Health promotion

Health promotion includes measures and activities that strengthen the health resources and potential of people is to be achieved. It describes the process of empowering people to increase control over the determinants of health and thereby strengthening its health. Not only are the behavior of the individual, focused his knowledge and skills, but also social, economic and environmental conditions. Health is defined in a holistic manner as a physical, mental and social well-being that is influenced by individual, social and social backgrounds. Health is thus less a state or objective, but rather a resource of everyday life. It is, according to the Bangkok Charter by the WHO in 2005, the path to a higher quality of life.

While prevention is aimed at the prevention or early detection of disease and thereby eg for vaccinations, healthy diet, early diagnosis and adequate exercise pronounce, the approach of health promotion focuses on strengthening the health of the people. The central question is what keeps people healthy. So focused are less diseases and their emergence, but determinants of health. By changing the labor, environmental and living conditions as well as individual behavior better conditions for healthy living should be created. The active involvement (participation) of individuals and groups in their living environments is essential in order to enable sustainable empowerment to act.

Analytically different Hurrelmann, Klotz and Haisch in their manual " Prevention and Health Promotion " (2010, page 17 ), the two forms of intervention so: both disease prevention and health promotion aim to achieve health gain, but their different ways. When disease prevention health gain to be achieved by pushing back the burden of disease, promote health by strengthening health care resources. Accordingly, targeted prevention her accent especially on risk factors for disease, health promotion, especially to maintain health, protective factors. The two forms of intervention can therefore be understood as a supplement to, and depending on the starting position once one and once the other form of intervention that may be appropriate and promising.

• 2.1 Approaches to health promotion
• 2.2 Models of health promotion

• 3.1 Health promotion in the workplace and in companies
• 3.2 Health promotion in schools and daycare centers
• 3.3 Health promotion in the social housing environment
• 3.4 Health promotion in primary care and in hospital
• 3.5 Health Report

• 6.1 Health hosts
• 6.2 Professional Association of Health Promotion
• 6.3 Professional Association of Integrative Health Promotion

Strategies and action areas

Originally, the concept of health promotion on 21 November 1986 by the World Health Organization (WHO ) has been developed within the first International Conference in Ottawa and summarized in the so-called Ottawa Charter. In further follow-up conferences (Adelaide (1988 ), Sundsvall (1991 ), Jakarta (1997), Mexico City ( 2000), Bangkok (2005), Nairobi (2009) ) single action areas of the Ottawa Charter were specified. The suggestions outlined in the Ottawa Charter basic ideas are as relevant today as an accepted framework for policy and practice of health promotion. The concept contains the main action strategies and action areas of health promotion. A distinction is made between three basic strategies and five central fields.

Action strategies

As action strategies of health promotion nominated by the WHO:

• Advocacy Royal advocacy for health: the health promotion workers actively champion health; in terms of the influence of political, economic, social, cultural, biological, environmental and behavioral factors.

• Empower and Enable: This action strategy aims to act in partnership with individuals or groups, to place the latter in a position to exercise control of their health concerns as well as to promote their resources and use (competence promotion, empowerment). The people should inter alia access to all relevant information and contacts to be made possible. This can also differences in health status, for example, be caused reduced by social inequality.

• Transfer and Connect: Under communication and networking refers to the active and continuous cooperation with all stakeholders within and outside the health sector. All areas that have an impact on health ( alongside actors of the health system including, for example, the political level, employers, associations and clubs, etc. ) are to cooperate as a network and thus can guarantee a continuity in health-promoting behavior of individuals and the development of health-promoting lifestyles.

Fields of action

The five priority action areas and levels (so-called multi-level model of health promotion ) According to the WHO:

• Healthy public policy development: The primary aim of healthy public policy is that health is on the political agenda in all policy areas and all levels. Politicians of the health consequences of their decisions and their responsibility for health need to be aware. The political level in federal, state and local authorities affected to a considerable extent the conditions of the population in the area of work, education, housing, leisure, care. All policies therefore have an impact on the health of citizens and contribute through healthy public policy to promote well-being and quality of life. A healthy public policy shall apply the mutually complementary approaches to such as legislative initiatives, fiscal measures, organizational and structural changes.

