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Farinatti P. A heuristic model for health-related autonomy based on health promotion ideas: the 'Health-Autonomy Interaction Model'. Health Promot Int 2023; 38:daab178. [PMID: 34734233 DOI: 10.1093/heapro/daab178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Autonomy and health are central concepts in health promotion literature. Operational frameworks explaining their relationship are important to support health-related autonomy actions. This study presents a heuristic model describing the 'health-autonomy relationship' based on health promotion ideas, particularly Antonovsky's and Nordenfeldt's works. Central to the 'Health-Autonomy Interaction Model' is the existence of inter-related dimensions of autonomy: thought, intention and action, all influenced by negative and positive factors of physical and social environments (extrinsic factors) and personal resources to cope with life needs (intrinsic factors). Intrinsic factors comprise elements often included in definitions of negative (ill-health) and positive health (well-being and fitness), therefore establishing a bridge between conceptions of health and autonomy. Unique to this biopsychosocial framework is the differentiation between the potential for being autonomous and the degree of autonomy effectively achieved-the potential autonomy reflects the individual set of abilities to accomplish any task, while the expressed autonomy results from the extent to which this satisfies the demands of the environment and vital goals. Conceptualizing autonomy in this manner highlights that it is a multi-factorial capability referred to external conditions, reflecting a cluster of abilities to be and do things indicative of a self-empowered life. Concluding, our model moves the concept of health-related autonomy from a focus on 'disease' and 'incapacity' to a broader view in which the meaning of 'capacity' depends on the achievement of 'self-fulfillment' in given circumstances. The notion of autonomy is regarded as a precondition for health and an essential priority in health promotion.
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Affiliation(s)
- Paulo Farinatti
- Institute of Physical Education and Sports, Laboratory of Physical Activity and Health Promotion, Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rua São Francisco Xavier, 524. Bloco F, sala 8121, Maracanã, Rio de Janeiro, RJ, Brazil
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Ritmak N, Rattanawong W, Vongmanee V. A New Dimension of Health Sustainability Model after Pandemic Crisis Using Structural Equation Model. SUSTAINABILITY 2023; 15:1616. [DOI: 10.3390/su15021616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
Abstract
Since the coronavirus (COVID-19) pandemic, it has been clear that the health dimension (HEDm) has a severe impact on sustainability, which was originally considered from the pillars of society, environment and economy. Hence, the integration of the health dimension into the other three pillars is plausible to define guidelines and criteria for progress monitoring and policy assessment towards a health-sustainable city. The objective of this study aims to present The Health Sustainability Model (HSM), a four-dimensional model for health sustainability (health, economy, environment, and society), using the Del-phi method to determine potential indicators agreed by eighteen experts, including physicians who deeply understand issues on health sustainability, and assess complex dimensions of health in the context of sustainability. The researchers have found that 45 indicators, later grouped into 15 elements and 4 dimensions, have a high level of agreement with Kendall’s W (KW) at 0.36. The HSM was then examined by the structural equation model (SEM) with reliability and validity shown as follows: the absolute fit with CMIN/DF = 1.44, RMSEA = 0.033, GFI = 0.96, AGFI = 0.94, RMR = 0.025, and the incremental fit with NFI = 0.94, CFI = 0.98, TLI = 0.97, and IFI = 0.98. Based on the results, the model is valid, in line with the empirical data. For further application, the HSM is expected to support city planners and decision makers by identifying room for improvement in each dimension through the indicators employed in the model. In contrast to existing studies that mainly use qualitative data, by conducting quantitative assessment, the model enables policy makers to objectively evaluate conditions and appropriately design policies to improve residents’ well-being.
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Affiliation(s)
- Nutthawut Ritmak
- Graduate School, University of the Thai Chamber of Commerce, 126/1 Vibhavadi Rangsit Road, Din Daeng, Bangkok 10400, Thailand
| | - Wanchai Rattanawong
- School of Engineering, University of the Thai Chamber of Commerce, 126/1 Vibhavadi Rangsit Road, Din Daeng, Bangkok 10400, Thailand
| | - Varin Vongmanee
- School of Engineering, University of the Thai Chamber of Commerce, 126/1 Vibhavadi Rangsit Road, Din Daeng, Bangkok 10400, Thailand
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Xia XF, Wang YQ, Shao SY, Zhao XY, Zhang SG, Li ZY, Yuan YC, Zhang N. The relationship between urologic cancer outcomes and national Human Development Index: trend in recent years. BMC Urol 2022; 22:2. [PMID: 35012527 PMCID: PMC8744298 DOI: 10.1186/s12894-022-00953-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/04/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To describe the influence of the socioeconomic development on worldwide age-standardized incidence and mortality rates, as well as mortality-to-incidence ratio (MIR) and 5-year net survival of urologic cancer patients in recent years. METHODS The Human Development Index (HDI) values were obtained from the United Nations Development Programme, data on age-standardized incidence/mortality rates of prostate, bladder and kidney cancer were retrieved from the GLOBOCAN database, 5-year net survival was provided by the CONCORD-3 program. We then evaluated the association between incidence/MIR/survival and HDI, with a focus on geographic variability as well as temporal patterns during the last 6 years. RESULTS Urologic cancer incidence rates were positively correlated with HDIs, and MIRs were negatively correlated with HDIs. Prostate cancer survival also correlated positively with HDIs, solidly confirming the interrelation among cancer indicators and socioeconomic factors. Most countries experienced incidence decline over the most recent 6 years, and a substantial reduction in MIR was observed. Survival rates of prostate cancer have simultaneously improved. CONCLUSION Development has a prominent influence on urologic cancer outcomes. HDI values are significantly correlated with cancer incidence, MIR and survival rates. HDI values have risen along with increased incidence and improved outcomes of urologic caner in recent years.
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Affiliation(s)
- Xiao-Fang Xia
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Yi-Qiu Wang
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
| | - Shi-Yi Shao
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Xin-Yu Zhao
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China
| | - Shi-Geng Zhang
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Zhong-Yi Li
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China
| | - Yi-Chu Yuan
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
| | - Nan Zhang
- Department of Urology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, China.
