Core 1 Better Health For Australians

Core 1
Better Health
for Individuals
Meanings of Health
- Definitions of health
- Dimensions of health
- Relative and dynamic nature of health

Meanings of Health
Health means different things to different people and this
meaning may change over time depending on
circumstances.
Health is dynamic, meaning it is always changing.
Activity
1. Complete the following sentences:
a. Good health to me means.
b. The signs of being healthy are..
c. To lead a healthy lifestyle you need to.
d. The thing I do that are good for my health..
e. When I am healthy I feel
f. The unhealthy things I do include.
2. After completing 1a-f, write your own definition of what
health means to you.

Definitions of Health
Definitions of health have changed over time. These
changes have taken place as a result of an increased
understanding of medicine, science, the physical
environment, the social environment and their influence
on people.
Up until the middle of the 20
th
century, health was
defined as the absence of disease. During this time
communicable diseases were the most common cause of
sickness and death. If you did not have a disease, you
were considered healthy.
Definitions of Health (cont.)
In 1948 the World Health Organization (WHO) defined
health as a state of complete physical, mental and social
wellbeing and not merely the absence of disease of
infirmity.
This definition can be made even broader by recognising
the impact of the spiritual and emotional dimensions of
health.
A holistic approach to health includes the physical,
social, mental, emotional and spiritual aspects of
individuals.
Holistic:
taking a
broad
view that
considers
the
whole
range of
relevant
health
factors
Activity
Health is a state of physical, mental and social
wellbeing. It involves more than just the absence of
disease or infirmity. wHO, 1948.

1. Explain how this definition incorporates a holistic
approach to health. (8 lines)
2. Outline the limitations, plus propose some changes to
the WHO definition in order to improve it. (10 lines)

Definitions of Health (cont.)
Dimensions of Health
Health is made up of a number of interacting
dimensions.

There are 5 dimensions of health that are considered
when measuring ones level of health and wellness, these
dimensions include:
1. Physical Health
2. Social Health
3. Emotional/Mental Health
4. Cognitive/Intellectual Health
5. Spiritual Health
Dimensions of Health (cont.)
Physical Health
Physical health is best described as the efficient
functioning of the body. Its the bodys capacity to
participate in everyday activities and the absence of
signs of disease, such as asthma, epilepsy or diabetes.
This dimension includes characteristics such as body size
and shape, level of fitness, energy level, weight and
ability to recover from illness.
Social Health
Social health refers to the ability to form and maintain
satisfying interpersonal relationships. It includes the
ability to relate to parents, teachers and friends in a way
that is accepted by our community. It also involves being
able to accept standards of behaviour (such as waiting in
a queue) and interacting positively in group situations.
Emotional/Mental Health
Emotional/Mental health refers to the ability to adapt to
change and cope with adversity. It also includes a
knowledge and acceptance of ones feelings and
emotions, the ability to manage stress in an appropriate
manner, the ability to be resilient in tough times and
having a well-developed sense of self.
Cognitive/Intellectual Health
Cognitive/intellectual health includes being able to
access, process and use knowledge to assist in decision
making, reasoning, weighing up the consequences of
actions, life planning and career development.
Spiritual Health
Spiritual health involves finding a purpose and meaning
to life. While it can include a belief in a higher being, it
can simply mean having a sense of ones self as part of
a bigger picture and is closely related to ones personal
value system. It often involves finding a sense of inner
peace or strength, a connection with nature, or optimism
for the future.
The key to good health is exercising each of the
dimensions and maintaining a balance between them.
Balancing the different dimensions of ones health may
not necessarily mean devoting equal time and energy to
each dimension but rather combining them in such a
way that a person gains an overall sense of wellbeing
(feelings of happiness, contentment and satisfaction).
Many health-enhancing behaviours that a person can
incorporate into their lifestyle fall into each of the
dimensions of health (see table on next slide and
handout).

Activity
Explain each of the dimensions of health and provide
examples of good health to illustrate each area. (5 lines for
each).
a) Physical health
b) Social health
c) Mental/emotional health
d) Cognitive/intellectual health
e) Spiritual health
Relative Nature of Health
- Relative means in relation to another
period of time, in relation to your
potential or in relation to others.
- One persons description of good health
might be quite different to the
description of another persons.
- For example: A child with asthma enjoys
a healthy, active lifestyle but
experiences events that a non-asthmatic
child might interpret as restrictive on
health.

Relative and Dynamic Nature of Health
Dynamic Nature of Health
- Dynamic refers to the constant fluctuations
that occur in our level of health.
- Our health is never static (remaining the
same). Our health varies over time,
fluctuating from minute to minute, day to
day, year to year.
- Illness, accidents, personal experiences or
environmental factors can move our level
of health any number of time during our
lives from very well to well, off-
colour to ill, very unwell to critically ill and
then back to full health. These changes
are known as dynamic.
Health Continuum
The health continuum measures our health status at
any moment in time. We are continually moving along
this continuum.
It enables us to rank our level of wellness or illness at
any given point in our lives.
Relative and Dynamic
Nature of Health (cont.)
Activity
Referring to the dynamic nature
of health, and the dimensions of
health, explain why health may
be viewed as a continuum. (10
lines)

Perceptions of Health
- Perceptions of their health
- Perceptions of the health of others eg
parents, the elderly, the homeless
- Implications of different perceptions of
health
- Perceptions of health as social constructs
- Impact of the media, peers and family
Perceptions of Health
How healthy am I?
How healthy do other people think I
am?
How healthy do I think other people
are?
Why would my perceptions of health
be similar or different to others?
How might an individuals
perception of health affect their
behaviour and wellbeing?
A persons perception of his or her
health status is highly subjective
(based on personal opinion that is
biased).
Some people perceive themselves as
healthy despite suffering from one or
more chronic diseases, while others
perceive themselves as ill even when
no objective evidence of disease can
be found.
Perceptions of their Health
(personal perceptions)
When making judgements about our level of health
and wellbeing our perceptions are influenced by a
range of factors:
- Our personal interpretation of the term health
- Our beliefs about our capacity to achieve good
health
- Our environment
- Health behaviours and lifestyle
- Past level of health
- Attitudes about health conveyed by family, peers
and media
- The value we place on the importance of being
healthy
Perceptions of their Health
(personal perceptions) (cont.)
Changing Perceptions of Health
Perception of the Health of Others
Just as our own level of health is
influenced by a range of factors, so
too are our judgements about the
health status of others.
Our different ways of seeing and
interpreting the living conditions,
fitness levels and health behaviours
of various groups significantly shape
our notions of how healthy people in
different circumstances are likely to
be.
These are stereotypical beliefs about
particular groups.
Activity 1
Working in pairs rate your own level of
health and then ask your partner to rate
what level of health they think you have,
stating why they have that perception.
Activity 2
In groups of 4 discuss where your group
(will be given to you) is placed on the health
continuum. Record your ideas on the paper
provided.
Activity 3
View the images on the next slide. Discuss
your perception of this persons health.