• Create health -promoting lifestyles: Through health promotion lifestyles should be created to offer people protection from threats to health and put them in a position to expand their skills and develop self-confidence with regard to health concerns. Health-promoting lifestyles include places where people live, work, play and spend their leisure time (eg, city, community, home, workplace, school, kindergartens ). Worlds include the access of people to resources and services for health, and relations to their environment.

• Health-related Community actions support: A major effort of health promotion is to support neighborhoods, community activities of citizens, self-help activities and communities in terms of increased self-determination, autonomy and control over their own health concerns.

• Personal skills develop: through health promotion personal skills and abilities to be developed that enables the individual to live his life, to overcome challenges and to integrate environmental changes. This includes, for example, communication and decision-making skills, problem solving skills, or dealing with stress. Based on this health-promoting behaviors ( such as healthy diet, exercise, social skills, healthy thought patterns ) to be learned. The decisive factor is the participation and self- determination of the recipients, in order to achieve adequate behavior change and to integrate into everyday life. People should be enabled to live a life-long learning. It is called upon to deal in the various stages of life as well as any chronic illnesses and disabilities. These include health education, health education, training, counseling and patient education.

• Health services reorient: The Health Services shall establish a supply system, which focuses on encouraging the promotion of health and no longer on medical- curative care. Above all, it should be based on the needs of the people. By reorienting the possibility of coordination between the health sector and other health-related social, political and economic forces should be improved.

Approaches and models of health promotion

In addition to the strategies and fields dominate different approaches and models of health promotion.

Approaches to health promotion

• Medical or preventive approach: the medical approach is aimed at measures to reduce diseases. The health promotion serves the improvement of medical intervention. Between three levels of prevention are often described.

• Approach to behavior change: individuals should be supported to adopt healthier behaviors that serve as a key to improving the health, for example through campaigns.

• Approach to health education: This approach attempts to provide people with the knowledge and skills they need to make decisions about the health behavior itself can. This can be done through information brochures, exhibitions, counseling sessions, group discussions or training programs. However, this approach from the approach of the change in behavior because the client has the freedom to decide on what to do next.

• Approach of empowerment: Individuals should receive a higher level of self-determination over their health. They should learn to recognize and understand their impact on their lifestyle. Furthermore, they must perceive their situation seriously trying to with the intention of changing. You must believe that they are able to be able to change their position with additional information, support and skills. Quality of life research provides valuable information to break through the barriers of action, which preclude a health-promoting lifestyle.

• Approach to social and political change: This approach (also called " fundamental health promotion ) describes the importance of socio-economic conditions as determinants of health, although he aims to politics or the general living conditions to bring about changes in the physical, social and economic living conditions.

Models of health promotion

The model according to Caplan & Holland (1990 ) consists of four paradigms or perspectives of health promotion, which result from the nature of knowledge ( objective or subjective ) and from the nature of the Company ( basic change or social regulation ). The traditional view reflects the approaches of medicine and behavior modification with imparting knowledge. The humanistic perspective draws on the approach of health information and education. The fundamental - humanistic perspective is with the term "empowerment" to understand. The fourth fundamental company based perspective focuses on the context of social inequalities and health.

Beattie developed in 1991 a model which consists of four strategies of health promotion ( information and education, legislative activities, personal counseling, community work ), the first, from the nature of the intervention ( authoritative or based on the negotiation ) and the starting point for other of thought ( objective or subjective )

The model of sound (1994 ) contains the fundamental objective to regain empowerment. Health promotion is the process of healthy public policy multiplied by the health information and education.

The practical model of Tannahill (1996 ), divided into three linked areas of intervention (health information and education, prevention, health protection), is widely recognized within the health professionals. It keeps the entire spectrum of health promotion in mind.

Setting approach

He aims at a change of everyday life through low-threshold systemic interventions in real life worlds such as school, workplace or neighborhood, involving all stakeholders. Basic philosophy of the setting intervention is that the target groups as active acting skills ( life skills ) to carry out their own health-related interests acquire (empowerment ) and non- recipients of health-promoting messages and offers are. Elements of the setting approach is the development of life skills. Participation is the participation or the degree of empowerment of individuals and groups in decision-making and action sequences in parent organizations (eg trade unions, political parties ) and structures ( society, state).