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OUP accepted manuscript. Health Promot Int 2022:6550366. [DOI: 10.1093/heapro/daac026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tabatabai S, Simforoosh N. Fundamental Values of the Healthcare and Medical Education System: Evolution of the Iranian-Religious Progress Model. JOURNAL OF RELIGION AND HEALTH 2021; 60:2138-2153. [PMID: 33398656 DOI: 10.1007/s10943-020-01118-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 06/12/2023]
Abstract
Iranian culture and religious teachings lead to a unique value-laden model in health and medical education systems. This research aimed to determine these fundamental values. To identify the health system values in the religious context of Iran, a mixed critical analysis-synthesis method was conducted. Furthermore, a focus group discussion with experts was conducted. Finally, we determined the fundamental values for the Iranian-religious progress model of health care and medical education. God centeredness, spirituality, divine and religious belief, ethical virtues, health centeredness and promoting all dimensions of human health, justice, protecting the human dignity, protecting health-related rights, social accountability, community centeredness, and scientific authority (excellence) are the values that should be considered to complete the value statement of the Iranian-religious progress model of health care and medical education.
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Affiliation(s)
- Shima Tabatabai
- Medical Education Group, Medical Ethics and Law Research Center, Shahid Beheshti University of Medial Sciences, Tehran, Iran.
| | - Nasser Simforoosh
- Department of Urology, Shahid Labbafi Nejad Hospital, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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The Organic Mindset: Insights from a Mixed Methods Grounded Theory (MM-GT) Study into Organic Food Systems. SUSTAINABILITY 2021. [DOI: 10.3390/su13094724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A broad understanding of food systems includes a complex web of activities, outcomes and drivers, encompassing not only the food and agriculture sectors, but also the social norms and cultures in which those activities are embedded. The organic food and farming movement has lately been portrayed as a food system of its own right, since it contains all necessary sub-systems, consisting of food environments, distribution networks, processing, as well as production and supply, all of which are bounded by an organic guarantee system. The underlying hypothesis of this investigation is that drivers in the organic food system operate on a paradigm level that is associated with the codified principles of ecology, health, fairness and care. Personality science suggests that the choice to act in pro-environmental ways is driven by an internalized sense of obligation or personal norms, which justifies our pursuit of seeking key drivers of food systems in the mindset of the actor. Through integrated findings from actor-centered mixed methods grounded theory research involving eleven case territories, this study identified a pattern of global mindset attributes that intuitively drive organic food system actors toward holistic human and sustainable development.
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Langmaid G, Patrick R, Kingsley J, Lawson J. Applying the Mandala of Health in the Anthropocene. Health Promot J Austr 2020; 32 Suppl 2:8-21. [PMID: 33067906 PMCID: PMC8596827 DOI: 10.1002/hpja.434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 10/03/2020] [Accepted: 10/13/2020] [Indexed: 01/21/2023] Open
Abstract
Issue addressed The Anthropocene is a new era in which human activity has been the dominant influence on climate and the environment. The negative impact humans have on the earth's systems pose significant threats to human health. Health promotion is a discipline well placed to respond to planetary health challenges of the Anthropocene. The overarching aim of this paper is to describe the elements of 21st century socio‐ecological health and apply them in a revised socio‐ecological framework for health promotion. Methods A qualitative description study design was employed to explore the significance of ecological and cultural determinants of health and review models in contemporary health promotion to inform the development of a revised Mandala of Health. Purposeful sampling was used to recruit ten experts from across Australia including academics and practitioners working at the nexus of health promotion, environmental management and sustainability. Data were analysed thematically, using deductive and inductive methods. Results A revised Mandala of Health could address existing gaps in health promotion theory and practice. Ecological and cultural determinants of health were considered essential components of health promotion that is often lacking in socio‐ecological frameworks. Indigenous Knowledge Systems were considered immensely important when addressing ecological and cultural determinants of health. Conclusions A revised Mandala of Health could encourage development of contemporary health models, assisting health promotion to evolve with the health and environmental issues of the Anthropocene. This study highlights the need for more theoretical development and empirical research regarding ecological and cultural determinants of health in a health promotion context. So what? In the context of the Anthropocene, this study highlights the potential gaps in health promotion theory and practice in terms of the natural environment and health and emphasises the need of a paradigm shift to embed ecological and cultural determinants with other determinants of health.
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Affiliation(s)
- Georgia Langmaid
- School of Health & Social DevelopmentDeakin UniversityBurwoodVic.Australia
| | - Rebecca Patrick
- School of Health & Social DevelopmentDeakin UniversityBurwoodVic.Australia
| | - Jonathan Kingsley
- Centre of Urban TransitionSwinburne University of TechnologySwinburne Place West, HawthornVic.Australia
| | - Justin Lawson
- School of Health & Social DevelopmentDeakin UniversityBurwoodVic.Australia
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Lawrence-Bourne J, Dalton H, Perkins D, Farmer J, Luscombe G, Oelke N, Bagheri N. What Is Rural Adversity, How Does It Affect Wellbeing and What Are the Implications for Action? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7205. [PMID: 33019735 PMCID: PMC7578975 DOI: 10.3390/ijerph17197205] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 01/28/2023]
Abstract
A growing body of literature recognises the profound impact of adversity on mental health outcomes for people living in rural and remote areas. With the cumulative effects of persistent drought, record-breaking bushfires, limited access to quality health services, the COVID-19 pandemic and ongoing economic and social challenges, there is much to understand about the impact of adversity on mental health and wellbeing in rural populations. In this conceptual paper, we aim to review and adapt our existing understanding of rural adversity. We undertook a wide-ranging review of the literature, sought insights from multiple disciplines and critically developed our findings with an expert disciplinary group from across Australia. We propose that rural adversity be understood using a rural ecosystem lens to develop greater clarity around the dimensions and experiences of adversity, and to help identify the opportunities for interventions. We put forward a dynamic conceptual model of the impact of rural adversity on mental health and wellbeing, and close with a discussion of the implications for policy and practice. Whilst this paper has been written from an Australian perspective, it has implications for rural communities internationally.
