Health Promotion: Socio-economic Influences, Government Strategies, and Models

This report analyzes the effects of socio-economic influences on health, government sources on health inequalities, and models of health promotion. It also discusses the role of health professionals and the importance of establishing routines for healthy living.

Health Promotion
Course Title

Executive Summary
This report will represent an analysis on the health promotion strategies.
In the first section, we have discussed the socio-economic influences on human health. This
section involves the analysis of the effects of socio-economic influences on health. We have
discussed about how poverty, income, education and unemployment are affecting the health of
an individual. We have also analyzed the government reports and enquiries to find out the major
reason for inequalities in health.
In the second part of the report, the models of health promotions have been discussed. Also we
discussed about the government health strategies for education at local level and analyze their
link with the models. The last part was based on the political analysis of health promotion
strategies.
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Socio-economic influences on health
1. Explain the effects of Socio-economic Influences on health:
The socioeconomic factors are considering to be the most powerful risk factor for health. The
person having low socioeconomic position can greatly suffer from the poor health conditions.
Poor socioeconomic circumstance can affect the people such as workers, low ranking staff and
other middle class individuals. Often the stressful situations are the reasons for anxiousness,
worries which is damaging people’s heath. The social and psychological issues are the reason for
long term stress. The people who are continuously in a state of anxiousness, anxiety, low self-
esteem, less or no concentration on work, or isolated are a big threat to their health.
These kind of psychological risks can lead to extreme mental illness and premature death. The
person who is facing long term anxiety, insecurity or isolation can badly damage his health.
Socioeconomic factors are clearly associated with the morbidity and mortality of a person. The
factors such as income, education, or occupation is closely link to the health problems. The
people who are facing issues with these socioeconomic factors can have multiple health
problems like low birthweight, cardiovascular disease, hypertension, arthritis, diabetes, and
cancer.
Poverty
The issues of poverty in a society can have a major impact on the health of people or even
become a reason for their deaths. People in poverty can barely have the basic material necessity
of their life. Sometimes, they can’t even afford to buy food for themselves. These kind of people
have major health problems due to anxiety and stress level.
Income
In addition to providing means for purchasing health care, higher incomes can provide better
nutrition, housing, schooling, and recreation. Independent of actual income levels, the
distribution of income within countries and states has been linked to rates of mortality.9
Although controversial, one explanation is that underinvestment in public goods and welfare and
the experience of inequality are both greater in more stratified societies and that these, in turn,
affect health.10 If this is correct, then highly stratified societies take an additional toll on health
beyond that associated with absolute deprivation. Although the association between income and
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health is stronger at lower incomes, income effects persist above the poverty level.11 Health
effects at the upper part of the distribution may more strongly reflect relative status, while at the
lower part they may be more linked to absolute deprivation.
Education
Education is the most important socioeconomic element because it shapes the future
opportunities and earning potentials of people. the knowledge a person can receive through
education can help him to form his life in a superior way. The education provides the knowledge
that allow the person to have better access to information regarding health. However, researchers
have also shown that education can also have negative effects on the mental health of a student.
The students might face multiple issues regarding their course, exams and other educational
concerns. These issues can become the cause of their depression and stress.
Unemployment
Although the people in the phase of getting education are more pessimistic about their future, but
some of them might not be able to get a job after their studies. This is the major reason of stress
for these people. the unemployed people are often more stressed, anxious and depressed. The
unemployed people usually visit the physicians more than other people, take medicines and even
spent more time in bed sick.
In general, having a job is better than being unemployed. But those individuals who have jobs,
can also have the health issues. These issues are mainly related to their job styles, timing,
workload, low pay etc.
2. Identification of Government sources and an assessment of the relevance of the
same sources in reporting inequalities in health:
Health issues and inequalities are the major concerns for the UK government. The government is
constantly making efforts to reduce the health issues through improving working conditions,
performances, incentives and continuously monitoring the arrangements. The approaches to
overcome the health issues are mainly based on the Black report and the Acheson report.
The Black Report (1980) was based on the analysis of health inequalities which was designed
by the Labor government in 1977. The report identifies the four reasons for the health
inequalities such as artifact, natural selection, cultural, and structural. the report was later
rejected by the conservation government because of the cost and political opposition issue.
In 1997, the new government established the inquiry through “the second black report” which
was the modified version of the last black report about health inequalities. The report also
identifies the future policy development in healthcare sector.