Activities
Click View
Images of Health + worksheet
Variations in Health Status
Implications of Different Perceptions
of Health
A number of
implications may
arise from different
perceptions of
health. Implications
refer to what might
happen as a result
of something else. A
persons belief about
health may
influence their
perceptions of the
cost and/or benefits
of engaging in
various health
compromising
behaviours.
We may treat people differently based on our perception of
health. For example, we may automatically assume that a
person in a wheelchair is unhealthy and can not involve them in
activities we are planning.
Other perceptions revolve around women in sport, often women
are considered weaker and less skilful then men.
At the societal level, different perceptions drive the agenda of
agencies responsible for developing health strategies and
interventions. They may lead to policies that affect the safety,
cost and even existence of many health products and
technologies.
Epidemiology is the study of patterns of diseases and ill health
within a population group. It is used to identify areas of health
that are emerging concerns, determine risk factors that
contribute to ill health and target prevention strategies towards
a particular population group or issue.
Implications of Different
Perceptions of Health (cont.)
Measures of Epidemiology
1. Mortality is the number of deaths in a given population
from a particular cause and/or over a period of time per
100 000 people.
2. Morbidity is the incidence or level of illness or sickness
in a given population per 100 000 people.
3. Life Expectancy is the average number of years of life
remaining to a person at a particular age, based on current
death rates.
4. Infant Mortality is the number of deaths in infants
(under 1 year of age), based on 1000 live births.
Perceptions of Health as Social
Constructs
Social construct is a concept that recognises that
people have different views based on their social
circumstances and ways of seeing, interpreting,
interrelating and interacting with their
environment.

Typical housing in third
world country.
Typical housing in first
world country.
A number of factors are likely to play a role in our social
construct of health:
- Socioeconomic status- our ability to earn money,
assets and possessions
- Geographic location- where we live, rural or cities,
farming or in town
- Cultural background- our ethnicity which affects the
foods we eat, our lifestyles, etc
- Gender- whether we are male or female and the
common stereotypes associated with each gender
- Age- our age, how younger and older people are
perceived
- Level of education- influences peoples perceptions on
our affluence, intelligence, place in society
- Community values and expectations- what is
expected of us by others in the community
Impact of the Media, Peers and Family
The media, our peers and our family have
a significant impact on the perceptions we
develop about health. These groups exert
a strong influence on the ideas that
people form about what constitutes good
health.

The Media
Media includes TV, radio, magazines, movies,
newspapers and internet
The media plays a significant role in disseminating
health-related information.
For example, news stories on binge drinking,
television advertisements about skin cancer or
feature articles in magazines on obsessive
compulsive disorder all seek to raise awareness and
increase peoples understanding of these health
issues.

Misleading messages in the media about health can
contribute to misconceptions or distorted perceptions of
health. For example, magazines, television, movies and
other forms of media are full of images of tanned,
attractive, slim women and men with athletic, muscular
physiques.

Sustained media coverage of a particular health
issue can lead to such attention and heightened
public concern that it can influence government
policy, priorities and health expenditure. For
example, frequent front page stories about road
crashes involving young people have been a critical
factor in increasing community awareness and
intensifying concerns about the over representation
of young people in accident statistics.

Peers and Family
Who we associate in and outside of school
markedly influences our attitudes about health
and health behaviours. Our family and peers are
the groups most likely to influence our ideas,
promote certain behaviours and provide support
in terms of our health.

When group members share similar ideas about
what good health means and place comparable
value on the importance of good health it is
easier for the individual to behave in ways that
will enhance their health and well-being.
Social pressures, along with the desire to fit in
may contribute to decisions being made that are
likely to negatively affect their health. Example:
experiment with drugs such as tobacco and
alcohol, take risks when driving, participate in
sexual activity, sun baking are all common
amongst peers

Families
Families have a significant influence in the lives of
most young people. Parents are our role models
from a very young age, so the ideas they
communicate about what health means and the
values they convey about the importance of good
health have a strong effect on the perceptions
that we develop.
The living conditions of families, along with other
socioeconomic factors such as income, education
and employment, also have a bearing on out
ideas about health.
People living in socioeconomic disadvantaged
areas generally live shorter lives and suffer more
illness and a lower quality of life than those well
off.

Poorer economic circumstances can also limit the
amount of money available to be spent on health
related expenses, therefore affecting the priority
given to health and the importance with which it
is viewed.

Questions
1. Growing up can be stressful and
challenging. Discuss how your perception
of health at different times impacts on
your behaviour and wellbeing; for
example, when you are fit and healthy
versus when you are feeling down or
unwell.
2. Investigate how body shapes have changed
since 1900. Collect pictures, photos and
newspaper clippings that highlight the
changing body shapes of men and women.
Use these images in a timeline that
demonstrated these changes. Discuss in
small groups how societys acceptance of
different body types has changed.
3. Analyse the degree to which a young
persons perceptions of health will be
socially constructed by the impact of
media messages.
4. A) Identify the factors that indicate
health is socially constructed.
B) Discuss how these factors influence our
health.

Health Behaviours of Young People
- The positive health status of young
people
- Protective behaviours and risk
behaviours
Health Behaviours of Young People
Health behaviours of young people is discussed frequently in
the media.
Issues discussed are increasing rates of obesity, escalating
consumption of junk food, declining levels of physical activity in
favour of computer games and TV, regular episodes of binge
drinking, rise in illicit drugs such as ecstasy and ice, growing
incidence of mental health problems, motor vehicle accidents,
etc
There is growing concern regarding young people and their
health.

The Australian Institute of Health and
Welfare (AIHW) undertake research into
the factors that influence a young persons
health.
The most recent finding about young
persons health was from a 2007 report
titled Young Australians health and Well
being . The report defined young persons
aged between 12-24. It concluded that
majority of young people are currently
faring well in terms of their health and well
being

The Positive Health Status of Young People

Evidence of this good state of health can have
improvements in life expectancy rates and a
decline in mortality in young people between
1980 and 2004, largely as a result of reductions
in deaths caused by injury, suicide and transport
accidents.

The Positive Health Status of Young
People (cont.)
Reductions in morbidity from chronic (persisting
over a long time, such as a long term disease or
illness) disease such as asthma, communicable
diseases such as rubella, mumps and
meningococcal, suicide, motor vehicle accidents
and other injuries such as poisoning have also
contributed to improvements in young peoples
health

People (cont.)
Despite a generally positive picture of the health
status of young people, the 2007 report did find a
particular group of young people were not
experiencing the same positive health status as
others in terms of their health and well being.
Individuals such as Aboriginal, young people living in
regional and remote areas, young people
experiencing socioeconomic disadvantage were
identified as experiencing lower health standards.

People (cont.)
Inequities in Indigenous Youth
Mortality rates are markedly different in the 2007
report finding death rates of ATSI people in 2002-
04 to be more than four times higher than that of
young non-indigenous Aust.
Indigenous people also experience a much lower life
expectancy, dying 17-20 years earlier than a non-
indigenous person.
For most indigenous people these health
disadvantages start at a young age and remain
throughout their life, resulting in ongoing negative
effects throughout their adult life.

Youth Living in Rural and Remote Areas
Young Austrians living in rural and very remote
communities were identified as another group
experiencing poorer levels of health.
Young people living in these areas had
significantly higher death rates and they had
more hospital admissions for particular health
problems associated with injuries or poisonings.
They would also more likely to engage in certain
risky health behaviours such as drinking and poor
dietary habits compared to those living in cities.

People (cont.)
Injuries, particularly those sustained from motor
vehicle accidents and intentional self harm, are an
area of concern in relation to young peoples health
as they continue to be the leading cause of ill
health, hospitalisation and deaths in this age
group.
Injuries were responsible for two-thirds of
premature deaths by young people, particularly
males, who were almost three times higher in
years of lost life than females

People (cont.)
Adolescence is the time when young people begin
to move from being dependent children to
independent adults. Along the way they face a
range of challenges and start to make decisions
about particular health behaviours. These
decisions will play a role in determining their
immediate and long term health.
Protective Behaviours: are those health behaviors
that are likely to enhance a persons level of
health, by eating adequate amounts of fruit and
vegetables, engaging in physical activity and
minimising risky behaviours such as drinking etc.

Protective Behaviours and
Risk Behaviours

Risk Behaviours: are those health behaviours that have
been found to contribute to the development of health
problems or poorer levels of health for example smoking.
The health and social behaviours that are adopted or
reinforced during adolescence often continue into
adulthood.
Behaviours relating to physical activity, diet, substance
abuse, sexual activity, risk taking, social connectedness
are those most likely to have the biggest impact on a
young persons life.