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Affiliation(s)
- Joanne Lawrence-Bourne
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW 2800, Australia; (J.L.-B.); (H.D.)
| | - Hazel Dalton
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW 2800, Australia; (J.L.-B.); (H.D.)
| | - David Perkins
- Centre for Rural and Remote Mental Health, University of Newcastle, Orange, NSW 2800, Australia; (J.L.-B.); (H.D.)
| | - Jane Farmer
- Social Innovation Research Institute, Swinburne University of Technology, Hawthorn, VIC 3122, Australia;
| | - Georgina Luscombe
- School of Rural Health, University of Sydney, Orange, NSW 2800, Australia;
| | - Nelly Oelke
- School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, BC V1V 1V7, Canada;
| | - Nasser Bagheri
- Centre for Mental Health Research, Australian National University, Acton, ACT 2601, Australia;
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Shao SY, Hu QD, Wang M, Zhao XY, Wu WT, Huang JM, Liang TB. Impact of national Human Development Index on liver cancer outcomes: Transition from 2008 to 2018. World J Gastroenterol 2019; 25:4749-4763. [PMID: 31528099 PMCID: PMC6718041 DOI: 10.3748/wjg.v25.i32.4749] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer death worldwide. Socioeconomic development, indicated by the Human Development Index (HDI), is closely interconnected with public health. But the manner in which social development and medical advances influenced liver cancer patients in the past decade is still unknown.
AIM To investigate the influence of HDI on clinical outcomes for patients with existing liver cancer from 2008 to 2018.
METHODS The HDI values were obtained from the United Nations Development Programme, the age-standardized incidence and mortality rates of liver cancer were obtained from the GLOBOCAN database to calculate the mortality-to-incidence ratio, and the estimated 5-year net survival of patients with liver cancer was provided by the CONCORD-3 program. We then explored the association of mortality-to-incidence ratio and survival with HDI, with a focus on geographic variability across countries as well as temporal heterogeneity over the past decade.
RESULTS From 2008 to 2018, the epidemiology of liver cancer had changed across countries. Liver cancer mortality-to-incidence ratios were negatively correlated and showed good fit with a modified “dose-to-inhibition response” pattern with HDI (r = -0.548, P < 0.0001 for 2018; r = -0.617, P < 0.0001 for 2008). Cancer survival was positively associated with HDI (r = 0.408, P < 0.01) and negatively associated with mortality-to-incidence ratio (r = -0.346, P < 0.05), solidly confirming the interrelation among liver cancer outcome indicators and socioeconomic factors. Notably, in the past decade, the HDI values in most countries have increased alongside a decreasing tendency of liver cancer mortality-to-incidence ratios (P < 0.0001), and survival outcomes have simultaneously improved (P < 0.001), with significant disparities across countries.
CONCLUSION Socioeconomic factors have a significant influence on cancer outcomes. HDI values have increased along with improved cancer outcomes, with significant disparities among countries.
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Affiliation(s)
- Shi-Yi Shao
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Qi-Da Hu
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Meng Wang
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Xin-Yu Zhao
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Wang-Teng Wu
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Jun-Ming Huang
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
| | - Ting-Bo Liang
- Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
- Zhejiang Innovation Center for the Study of Pancreatic Diseases (ICSPD-ZJ), Hangzhou 310003, Zhejiang Province, China
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Jumbri IA, Ikeda S, Managi S. Heterogeneous global health stock and growth: quantitative evidence from 140 countries, 1990-2100. Arch Public Health 2018; 76:81. [PMID: 30607246 PMCID: PMC6309060 DOI: 10.1186/s13690-018-0327-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the prevailing economic perspective, health is viewed as a type of capital stock that yields 'healthy days' in human society. However, evaluations of this health capital stock are still limited to specific contexts. The primary aim of this study is to measure and forecast the global health stocks in 140 countries from 1990 to 2100. METHODS The health capital stock in each country from 1990 to 2015 was estimated using a capital approach. The future health stocks between 2016 and 2100 were forecast using a time-series model. RESULTS Based on the health stocks from 1990 to 2015, low-income countries have much larger and more rapidly growing health stocks. In the long-term, to 2100, upper-middle income countries, particularly countries in the Middle East and North Africa, exhibit great growth that benefits from the peaks in their youth or working-age populations. Immigration also contributes to health stock growth, as do other factors, e.g., the fertility rate, population ageing, and working-age and youth populations. CONCLUSIONS Health stock is a vital component of global sustainable development that should be consistently included as a stock-based sustainability index in the evaluations of other capital to accurately measure national wealth and sustainability.
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Affiliation(s)
- Isma Addi Jumbri
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Shinya Ikeda
- College of Agriculture, Regional and Environmental Science, Ibaraki University, Inashiki, Japan
| | - Shunsuke Managi
- Department of Urban and Environmental Engineering, and Urban Institute, Kyushu University, Fukuoka, Japan
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Seymour V. The Human-Nature Relationship and Its Impact on Health: A Critical Review. Front Public Health 2016; 4:260. [PMID: 27917378 PMCID: PMC5114301 DOI: 10.3389/fpubh.2016.00260] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 11/03/2016] [Indexed: 02/05/2023] Open
Abstract
Within the past four decades, research has been increasingly drawn toward understanding whether there is a link between the changing human-nature relationship and its impact on people's health. However, to examine whether there is a link requires research of its breadth and underlying mechanisms from an interdisciplinary approach. This article begins by reviewing the debates concerning the human-nature relationship, which are then critiqued and redefined from an interdisciplinary perspective. The concept and chronological history of "health" is then explored, based on the World Health Organization's definition. Combining these concepts, the human-nature relationship and its impact on human's health are then explored through a developing conceptual model. It is argued that using an interdisciplinary perspective can facilitate a deeper understanding of the complexities involved for attaining optimal health at the human-environmental interface.