"Settings are organizations that represent a recognized by their structure and task social unit " ( Baric, Conrad 2000, p 18). So it is relatively permanent social relationships, which give important impetus for health ( health hazards, health resources). According to the World Health Organization ( WHO), health is the state of complete physical, mental, spiritual and social well-being.

Health promotion in the workplace and in companies

The workers in one enterprise is a self-contained target group for health promotion. It increases the chance of participation in health programs, as there are already established channels of communication within the workplace. One reason for promoting health in the workplace is the Occupational Health and Safety, which is the protection of employees against damage to their health that can be caused by certain occupational activities. The aim of occupational health and safety is the avoidance or reduction of emanating from the work environment harmful stress factors. Health promotion in the workplace is concerned, among other things with the areas of first aid and medical treatment, examinations, accident prevention, monitoring of health and infection risks, education and counseling to healthier lifestyles, procedures and regulations to create healthier working conditions and the provision of services.

A number of research findings shows that certain types of work such as uniformity, lack of action and decision latitude, lack of social support and lasting stress have a negative effect on health.

Health promotion in schools and daycare centers

Schools and daycare centers are seen as the most important settings for health promotion, since it is a large part of the population is over many years. The special importance of school and daycare center is also based on the realization that the knowledge, attitudes and behaviors in dealing with health and illness are already acquired in early childhood. This value is placed on ensuring that the children and young people improve their understanding of health and make more conscious decisions about their health behavior.

Health promotion in the social housing environment

The key factor in promoting health in this setting is that people define their social living environment themselves and feel that they are doing something for their future together, the Services and the appearance of their neighborhood. A direct confrontation with the social fabric and quality of life, residents can have more control over their living conditions, their neighbors to know, possibly come out of isolation and a say. The methods of health promotion in residential areas are largely taken from the community work. Applies the theory, for example, in the neighborhood management, an instrument of the federal program "Social City". A second approach, the " Healthy City " in the sense of WHO, is committed to a holistic approach ( mind, body and soul) and should work on all levels ( kindergarten, schools, businesses, hospitals and in the general health promotion ), actively be. The particular strength of health promotion in the living environment is the availability of socially disadvantaged people and thus the opportunity to contribute effectively to promote health equity.

Health promotion in primary health care and hospital

The primary health care is the first level of local health care. The " Health for All " program of the WHO called for a reorientation of health services. The focus of the health system should be placed on primary care because the health-promoting principles of participation, cooperation and equal opportunities can be integrated. The primary care provides a setting in which takes place health promotion in primary, secondary and tertiary level.

The hospital offers a variety of opportunities for health promotion, since a large number of employees are in close contact with the patient. This comes at a time when they have an increased awareness of health and disease. They are therefore more motivated to make significant changes in their lifestyle. Health promotion in hospitals includes both measures for a more holistic care to patients as well as strategies to improve the working conditions of the entire hospital staff.

Health Report

First time in 2010, a study was conducted by the Centre for Health of the German Sports University in Cologne. 2012 has been a second study to the German Health Insurance ( DKV). The result shows that young German unhealthier life than ever before. 46 percent of people are overweight and 22 percent among active smokers. The population must be educated. Obesity and lack of exercise should be given as much attention as the AIDS prevention, calls Clemens Muth of the DKV.

Legal foundations

For health promotion different legal bases, which are fundamental apply in Germany:

• Social Code Book V (SGB V, Statutory Health Insurance ), in particular § 20: prevention and self-help; § 20a Workplace Health Promotion; § 20b prevention of work -related health hazards; § 20c promotion of self-help
• SGB ​​VII, Statutory Accident Insurance, in particular § 14: prevention task Unfallkasse
• SGB ​​IX, rehabilitation and participation of disabled people, in particular § 84 (2): Occupational Integration Management
• Occupational Safety and Health Act ( ArbSchG): organization of the labor protection during operation
• Occupational Safety Act ( ASIG ): Law on occupational physicians, safety engineers and other specialists for occupational safety

Spending on health promotion

The Organization for Economic Cooperation and Development (OECD) in Paris has published in July 2007, data on the issues of different States in 2005 for " prevention and public health." The average of the 20 countries covered is 2.5 % of the national total health expenditure. The extremes are Canada ( 6.1%) and Iceland ( 0.6%). Some other countries: New Zealand 6%, U.S. 3.5%, Germany 3.3%, France and Switzerland 2.1%, Austria 2%, Italy 0.7%. Compared to 2000, the expenditure of the 20 countries have increased on prevention and public health by 6%.