Protective Behaviours and Risk
Behaviours (cont.)
Behaviours Relating to Physical Activity
A certain level of physical activity is necessary to help
maintain a good level of health. 12-18yr olds should:
- Partake in at least 60 minutes of moderate to vigorous
physical activity everyday
- Limit the time on the computer, watching TV or
playing video games to two hours unless educational.
- Involvement in physical activity helps prevent
hypokinetic (lifestyle) diseases, improves mental and
social health and enables a person to improve their
physical conditioning.

Behaviours Relating to Health Eating
Adequate consumption of fruit and vegetables is
another health behaviour that helps protect
against a range of illnesses that include Coronary
heart disease (narrowing of the small blood
vessels that supply blood and oxygen to the
heart), hypertension, stroke, type 2 diabetes and
various cancers.
Research suggests that people aged between 12-
18yrs of age consume three servings of fruit and
vegetables daily, while those aged 19-24yrs
should increase their intake to two serves of fruit
and five serves of vegetables a day

Limited consumption of fruit and vegetables
suggest that young people may be skipping
meals and not eating three meals a day, this
makes it harder to eat the recommended
amount.
Research indicated that the maintenance of
healthy weight is closely linked to regular
consumption of breakfast, lunch and dinner,
making skipping meals a risk factor for becoming
over weight or obese.

Behaviours (cont.)
Behaviours Relating to Eating Patterns
There are many problems associated with teens
being overweight or obese.
Short term - most likely will negatively affect a
young persons social and emotional wellbeing,
particularly their self image and sense of
confidence.

Behaviours (cont.)
Overweight and obese teens also increase
their risk and susceptibility of developing
CVD and type 2 diabetes. Type 2 diabetes
in on the increase for teenagers. The
development of ATHEROSCLEROSIS
(depositing of plaque eg. fat and
cholesterol on the arterial walls) and
ARTERIALSCLEROSIS (hardening of
plaque) over years becomes a major risk
factor for CVD
Ongoing problems can occur in adulthood
as a result of having excess weight, these
can include certain cancers, gallstones,
disordered sleeping and osteoarthritis.

Behaviours Relating to Drug Use
Adolescence is a time where teenagers may
experiment with substances such as tobacco,
alcohol and other illicit drugs. The use of all these
drugs can pose a risk to health , with misuse
likely to cause numerous immediate and long
term health problems.

Behaviours (cont.)
Tobacco smoking has long been identified as the
leading cause of preventable death and chronic ill
health in Australia, with 19,000 deaths being
attributed to smoking annually. Smoking can be
linked to many forms of cancer, CVD, respiratory
disease such as bronchitis and emphysema,
circulatory problems and pregnancy difficulties.

Behaviours (cont.)
The commencement of smoking at a young age increases the
likelihood that a person will continue to smoke more heavily and
have greater difficulty in quitting.

Behaviours (cont.)
Binge Drinking
Drinking excessive amounts of alcohol is a major cause of ill
health and death.
Consuming large amounts of alcohol in short periods of time can
cause alcohol poisoning that can severely impair brain function,
resulting in a coma and even death.
Binge drinking causes increased confidence, a lowing of inhibitions
and the impairment of decision making as well as motor skills.

Behaviours (cont.)
Behaviours Relating to Sexual Activity
Adolescence is a time of heightened sexual
awareness, an intensified interest and feelings
towards others.
At this time young people may choose to enter
into close, intimate relationships and begin
participating in sexual activity.

Behaviours (cont.)
Unsafe sex increases the risk of contracting
sexually transmitted infections (STIs). A number
of diseases which are increasing in terms of
prevalence (widespread) are chlamydia and
gonorrhea.
Unsafe sexual activity can lead to unwanted and
unplanned pregnancies.
Studies have indicated that teenage pregnancies
are linked to a number of health and social
outcomes.

Behaviours (cont.)
Experiences of unwanted sexual activity can also lead to
consequences that can last a life time. There are many physical
harms such as STI, pregnancy and injury as well as sexual assault
this can result in the victim feeling a range of emotions
including anger, shame, guilt, fear, mistrust, betrayal, loneliness
and disempowerment. If left unresolved, theses emotions can lead
to poor mental and social health.

Behaviours (cont.)
Young people who are sexually active need to
look after their physical health by using
protective behaviour this will eliminate the
possibility of an unwanted pregnancy and being
infected with an STI.
ABSTINENCE is the best form for protecting
yourself against any STI and pregnancy!!!!!!

Behaviours (cont.)
Questions
1.Over the past Over the last 20
years rates of obesity in children
have risen greatly in many
countries around the world, leading
some researchers to speak of an
international epidemic of childhood
obesity. Outline some major social,
emotional and physical problems
that these children will experience
as they age. (15 lines)

2. 18 lines

Questions (cont.)
3. In 2008, the NSW and Federal
governments proposed an increased tax
on alcopops or ready to drink (RTD)
alcoholic beverages. Examine how this was
an attempt to tackle adolescent drug use
and propose some consequences of such a
tax. (10 lines)
4. There has been an increase of children
with obesity. Relate to how it causes
hypokinetic diseases, especially Type II
Diabetes.
5. Discuss why childrens lifestyles have
become more sedentary than in previous
years, particularly due to technology.
6. Research current trends in participation
for young children.
http://www.abs.gov.au/ausstats/abs@.nsf/0/
0F4B69DDFF667646CA25732C00207F4
4?opendocument go place to start
looking!

The determinants of health
- Individual factors eg. Knowledge and skills, attitudes,
genetics
- Sociocultural factors eg. Family, peers, media, religion,
culture
- Socioeconomic factors eg. Employment, education,
income
- Environmental factors eg. Geographical location, access
to health services and technology
The Determinants of Health
Health determinants are the individual,
socioeconomic, sociocultural and environmental
factors that can have a positive or negative
influence on the health of individuals or
populations.
Research has shown that health of individuals and
communities is affected by a broad range of
factors relating to the community, environment
and social context in which people live, along with
the health behaviours in which people adopt.

Individual Factors
Individual factors are those factors unique to
each person that can determine their level of
health. The include:
- Knowledge we have about health and the
skills we possess that enable us to act in way
to promote better health.
- Attitudes and values that we place on health
and the importance of leading a healthy
lifestyle
- Genetic factors that increase the likelihood
we may experience particular health
problems.
The Determinants of Health (cont.)
Knowledge & Skills
Knowledge and understandings that we develop
about protective and health risk behaviours,
health products and people available to support
good health are an important influence on our
ability to act in ways that contribute to good
health.
When we compare the level of education between
highly educated people and poorly educated
people in Australia, those with poorer education
appear to suffer from chronic illness as well they
are more likely to perceive their own health as
fair or poor

Knowledge & Skills (cont.)

Health knowledge comes from a variety of
sources parents, siblings, peers, teachers, the
internet and the media all of who play an
important roll in conveying information to us.
Previous experience can also contribute to what
we know and understand about particular
health problems, although having the
knowledge does not always mean that people
are willing to make healthy choices.

Knowledge & Skills (cont.)

Health literacy enables people to gain access to,
understand and use information in ways that can
promote or maintain good health. It also enables
people to access the accuracy and reliability of
information they may find.

Attitudes
Strong link between knowledge and attitudes,
with a persons level of knowledge more likely to
influence their attitudes they develop and the
way they behave. Example someone who has a
detailed understanding of the illnesses that are
associated with tobacco smoking are more likely
to be against tobacco smoking and not smoke
themselves.
The attitudes we develop are usually influenced
by our family, peers, the media, education and
the culture within our community.

Attitudes (cont.)

