HEALTH PROTECTION

AND PROMOTION
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Let’s discuss…

«The same
health law
governs both
disease and
health.»
Florence Nightingale

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What is "Health Protection"?
Health protection is defined as legal or financial controls and
other regulations to promote health and prevent disease.

The concept of health protection, often used interchangeably

with the term disease prevention, reflects a focus on disease.

Both disease prevention and health protection activities aim

to prevent illnesses.

The focus is on specific groups or individuals who are at risk

of potential diseases.

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 What is "Health Protection"?

Health protection = Disease prevention

Health protection ≠ Health promotion

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HEALTH PROMOTION
HEALTH PROMOTION: Alma-Ata Declaration (1978)

The World Health Organization (WHO), in the Primary Health Care Declaration
made in Alma-Ata in 1978, emphasized that health is one of the fundamental
human rights and, therefore, the concept of 'Health for All' should be targeted.

It also underlined the need for efforts from many other social and economic
sectors in addition to the health sector to achieve this goal.

After this process, the public health movement worldwide gained a new
dimension, and the concept of health promotion became one of the key
aspects in achieving these goals
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HEALTH PROMOTION
Health promotion has been defined as the enhancement of an
individual’s or group’s well-being and self-actualization (Pender et al.,
2015).

Health promotion is also described as lifestyle coaching designed to enhance

the highest level of health, quality of life, and well-being

Health promotion is the process that enables people to increase control over
their health by empowering them to change their personal behaviors and
lifestyles, and by supporting environments that contribute to healthy living.

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HEALTH PROMOTION
The more broader definition of health literacy contains the following:

• Healthcare and disease prevention policies

• Strategies and activities that address the social, economic, and
physical environment,
• Cultural factors,
• Equity and diversity,
• Education and training,
• Services, facilities, and products,
• Community-based activities
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 HEALTH PROMOTION: CONTEXT

Context of health promotion

Identification Preventive Development

Health
and Reduction Empowerment Advocacy Health of Health
Education
of Health Risks Services Policies

içermektedir.
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HEALTH PROMOTIN: Primary Goals
• Promoting health and well-being across all
Ensuring that people of all stages of life to help individuals maintain
ages remain healthy optimal health.

Optimizing health in cases • Supporting individuals with chronic conditions

of chronic illness or or disabilities to achieve the highest possible
disability level of health and quality of life.

• Designing and fostering environments—both

Creating healthy physical and social—that support and promote
environments health for individuals and communities.

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HEALTH PROMOTIN: Primary Goals

These goals highlight the importance of promoting health across all ages, managing chronic
conditions effectively, and establishing environments that contribute to overall well-being.
To achieve these goals, it is necessary to develop strategies that both promote the health of
individuals within the family and community and address the environments in which
individuals live and work.

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 Characteristics of Initiatives to Implement
the Health Promotion Approach

Promote
Community
Empowerment Equality and
Involvement
Justice

Multi-Sectoral Multi-Strategic
Accessibility
Collaboration Approach
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 Characteristics of Initiatives to Implement
the Health Promotion Approach: Examples
Community Health • Educating residents on nutrition, exercise, and preventive healthcare.
Workshops:
School-Based Health • Implementing health education in schools to teach children about
healthy behaviors.
Programs:
Workplace Wellness • Encouraging businesses to promote health among employees through
fitness programs and mental health support.
Programs:
Public Health • Launching campaigns focused on smoking cessation, healthy eating, or
physical activity to raise awareness and encourage behavior change.
Campaigns: 13
 HEALTH PROMOTION:
Ottawa Charter for Health Promotion (1986)
It is the first document focused on health promotion as a
process.

It has established the foundation for theories and practices

related to health promotion, emphasizing the role of social and
personal resources, as well as the need for equity in health.

It has documented the responsibility of civil society and public

institutions in creating supportive environments and health
public policies.
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 HEALTH PROMOTION:
Ottawa Charter for Health Promotion (1986)

Prerequisites for Health

Stable Sustainable Social

Peace Shelter Education Nutrition Income Ecosystem
Equality
Resources Justice

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 HEALTH PROMOTION:
Bangkok Charter for Health Promotion in a
Globalized World (2005)
By updating the Ottawa Charter, it has made health promotion a fundamental responsibility of the global
development agenda and all governments.