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Affiliation(s)
- Valentine Seymour
- Department of Civil, Environmental and Geomatic Engineering, University College London , London , UK
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McIntyre L, Patterson PB, Anderson LC, Mah CL. A great or heinous idea?: Why food waste diversion renders policy discussants apoplectic. CRITICAL PUBLIC HEALTH 2016. [DOI: 10.1080/09581596.2016.1258455] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lynn McIntyre
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Patrick B. Patterson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Laura C. Anderson
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Catherine L. Mah
- Health Policy, Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada
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Lam S, Leffley A, Cole DC. Applying an Ecohealth perspective in a state of the environment report: experiences of a local public health unit in Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 12:16-31. [PMID: 25546271 PMCID: PMC4306848 DOI: 10.3390/ijerph120100016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 12/15/2014] [Indexed: 11/16/2022]
Abstract
We applied an Ecohealth perspective into a State of the Environment report for Grey Bruce Health Unit and summarized environmental and health data relevant for public health practice. We aimed for comprehensiveness in our data compilation, including: standard media categories (e.g., air, water, land); and ecological indicators (e.g., vectors, forests, wetlands). Data sources included both primary (collected by an organization) and secondary (assembled by others). We organized indicators with the Driving forces-Pressure-State-Exposure-Effect-Action (DPSEEA) framework created by the World Health Organization. Indicators of air, water and land quality generally appeared to point towards a healthy state. Vector-borne diseases remained low. Forests and wetlands appeared to be in good condition, however more monitoring data was needed to determine trends in their ecological indicators. Data were not available on biodiversity and fish conditions. The results of our application of the DPSEEA framework suggest that routinely collected environmental and health data can be structured into the framework, though challenges arose due to gaps in data availability, particularly for social and gender analyses. Ecohealth approaches had legitimacy with broader healthy community partners but applying such approaches was a complex undertaking.
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Affiliation(s)
- Steven Lam
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario N1G 2W1, Canada.
| | - Alanna Leffley
- Grey Bruce Health Unit, 101 17th St E, Owen Sound, Ontario N4K 0A5, Canada.
| | - Donald C Cole
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario M5T 3M7, Canada.
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Macfarlane RG, Wood LP, Campbell ME. Healthy Toronto by Design: Promoting a healthier built environment. Canadian Journal of Public Health 2014; 106:eS5-8. [PMID: 25955548 DOI: 10.17269/cjph.106.3855] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 06/03/2014] [Accepted: 06/03/2014] [Indexed: 11/17/2022]
Abstract
Chronic diseases, obesity and sedentary lifestyles are some of the health challenges facing Canada today. There is increasing recognition and evidence that the way our cities are planned, designed and built can contribute to these problems. Many of the policy levers to address the built environment exist outside the health sector and at the municipal level in areas such as urban planning, transportation, parks and recreation, and housing. The challenge for the public health sector is to build and sustain partnerships and collaboration across various sectors to ensure that health is considered in built environment policies. As the public health unit for the city of Toronto and part of the municipal government, Toronto Public Health is in a unique position to provide leadership, advocacy and support for healthy municipal public policies related to the built environment. This article provides some examples of CLASP (Coalitions Linking Action and Science for Prevention) initiatives undertaken to help create support for healthy public policies in the built environment and suggests that the "Healthy Cities" approach is a useful framework to promote policy change in the built environment at the municipal level.
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Lam W, Dawson A, Fowler C. Health promotion interventions to prevent early childhood human influenza at the household level: a realist review to identify implications for programmes in Hong Kong. J Clin Nurs 2014; 24:891-905. [PMID: 24964081 DOI: 10.1111/jocn.12646] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2014] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To identify factors affecting the delivery of health promotion interventions to prevent early childhood human influenza at the household level. BACKGROUND Yearly, influenza epidemics seriously affect all age groups, particularly those with weakened immune systems, including children. Influenza is transmitted easily from person to person through droplet and direct contact. Maintaining personal hygiene, avoiding close contact with the infected person and proper hand washing are recommended as the most effective means of preventing the transmission of influenza. However, it is not clear what programme-related mechanisms and contexts are crucial to the successful delivery of interventions in the home. This study systematically reviewed published research studies to identify factors influencing the effective delivery of health promotion programmes targeting influenza in a household. DESIGN Realist review. METHODS A realist review methodology was selected to examine what interventions are effective in preventing and managing influenza at the household level and in what circumstances. A structured search of the peer-reviewed primary research literature was undertaken using a defined search protocol. RESULTS Eight studies were retrieved for the analysis. Mechanisms impacting on intervention delivery were identified, including timing of implementation, programme reach, organisational and healthcare worker involvement, mode and place of delivery, contact with infected person, health practice compliance and sustainability at home. CONCLUSION These findings suggest contextual factors that could be identified through ecological approaches to health promotion that are crucial for policymakers to consider when designing interventions. RELEVANCE TO CLINICAL PRACTICE The active involvement of community nurses through an integrated household visiting programme may help to better deliver family-based health promotion interventions to prevent illnesses such as influenza in children.
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Affiliation(s)
- Winsome Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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Beery M, Adatia R, Segantin O, Skaer CF. School food gardens: fertile ground for education. HEALTH EDUCATION 2014. [DOI: 10.1108/he-05-2013-0019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Macmillan A, Connor J, Witten K, Kearns R, Rees D, Woodward A. The societal costs and benefits of commuter bicycling: simulating the effects of specific policies using system dynamics modeling. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:335-44. [PMID: 24496244 PMCID: PMC3984216 DOI: 10.1289/ehp.1307250] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 02/03/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Shifting to active modes of transport in the trip to work can achieve substantial co-benefits for health, social equity, and climate change mitigation. Previous integrated modeling of transport scenarios has assumed active transport mode share and has been unable to incorporate acknowledged system feedbacks. OBJECTIVES We compared the effects of policies to increase bicycle commuting in a car-dominated city and explored the role of participatory modeling to support transport planning in the face of complexity. METHODS We used system dynamics modeling (SDM) to compare realistic policies, incorporating feedback effects, nonlinear relationships, and time delays between variables. We developed a system dynamics model of commuter bicycling through interviews and workshops with policy, community, and academic stakeholders. We incorporated best available evidence to simulate five policy scenarios over the next 40 years in Auckland, New Zealand. Injury, physical activity, fuel costs, air pollution, and carbon emissions outcomes were simulated. RESULTS Using the simulation model, we demonstrated the kinds of policies that would likely be needed to change a historical pattern of decline in cycling into a pattern of growth that would meet policy goals. Our model projections suggest that transforming urban roads over the next 40 years, using best practice physical separation on main roads and bicycle-friendly speed reduction on local streets, would yield benefits 10-25 times greater than costs. CONCLUSIONS To our knowledge, this is the first integrated simulation model of future specific bicycling policies. Our projections provide practical evidence that may be used by health and transport policy makers to optimize the benefits of transport bicycling while minimizing negative consequences in a cost-effective manner. The modeling process enhanced understanding by a range of stakeholders of cycling as a complex system. Participatory SDM can be a helpful method for integrating health and environmental outcomes in transport and urban planning.