A persons attitude towards health behaviours,
their willingness to seek help and address any
health concerns does play an important role in
what they see as an important value that is
placed on their health .

Genetics
Genetics refers to the characteristics, features or
hereditary diseases that are genetically linked
and are passed on within the family.
There a number of genetic disorders, such
muscular dystrophy and cystic fibrosis, which can
lead to chronic ill health and a decreased life
expectancy. These diseases can be caused by our
genetic make up.

Genetics (cont.)
Down syndrome, which can affect a
persons physical development as well as
intellectual functioning are the result of
chromosomal abnormalities that can occur
during pregnancy.

Genetics (cont.)
Our genetic make up can make us more
susceptible to developing particular diseases such
as breast cancer, asthma, heart disease and
diabetes which have been linked to genetics.
Genetic information that is passed on by our
parents can be a positive influence on our health.
These genes we inherit provide us with potential
in terms of intellectual capacity, physical abilities
and life expectancy. Example how fast we can
run, how coordinated we are and how well suited
we are to particular sports.

Sociocultural Factors

Sociocultural factors: Relate to the society in
which people live and the cultural practices and
expectations that exist within these communities.
Families, peers, media, religion and cultural group
are the biggest influences on our level of health.
Assumptions on how certain groups should look,
think and behave can create pressure to conform
that leads to risk taking.

Family
Research has shown that a persons family
and their home environment can
significantly influence their health and
well-being.
Families are responsible for ensuring
physical needs are meet such as food,
safe housing, clothing and medical
requirements, they also provide emotional
support such as love and care.
Family (cont.)
Children living in situations of violence, abuse or
neglect are at risk of immediate physical injury
or emotional distress and are likely to suffer
adverse consequences on their long term
physical, emotional and social well-being
Families who serve 3 meals a day which contain a
variety of nutritious foods instill in their children
the importance of healthy eating.
Research has shown that children living with
someone who smokes are more likely to take up
smoking themselves.

Family (cont.)
Families are also an important source of
information and support when people experience
health related problems. They provide someone
to talk to and gain advice off.

Peers
Peers have a powerful influence
on the decisions people make
relating to health and the type of
behaviours they undertake.
If peer groups share common
interests and similar values it can
be easier to make healthy choices
e.g. being part of a peer group
that enjoys being active and
supports the participation of
people regardless of their level of
ability. This will help people feel
comfortable and encourage them
to join in.

Peers (cont.)
Making healthy choices can be difficult when the
peer group is not supportive or when the values
are held by those in the group differ from those
held by the individual.
Example, it can be difficult to maintain a decision
not to drink alcohol if you attend a party where
everyone else is drinking and you are commonly
offered a drink or questioned about why you are
not drinking.

Media
The media can have a powerful influence on a
persons opinions, beliefs and habits. The media
is seen as a social cultural determinant of health.
Electronic media such as TV, movies, internet,
newspapers and magazines play an important
role in spreading information about health e.g.
skin cancer and domestic violence. It has the
ability to raise awareness and enhances peoples
understanding on a particular issue.

Media (cont.)
Information that is given by the media needs to
ensure it is accurate, fair and balanced, as bias or
inaccuracies can lead to misconceptions and
confusion that can endanger someone's health.
Research has shown that media images
glamourising drug use can have a significant
influence on a persons attitude towards that drug
and the likelihood they will use the drug.
Example includes in the movies that associate
smoking with positive personal qualities such as
popularity, success and being cool.

Media (cont.)
Images conveyed through the media can also
have a significant impact on expectations that
society forms and the risk behaviours that result
from these expectations. Males driving fast cars
at high speeds, all night drinking sessions these
images can lead to immediate long term health
harms.
The constant portrayal of images of people who
are tanned, attractive and slim can contribute to
what society sees as being the ideal body shape.

Media (cont.)
The media can assist to shift societies attitudes about particular
health behaviours. Health promotion campaigns on TV and radio,
such as those about drink driving, binge drinking are frequently
used to raise awareness of these issues. They also act to reduce
mortality and morbidity rates.

Religion
Religious beliefs are another sociocultural factor that can influence
a persons health decisions and behaviours.
Beliefs relating to food, sexual activity and drug use are examples
where religious faith can affect a persons lifestyle choices.
Some religious beliefs do not believe in sexual activity before
marriage.

Religion (cont.)
Muslims, Seventh day Adventists and Buddhists forbid or
discourage the consumption of alcohol, meaning that the risk of
suffering health problems related to alcohol is reduced for people
who adhere to these beliefs.

Religion (cont.)
Religion also has the ability to govern what foods can and cannot
be consumed, based on religious belief.
Having a strong religious faith can also benefit a persons spiritual
health and well-being, by adding meaning to their life, creating a
sense of hope and optimism and providing support during times of
adversity.

Culture
Culture can simply be described as patterns of human activity
including the values and knowledge shared by society
Australia is often described as a multicultural society, referring to
our diverse ethnic and cultural backgrounds
Different cultural groups practice different eating patterns, daily
rituals, religious patterns of physical activity, gender roles,
patterns of employment, ways of communicating, family
structures etc

Culture (cont.)
According to Australian Health 2008, the death and hospitalisation
rates for people born overseas who migrated to Australia are
generally lower than those people born here.
Rates of disability and lifestyle related risk factors are also lower.
Diet is a major contributing factor, with many migrant groups
eating their traditional foods which often consist of highly
nutritious, fresh foods. Example most Asian diets, consist of low
fat foods such as rice, lean meats and vegetables.

Culture (cont.)
Language difficulties can be a barrier for cultures in terms of
health. In terms of the Australian health cared system, a lack of
fluency in English or cultural insensitivities can prevent or make it
difficult for migrants to access the appropriate health care.

Culture (cont.)
Attitudes and beliefs about PA can restricts the level of
participation in PA, particularly by women and girls. A survey in
2002 found that rates of participation in sports and PA were
significantly lower in those born in a non-English speaking country
compared to those born in Australia.
Being an ATSI descent also had a significant influence on health.
Indigenous people experience much poorer health than other
Australians.

Socioeconomic Factors

Socioeconomic factors relate to a persons level of income,
education and employment.
Low socioeconomic status (low SES) has a detrimental influence
on health in terms of poor health and disability, this affects
education and employment opportunities.
Education, income and employment are closely interrelated.
Higher education usually leads to a higher paying job. A higher
income also increases access to health services.


Employment
An individuals pattern of employment, including unemployment, is
a major component of lifestyle.
Reports have indicated that mortality rates are 50% higher for
unemployed Australians than for those who are employed.
Employment provides opportunities to be active, interactive with
others and feel a sense of control over our lives, as well as
ensuring financial security.

Employment (cont.)
Unemployment has been linked to a loss of confidence, limited
social contract, feelings of depression, this can affect a person
emotional and social health.
Types of occupation can also determine health; such as manual
jobs, trades and transport, which have higher rates of death and
injury than clerical, managerial or professional occupations. The
later group will be less physically active at work.

Education
Higher levels of education contribute to better
health status for individuals and their families.
Generally related to higher incomes and better
employment opportunities.
Education also provides people with greater
knowledge and skills for accessing health
services, facilities and information.

Income
Income is closely related to education and
occupation
Higher income provides access to better quality
goods and services to support health. Examples
include better housing, food health services and
preventative health.
Financial security can lead to greater sense of
control over work and life that contributes to
higher self esteem and emotional well being.

Environmental Factors
Environmental factors are those things present in
the environment in which people live and work
that can affect their health in a positive or
negative way.
Factors that relate to environmental factors are;
where you live, quality of air, food, water
available, climate conditions.
Poor building design, increasing level of pollution
and climate change all contribute to poor health.

