Pages: 60

No chapter abstract available.

Pages: 25

This chapter argues that understanding people is central to understanding their health. It explores a person as a continuously evolving human being who is shaped by interactions between their biology, psychology and their socio-cultural context. This is discussed with reference to the neuroscience of the brain, Bronfenbrenner's bioecological model of human development, the development of self-concept and the sociological proposition of the biological and social body. For humanists, such as Rogers and Maslow, a person strives to become their true self, a concept closely aligned to achieving health. A person's view of what health means to them is unavoidably entwined with being a living person and the values they hold. It is shaped over a lifetime in the context of the real and perceived influence of others, their values and their vision of a healthy society. We discuss the influence of the medical model, biopsychosocial model and the World Health Organization. The chapter ends with a concept of health based on contemporary thinking, arguing it may be person-centred, time-dependent, positive and holistic, but these ideas continue to be debated.

Pages: 33

This chapter explains the various ways in which people begin and progress their careers in health promotion and public health. The UK public health workforce comprises public health specialists, public health practitioners and the wider public health workforce. Each category contains a wide range of job roles which can be found across a range of sectors and organisations. The chapter outlines four competency frameworks which set professional standards and support individuals to carry out their work effectively. These are the UK Public Health Skills and Knowledge Framework (UK PHSKF), WHO-ASPHER Competency Framework, the International Union for Health Promotion and Education (IUHPE) Competencies and Professional Standards and the UK Public Health Register Practitioner Standards for Registration. The chapter explains the importance of professional registration and continuous professional development. The chapter includes many illustrations of job roles and career routes.

Pages: 234

No chapter abstract available.

Pages: 26

The chapter will introduce the principles and practice of epidemiology. It begins by defining epidemiology and related definitions such as outbreaks, epidemics and pandemics. It outlines the history of epidemiology including the work of Hippocrates, John Graunt and Dr John Snow and explains some of the most common measures of disease and death such as mortality and morbidity rates. It discusses how epidemiologists try to establish ‘cause and effect’, by identifying associations between health exposures and outcomes such as diseases. The chapter describes observational and experimental epidemiological research study designs with some of their strengths and limitations. These include cross-sectional studies, case reports and case series, ecological studies, cohort studies, case control studies, clinical trials and community trials. Finally, the chapter discusses screening tests and the concepts of sensitivity, specificity, positive predictive value and negative predictive value as one example of the many nuances that need to be considered when presenting epidemiological data.

Pages: 24

Health promotion and public health practice is underpinned by the evidence that is produced by rigorous research. This chapter explains some of the important factors to consider when planning to undertake research and includes a useful glossary of research terms. It defines types of research, such as primary, secondary, empirical and theoretical, and the concepts positivism and interpretivism. The chapter guides the reader through how and where to search for online literature and assess its quality and explains how a literature review supports the rationale for a research study. It explains how research methods can be defined as quantitative or qualitative methodologies and outlines five qualitative methodologies: ethnography, narrative research, phenomenology, grounded theory and case study. The chapter discusses questionnaires, interviews, focus groups, observation and documentary analysis, with the main advantages and disadvantages of each method. The chapter describes four types of research samples: convenience, random or probability, strategic and snowball, and includes guidance on recruitment. It explains how researchers need to consider the validity and reliability of their research and highlights the important features of ethical research practice that must permeate the whole research process.

Pages: 20

Health-related behaviours are important for health promotion and public health because they are associated with major non-communicable diseases. Health psychology is concerned with identifying, targeting and changing people's health-related behaviours. This chapter describes, applies and critiques six theories and models of behaviour change. These include the health belief model, the theory of reasoned action, the theory of planned behaviour, the transtheoretical model, the common-sense model and nudge theory. It includes examples related to the prevention and early detection of breast cancer, colorectal cancer screening, rough sleepers with dependence on alcohol and/or drugs, type 2 diabetes and hospital food and sugary drinks. The chapter discusses how each theory or model has limitations.

