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2 - Strategies for improving health

Published online by Cambridge University Press:  05 February 2013

Anne Andermann
Affiliation:
McGill University, Montréal
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Summary

Almost 40 years ago, the Declaration of Alma-Ata set forth the aspirational goal of “health for all”. While a great deal of progress has been made in recent decades, there remain many important decisions still to be made if we want to come even closer to achieving this goal. However, if the aim of making more evidence-informed decisions is to improve health, it would be helpful to first know what health is. While this appears to be a rather straightforward question, as Socrates found over two millennia ago, many people, when pressed, have difficulty defining even the most fundamental concepts – like knowledge and justice – that are central to their everyday lives. Similarly, health and health inequities are also basic concepts that should be explored further from the outset. What is health? Why should we want to improve health? What are the most effective strategies for improving health? How can we measure whether there have been health improvements? This chapter provides an overview of the concepts of health and health inequities, of the causes of poor health, and of the various strategies to improve health and reduce health inequities.

Health and health inequities

Health is a complex concept that can be examined and defined in many different ways. A widely used definition is inscribed in the 1948 constitution of the World Health Organization (WHO), which considers health to be “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This definition moves away from a strictly biomedical model of health that focuses only on the disease or disability. Instead, the WHO definition adopts a wider bio-psycho-social model to better integrate the importance of the psychological and social dimensions of health. One might go even further and include a spiritual dimension of health. According to the Canadian Royal Commission on Aboriginal Peoples, many indigenous communities consider health to be “a state of balance and harmony involving body, mind, emotions and spirit. It links each person to family, community and the earth in a circle of dependence and interdependence, described by some in the language of the Medicine Wheel”. Health is therefore a holistic and multidimensional concept that must be explored from different angles and perspectives to be fully understood (Fig. 2.1).

Type
Chapter
Information
Evidence for Health
From Patient Choice to Global Policy
, pp. 5 - 25
Publisher: Cambridge University Press
Print publication year: 2012