Geographic Location
Rural: defined by the Australian Bureau of Statics
as populations between 5000 and 99 000.
Remote: have populations of less than 5000
People living in rural and remote parts of
Australia have poorer health outcomes than
people living in major cities.

Geographic Location (cont.)
People living in rural and remote areas normally have to
drive long distances which can lead to accidents caused by
speed, fatigue, animals on the road etc.
They are also more likely to face harsh living and working
conditions and experience severe climatic conditions such
as extreme heat, drought and floods which can have a
negative impact on both physical and emotional health.
The remoteness of communities and the distance between
people may make it harder to create or maintain social
support. This may lead to poorer mental health and
depression.
Indigenous Australians make up a significant
proportion of the population living in rural and
remote areas. Current statistics estimate 24% of
indigenous people live in remote areas, while
45% are in isolated areas.
There a number issues that relate to Aboriginals
who live in remote areas these include: disease
outbreaks, contaminated water, and
overcrowding. These factors contributing to ill
health

Living in cities and large built up areas may also have an
affect a person health. High levels of air pollution, more
motor vehicles and industrial complexes.
Poor air quality resulting from the production and release of
poisonous emissions from vehicles and heavy industry
increases the risk of respiratory infections, asthma,
bronchitis and CVD conditions.
Traffic congestion can contribute to high levels of stress as
motorists can become angry and frustrated, this also
increase the chance of crashes.

Access to Health Services
Some groups within the
community may have difficulty
accessing, understanding or
using information about health.
Access to Health Services (cont.)
People who are geographically isolated have
less access to health care and specialist
treatment services.
A range of health care options in rural and
remote areas is less than in urban areas, such
as access to screening programs and support
groups, alternative health professionals (eg.
Chiropractor, acupuncturist) and specialist
treatment services.

Some people may have to wait longer for
health care or travel long distances to
receive the necessary health care.
Those with ongoing conditions may be
required to be away from home for long
periods of time while undergoing
treatment, result in distress and financial
hardship.

People from non-English speaking backgrounds may
not assimilate new information as quickly as native
English speakers.
Studies have shown that certain people from some
non-English speaking backgrounds are not as
informed about risky health behaviours as their
English speaking counter parts (eg. in some places
smoking is seen as the norm so the are not aware of
the health and social problems associated with
smoking)

People living in major cities can also
experience difficulties accessing health
care, especially those relying on the public
transport system.
Highly populated areas can have
insufficient hospital beds available or long
periods waiting to be treated.
Those without private health needing non-
essential (eg. knee replacements)
procedures may have a lengthy waiting
period.
Some health care treatment is not
covered or only partially covered by
Medicare, meaning not everyone can
afford equal health care.

Access to Technology
Increasing use of technology, such as computers, mobile phones
and electronic games, has impacted significantly on peoples
health, particularly the health of young people.
Studies have found that young people spend significant
amounts of time involved in small screen recreation (watching
TV, playing computer games, using the internet, etc) often at
the expense of physical activity.
Excessive small screen recreations are associated with
increased risk of overweight and obesity.

Access to Technology (cont.)
Advances in technology have helped address some
problems associated with living in rural and remote areas.
The internet allows people to access accurate health
information and allows health professionals in rural and
remote areas to keep up to date with the latest research
and advances.
Email, social network sites, skype, etc have reduced
peoples sense of isolation by allowing them to keep in
touch. This technology also allows doctors in rural and
remote areas quickly and easily communicate with patients
and consult with health care providers/specialists in
different locations., which can reduce travel time.
Scanners and digital imaging technology
allows images to be sent to specialists in
urban areas and reduces the amount of
time the patient is required to spend away
from family and work.
Mobile phone technology and coverage
has improved meaning a reduced time to
get medical help or assistance.

A number of difficulties still exist that limit or prevent the
effective use of technology to support peoples health, such
as:
- Lack of infrastructure in rural and remote areas can restrict
access to fast and reliable technology
- The cost of purchasing a mobile phone or computer,
software and connection fees (people living in rural and
remote areas statistically have a lower income than those in
major cities).
- Computer illiteracy and reduced access to support services
such as technical support and repairs.

Click View
Determinants of Health + worksheet
Variations in Health Status + worksheet
Questions
1. Create a mind map to help remember the
Determinants of health.
2. Environmental factors can greatly
influence an individuals health. Investigate
why not all people have equal
opportunities to achieve and maintain
optimal levels of health and physical
activity.
3. Investigate how the determinants of
health explain why some individuals and
groups have better or worse health than
others.

The degree of control individuals can exert
over their health
- Modifiable and non-modifiable health
determinants
- The changing influence of determinants
through different stages of life
The Degree of Control Individuals
can have over their Health
Many health problems that are currently
prevalent (widespread or predominant) in
Australia are linked to the decisions people make
about their health and the lifestyle that they lead.
However, a persons level of health is not solely
determined by individual choices.
Not all Australians are able to exert the same
degree of control over their health, which has
resulted in inequalities arising in the health status
of particular population groups.
Inequality is the unequal distribution of illness
or conditions throughout the population.
Disadvantaged Population Groups
Disadvantaged
Population
Groups
ATSI
People from
low
socioeconomic
groups
People living
in rural and
remote areas
People
suffering
from a
disability
Australians
born
overseas
Older
people
The Degree of Control Individuals can
have over their Health (cont.)
Modifiable Health Determinants
Modifiable health determinants are those
that can be changed or controls so they
have a different level of influence on our
health.
There are 5 main factors that are central
to the control we are likely to exert over
our health, socioeconomic advantage, self-
efficiency, health knowledge and skills,
interest or desire and attitude.
Socioeconomic Advantage
Being in a position of socioeconomic advantage
provides us access to physical and social resources
such as education, money and health services that
can make our life better.
For some people, modifying the socioeconomic
determinants that influence their health, such as
education, employment and income, can be
difficult.
Their overall outlook on life can help them to
overcome barriers created by their socioeconomic
conditions and change their health behaviours.
Modifiable Health Determinants (cont.)
Self-Efficiency
Self-efficiency refers to our belief in our
ability to bring about change.
The stronger our self-efficiency, the
greater our levels of perseverance and
persistence and feelings of control.
If we have low self-efficiency we are more
likely to feel powerless and produce
negative self-evaluations that can lead to
lower self-esteem.

Health Knowledge and Skills
The health knowledge and skills that people
possess is one area that can be modified to
enable them to assert greater control over
their health.
Reliable and accurate information on issues
such as how to prepare healthy meals or
increase our physical activity are available in
places such as doctors surgeries, local
newspapers and on the internet.
Not everyone will have the same access to
this information. The long term unemployed,
homeless and some Indigenous people are
likely to find it most difficult to improve their
health knowledge and skills.
Interest or Desire
People need to possess an interest or
desire to improve their health knowledge
and skills. Health is not always the central
consideration when people make
decisions. Often the immediate demands
and pressures of daily life take
precedence.

Attitudes
Peoples attitudes to health are another
determinant that may be modified.
Different experiences in our life (eg. Developing
skin cancer or losing a friend in a road accident)
may lead to a change in our health attitudes.
Health promotion campaigns are a commonly used
strategy that seek to change peoples attitudes
and beliefs.
Factors that influence a persons attitude include
age, society attitudes, self-efficiency, individual
beliefs.
Non-Modifiable Health Determinants
Non-modifiable health determinants
are determinants that cannot be
changed or altered.
The only factors that might be seen
as non-modifiable determinants of
health are genetics/heredity and
some environment factors.
Genetics
The genetic material we receive from our parents can pass on
certain health conditions, increase our susceptibility to
particular illnesses or see us inherit characteristics that can
affect our health.
This genetic material cannot be altered, although tests for
certain conditions such as Down Syndrome can be performed
prior to conception and during pregnancy.
Progress in treatments of particular genetic conditions, has
meant that people born with conditions that use to be life
threatening, such as haemophilia, can generally now lead
healthy, normal lives.
People with a family history of a particular illness such as
breast cancer can also undergo monitoring, screening and
surgery before symptoms are detected in an effort to reduce
the risk of cancer developing.