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Pech E, Rose U, Freude G. Zum Verständnis mentaler Gesundheit — eine erweiterte Perspektive. ZENTRALBLATT FUR ARBEITSMEDIZIN ARBEITSSCHUTZ UND ERGONOMIE 2014. [DOI: 10.1007/bf03344289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Coutts C, Forkink A, Weiner J. The portrayal of natural environment in the evolution of the ecological public health paradigm. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:1005-19. [PMID: 24434596 PMCID: PMC3924488 DOI: 10.3390/ijerph110101005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/19/2013] [Accepted: 12/20/2013] [Indexed: 11/16/2022]
Abstract
This paper explores the conceptualization of the natural environment in an evolving ecological public health paradigm. The natural environment has long been recognized as essential to supporting life, health, and wellbeing. Our understanding of the relationship between the natural environment and health has steadily evolved from one of an undynamic environment to a more sophisticated understanding of ecological interactions. This evolution is reflected in a number of ecological public health models which demonstrate the many external and overlapping determinants of human health. Six models are presented here to demonstrate this evolution, each model reflecting an increasingly ecological appreciation for the fundamental role of the natural environment in supporting human health. We conclude that after decades of public health's acceptance of the ecological paradigm, we are only now beginning to assemble knowledge of sophisticated ecological interdependencies and apply this knowledge to the conceptualization and study of the relationship between the natural environment and the determinants of human health.
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Affiliation(s)
- Christopher Coutts
- Department of Urban and Regional Planning, Center for Demography and Population Health, Florida State University, 113 Collegiate Way, Tallahassee, FL 32306, USA.
| | - Annet Forkink
- Department of Urban and Regional Planning, Center for Demography and Population Health, Florida State University, 113 Collegiate Way, Tallahassee, FL 32306, USA.
| | - Jocelyn Weiner
- Department of Urban and Regional Planning, Center for Demography and Population Health, Florida State University, 113 Collegiate Way, Tallahassee, FL 32306, USA.
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Bentley M. An ecological public health approach to understanding the relationships between sustainable urban environments, public health and social equity. Health Promot Int 2013; 29:528-37. [DOI: 10.1093/heapro/dat028] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gudes O, Kendall E, Yigitcanlar T, Pathak V, Baum S. Rethinking health planning: a framework for organising information to underpin collaborative health planning. Health Inf Manag 2011; 39:18-29. [PMID: 20577020 DOI: 10.1177/183335831003900204] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The field of collaborative health planning faces significant challenges created by the narrow focus of the available information, the absence of a framework to organise that information and the lack of systems to make information accessible and guide decision-making. These challenges have been magnified by the rise of the 'healthy communities movement', resulting in more frequent calls for localised, collaborative and evidence-driven health related decision-making. This paper discusses the role of decision support systems as a mechanism to facilitate collaborative health decision-making. The paper presents a potential information management framework to underpin a health decision support system and describes the participatory process that is currently being used to create an online tool for health planners using geographic information systems. The need for a comprehensive information management framework to guide the process of planning for healthy communities has been emphasised. The paper also underlines the critical importance of the proposed framework not only in forcing planners to engage with the entire range of health determinants, but also in providing sufficient flexibility to allow exploration of the local setting-based determinants of health.
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Affiliation(s)
- Ori Gudes
- Griffith Institute of Health and Medical Research, Griffith University, Queensland, Australia.
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Tools for thoughtful action: the role of ecosystem approaches to health in enhancing public health. Canadian Journal of Public Health 2011. [PMID: 21370776 DOI: 10.1007/bf03403959] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The intimate interdependence of human health and the ecosystems in which we are embedded is now a commonplace observation. For much of the history of public health, this was not so obvious. After over a century of focus on diseases, their biologic causes and the correction of exposures (clean water and air) and facilitation of responses (immunizations and nutrition), public health discourse shifted to embrace the concept of determinants of health as extending to social, economic and environmental realms. This moved the discourse and science of public health into an unprecedented level of complexity just as public concern about the environment heightened. To address multifactorial, dynamic impacts on health, a new paradigm was needed which would overcome the separation of humans and ecosystems. Ecosystem approaches to health arose in the 1990s from a rich background of intellectual ferment as Canada wrestled with diverse problems ranging from Great Lakes contamination to zoonotic diseases. Canada's International Development Research Centre (IDRC) played a lead role in supporting an international community of scientists and scholars who advanced ecosystem approaches to health. These collective efforts have enabled a shift to a research paradigm that embraces transdisciplinarity, social justice, gender equity, multi-stakeholder participation and sustainability.
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Parker EA, Chung LK, Israel BA, Reyes A, Wilkins D. Community organizing network for environmental health: using a community health development approach to increase community capacity around reduction of environmental triggers. J Prim Prev 2010; 31:41-58. [PMID: 20306137 PMCID: PMC2891016 DOI: 10.1007/s10935-010-0207-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The Community Organizing Network for Environmental Health (CONEH), a project of Community Action Against Asthma, used a community health development approach to improve children's asthma-related health through increasing the community's capacity to reduce physical and social environmental triggers for asthma. Three community organizers were hired to work with community groups and residents in neighborhoods in Detroit on the priority areas of air quality, housing, and citizen involvement in the environmental project and policy decision-making. As part of the evaluation of the CONEH project, 20 one-on-one semi-structured, in-depth interviews were conducted between August and November 2005 involving steering committee members, staff members, and key community organization staff and/or community members. Using data from the evaluation of the CONEH project, this article identifies the dimensions of community capacity that were enhanced as part of a CBPR community health development approach to reducing physical and social environmental triggers associated with childhood asthma and the factors that facilitated or inhibited the enhancement of community capacity.
