) defines health as: "a state of complete physical, mental and social well-being rather than a mere Physical absence of disease or infirmity.” Sexual Mental Spiritua Emotion l al Social 49  Public Conceptions of Health 1. Not being ill 2. Fitness 3. Sense of wellbeing 4. Ability to carry out tasks 5. Resources for living 6. Assets to be managed (summarized in Segall & Fries, 2011, p. 238-240) Rootman, I. & O’Neill, M. (2012). Chapter 2: Key Concepts in Health Promotion. In R. 50 Rootman, S, Dupere, A. Pederson, and M. O’Neill [Eds.], Health Promotion in Canada (p. 18- 32). Toronto: Canadian Scholars’ Press Inc.  World Health Organization (WHO) Definition of Health “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Rootman, I. & O’Neill, M. (2012). Chapter 2: Key Concepts in Health Promotion. In R. 51 Rootman, S, Dupere, A. Pederson, and M. O’Neill [Eds.], Health Promotion in Canada (p. 18- 32). Toronto: Canadian Scholars’ Press Inc.  Medical Definition of Health “The normal physical state, ie., the state of being whole and free from physical and mental disease or pain, so that the parts of the body carry on their proper function.” - Critchley, 1978, p. 784 Rootman, I. & O’Neill, M. (2012). Chapter 2: Key Concepts in Health Promotion. In R. 52 Rootman, S, Dupere, A. Pederson, and M. O’Neill [Eds.], Health Promotion in Canada (p. 18- 32). Toronto: Canadian Scholars’ Press Inc.  Academic Definition of Health Health “involves the interplay of biology, psychological and social aspects of the person’s life” - Sarafino, 1990, p. 16 Rootman, I. & O’Neill, M. (2012). Chapter 2: Key Concepts in Health Promotion. In R. 53 Rootman, S, Dupere, A. Pederson, and M. O’Neill [Eds.], Health Promotion in Canada (p. 18- 32). Toronto: Canadian Scholars’ Press Inc.  Indigenous Definitions of Health “Living in total harmony with nature and having the ability to survive under exceedingly difficult circumstances.” - Spector, 1985, p. 181 Rootman, I. & O’Neill, M. (2012). Chapter 2: Key Concepts in Health Promotion. In R. 54 Rootman, S, Dupere, A. Pederson, and M. O’Neill [Eds.], Health Promotion in Canada (p. 18- 32). Toronto: Canadian Scholars’ Press Inc. Source: https://cbpp-pcpe.phac-aspc.gc.ca/aboriginalwtt/ 55  Health Education Settings 1. School The majority of the population attends school at some point in their lives Children informally learn new skills, including how to deal with stress, change, and peer pressure Curricula formally cover health education topics at each grade level 2. Workplaces Adults spend approximately 60% of their waking hours at work Creates an opportunity to interact with the “healthy” adult population 3. Communities - People feel a connection to their community - Neighbourhoods can create and promote health 56  Health Education Settings 4. Healthcare Sites - Health practitioners are seen as a credible sources of health information by the public - Offer 1:1 communication about health 5. Home - Home visits, Internet, telephone, mail - Convenient and possible to reach larger groups 6. Consumer Marketplace - Consumer health information via social marketing 7. Communication Environment - Internet, social media, SMS, Apps, virtual worlds 57  Measuring Health Why? – To establish priorities – To assist in planning – To justify resources – To promote the health promotion field 58  How can we measure health? The definition of health you use will determine how it is measured 59  Discussion If you wanted to develop a program to improve the health of workers at your workplace, would number of workplace accidents be a good or bad health indicator? Why or why not? Can you think of other indicators? Are they positive or negative health indicators? 60  Measuring Health Negative measurements – measuring the opposite of health Examples: – Mortality – Morbidity Are these good indicators of health? Where do we find them? 61  Measuring Health Positive measurements-measuring health in its own right Measures can include physical, psychological and social well being, quality of life, and others 62  Health Indicator Examples Morbidity Wealth Mortality Housing density Neighbourhood Dental health initiatives Availability of WSIB claims services Suicide rates Hospital wait times Healthy workplace Absence from work initiatives Smoking rates Vaccine rates 63  Next week Social determinants of health 64