Non-Modifiable Health Determinants (cont.)
Environmental Factors
Factors such as geographic location,
access to health care, availability of
technology and other environmental
factors are also largely non-modifiable.
People living in rural and remote areas
have little control over the limited health
services available, the sparse
infrastructure, the occupational hazards,
social isolation or natural disasters.
Non-Modifiable Health Determinants (cont.)
People living in areas surrounded by
heavy industry or high volumes of traffic
have little control over the levels of air
pollution that may be present in the
environment.
Precautions can be taken such as staying
indoors when there is high levels of
pollution.
Some people lobby governments for
increased expenditure for health services
or tighter controls on factory
emissions, however, high levels
of knowledge are usual required to
initiate change.

Changing Influence of Determinants
through Different Life Stages
The influence of health determinants changes
through the different life stages. Children of
less affluent families are more likely to
experience failure at school, work in the more
disadvantaged sectors of the workforce, and
experience unemployment early in their
working lives.
Poorer families are more likely to produce
babies of lower birth weight. Children with low
birth weight have an increased risk of
socioeconomic disadvantaged during childhood
and adolescence and an increased risk of
chronic disease in middle age.

The transition from school to work is
regarded as having influence on the
determinants of health.
People who enter less well paid
employment are at greater risk of
experiencing insecurity and being exposed
to physical and chemical hazards at work.
They are also more likely to live in less
well constructed housing in more polluted
neighbourhoods, and retire on no more
than the basic pension.
As people age they become more
susceptible to disease. These are
known as DEGENERATIVE
DISEASES.

Activity
Relate to how the Elderly can modify
their lifestyle to decrease their
susceptibility to degenerative disease.
Changing Influence of Determinants
through Different Life Stages (cont.)
Health as a social construct
- Recognises the interrelationship
of determinants
- Challenges the notion that
health is solely the individuals
responsibility
Health as a Social Construct
The social construct of health recognises that
people have different views of health based
on their social circumstances and ways of
interpreting, interrelating and interacting with
their environment.
It varies from one society to another.
Recognising health as a social construct helps
us to explain why some groups or individuals
experience better or worse health than
others.

Recognises the Interrelationship of
Determinants
Health is a dynamic quality that is
affected by a complex
interrelationship between individuals
and their physical, social, economic
and political environments.
Recognition of the interrelationship
of the determinants of health is
reflected in a social view of health.
This sees health as being created in
the settings where people live and
work.
It recognises the need for:
- Personal skills development
- Empowerment of communities to take action to
promote health
- The creation of social and physical environments
that are supportive to health
- An awareness of the impacts on health of public
policies
- Health services that are orientated towards health
promotion and the prevention of ill-health
The interrelationship that exists between our social
environments- the care and nurturing we receive
when young, our interactions with others and our
sense of inclusion- determine our health and
wellbeing.
Recognises the Interrelationship of
Determinants (cont.)
Challenges the notion that health is
solely an individuals responsibility
A social view of health recognises that
health risk cannot be attributed solely to
individual risk behaviours. It understands
that a persons health and wellbeing are
associated with social institutions, such as
families, communities, workplaces and the
health care system.
These institutions can support or diminish
the health of the individual.
Viewing health as a social construct helps explain:
- Why certain groups behave in particular ways
- Why certain groups do not have the same
opportunity
- How behaviour can be associated with social and
cultural meanings
Factors influencing the health behaviours of a person
or group are often categorised as:
- Predisposing: factors that increase the likelihood of
the behaviour
- Enabling: factors that support the behaviour
- Reinforcing: factors that help the behaviour to
continue

Challenges the notion that health is
solely an individuals responsibility
(cont.)
Questions
1. Discuss to what degree an individual is able to
determine his or her own health status.
2. Explain whether the level of control is the same
for everyone.
3. Why do certain groups not have the same
opportunity to achieve good personal health
as others? For example; a) children who are
obese or vcery overweight, b) ATSI and
c)people who live in remote areas.

4. Imagine a young person who has two to the below
characteristics:
- Lives in a remote or rural area
- Has a disability
- Lives in a low socioeconomic area
- Is homeless
- Has a culturally diverse background
Discuss how the two characteristics you selected would
influence the young persons health behaviours.
5. Describe the factors that support better health.
6. Describe the factors that act as barriers to better health.
7. Explain whether individuals can achieve better health
despite these barriers.

What is health promotion?
What is Health Promotion
Health promotion aims to increase
awareness of hypokinetic diseases
in an attempt to empower
individuals to make positive lifestyle
changes.
It is able to deliver awareness
through a range of mediums such as
EDUCATION, SCIENCE and through
health promotion CAMPAIGNS that
are advertised through the media.
What is Health Promotion (cont.)
Responsibility for health promotion
- Individuals
- Community groups/schools
- Non-government organisations
- Government
- International organisations eg. WHO,
United Nations
Responsibility for Health Care
A wide range of people and groups
are responsible for promoting
health. These include:
- Individuals
- Community groups and schools
- Non-government organisations
- Various levels of government
- International organisations
For health promotion to be effective there
needs to be INTERSECTORAL
COLLABORATION (forming partnerships)
between organisations, schools,
cooperation of professional personnel, etc.
to instigate positive health outcomes
A coordinated approach by all people and
organisations involved is needed to
successfully plan, develop and deliver
initiatives that address identified areas of
concern.

Individuals
Individuals play a key role in promoting
their own health, because personal
behaviour is the major determining factor
of health status.
For health promotion to be effective,
individuals need to be empowered.
Individual empowerment refers to an
individuals ability to make decisions
about, or have personal control over their
life.
Health promotion includes and
encourages individual responsibility
and action.
Individuals can take advantage of
health professions (GPs, dieticians,
counsellors, dentists, health workers
and community nurses) to improve
their lifestyle.

Community Groups and Schools
Community health programs may have
targets on varying scales. They may be
directed at individuals, local communities,
states or the entire country.
Health information is provided to the
general public through mass media.
Journalists have an influential role in
delivering health information.

Architects, engineers and urban planners
also contribute to health through they way
they plan and build houses and urban
infrastructure, such as roads and bridges.
They health determine the structure of the
environment in which people live, work
and play.
Health education and personal
development are important parts of the
school curriculum, and teachers play a key
role in their delivery.
Schools also implement health-promoting
policies, such as using sun protection in
the playground, banning smoking on
school grounds and providing healthy food
choices in canteens.

Community Groups and Schools (cont.)
Schools have an important role in
health promotion as they are the
sites where health knowledge is
gained, healthy behaviour is
encouraged and health skills
developed.

Non-government Organisations (NGOs)
NGOs are non-profit making organisations that
operate at local, national and international levels.
NGOs focus on specific disease or health issues.
They are funded by a variety of sources, including
public donations, fundraising and government
grants.
Examples of NGOs are The Heart Foundation, Jump
Rope for Heart, Cancer Council and Asthma
Foundation, Headspace and Youthsafe.

Governments work closely with NGOs to
improve the quality and availability of
human and financial resources directed at
health promotion.
NGOs are not controlled by governments
and their work is not controlled or limited
by government policy.