Pages: 24

Communication is central to promoting health. This chapter will define and discuss health communication, its scope, purpose and characteristics. It includes a discussion about communication processes, verbal and non-verbal communication, one-to-one communication and group work. It describes examples of health-related digital communication and social marketing. The pros and cons of health-related mass communication are considered using the example of the COVID-19 coronavirus-related media in the UK. The World Health Organization's Strategic Communications Framework sets the standard for its health-related communication across the world and provides a model for communicating effectively with populations about health matters. The chapter will outline a selection of health communication theories and models including the health belief model, theory of planned behaviour, transtheoretical model, elaboration likelihood model, heuristic-systematic model and self-efficacy. The chapter ends with a discussion about the importance of health literacy to understanding as well as creating health communications.

Pages: 37

The origins of mass health education in the UK began during the Victorian public health movement in the form of propaganda, coercion and instruction. Sanitary inspectors, medical officers and the Schools for Mothers had some success, but many people resisted the authoritarian approach. Modern health education includes a continuum from simple instruction to learning that seeks to foster autonomy, freedom to choose and empowerment. The process of learning is as important as the content because it determines whether the educator keeps or gives away power to the learner. This chapter describes three health education models: preventive, educational and empowerment. The preventive model is an expertled, ‘top down’, one-way communication with the aim of preventing disease by persuasion. The educational model is educator led, includes two-way communication and aims to enable people to make free and informed choices. The empowerment model is led by individuals or communities. It comprises ‘bottom up’ communication with the aim to put informed choices into action using skills. The latter two models emphasise learning and health as holistic, person-centred concepts. Health education augmented into health promotion in the 1980s in recognition of the need to address the social determinants of health alongside educational measures.

Pages: 31

This chapter builds on Chapters 1 and 7 and describes health promotion as a combination of health education and policies which seek to make health attainable and accessible for all. We describe the four models of health promotion and how they work in practice. The international community signed the Ottawa Charter for Health Promotion in 1986, in which the World Health Organization describes health promotion as the new public health; the way in which the world can work to achieve ‘health for all’ people across the world. The Ottawa Charter clarified the aims, scope and broad principles of health promotion. This chapter discusses the core characteristics of health promotion: the politics and ethics of health promotion, building healthy public policy, partnership working, strengthening community action and creating healthy settings. It takes the reader through the practical steps of implementing and evaluating a health promotion strategy with individuals, groups or communities. The chapter ends by considering the relationship between health promotion and public health.

Pages: 24

This chapter explains the historical origins and contemporary practice of public health in the UK. This includes an overview of the history of public health in the UK from the 1830s to today. Public health practice comprises three domains: health protection, health improvement and healthcare public health. Directors of public health are required to publish local health-related data. These data are used for local and national profiles and for their own annual public health reports. The chapter explains the process of carrying out a health needs assessment to understand the needs of a population and determine the priorities for interventions to improve their health. It also describes the process of carrying out a health impact assessment which aims to predict how a proposed intervention may affect the population's health.

Pages: 26

This chapter will cover the key concepts, definitions, terminologies and tools that are used to manage and reduce risks of disease in populations, and it will explain how health protection is organised in the UK. It begins by discussing the surveillance of communicable diseases and how they are spread and managed. This includes explaining outbreak management, point source outbreaks, control measures and the management of pandemics. The chapter defines the terms ‘immunity’ and ‘vaccination’ and explains how vaccination works. Herd immunity is explained alongside some vaccine-related challenges for public health. The chapter details common food safety hazards such as campylobacter, salmonella and E. coli 0157, and explains how to reduce food poisoning from cross contamination. The chapter outlines how the public are protected from chemical, biological, radiological and nuclear hazards. The examples of the Union Carbide disaster in Bhopal, the nuclear disaster at Chernobyl and the emergency response to Novichok poisoning in Salisbury are included. The chapter explains the principles of risk assessments and incident recording in the workplace and ends with an overview of UK screening programmes, including breast and cervical screening and the criteria which screening programmes must meet to be allowed to proceed.

Pages: 20

This chapter introduces the field of arts and health. It defines five arts forms: visual arts, design and craft; online, digital and electronic art; community and cultural festivals; performing arts and literature. Arts and health describes the practice of applying the arts across the health continuum, from end of life to optimal wellness, and includes using the arts for the intention of maintaining or improving health. Arts and health spans many sectors including arts and culture, education, health, government and the voluntary sector. The chapter provides an outline of the history of arts and health and explains how the field contributes to primary, secondary and tertiary disease prevention and salutogenesis. The work directly influences people's health and also the determinants of health. The chapter presents a healthy arts framework and provides an overview of how arts and health, underpinned by research-based evidence, has been growing over the last 25 years. Four examples of arts and health are described. These include BBC Music Day 2019 in the UK; Singing for people with chronic obstructive pulmonary disease in Kent; Promesas y Traiciones, a radio novella broadcast in Alabama; and a Creative Arts Pilot Project to engage patients being cared for in an Australian mental healthcare unit.