In Acheson report (1998), it has been shown that the scientific evidences can supports the
socioeconomic factor in order to overcome the health inequalities. The report mainly supported
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the models of individual lifestyles and socioeconomic environment. The report mentioned that
all policies should be evaluated to have an impact on the healthcare inequalities. The health of
families and children should be a first and high priority. Also the income level should be
improving to overcome the health issues.
The final report is “Commission On Social Determinant of Health (CSDH)” which was
established by Dr. JW Lee (former director general of World Health Organization) in 2005. The
purpose of this report was to support the countries and health partners to speak about the social
factors of health and health inequalities. The report was presented to draw the government and
society’s attention towards the health conditions. The WHO received this report from the
commission in July 2008. For preparing the report, it took almost 3 years to gather and review
the evidences regarding the health inequalities worldwide. The report recommended to build
partnership with the countries to tackle the health inequality issues.
3. Discuss the potential reasons for barriers in accessing healthcare:
There can be multiple reasons why people are not visiting doctors or health care centers for their
illnesses. Some people have the fear that they may receive any bad news related to their health so
they chose not to visit the doctor. Also there are few people who find it not necessary to visit the
doctor and they chose to take medicines without prescription which is really dangerous for their
health. The health care delivery system has many problems, one of the main problem is their
financial structure. The patients, having health insurance, also faces problems while receive the
services of health care and they also have to pay for it sometimes.
The barriers to access the healthcare centers can be attributed to the low income and unemployed
people. the people with low income or unemployed usually have multiple problems to get access
to the healthcare, one of the major problem is the affordability of health care expenses.
The lack of these following aspects are becoming the reasons of barrier to access the healthcare:
 Affordability: It’s a fact that majority of people, with low income, avoid to visit the
health care centers because they cannot afford the prices of the health services.
 Availability: one of the major barrier in accessing the healthcare is the unavailability of
health resources. The health service providers may not have enough resources to deal
with the patients more efficiently.
 Accommodation: The healthcare providers may sometimes unable to provide the
patients the services they need.
 Accessibility: Sometimes the patients, living at a distant place, cannot afford to travel to
the healthcare centers.
 Acceptability: the factors of age, ethnicity, gender, religion etc. of the healthcare
providers and patients can impact their attitude and behavior towards each other.
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Health is the first priority of the UK government. The current government has made the
assurance to reduce the level of health inequalities in UK. The government is establishing the
policies to address the wide determinants. However, the government is facing some difficulties
to coordinated the policies with the participants.
Different approaches to health
1. Models of health promotion:
Beattie’s model of Health Promotion
Beattie’s model is basically a complex analysis of intervention which is based on the four
quadrants. The model helps an individual to analyze the health promotion strategies and it also
allows the individual to provides his own resources to generate new strategies for health
promotion.
The model is based on the 4 main strategies for health promotion:
 Health Persuasion
 Legislative Action
 Personal Counselling
 Community Development
The government and health professionals use the Health persuasion and legislative action
approach to focus on the health education, behavioral changes, policy, actions and sources of
individual health.
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The personal counselling in the model is the analysis of personal development. It is closely
related to the empowerment approach where the health promoters act as facilitators. The last
approach is the community development which is an approach to enhance and facilitate the
community as whole. These four approach in the model is completely dedicated to the efforts of
reducing the element health inequalities worldwide.
Tannahill Model of Health Promotion
Tannahill created the health promotional model in 1980. The model was based on 3 spheres of
activities:
1. Positive health education
2. Prevention
3. Heath protection
Tannahill develop this model to shift the focus on these three elements. According to the model,
the health education is based on the knowledge, beliefs, attitudes, and behaviors that helps to
facilitate health. The second point of prevention is mainly related to the disease prevention to
reduce the risk elements and consequences of diseases. The prevention process is centered on
primary, secondary and tertiary prevention of diseases. In the third point, the model focuses on
the health protection through fiscal and legal controls and policies that can help the facilitators to
improve their wellbeing.
2. The government health strategies for health education at the local level:
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1. Every Child Matters
Every Child Matters was one of the health strategies of UK government which is based on a
simple and aspiring policy for children and adult people. this strategy was formulated to manage
the circumstances of families that can affect the lives of children and young people.