Government
All levels of government- local, state and federal- have to
play a key role in health promotion.
Local Government
Local government has significant responsibilities for health
promotion as its decisions and policies affect a number of
the determinants of health. It is responsible for many
aspects of community living, including environmental and
land use planning, recreational facilities, community
development, environmental and heritage conservation,
home care, child care and community transport. It is also
responsible for waste management and food safety. Each
of these areas of responsibility makes a substantial
contribution to the health and wellbeing of the community.
State Government
State governments are responsible for supervision of
health protection functions, such as food safety,
environmental health and use of drugs and poisons.
It is also responsible for disease prevention and
control, which involves health education,
immunisation, refugee screening and cancer
screening. State governments also have an important
role in determining the strategic direction of health
promotion, such as in the areas of nutrition, physical
activity, womens health, injury prevention, and
tobacco, alcohol and other drug use.
Government (cont.)
Commonwealth Government
At the federal level, the Commonwealth
Government is responsible for how well
the health system serves the needs of the
people, health financing, policies and
program implementation. Specialist
agencies have been set up at the federal
level to regulate and monitor health. They
include Food Standards Australia New
Zealand.
Government (cont.)
International Organisations
To assist and guide countries in achieving the
best health for their citizens, a number of
international health organisations have been
established. The United Nations, World Health
Organization and United Nations Childrens Fund
are three such organisations. All three bodies
are involved in promoting global health.
The United Nations (UN) maintains
international peace and security; develops
friendly relations between countries based
on respect for the principle of equal rights
and self-determination of peoples;
cooperates in solving international
economic, social, cultural and
humanitarian problems; and promotes
respect for human rights and fundamental
freedoms.

Within the UN are administrative bodies
that play a key role in health promotion,
including the WHO and United Nations
Childrens Fund (UNICEF).
WHO is the directing and coordinating
authority on international health within
the UN.

International Organisations (cont.)
WHO experts produce guidelines and
standards and help countries to address
public health issues. It also supports and
promotes health research.
Through WHO, governments can work
together to address global health
problems and improve peoples wellbeing,
eg. polio free India.

Activities/Questions
1. Create a mind map on the Responsibility
for Health Promotion.
2. Describe the role and responsibility of
community groups/schools in health
promotion

Health promotion approaches and
strategies
- lifestyle/behavioural approaches eg. quit
smoking programs, health education
- Preventative medical approaches eg.
childhood immunisation, cancer screening
- Public health approaches eg. health-
promoting schools and workplaces

Health Promotion Approaches and
Strategies
Health promotion is aimed at improving the health of an
individual or community or changing behaviour that may have
a negative influence on health.
Health promotion approaches and strategies range from
individually focused interventions (such as posters providing
positive health messages) through to the development of a
national health promoting policy (such as the National Mental
Health Strategy).
The approaches include:
- Lifestyle and behavioural approaches
- Preventative medical approaches
- Public health approaches

Lifestyle/Behavioural Approaches
A lifestyle approach to health promotion
aims to reduce or prevent the incidence of
risk behaviours that contribute to poor
health
It is based on the premise that the major
causes of morbidity and mortality within
Australia are diseases resulting in poor
lifestyle choices.
This approach is directed at improving risk
factors related to individual behaviour
such as poor eating habits, physical
inactivity, smoking, unsafe sexual activity
and drug and alcohol abuse.
Health education programs, social
marketing campaigns, the promotion of
self-help or self-care practices and public
policies are strategies that are commonly
used.

Example of health promotion programs
that work within this model include:
- Web based services such as Reach Out!
That seek to enhance health knowledge
and skill to support and improve mental
health and wellbeing
- Physical activity initiatives targeting
school aged children that aim to increase
levels of regular physical activity and
reduce sedentary behaviours
Lifestyle/Behavioural Approaches (cont.)
- Quit smoking campaigns and strategies to
encourage people to stop smoking or
remain smoke free
- Road safety campaigns that challenge
peoples attitudes towards unsafe driving
behaviours such as speeding

DISCUSSION
Harm Minimisation Approach vs Zero
Tolerance Approach. Both of these are
included in the lifestyle/behavioural
approaches to health promotion
approaches and strategies.
Lifestyle/Behavioural Approaches (cont.)
Preventative Medical Approaches
Preventative medical approaches are those that use
medical treatments or interventions to promote
health. It is a more traditional approach to health
promotion.
This approach is directed at improving the
physiological risk factors, that is those relating to the
way living things function, such as high blood
pressure, abnormal cell production or lack of
immunisation.

Health promoting action used in preventative
medical approaches commonly occurs in a
series of stages: primary, secondary and
tertiary prevention.
Primary prevention- preventing initial
occurrence of an illness, such as through
childhood immunisation programs.
Secondary Prevention- stopping or slowing an
existing illness, such as provision of cervical
screening services
Tertiary prevention- reducing the re-occurrence
and establishment of chronic illness, such as
provision of effective rehabilitation services.

Preventative Medical Approaches (cont.)
Public Health Approaches
The public health approach to health promotion
involves establishing programs, policies and services
that create environments that support health.
Public health approaches are a more recent trend in
health promotion.
They have been significantly influenced by the
WHOs policies and philosophies.
Public health approaches aim to provide the
maximum benefit for the largest number of people.
They are concerned with preventing disease and
injury form occurring or reoccurring, promotion of
health, and returning health to populations and
communities following natural or man-made
disasters.
The key steps in public health approach
include:
- Defining and monitoring the extent of the
problem
- Identifying the cause of the problem
- Formulating and testing ways of dealing
with the problem
- Applying widely the measures that are
found to work
Settings for health promotion to reach a
large number of people include schools
and the workplace

Public Health Approaches (cont.)
Health Promoting Schools
A health promoting school is one that operates in a
way that demonstrates a whole-school commitment
to improving and protecting the health and wellbeing
of the school community. The 3 components of the
health promoting school framework are:
- curriculum, teaching and learning what is taught
and learnt and how it is taught and learnt
- School organisation, ethos and environment how
the school feels eg. safe, fun, stimulating
- Partnerships and services partnerships formed
with the wider community and with the families of
the students.
Health Promoting Workplace
The workplace influences the physical,
social, mental and economic wellbeing of
workers and, in turn, the health of their
families, communities and society.
Workplace promotion includes activities
and strategies that are designed to
improve the health of workers and the
community.
It includes programs such as occupational
health and safety.
Health Promotion Campaigns
For each campaign identify the health promotion
message and what it is trying to prevent.
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The Ottawa Charter as an effective health
promotion framework
- Developing personal skills
- Creating supportive environments
- Strengthening community action
- Reorienting health services
- Building healthy public policy
The Ottawa Charter
In 1986, the
marked the
beginning of a new era
of public health. Ottawa
Charter became the first
conference for
international health
where the initial goal
was to achieve health for
2000 and beyond.
The Ottawa Charter recognised that in order for
health to be achieved, it needed to focus on a

The thrust of the charter was to establish health
as a human right that should be incorporated in
all public policy and decision making.
The Ottawa Charter clearly reflects the belief that
health is socially based.
1.What is the Ottawa Charter and
when was it established.?
2.What is its purpose?
3.List and briefly describe the 5
principles [action areas] of the
Ottawa Charter.
4.Locate and save or paste into to
your notes, the Ottawa Carter
Symbol.
The charter is significant because it
gave direction to health promotion
through clear definitions, action
plans and positive involvement.
Agreement to the principles of the
Ottawa Charter saw countries across
the world adopt the public health
approach as a new way of
approaching health promotion
It acknowledges the role of health
and social factors, such as housing,
water and food quality, education,
transport, employment, government
social support policy and access to
health care.

