Older People - Health Promotion and Public Health

Original Editor - Bhanu Ramaswamy as part of the AGILE Project.

Top Contributors - Bhanu Ramaswamy, Lucinda hampton, Kim Jackson, Vidya Acharya and Evan Thomas  

Health Promotion and Public Health

As physiotherapists, we can influence people of all ages to increase their physical activity levels plus educate them to improve their general state of health and well-being. Take a look at this light heart video on activities and the elderly

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The Chartered Society of Physiotherapy defines physiotherapy as a healthcare profession concerned with human function and movement, maximising a person’s potential. By identifying factors that affect movement, physiotherapists can manage/improve a condition through approaches including health promotion, preventative advice, treatment, and rehabilitation. Literature by C Borras et al. suggests that centenarians have healthy ageing because of the delay in processes like physiological decline and age-related diseases or syndromes. The genetic component of the individual also plays an important role in longevity. The researchers suggest that the biology of centenarians yields a key for intervention to promote healthy ageing in the general population[2].

The World Health Organization (WHO) is the mandated leader in global health; they provide the following definitions to terms related to health.

Good Practice

It is worth knowing the definitions that separate terms often used in health promotion and public health.

Health as defined in the WHO constitution of 1948

A state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.
Health is a resource for everyday life, not the object of living. It is a positive concept emphasizing social and personal resources as well as physical capabilities.

Health Promotion

The process of enabling people to increase control over, and to improve their health. Health promotion is the practical applicability of health, expressed as a resource to permit people to lead an individually, socially and economically productive life.

Public Health

The science and art of promoting health, preventing disease, and prolonging life through the organised efforts of society.
To ensure health and health equity a country requires an empowered public sector must utilise principles of justice, participation, and collaboration. Actions include: policy coherence across government; strengthening action for equity and finance; and measurement, evaluation, and training  

Between 2005 and 2008, a Commission on Social Determinants of Health was established to collate and publish a report in response to increasing concern about persisting and widening inequalities in social determinants of health globally.

The social determinants of health are described as the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power, and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequalities - the unfair and avoidable differences in health status seen within and between countries.

The three main recommendations advocate:

  1. Ways to improve daily living conditions
  2. Tackle the inequitable distribution of power, money, and resources
  3. Measure and understand the problem and assess the impact of an action

The Commission strongly advocated the central role of government and the public sector in taking an action, but recognised the need for support and action across multiple agencies such as global institutions, national and local governments, civil society, research and academic communities, and the private sector.

Thus, two problems have been identified when considering health promotional issues:

  1. Lack of evidence of their effectiveness. Whilst we observe daily improvements in health-related technology and in our increasing life expectancy rates, we are developing increasing chronic illnesses,
  2. Many of these illnesses e.g. heart disease, diabetes, alcoholism, and drug abuse, or obesity are preventable, yet many within a population do not choose options that promote a healthy lifestyle.
Play therapy elderly dancing.jpeg

See also Consent and Confidentiality

References

  1. Break the stereotypes Break the Stereotype- Elderly Physical Health Promotion. Available from: https://www.youtube.com/watch?v=AdH8TKA0Pu0 (last accessed 20.5.2019)
  2. Borras C, Ingles M, Mas-Bargues C, Dromant M, Sanz-Ros J, Román-Domínguez A, Mallench-Gimeno L, Gambini J, Viña J. Centenarians: An excellent example of resilience for successful ageing. Mechanisms of Ageing and Development. 2019 Dec 31:111199.