Professional field and training

Graduates are specialists in health promotion and fulfill a variety of different tasks in prevention and health promotion, health monitoring, and evaluation. You create or analyze scientific expertise in various health-related disciplines, such as epidemiology, food science or risk factors protection in order to achieve optimal care while containing costs. They develop, organize, implement and evaluate health-oriented interventions with individuals and groups. My approach here is evidence- based, target-group -oriented and sustainable. Interventions are aimed at both behavioral and relationship -oriented and interdisciplinary and intersectoral collaboration in general.

Health hosts

Health economists practice activities in public relations and awareness raising. In this design, and they look after public campaigns or working on education campaigns. As part of the project or organization they lead developments for example health promotion in companies through. Also performing health training and health advice and training by professionals in the fields of nutrition and exercise can be part of their duties.

Graduates are concerned with the health of the consumer or patient. In all their work areas, they endeavor to persuade the Council seekers to rethink and to convince them that a healthy behavior and lifestyle is the best health. Since the health care until now could cause a still relatively low long-term success in the area of ​​behavior, health economists, however, are exposed to the tension between theoretical possibilities of prevention and prevention actually achieved successes.

The areas of health economists are diverse. You can find employment in: health, business, counseling services, educational institutions, associations and federations, public institutions, scientific institutions.

After graduation, graduates receive among other things the degree " Bachelor of Arts". For example, the training takes place at the University of Magdeburg- Stendal "Bachelor of Arts in Health Promotion and Management" within 6 semesters.

Professional Association of Health Promotion

The Professional Association of Health Promotion eV is a professional political advocacy by health economists. It was founded on the initiative of some health economists in Magdeburg on 15 May 2004. Main concern is the creation of transparency regarding the qualifications of actors in the professional field of health and prevention. The work focuses on the establishment of a unified vision for the profession of health host. Today, around 380 members are represented in all occupational and educational affairs. The professional association organized trainings, members meetings and participates in conferences, symposia, such as: the Summer Academy of Health Promotion

Professional Association of Integrative Health Promotion

Graduates of the course Integrative Health Promotion Coburg University also established a professional political interest group. Enter the academic degree Bachelor of Science ( B.Sc.). Their training enables them to develop health-oriented interventions in the settings work and education, cure and rehabilitation, tourism and leisure, to organize, implement and evaluate. The measures aim here from both the behavior as well as to the circumstances of the addressees. Considering the core principles of participation ( participation, involvement ) and empowerment ( empowerment ) here are the highest possible self-determination of the people as well as successful and sustainable change can be achieved. The Being founded on a holistic understanding of health encompasses the physical, mental, spiritual and social dimensions. For the purposes of salutogenesis always stand next to the adverse health risk factors and the protective factors in the focus of the measures. The substantive elements generally provide exercise, nutrition, stress management, psychosocial well- being, life style modification and ratio reference and structural development dar. The professional association founded in 2007 Integrative Health Promotion Association represents its members in all professional policy matters and provides a platform for the ongoing development of the profession dar. in addition to promoting training and quality assurance, he works on the steady expansion of networking with relevant stakeholders in health promotion. In addition, the professional association also supports the students in their academic life. The professional association is independent in its work and has no economic interests.

Networks and organizations

Worldwide, there are several networks of health promotion. Among other things, the Healthy Cities Network, the International Network of Health Promoting Hospitals and Health Services, the German Network of Health Promoting Hospitals, the German Network for Workplace Health Promotion, " School & Health " or " European Network of Health Promoting Schools". There are emerging more and more networks that provide a holistic approach to the fore and with efficient and effective designs characterize a pro-active approach to industrial society. In Germany there is next to the National Association of Prevention and Health Promotion Association ( BVPG ) in most provinces, regional working groups for health promotion.