-state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity" (WHO).
-Core concept in society.
-has multidimensionality and is applicable to both individuals and groups.
-Based on variety of factors.
-Describes a state of life that is balanced, personally satisfying, and characterized by the ability to adapt and to participate in activities that enhance the quality of life (D'Amico).
-Concepts basic to wellness include self-responsibility and decision making.
Determinants of Health
-policymaking, social factors, health services, individual behavior, biology and genetics.
-What makes some people healthy and others unhealthy?
-How can we create a society in which everyone has a chance to live long healthy lives?
Social Determinants of Health
-Circumstances in which people are born, grow up, live, work, and age, and the systems put in place to deal with illness. (WHO)
-Examples----availability of resources to meet daily needs---safe housing, local food markets, quality of education, job opportunities, access to health care, transportation options, health literacy
Healthy People 2020
set of goals and objectives with10-year targets designed to guide national health promotion and disease prevention efforts to improve the health of all people in the United States. Created by scientists both inside and outside of Government, it identifies a wide range of public health priorities and specific, measurable objectives.
-Builds on a foundation of three decades of work in health promotion and disease prevention objectives aimed at improving the health of all Americans.
-Is grounded in science, guided by public input, and designed to measure progress.
-Seeks to improve health outcomes through prevention strategies that address "ecological contexts" and determinants of health.
What Is Healthy People?
-A national agenda that communicates a vision for improving health and achieving health equity.
-A set of specific, measurable objectives with targets to be achieved over the decade.
-These objectives are organized within distinct Topic Areas.
Key Features of Healthy People
-Creates a comprehensive, strategic framework that unites health promotion and disease prevention issues under a single umbrella.
-Requires tracking of data-driven outcomes to monitor progress and to motivate, guide, and focus action.
-Engages a network of multidisciplinary, multisectoral stakeholders at all levels.
-Guides national research, program planning, and policy efforts to promote health and prevent disease.
-Establishes accountability requiring all PHS grants to demonstrate support of Healthy People objectives.
Healthy People 2020 Objectives
-Represent quantitative values to be achieved over the decade.
-Organized within the Topic Areas.
-Managed by lead Federal agencies.
-Supported by scientific evidence.
-Address population disparities.
-Data driven and prevention oriented.
intended to help everyone more easily understand how healthy we are as a Nation and which are the most important changes we can make to improve our own health as well as the health of our families and communities.
The Leading Health Indicators are:
-Overweight and Obesity
-Responsible Sexual Behavior
-Injury and Violence
-Access to Health Care
-If a health outcome is seen in a greater or lesser extent between populations
-Race or ethnicity, sex, sexual identity, age, disability, socioeconomic status, and geographic location all contribute to an individual's ability to achieve good health. It is important to recognize the impact that social determinants have on health outcomes of specific populations. Healthy People 2020 strives to improve the health of all groups.
Healthy People 2020 Health Disparity
"a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion."
Health Disparities (inequities or inequalities)
-Are avoidable inequalities in health between groups of people within countries and between countries (WHO).
(poorest of the poor have the worst health).
-Social and economic conditions and their effects on peoples lives determine their risk of illness and the actions taken to prevent them becoming ill or treat illness when it occurs. (ex: infant mortality rates)
-being able to read, understand and act on health care information.
able to grasp and understand medical terminology
able to obtain and apply relevant information
ability to operate a computer
able to understand visual information
What Factors Affect Health Literacy?
-Communications skills of both the patient and health care provider
-Patient knowledge of health care topics
-Dependent on culture---understand information---when and why patients seek health care
-Demands of the health care system---services, access
Why is Health Literacy Important?
-Helps patient to navigate the health care system
-Increases ability to manage chronic illness
-Increases understanding and participation in health promotion behaviors
-Impacts---health outcomes, healthcare costs, and quality of care
-Patients with limited health literacy skills have higher utilization of treatment services, hospitalization, emergency services and lower utilization of preventive services
Who is at risk? (Vulnerable populations)
Limited health literacy is greatest among:
-Older adults--- Two thirds of U.S. adults age 60 and over have inadequate or marginal literacy skills
-Poor---low income families--- Approximately half of -----Medicare/Medicaid recipients read below the fifth-grade level
-Limited education---lack of educational opportunity
-Minority populations/Limited English proficiency
-People with chronic mental and/or physical health conditions
Who is affected by health literacy Issues?
-Health care professionals
-Society at large
Clues to Low Health Literacy
-Do not seek preventive health care
-Difficulty locating providers and services
-Difficulty understanding the connection between risky behaviors and health
-Do not complete medical forms
-"forget their glasses"
-Are unable to identify their medications or directions for taking them
-Seem anxious or unable to focus during the interview
-Manage chronic conditions
-Difficulty understanding medical condition
Strategies to Improve Health Literacy
-Recognize the scope of the problem with your patients
-Educate colleagues about the scope of the problem
-Evaluate patient education materials
-Know available community resources
-Promote health literacy research
-Improve usability of health information and services
-Advocate for health literacy improvement
-Acknowledge cultural differences
Why is Global Health Important?
1.can improve health in the U.S.
2.Can support national and global security interests by fostering political stability, diplomacy, and economic growth worldwide.
3.Plays a role due to extensive international travel and commerce.
4.Rapid identification and control of emerging infectious diseases helps promote health abroad, prevent international spread of disease, and protect the health of the U.S. population.
5.Expanding international trade introduces new health risks.
Global Health Concerns
-Physical good health eludes millions of people
-Death and disease remain high from preventable causes (communicable disease, perinatal conditions, nutritional deficiencies)
-Diabetes and obesity
-Substance abuse including tobacco
Four Common Causes of Chronic Disease
Four modifiable health risk behaviors—lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption—are responsible for much of the illness, suffering, and early death
How does the U.S. help improve global health?
How does improved global health help the U.S.?
-Decrease outbreaks of disease that spread from country to country.
-Learn from experiences from other countries.
high level of wellness of the individual
early diagnosis of health problems and prompt treatment---"screening".
aimed to restore the individual to the highest possible level of health and functioning. Rehabilitation is the focus.
Steps to Healthier U.S.
-Promote health and wellness programs at schools and work sites and in faith- and community-based settings.
-Enact policies that promote healthy environments.
-Ensure access to a full range of quality health services.
-Implement programs that focus on eliminating racial, ethnic, and socioeconomic-based health disparities.
-Educate the public effectively about their health.
-Series of interventions targeted at improving the health of individuals, families, communities, or populations.
-Refers to those actions used to increase health or well-being---helping people change lifestyles to maintain health.
-Includes the prevention of disease and prevention measures.
-Comprises strategies related to individual lifestyle and personal choices made in a social context that have a powerful influence over one's health.
-Generally organized around developmental stages.
-Specific attention is given to needs of special populations.
Health Promotion---Changing Behaviors at Many Levels
Unique Features of Health Promotion
-Holistic view of health.
-Focus on participatory approaches.
-Focus on the determinants of health---root causes of health and illness.
-Building on existing strengths---not just dealing with health problems.
-Using multiple strategies.
Health Promotion Values
Health Promotion/Disease Prevention
-Health promotion is motivated by the desire to stay healthy and the focus is on assets and strengths--(behaviors that increase well being).
-Disease prevention is motivated by a desire to avoid illness---concerned with the prevention of chronic illness---(behaviors that help avoid disease)