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Affiliation(s)
- Edith A Parker
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
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Zoller HM. The social construction of occupational health and safety: barriers to environmental-labor health coalitions. New Solut 2010; 19:289-314. [PMID: 19778829 DOI: 10.2190/ns.19.3.b] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Occupational and environmental health advocates promote the potential of alliances between workers and community members to address shared health problems resulting from industrial processes. Advocates recognize the need to overcome job blackmail, which has successfully pitted these groups against one another by threatening job loss in the face of calls for improved standards. This strategic form of issue management represents a dualism between good health and clean environments on one hand and jobs and tax bases on the other. The author argues that overcoming job blackmail requires attention not only to this dualism, but to the broader social construction of occupational and environmental health. The article describes a series of oppositional constructions, in both strategic organizational rhetoric and everyday cultural discourse, which reinforces job blackmail and impedes the development of solidarity among workers, neighbors, and environmental advocates. These dualisms polarize our views of work and environment, science, and social identity, thereby producing barriers to coalition formation. Understanding these reifications helps to build an activist agenda and identify potential resources for organizing to overcome these barriers.
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Affiliation(s)
- Heather M Zoller
- Department of Communication, University of Cincinnati, OH 45211, USA.
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Applying Dixon and Dixon's Integrative Model for Environmental Health Research toward a critical analysis of childhood lead poisoning in Canada. ANS Adv Nurs Sci 2010; 33:E1-16. [PMID: 20154520 DOI: 10.1097/ans.0b013e3181cd834d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Occurrences of childhood lead poisoning resulting from exposure to residential sources of lead is an underresearched area in Canada. Dixon and Dixon's Integrative Model for Environmental Health Research substantiates this claim by grouping Canadian research on this health topic into the model's 4 domains: physiological, vulnerability, epistemological, and health protection. This process is useful not only for identifying research gaps within the Canadian context but also in setting the groundwork for a future critical analysis to illuminate the sociopolitical and economic influences that shape healthcare knowledge, and ultimately, influence how healthcare providers and policy makers produce and use this information.
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Elwood Martin R, Murphy K, Hanson D, Hemingway C, Ramsden V, Buxton J, Granger-Brown A, Condello LL, Buchanan M, Espinoza-Magana N, Edworthy G, Hislop TG. The development of participatory health research among incarcerated women in a Canadian prison. Int J Prison Health 2009; 5:95-107. [PMID: 25759141 PMCID: PMC2704626 DOI: 10.1080/17449200902884021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This paper describes the development of a unique prison participatory research project, in which incarcerated women formed a research team, the research activities and the lessons learned. The participatory action research project was conducted in the main short sentence minimum/medium security women's prison located in a Western Canadian province. An ethnographic multi-method approach was used for data collection and analysis. Quantitative data was collected by surveys and analysed using descriptive statistics. Qualitative data was collected from orientation package entries, audio recordings, and written archives of research team discussions, forums and debriefings, and presentations. These data and ethnographic observations were transcribed and analysed using iterative and interpretative qualitative methods and NVivo 7 software. Up to 15 women worked each day as prison research team members; a total of 190 women participated at some time in the project between November 2005 and August 2007. Incarcerated women peer researchers developed the research processes including opportunities for them to develop leadership and technical skills. Through these processes, including data collection and analysis, nine health goals emerged. Lessons learned from the research processes were confirmed by the common themes that emerged from thematic analysis of the research activity data. Incarceration provides a unique opportunity for engagement of women as expert partners alongside academic researchers and primary care workers in participatory research processes to improve their health.
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Affiliation(s)
- R Elwood Martin
- Department of Family Practice, University of British Columbia
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28
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Yoo WS, Kim KY, Koh KW. [Introduction of health impact assessment and healthy cities as a tool for tackling health inequality]. J Prev Med Public Health 2008; 40:439-46. [PMID: 18063898 DOI: 10.3961/jpmph.2007.40.6.439] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In order to reduce the health inequalities within a society changes need to be made in broad health determinants and their distribution in the population. It has been expected that the Health impact assessment(HIA) and Healthy Cities can provide opportunities and useful means for changing social policy and environment related with the broad health determinants in developed countries. HIA is any combination of procedures or methods by which a proposed 4P(policy, plan, program, project) may be judged as to the effects it may have on the health of a population. Healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential. In Korea, social and academic interest regarding the HIA and Healthy Cities has been growing recently but the need of HIA and Healthy Cities in the perspective of reducing health inequality was not introduced adequately. So we reviewed the basic concepts and methods of the HIA and Healthy Cities, and its possible contribution to reducing health inequalities. We concluded that though the concepts and methods of the HIA and Healthy Cities are relatively new and still in need of improvement, they will be useful in approaching the issue of health inequality in Korea.
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Affiliation(s)
- Weon-Seob Yoo
- Department of Preventive Medicine, College of Medicine, Eulji University.
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Kothari* A, Edwards N, Yanicki S, Hansen-Ketchum P, Kennedy MA. Modèles socio-écologiques : renforcement de la recherche interventionnelle dans le contrôle du tabac. ACTA ACUST UNITED AC 2008. [DOI: 10.7202/016952ar] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Résumé
Quelques aspects dans le domaine du contrôle du tabac ont été marqués par une conceptualisation plus large des facteurs complexes qui déterminent la santé de la population. Les programmes de santé publique de contrôle du tabac accordent une part de plus en plus grande à des interventions à plusieurs niveaux et à des changements de politiques pour influencer le contexte. De plus, des concepts socio-écologiques (par exemple, stratégies visant des interactions intrapersonnelles, interpersonnelles et socio-environnementales) sont implicites à de nombreuses politiques exhaustives de réduction du tabac. Par contraste, la recherche interventionnelle sur le tabac est à la traîne par rapport à cette progression, avec des stratégies au niveau individuel qui continuent à dominer le programme de recherche. De nouvelles méthodes de recherche sont suggérées pour renforcer la recherche interventionnelle dans la prévention et l’arrêt du tabagisme. En utilisant l’exemple des adolescents et des transitions développementales, nous illustrerons comment la réflexion entourant les modèles socio-écologiques offre de nouvelles possibilités pour la recherche interventionnelle sur le contrôle du tabac.