This document has transformed health promotion from an individual healthy lifestyle education model into
a socio-economic model that addresses the social determinants of health.

In the Bangkok Charter, health promotion is viewed as a core responsibility of all governments
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 HEALTH PROMOTION:
Bangkok Charter for Health Promotion in a
Globalized World (2005)
By updating the Ottawa Charter, it has made health promotion a fundamental responsibility of the global
development agenda and all governments.

The Bangkok Charter serves as a guiding framework for countries and

Thisorganizations to develop
document has transformed and implement
health promotion effective
from an individual health
healthy lifestyle promotion
education model into
strategies that are
a socio-economic inclusive,
model equitable,
that addresses and sustainable.
the social determinants of health. It
underscores the collective responsibility to create a healthier world
for all.

In the Bangkok Charter, health promotion is viewed as a core responsibility of all governments
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 Principles Defined for Guiding Health Promotion
(HP) Programs
• Active involvement of all the stakeholders in the development and
Participation: implementation of HP programs.

• Programs should focus on empowering individuals and communities to take control of their
Empowerment: own health through education, access to information, and by fostering environments that
support healthy choices.

• Addressing not just physical health but also mental, emotional, and social well-
Holistic approach: being.

• Collaboration across various sectors such as education, housing, employment,

Multi-sectoral approach: and environment

• Demanding integrity in health and social justice

Justice:
• Implementing changes even after programs have ended.
Sustainability:
• Relying on collaboratively developed approaches
Multiple strategies: 18
 HEALTH PROMOTION APPROACHES
Health promotion measures often target a range of priority diseases, both communicable and non-
communicable.

The Millennium Development Goals identified some key health issues considered critical for development.

These issues include maternal and child health, malaria, tuberculosis, HIV, and other determinants of health.

In the past two decades, non-communicable diseases have significantly impacted the global disease burden
and mortality.

Non-communicable diseases can largely be prevented through effective and feasible public health
interventions that address modifiable risk factors such as tobacco use, unhealthy diet, physical inactivity, and
harmful alcohol use
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HEALTH PROMOTION APPROACHES
HEALTH PROMOTION APPROACHES

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 HEALTH PROMOTION APPROACHES
An individual's health is influenced by the family, community,
environment, and political setting in which they live.

In fact, socioeconomic factors have a greater impact on a

individual's health than individual health behaviors.

Therefore, health promotion must also include legal, economic,

environmental, educational, legislative, and organizational
interventions necessary to improve health. 22
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HEALTH EDUCATION
 HEALTH EDUCATION

Health education is an integral part of health promotion.

It involves informing individuals about the nature and causes of health

and diseases and activities that examine their personal risk levels
related to lifestyle behaviors.

Health education motivates individuals to embrace the process of

behavior change by directly influencing their values, beliefs, and
attitudes.
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HEALTH EDUCATION

Health education is concerned with providing individuals and

communities with health information and equipping them
with the skills needed to voluntarily adopt healthy behaviors.

It is a combination of learning experiences designed to

increase the knowledge levels of individuals and communities
or to influence their attitudes, helping them improve their
health.

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DETERMINANTS OF
HEALTH
 DETERMINANTS OF HEALTH

Determinants
of Health

Social Economical Physical Individual

Behaviors
Environment Environment Environment Characteristics

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DETERMINANTS OF HEALTH

It is not very possible for individuals to directly

control many of the determinants of health.

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The determinants of health — or the things that
make people healthy — are as follows-1:
Income and Social • Higher income and social status are linked to better health. The greater
the gap between the rich and the poor, the greater the differences in
Status: health.

• Higher levels of education are associated with better health, as education

Education: improves knowledge of health behaviors and provides better job
opportunities.

Physical • Clean air, safe water, and housing contribute to good health, while
polluted environments pose a health risk.
Environment:
Social Support • Strong social ties can improve mental and physical health, while isolation
can be harmful to health.
Networks: 29
The determinants of health — or the things that
make people healthy — are as follows-2:
• Inherited factors play a role in determining life
Genetics: expectancy, vulnerability to certain illnesses, and
other aspects of health.