Action Areas of the
Ottawa Charter

1. Developing Personal Skills (empower
the individual to make positive
health/lifestyle choices)
2. Building Healthy Public Policy (Policy
and legislation that supports health)
3. Strengthening Community Action
(Community working together to enhance
health)
4. Creating Supportive Environments
(creating safe, healthy, stimulating work,
school and community environments)
5. Reorienting Health Services (taking
the emphasis away from curing disease
to preventing disease)

Developing Personal Skills
Health promotion supports personal and
social development through providing
information, education for health and
enhancing life skills. By so doing, it
increases the options available to people
to exercise more control over their
environment, and to make choices
conductive to health.
Extract from the Ottawa Charter
These skills (communication, problem
solving, planning, decision making,
conflict resolution and goal setting) can be
developed in schools, workplaces and in
other community settings.
Examples of this action in Australia
include:
- Health education in schools
- Media campaigns encouraging
healthy life choices
- Anti-smoking programs
- The work of NGOs, such as Cancer
Council and the National Heart
Foundation
Developing Personal Skills (cont.)
Creating Supportive Environments
The overall guiding principle for the world, nations,
regions and communities alike, is the need to
encourage reciprocal maintenance- to take care of
each other, our communities and our natural
environment. The conservation of natural resources
throughout the world should be emphasised as a
global responsibility.
This action area focuses on the places where people
live, work and play and on increasing peoples
ability within these settings to make health-
promoting choices.
Workplaces, support groups, health services, school
the media and family can all help to provide
supportive environments

Examples of this action area in Australia
include:
- The use of unleaded petrol
- Alcohol free areas at sporting venues and
in the community
- Recycling programs conducted by local
councils
- Healthy school canteens
- On the sporting field- padded areas,
modified rules and protective equipment
- The policy of speeding in school zones
- In the home- smoke alarms, smoke free
zone

Creating Supportive Environments (cont.)
Strengthening Community Action
Health promotion works through concrete
and effective community action in setting
priorities, making decisions, planning
strategies and implementing them to
achieve better health. At the heart of this
process is the empowerment of
communities- their ownership and control
of their own endeavours and destinies.
The focus of this area is the empowerment
of communities to identify and implement
actions to address their health concerns.
Communities will respond more positively
to initiatives that they have had a role in
developing.
Examples of resources that can work
effectively together are schools,
workplaces, self-help groups, local
governments, community health centres,
doctors and the media.
include:
- Health promoting in schools
- Self-help groups, such as Alcoholics
Anonymous and CanTeen
- Lions Club Driver Reviver stations

Strengthening Community Action (cont.)
Reorienting Health Services
The responsibility for health promotion in
health services is shared among individuals,
community groups, health professionals,
health service institutions and governments.
They must work together towards a health
care system which contributes to the pursuit
of health. The role of the health sector must
move increasingly in a health promotion
direction, beyond its responsibility for
providing clinical and curative services.
The reorientating of health services has
focused on the wellbeing of the whole person:
promoting ill health and supporting wellbeing.
Simply, focusing on prevention rather than a
cure.
Reorientation means adjusting
the direction or focus of a
service to create a fresh
approach.
include:
- Increased funding for health promotion
and research
- Doctors working with child-care centres to
promote immunisation programs
- Pharmacists working with community
health centres in order to engage in
improved preventative strategies
- Police working with schools to address
issues such as drink-driving, bullying and
other crimes.

Reorienting Health Services (cont.)
Build Healthy Public Policy
Health promotion combines diverse but
complementary approaches including
legislation, fiscal measures (government
spending), taxation and organisational
change. It is coordinated action that leads
to health, income and social policies that
foster equity. Joint action contributes to
ensuring safer and healthier goods and
services, healthier public services and
cleaner, more enjoyable environments.
This relates to the decisions made at all
levels of government and by organisations
that work towards health improvement.
The purpose of this principle is to guide
public policy so that it provides an
environment in which healthy choices are
made easy.

include:
- Legislation to restrict advertising of
cigarettes
- Smoke-free workplaces and public
buildings
- Reduced tax on unleaded petrol and low-
alcohol beer
- Compulsory swimming pool fences
- Incentives for private health insurance
- Government employment programs, such
as CentreLink
Build Healthy Public Policy (cont.)
Activity/Questions

Activity/Questions (cont.)
3. Explain how the action areas of the
Ottawa Charter can contribute to
reduction in the incidence of a health
concern (for example tobacco use or road
injuries).
4. In small groups, choose a health issue or
behaviour that you would like to address
within our school community. Who will be
your target audience? Will it be students,
staff, parents, community members or all
of these? Using the Ottawa Charter for
Health Promotion framework, propose
strategies under each of the action areas
to improve the health of your audience in
relation to your chosen health issue or
behaviour.

5. The Ottawa Charter has had considerable
influence on the understandings of health
promotion that have developed in
Australia, the approaches that have been
adopted and the people or organisations
that have involved themselves in these
approaches. Explain how the Ottawa
Charter marked a change in approaches
to health promotion in Australia.

Principle of social justice
- Equity
- Diversity
- Supportive environments

Principles of Social Justice
Social justice refers to eliminating
inequities that exist amongst population
groups. It aims to promote equity and
inclusiveness so that health outcomes are
equitable irrespective of race, gender,
culture, location and age.
If all people are to reach their optimum
health, equal opportunity is essential.
Equality does not mean giving everyone the
same thing but giving each group what
they need to achieve optimum health.
Equal opportunity rights apply to everyone,
social justice targets marginalised or
disadvantaged groups in society.
Social justice is concerned with ensuring that
ever Australian lives free from discrimination and
has the means to make choices about how they
live.
The principles of social justice can be
summarised as equity, diversity and supportive
environments.
Medicare is an example of the social justice
principles in action. It provides all members of
the population with the opportunity to access
basic medical services and hospital care,
regardless of socioeconomic status, race or
gender.

Equity
Equity involves making sure resources and
funding are distributed fairly and without
discrimination, and based on the needs of
the individuals or populations.
Health equity means that everyone has
access to the health services and support
they need, when they need it and in a
place that is easily accessible.
Principles of Social Justice (cont.)
Diversity
Diversity is variety, or difference, between
individuals and groups of people.
The valuing of diversity helps to eliminate prejudice
and discrimination.
This principle of social justice is a commitment to
encouraging men and women of diverse racial,
social and economic groups to play major roles and,
in a spirit of mutual respect, come to understand
and appreciate what each brings to a whole.
It involves all groups of the community in planning
and making decisions about health issues.

Accepting diversity involves:
- Recognising the cultural and social diversity of
society and examining and evaluating diverse
values, beliefs and attitudes
- Recognising the contribution of social, cultural,
economic and biological factors to individual
values, attitudes and behaviours
- Exploring different views about issues such as
gender roles, physical activity, peer-group
relationships, sexuality, cultural beliefs and what
constitutes a healthy environment
- Exploring conflicting values, morals and ethics for
wellbeing when making decisions.

Supportive Environments
As a principle of social justice,
establishment and maintenance of
supportive environments is aimed at
ensuring all community members have
equal opportunity to achieve good health.
People are encouraged to engage actively
in making environments more supportive
of health. These environments include
those where people live (including their
local community and their home) as well
as where they work and play.
It requires that physical, social, economic
and political environments are supportive
of health rather than damaging to it.
This principle is also concerned with
ensuring people have access to resources
and opportunities for empowerment that
will support their health.

Questions
1. A) Identify the social justice issue in the scenarios below:
- A local high school does not have disabled access. Students
with disabilities are not encouraged to enrol at this school.
- Local rural hospitals are having difficulty in employing
doctors and nurses who have knowledge and understanding
about the health issues of young people in the community.
The youth are worried about the impact of this on provision
of health services for young people.
- A local high school is situated on a busy main road. The
school community has complained to the local council about
road safety issues concerning their school.
B) Propose examples of health actions that can be taken to
support the principles of social justice.
2. Discuss the aim of health equity for Australians. Is it to
provide them with the opportunity to achieve good health or
is it to ensure all have the same level of health?

Core 1 Better Health For Australians

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