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Affiliation(s)
| | | | | | | | - Margaret Ann Kennedy
- Professeure adjointe, École des sciences infirmières, Université Saint-François-Xavier
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Abstract
To improve population health, one must put emphasis on reducing health inequities and enhancing health protection and disease prevention, and early diagnosis and treatment of diseases by tackling the determinants of health at the downstream, midstream, and upstream levels. There is strong theoretical and empirical evidence for the association between strong national primary care systems and improved health indicators. The setting approach to promote health such as healthy schools, healthy cities also aims to address the determinants of health and build the capacity of individuals, families, and communities to create strong human and social capitals. The notion of human and social capitals begins to offer explanations why certain communities are unable to achieve better health than other communities with similar demography. In this paper, a review of studies conducted in different countries illustrate how a well-developed primary health care system would reduce all causes of mortalities, improve health status, reduce hospitalization, and be cost saving despite a disparity in socioeconomic conditions. The intervention strategy recommended in this paper is developing a model of comprehensive primary health care system by joining up different settings integrating the efforts of different parties within and outside the health sector. Different components of primary health care team would then work more closely with individuals and families and different healthy settings. This synergistic effect would help to strengthen human and social capital development. The model can then combine the efforts of upstream, midstream, and downstream approaches to improve population health and reduce health inequity. Otherwise, health would easily be jeopardized as a result of rapid urbanization.
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Affiliation(s)
- Albert Lee
- Centre for Health Education and Health Promotion, Department of Community and Family Medicine, The Chinese University of Hong Kong, School of Public Health, Prince of Wales Hospital, Shatin, New Territory, Hong Kong.
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31
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Parker EA, Baldwin GT, Israel B, Salinas MA. Application of health promotion theories and models for environmental health. HEALTH EDUCATION & BEHAVIOR 2004; 31:491-509. [PMID: 15296631 DOI: 10.1177/1090198104265601] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The field of environmental health promotion gained new prominence in recent years as awareness of physical environmental stressors and exposures increased in communities across the country and the world. Although many theories and conceptual models are used routinely to guide health promotion and health education interventions, they are rarely applied to environmental health issues. This article examine show health promotion theories and models can be applied in designing interventions to reduce exposure to environmental health hazards. Using the Community Action Against Asthma (CAAA) project as an example, this article describes the application of these theories and models to an intervention aimed at reducing environmental triggers for childhood asthma. Drawing on the multiple theories and models described, a composite ecological stress process model is presented, and its implications for environmental health promotion discussed.
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Affiliation(s)
- Edith A Parker
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
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Abstract
This article reports findings about student nurses' understanding of the nursing role in health promotion related to tobacco issues. These findings were derived from the data of a larger project, examining smoking practices of baccalaureate nursing students in Manitoba, Canada. The study was conducted with second-year, third-year, and fourth-year university nursing students studying at several sites throughout the province (N = 272). From the data analysis of the interviews, class forums, and open-ended survey questions, five themes emerged (i.e., who they are-who they are becoming, central beliefs and attitudes, learning the facts, practice world-limited options, role conflict). Students expressed considerable uncertainty and conflict concerning individual autonomy around decisions about tobacco use. This resulted in confusion about themselves as role models and their use of health promotion interventions.
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Affiliation(s)
- Karen Chalmers
- Faculty of Nursing, Helen Glass Centre for Nursing, University of Manitoba, Winnipeg, Manitoba, Canada.
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Abstract
The authors' 1990 article "Producing Health, Consuming Health Care" presented a conceptual framework for synthesizing a rapidly growing body of findings on the nonmedical determinants of health. The article received a very positive response, and here the authors reflect on what lessons might be learned from that response about the style or content of effective interdisciplinary communication. Much substantive knowledge has been accumulated since 1990, and a number of different frameworks have been developed before and since. The authors situate theirs within this literature and consider how they might have modified it if they "knew then what they know now." They ask what impact this article, and the much broader stream of research on the determinants of health, has had on public policy?
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Affiliation(s)
- Robert G Evans
- Department of Economics and the Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
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Hancock T. Indicators of environmental health in the urban setting. Canadian Journal of Public Health 2002. [PMID: 12425175 DOI: 10.1007/bf03405118] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The North American population is approximately 80% urbanized and spends almost 90% of the time indoors. Accordingly, the built environment is the most important--one might almost say "natural"--human environment. Urban settlements incorporate within their boundaries natural ecosystems of plant and animal life (often highly adapted to the urban environment), and are in turn incorporated within wider bioregions and global ecosystems. But urban settlements are not just built and natural physical environments, they are social, economic, cultural and political environments; the whole constitutes an urban ecosystem. These ecosystems have profound implications for the physical, mental, social, emotional and spiritual well-being of their human inhabitants, as well as for human beings remote from these urban ecosystems. Therefore, this paper discusses urban ecosystems and human health and presents a framework for indicators of environmental health in the urban setting based on such an understanding. The concepts of environmental viability, ecological sustainability, urban livability, community conviviality, social equity, and economic adequacy are discussed in relation to human health and are used to organize proposed candidate indicators for urban ecosystems and public health.
