Nursing and health promotion

Aboriginal Nurse, The,  Dec 2000  

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Nursing Matters fact sheets provide quick reference information and international perspectives from the nursing profession on current health and social issues.

ICN on Mobilising Nurses for Health Promotion

Health is a basic human right and a prerequisite for social and economic development. It is a positive concept, emphasizing social and personal resources, as well as physical capacities. Health promotion is an essential element in encouraging better health. This term has become a buzz word among the public and health professionals alike. But what does health promotion really mean? The World Health Organization (WHO) defines health promotion as a process of enabling people to increase control over the determinants of health and therefore to improve their health. Health promotion encompasses strategies that allow populations to be healthy and enable them to make healthy choices. Health promotion is carried out by and with people, not on or to people. It improves the ability of individuals to take action for their health, and capacity of groups, organizes tions or communities to influence the determinants of health. The health promotion process provides support for populations to become agents of their own health by their own actions and choices. Because of the multiple determinants of health, health promotion requires collaboration between the community, health professionals and other sectors. Health promotion and health education are often used interchangeably to mean the same thing. However, health education is mainly concerned with providing information about health and illness with the aim of changing individual attitudes and behaviours.The individual focus and lifestyle approach of health education has led to criticism and concerns of "victim blaming" . In contrast, health promotion is much broader in scope and encompasses political and social interventions designed to change policies and services as well as promoting social responsibility for health.

Determinants of health

Health is a result of many factors including shelter, food, education, social security, health and social services, income, and respect for human rights and employment. Often these determinants shape people's values, their lifestyles choices, coping skills and health behaviours. If people are given opportunities, knowledge and access to services and resources, they have the capacity to `produce their own health', and the health of their families, by their own actions. Health promotion goes beyond health care. Many of the determinants of health lie outside the health sector and health professionals must collaborate with other sectors.

An understanding of the circumstances in which people live and the choices available to become healthy is important. In order to improve health and reduce illness, health promotion strategies must address the multiple determinants of health.The aim of health promotion is to create a healthy public policy in which the different sectors integrate health priorities into their policies and programs. In this way they enable people to have control over their health and to make "the healthy choices the easy choices".

Poverty is one of the greatest threats to health. It frustrates people's ambitions for building a better future, undermines their self-care actions and creates a sense of powerlessness and loss of control over their lives and the determinants of health [vi].

Social and behavioural factors such as a sedentary lifestyle, stress, substance abuse, road traffic injuries and violence are also major threats to health and wellbeing, especially in vulnerable populations. Globalization, marketing and advertising of alcohol and tobacco products and environmental degradation, continue to be major obstacles to health promotion.

Measures that reduce poverty and build capacity are effective in creating an enabling environment for promoting health. Health promotion uses different strategies and approaches to develop capacity and change people's social circumstances and health behaviours.These interrelated strategies aim to:

* Build healthy public policy.

* Create a supportive environment for health.

* Strengthen community action.

* Develop personal skills.

* Reorient health services.

Health-promoting actions by nurses and others

Nurses work in diverse settings that provide ideal opportunities for health promotion to create healthy homes, schools, healthy cities and workplaces. Individually and through national associations, nurses can be effective in paving the road to health through health promotion and along with other health care providers, managers and policy makers can:

* Create awareness of the multiple and changing determinants of health.

* Foster joint action for safer products, healthier public services, and cleaner environments.

* Build a network with other organizations and sectors to remove obstacles to health promotion.

* Promote caring environments that foster support.

* Lobby for living and working conditions that are safe, stimulating and supportive.