The strategy was formulated to focus on the wellbeing of the children and teenagers. The
government aim is to provide health, safety, enjoyable environment, positive contribution and
economic wellbeing to every single child and teenager.
According to this strategy, the schools, hospitals and other voluntary group should work together
to protect the children and young people from every kind of harm and help them to develop their
personalities. This strategy is closely related to the collective action model because the
government is involving the organizations to work collectively to make the lives of children and
young people even more better and provide them extra safety to build up their personalities for
future.
2. Vaccination program
The process of vaccination is indeed a cost effective and standard way of providing healthcare
services. The government of UK has established the immunization program for the people to
prevent disease and reduce death rate. Majority of the vaccines are cheap. The influenza vaccines
are even free for children and adults. After the birth of a child, the local health authority enrolls
the name of the child in computerized database for immunization. This strategy is related to the
self-empowerment model but in that case, the people are providing the healthcare facilities to
their families to improve their wellbeing. The government is influencing the parents to follow the
vaccinating process of their child to avoid any disease and health problem in future.
3. Explain the role of health professionals in health promotion and the importance
of establish routines for healthy living:
Role of Health professionals:
 School nurses
The school’s nurses are the health professionals that provide a comprehensive health services to
the children and teenagers in schools. The schools are the place where the students enter with
chronic health conditions. It’s the responsibility of the school management to ensure a safe and
healthy environment for every single student. The importance of health should be a first priority
for the school management. The school’s nurses serve as team to provide the preventive services
for health. School nurses are the important factor of success.
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The role of a school nurse is to promote health and connect the children and families with
healthcare services. Almost every school has the school based health center where school nurses
coordinated the healthcare activities with the team. Basically a school nurse provides direct care
to the students, provide health services, analyze the health conditions, promotes health and a
healthy environment, plays an important role to develop healthcare policies and programs in
schools, plays a role of liaison between management, family, health care professionals, and the
students.
The parents also help the school nurse to update them about the sleep and behavioral changes in
their children.
The importance of health routine:
Healthy living is highly important to reduce the health problems. The routines are necessary to
adopt a healthy lifestyle. Routine bring a sense of safety and safe a lot of time for an individual.
With the help of proper routine, the person can divide its time equally on exercise, rest time,
work time and family time. When everything is properly schedule, the individual can set a
routine for his personal care which is highly important to have a good hygiene. When you have
routine for exercise, eating, bathing and sleeping, your body will function properly. It is
necessary to maintain a balance that is only possible with the help of setting routine.
The routine will help the mental health to grow and reduce the anxiety and stress level. When
you have a proper routine to do every work on time, you will never face any stress about the
things. Also you will have more time to relax. Routine will also help you to reduce the bad habits
if you already aligned all the healthy habits in your routine. Routine will also reduce the level of
procrastination. With a good routine, at the end you will have a good sleep with less stress and
worries.
Factors that influence health promotion
1. Define the concept of heath belief and examine 3 health beliefs that are present
in the UK society:
The concept of health belief is most commonly used in health promotion and health education.
The health belief model is widely used for the understanding of the behaviors associated with the
health. This model motivates people to take positive actions to improve their health. For
example, the desire to avoid any dangerous health condition is actually a motivation to adopt
positive health practices. The key element of this model is to avoid the consequences of bad
health. The government and healthcare centers can use this model to develop the health
education strategies and promote health and safety among people.
The 3 health beliefs in UK society:
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 Perceived susceptibility
 Perceived severity
 Perceived benefits
2. Critically assess that 3 beliefs based on two health behavior model:
The Health Belief Model by Becker:
This model was a psychological model which explain and predict the health behaviors of a
society. The model was based on focusing the individual attitude and beliefs with regards this
health. The model was developed in response to the failure of tuberculosis health screening
program. With the passage of time, the model explores the long term and short term health
behaviors and focus on the individual’s health related actions.
This model has been applied to a broad range of health behaviors. The model identified three
broad areas:
1. Preventive health behavior: this includes the health risk and promotion behaviors, also it
includes the vaccination practices.
2. Sick role behavior: it includes the obedience of professionals that are diagnosing illness.
3. Physician visits to clinics.
The concepts that has been discussed in this model are:
 Perceived severity which is based on the perception about the seriousness of a disease.