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Abstract
The question of what is the good life has been discussed by philosophers since antiquity. The good of an individual and of a community is complicated. Communities influence an individual's experiences and world views, which are always individual. Public health nurses promoting the good life need multidisciplinary knowledge, as well as other skills such as personal competence and qualifications. The focus of the theoretical framework of promotion of the good life is based on models of health promotion and sustainable development. Working with different clients requires nursing theories, other theories, and multidisciplinary models in practice. Continual quality improvement is needed in order to increase customer satisfaction. This article discusses a doctoral thesis that consists of three empirical studies. The theoretical framework for promotion of the good life as the work of public health nurses is outlined, and the outcomes of the first study, the qualifications concerning health, and the environment are described. In the other parts of the study, curriculum building using future methodology and evaluation with concept maps is reported.
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Affiliation(s)
- L M Uosukainen
- Mikkeli Polytechnic at School of Health Care, Savonlinna, Finland.
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Indicators that count! Measuring population health at the community level. Canadian Journal of Public Health 2000. [PMID: 10686755 DOI: 10.1007/bf03403574] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We begin with a discussion of some vitally important conceptual and methodological issues. These issues concern our understanding of community, of health, of population health and its determinants, of the concept of 'measurement' and the values that underlie it, and our reasons for wishing to measure these constructs. We then present a framework for indicator categories, propose some criteria for indicator selection and suggest an initial set of core indicators. This indicator set reflects not simply health status--no matter how broadly defined--but also the environmental, social and economic determinants of health and the "healthfulness" of the community itself. Our most important conclusion is that if the information that is contained in the data of the indicator set is to be transformed into knowledge that can empower and emancipate the community, it has to be developed in consultation with the local community and local users of the information.
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Falk Rafael AR. The politics of health promotion: influences on public health promoting nursing practice in Ontario, Canada from Nightingale to the nineties. ANS Adv Nurs Sci 1999; 22:23-39. [PMID: 10961264 DOI: 10.1097/00012272-199909000-00004] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The marked and significant differences in the various meanings ascribed to health promotion in professional literature provide evidence of the concept's evolution over the last half of the 20th century and testify both to the powerful influences of dominant ideologies and the invisibility of others. The "new public health" marks a return to a conceptualization of health that is consistent with a nursing paradigm and thus potentially useful in supporting nursing health promotion practice. To take full advantage of this knowledge, however, it is critical that nurses reclaim their legacy in health promotion, critically appraise outside influences that threaten to undermine their work, and educate the public and other disciplines about nursing's unique focus on health promotion.
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VanLeeuwen J, Waltner-Toews D, Abernathy T, Smit B. Evolving Models of Human Health Toward an Ecosystem Context. ACTA ACUST UNITED AC 1999. [DOI: 10.1046/j.1526-0992.1999.09931.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Harris E, Wills J. Developing healthy local communities at local government level: lessons from the past decade. Aust N Z J Public Health 1997; 21:403-12. [PMID: 9308206 DOI: 10.1111/j.1467-842x.1997.tb01722.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
There have been many approaches by the health sector to developing healthy communities based on local government areas in Australia in the past decade. Each has struggled with the need to establish realistic goals and to find ways of working more effectively with local government. This paper outlines four of these approaches--Healthy Cities, the Healthy Localities project, municipal health plans, and programs to address specific health problems or issues. Although the picture is one of huge diversity in the ways in which the issue is defined and action taken, a number of dimensions to a healthy community are emerging. However, if we are to be able to monitor change within and between the health of communities over time, indicators need to be developed and goals set. This will require a shift away from defining goals and targets in terms of populations (people), towards goals based on changes in organisations and systems. Engaging local government in this process will be vital and will require the health sector to develop a better understanding of the ways in which local government defines its role in creating healthy communities. It will also involve learning from local government the strategies that they have found most effective in dealing with complex problems that require action at many levels.
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Affiliation(s)
- E Harris
- School of Community Medicine, University of New South Wales, Sydney
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40
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Pedersen D. Disease ecology at a crossroads: man-made environments, human rights and perpetual development utopias. Soc Sci Med 1996; 43:745-58. [PMID: 8870139 DOI: 10.1016/0277-9536(96)00119-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
There is a growing body of critical literature on health, development and environmental sustainability in a world of finite resources and overburdened ecosystems. The ethics of progress and perpetual development in pursuit of unlimited economic growth and ever-expanding markets are no longer viable, given the constraints imposed on the life-support systems of the biosphere and a finite resource base, which poses the most serious threat to life on Earth. Despite increasing evidence of the linkages between economic growth and environmental deterioration and a rhetoric expressed in a growing body of laws, regulations, accords and global "agendas" at the national and international level, there are all too few success stories in reversing or even slowing down the current trends of ecosystem degradation and decreasing cultural and biological diversity. On the contrary, there is evidence that environmental stress and deterioration are increasing, and the impact on the mental, physical and social health and well-being of populations is more significant now than in any previous time in history. The fragmentation of countries, the rise of nationalism and ethnic conflict, the decimation of indigenous nations and human rights abuses are often closely interrelated with environmental degradation and development initiatives. This paper reviews some of the concepts and underlying values of the main "models" developed by health and social scientists for interpreting this reality, with the aim of stimulating debate that could lead to the adoption of a larger and more comprehensive framework for analysing the interactions between human health, development and environmental change.
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Affiliation(s)
- D Pedersen
- Department of Social Medicine, Harvard Medical School, Boston, MA, USA
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Clark NM, McLeroy KR. Creating capacity through health education: what we know and what we don't. HEALTH EDUCATION QUARTERLY 1995; 22:273-89. [PMID: 7591785 DOI: 10.1177/109019819402200303] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Researchers in health education have rarely convened to outline research priorities in the field. This article discusses the results of a meeting to develop a research agenda aimed at creating capacity to promote and maintain health. Salient research findings related to individual and community health are summarized and priority issues for future research are presented.
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Affiliation(s)
- N M Clark
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA
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Adams L, Pintus S, Adam L, Pintus S. A challenge to prevailing theory and practice. CRITICAL PUBLIC HEALTH 1994. [DOI: 10.1080/09581599408406282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Harris E, Wills J. Developing healthy local communities at local government level: lessons from the past decade. Aust N Z J Public Health 1977. [DOI: 10.1111/j.1467-842x.1977.tb01010.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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