Healthcare • Access to and utilization of healthcare services affect

health in the prevention and treatment of disease.
services:
• Gender differences can influence health outcomes
Gender: and risk factors for certain conditions.
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DETERMINANTS OF HEALTH

Among the determinants of health, social conditions

are considered the most important determinant
because they affect health both directly and indirectly

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 SOCIAL DETERMINANTS OF HEALTH
The social conditions in which individuals are born, grow, live,
work, and aged are shaped by the health system and influenced by
the distribution of money, power, and regional, national, and
global resources.

The social determinants of health include living conditions,

employment (or unemployment), education, and housing
conditions.

The social determinants of health are responsible for the

inequalities in health observed among and within individuals,
families, communities, and countries.

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HEALTH INEQUALITIES
 HEALTH INEQUALITIES
Health inequality is a term that describes the differences in health between individuals or
groups.

Any measurable aspect of health that varies among individuals or social groups can be referred to
as health inequality.

Health inequality refers to the observable disparities in health outcomes and access to health
resources between different individuals or groups.

According to another definition, health inequality refers to the differences in the distribution of
health determinants or health status among different population group. 34
 HEALTH INEQUALITIES can root from…
the factors that influence behavior or lifestyle choices or access to resources:

Socio-
Geographic
economic Age Sex/Gender
location
differences

Access to Usage of
Health status healthcare healthcare
services services

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HEALTH INEQUALITIES

The issue of health inequalities was emphasized internationally for the first
time in the Alma-Ata Declaration in 1978.
• This landmark declaration highlighted the unacceptable health conditions
faced by a significant portion of the global population, marking a pivotal
moment in public health advocacy.

The WHO’s declaration in the 21st century titled "Health for All"
emphasized that the health disparities among socioeconomic groups within
countries should be reduced by 25% by improving the health levels of
disadvantaged groups in all member countries.

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INDICATORS OF HEALTH INEQUALITIES
Incidence (new cases of a disease
or health-related condition)

Mortality

Survival rates

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 NDICATORS OF HEALTH INEQUALITIES:
EXAMPLES

The maternal and infant mortality

In terms of life expectancy,
rates, which determine the level of
individuals in less developed
development of a society, are
countries live approximately 30
higher in less developed or
years less than those in developed
developing countries compared to
countries
developed countries.

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VARIABLES USED IN MEASURING HEALTH
INEQUALITIES

Life expectancy Mortality rates Health Public health

workforce services

Health Demographic Socio-economic

expenditures indicators indicators 39
MAIN INDICATORS THAT ARE USED IN
HEALTH INEQUALITY RESEARCH
Life
expectancy

Maternal
mortality
rate

Infant
mortality
rate

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In the reduction of health inequalities;

In addition to health-related
indicators, improving and developing
socioeconomic indicators, primarily
income and education levels, are also
the important determinants.
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 Recommendations from the World Health
Organization for Reducing Health Inequalities
Improving living conditions of individuals or communities.

Stopping the unequal distribution of power, money, and resources, which is the structural
cause of everyday living conditions, at global, national, and local levels.

Measuring and evaluating the dimensions of the problem, expanding knowledge related to
the issue.

Creating a trained workforce knowledgeable about the social determinants of health.

Increasing public awareness regarding the social determinants of health.

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 IN A NUTSHELL…
Health is not just the absence of disease; it also encompasses social, emotional, psychological, and spiritual elements.

Ensuring and maintaining the health of individuals is a societal goal for all countries worldwide.

The determinants of health include social and economic environments, physical environments, individual characteristics, and
behaviors.,

The first document focused on health promotion as a process is expressed in the Ottawa Charter.

Health promotion involves activities that provide individuals with better opportunities for living.

Initiatives for health promotion should be empowering, participatory, equitable, intersectoral, accessible, and multi-strategic.

Health education is an integral part of health promotion.

The social determinants of health are responsible for health inequalities.

Improving health-related indicators and socioeconomic variables is important for reducing health inequalities." 43
TEŞEKKÜRLER

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