Pages: 58

No chapter abstract available.

Pages: 26

Tobacco, alcohol and drugs are collectively described as substances. Models of substance use describe how a society understands and approaches substance use. The UK adopts a combination of the moral, medical and social models of substance use which directly relate to the three dominant models of health and illness: traditional, medical and social. Examples include drug laws, nicotine replacement medicines and enabling local communities to influence alcohol licensing decisions. The UK's approach is influenced by its participation in international initiatives for tobacco, alcohol and drug control. Although the four nations of the UK have their own policies for tackling substances, this chapter describes the eight principles they share. These include universal and targeted approaches, early intervention, life course approach, partnerships, evidence, reducing harmful outcomes, protection from commercial interests and a combination of laws, treatment and prevention measures. Health promotion interventions are those communications which encourage health-related learning and healthy policies. The chapter provides examples of UK initiatives which reflect the preventive, educational, empowerment and social change models of health promotion. These include health warnings, mass media, brief opportunistic interventions, substance-related education, mutual aid, harm reduction and policies such as those that limit advertising.

Pages: 30

We start this chapter by explaining metabolism, energy balance and energy imbalance. It is a scientific truth that if we consume more calories than we expend, we gain body fat. However, tackling overweight and obesity is complex because people are biopsychosocial beings and not machines. This chapter examines the non-modifiable risk factors for weight gain such as genes and age, and then modifiable ones such as sedentary behaviour, physical activity and diet. Reasons for overconsuming calories include large portions, calorie-dense foods, mindless eating, emotional eating and cheap fast/processed foods and drinks. The chapter examines why some weight loss dieting practices are unhealthy and counterproductive while others are successful. The importance of a Mediterranean diet, physical activity, the microbiome and the obesogenic environment are discussed alongside intermittent fasting, intermittent energy restriction, timing of meals and how nutrients affect hunger and satiety. The chapter concludes with evidence-based principles for tackling overweight in individuals and populations.

Pages: 56

No chapter abstract available.

Pages: 27

Common work-related health concerns in the UK include stress, depression and anxiety; musculoskeletal disorders; injuries and breathing and lung problems. Contributing factors include working long hours; air pollution; slips, trips and falls; lifting; manual handling and violence. Health risks, health-related behaviours and health outcomes differ across occupations. This chapter examines how the physical and psychosocial environment is a powerful influence on workers’ health. For example, a workplace characterised by stress, high demand/low control, an imbalance in effort and reward, organisational injustice and poor social capital, including low social support, directly and indirectly encourages cardiovascular disease, mental health problems and wider health inequalities. Individuals do not enter workplaces with equal health and their work experiences can enhance their health or cause it to deteriorate. The example of migrant workers is given. The chapter describes how workplaces can protect and promote workers’ health through complying with UK health and safety legislation; fostering personal protective factors such as resilience and empowerment; providing good quality work as defined by the Good Work Index and Fair Work Framework; listening to and valuing workers, utilising human resources and occupational health services and creating healthy workplaces.

Pages: 27

The consequences of setting up the UK's National Health Service (NHS) as a disease-centred care service in 1948 had several consequences including reinforcing the medical model and presenting healthcare practitioners as the guardians of the nation's health. This led to ‘care’ being understood by many as being synonymous with ‘health’. Today, the NHS is changing to become one part of a wider intersectoral UK health system and it is trying to enhance its health, as opposed to care, -related work. We describe the standards set out by the International Network for Health Promoting Hospitals and Health Services and suggest healthcare practitioners need to use what Antonovsky defined as pathogenic and salutogenic approaches to promoting people's health and quality of life. The chapter provides examples such as the All Our Health online resources for healthcare practitioners, the concept of having a sense of coherence, changing health-related behaviours and the Making Every Contact Count programme. It briefly considers healthcare practitioners as healthy role models in the context of the health of the setting in which they work. Many healthcare practitioners may benefit from increasing their health-related knowledge, but many are already using core health promoting communication skills as part of their care.