 Perceived benefit which is related to the positive consequences of a disease
 Perceived susceptibility which is a risk of contraction of health disease
 Perceived barriers which is the disadvantage of health related actions
 Self-efficacy linked with high achievements
 Cues to action which includes the environmental effects on final actions
Health Action Model by Tones (1990)
The Health action model was developed by Tones in 1990. The model is related to the models of
health education and promotion. The model provides a comprehensive approach to the key
variable that are influencing the health and safety of an individual. The model has two main
elements: one of them is the study of beliefs, motivation and normative and the other is the study
of individual actions. The health promotion is basically another name of health education and
healthy public policy. the model defines that the purpose of health promotion is the
empowerment. The highlighted that self-esteem influences individual behavior, a person with
high self-esteem is more likely to be motivated and healthy than others. This model helps the
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health promoters to boost people’s self-esteem. The model also defined the stages of behavioral
change in individual.
Prochaska and DiClemente’s Stages of Change Model
The “Stages of Change Model” was developed by James Prochaska and Carlo DiClemente’s in
1980. The model is related to the behavioral change model and its basically recognized to study
the individual behaviors such as weight loss, injury prevention, alcohol and drug problems etc.
the model analyzed that the behavior does not happen at once rather it goes through different
stages and change according to the situations. Each and every stage in changing comes along
with the different kinds of issues and tasks.
 Pre-contemplation: At this stage, the individual is not aware of the problem with his
behavior that needs to be changed.
 Contemplation: The stage is a point where the person acknowledged the problem but not
prepared to make a change in behavior.
 Determination: At this point, the person is acknowledged and ready to change his behavior.
 Action: This stage is a process of changing behavior
 Maintenance: After the person changed his behavior, he is maintaining that change in this
stage.
 Relapse: This stage is a phase where the person is returning to his old behavior and leaving
the new changes behind.
3. Discuss how different political positions can reflect on different health
promotion strategies and explain the relevance of providing relevant health
information to the public through schools, workplace and neighborhoods:
Health promotion is a process of improving the health and wellbeing of people. the government
always plays an important role to raise the health promotion strategies. Health promotion
activities are completely based on promoting health and preventing illnesses. The process of
health promotion enables the individual to control his health and prevent from dangerous
diseases.
Health promotion is becoming an essential element of the politics. The sector is heavily funded
by government. The public health professionals such as health promoters, educators, nurses and
doctor are extensively supporting the health promotion strategies but every individual is
influenced by the health promotion strategies. The government agencies have conflicts while
promoting health. The ministry of health is struggling to reduce the consumption of tobacco and
alcohol because it’s a major threat to individual’s health. But on the other side, the agriculture
ministry will face losses if the tobacco consumption will reduce.
Health promotion
In schools:
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 Formulate school’s health policies
 Establish a physical environment (buildings, grounds and play areas)
 Develop the social environment of school
 Provide health education
 Establish community links between student’s family and school
 Provide health services
In workplace:
The health is an important element to increase productivity level. The employer should take
corrective actions to improve the wellbeing of the employees. The employers should:
 Improve the work methods
 Improve the work environment
 Encourage the employees to participate in healthy activities
 Encourage personal development
In neighborhood:
 Establish a healthy social environment
 Promote better communication
 Understanding of policies
 Create cooperative culture
The health belief model assumes that all individuals make decisions in a rational manner, by weighing up
the pros and cons before acting in the most reasonable manner. However, this may oversimplify the
decision making process by not taking into account other ‘irrational’ factors that affect the way
individuals consider their health. For example, an individual who continues to engage in risky sexual
behaviours despite knowing the health risks, thereby sacrificing long-term health for short-term pleasure.
References:
 Abraham, Charles, Paul Norman, and Mark Conner. Understanding And
Changing Health Behaviour. 1st ed. Amsterdam: Harwood Academic, 2000. Print.
 Kumar, Sanjiv and GS Preetha. "Health Promotion: An Effective Tool For Global
Health". N.p., 2016. Print.
 Davies, Maggie and Wendy Macdowall. Health Promotion Theory. 1st ed.
Maidenhead: Open University Press, 2006. Print.
 "SOCIO-ECONOMIC FACTORS". Acta Medica Scandinavica 181.S470 (2009):
69-70. Web.
 Fischer, Florian et al. "Barriers And Strategies In Guideline Implementation—A
Scoping Review". Healthcare 4.3 (2016): 36. Web.
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