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References

International Conference on Primary Health Care. Declaration of Alma-Ata. Geneva: World Health Organization, 1978. Available at: .Google Scholar
World Health Organization. Working for Health: An Introduction to the World Health Organization. Geneva: World Health Organization, 2007. Available at: .Google Scholar
World Health Organization. WHO Constitution. Geneva: World Health Organization, 1948. Available at: .Google Scholar
Royal Commission on Aboriginal Peoples. Royal Commission Report on Aboriginal Peoples. Ottawa: Canada Communication Group Publishing, 1996. Available at: .Google Scholar
Reading, J, Kmetic, A, Gideon, V. First Nations Wholistic Policy and Planning Model: Discussion Paper for the World Health Organization Commission on the Social Determinants of Health. Ottawa: Assembly of First Nations, 2007. Available at: .Google Scholar
Kleinman, A. The Illness Narratives: Suffering, Healing, and the Human Condition. New York: Basic Books, 1988.Google Scholar
World Health Organization. International Classification of Functioning, Disability and Health. Geneva: World Health Organization, 2003. Available at: .Google Scholar
Patrick, D, Starks, H, Cain, K, Uhlmann, R, Pearlman, R. Measuring preferences for health states worse than death. Med Dec Making1994; 14(1): 9–18.CrossRef
Graunt, J. Natural and Political Observations Made Upon the Bills of Mortality. London: Roycroft Printers, 1662.Google Scholar
Organisation for Economic Co-operation and Development. OECD Factbook 2010. Paris: Organisation for Economic Co-operation and Development, 2010.Google Scholar
World Health Organization. World Health Statistics Report 2010. Geneva: World Health Organization, 2010. Available at: .Google Scholar
Drummond, M, Sculpher, M, Torrance, G, O’Brien, B, Stoddart, G. Methods for the Economic Evaluation of Health Care Programmes, 3rd edn. Oxford: Oxford University Press, 2005.Google Scholar
World Health Organization. Ottawa Charter for Health Promotion. Geneva: World Health Organization, 1986. Available at: .Google Scholar
Commission on Macroeconomics and Health. Investing in Health: A Summary of the Findings of the Commission on Macroeconomics and Health. Geneva: World Health Organization, 2002. Available at: .Google Scholar
Naylor, D, Basrur, S, Bergeron, M et al. Learning from SARS: Renewal of Public Health in Canada. Ottawa: Health Canada, 2003.Google Scholar
Young, TK. Population Health: Concepts and Methods, 2nd edn. Oxford: Oxford University Press, 2005.Google Scholar
The World Bank. World Development Indicators (WDI) database. Washington DC: World Bank, Development Research Group, 2012. Available at: .Google Scholar
Australian Bureau of Statistics. The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples. Canberra: Australian Bureau of Statistics, 2005. Available at: .Google Scholar
Canadian Institute for Health Information. Improving the Health of Canadians. Ottawa: Canadian Institute for Health Information, 2004. Available at: .Google Scholar
Koch, R. Die Aetiologie der Tuberkulose. Mitt Kaiser Gesundh 1884; 2: 1–88.Google Scholar
Heymann, D (ed.). Control of Communicable Diseases Manual, 19th edn. Atlanta: APHA, 2008.
Doll, R, Peto, R, Boreham, J, Sutherland, I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519–28.CrossRefGoogle ScholarPubMed
Kannel, W. The Framingham Study: its 50-year legacy and future promise. J Atheroscler Thromb 2000; 6(2): 60–6.CrossRefGoogle ScholarPubMed
Ebrahim, S, Beswick, A, Burke, M, Davey, Smith G. Multiple risk factor interventions for primary prevention of coronary heart disease. Cochrane Database Syst Rev 2006; (4): CD001561.CrossRefGoogle ScholarPubMed
Federal, Provincial and Territorial Advisory Committee on Population Health. Toward a Healthy Future: Second Report on the Health of Canadians. Ottawa: Minister of Public Works and Government Services Canada, 1999. Available at: .Google Scholar
Evans, R, Barer, M, Marmor, T. Why Are Some People Healthy and Others Not? The Determinants of Health of Populations. New York: Walter de Gruyter, 1994.Google Scholar
Commission on Social Determinants of Health (CSDH). Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health, Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization, 2008. Available at: .Google Scholar
Lalonde, M. A New Perspective on the Health of Canadians. Ottawa: Health Canada, 1974. Available at: .Google Scholar
Power, M, Faden, R. Social Justice: The Moral Foundations of Public Health and Health Policy. Oxford: Oxford University Press, 2006.Google Scholar
Hamilton, N, Bhatti, T. An Integrated Model of Population Health and Health Promotion. Ottawa: Health Canada, 1995. Available at: .Google Scholar
Rose, G. Sick individuals and sick populations. Int J Epidemiol 1985; 14: 32–8.CrossRefGoogle ScholarPubMed
Andermann, A. Screening for abdominal aortic aneurysm: should we lower the intervention cut-off point? [commissioned editorial] BMJ 2012; 344:e3111.CrossRefGoogle ScholarPubMed
Last, J. A Dictionary of Epidemiology, 4th edn. Oxford: Oxford University Press, 2001.Google Scholar
Freemantle, N, Cleland, J, Young, P, Mason, J, Harrison, J. Beta blockade after myocardial infarction: systematic review and meta regression analysis. BMJ 1999; 318(7200): 1730–7.CrossRefGoogle ScholarPubMed
Michael, Y, Lin, J, Whitlock, E, et al. Interventions to Prevent Falls in Older Adults: An Updated Systematic Review. Rockville, MD: Agency for Healthcare Research and Quality, 2010. Available at: .Google Scholar
World Health Organization. Bangkok Charter for Health Promotion in a Globalized World. Geneva: World Health Organization, 2006. Available at: .Google Scholar
Thaler, R, Sunstein, C. Nudge: Improving Decisions about Health, Wealth and Happiness. New haven: Yale University Press, 2008.Google Scholar
Winslow, C. The untilled fields of public health. Science 1920; 51(1306): 23–33. Available at: .Google Scholar
Acheson, D. Public Health in England: The Report of the Committee of Inquiry into the Future Development of the Public Health Function. London: HMSO, 1988.Google Scholar
Institute of Medicine. The Future of Public Health. Washington, DC: National Academy Press, 1988.Google Scholar
Public Health Functions Steering Committee. Ten Essential Public Health Services. Atlanta: Centers for Disease Control and Prevention, 1994. Available at: .Google Scholar
Advisory Committee on Population Health. Survey of Public Health Capacity in Canada: Highlights. Ottawa: Advisory Committee on Population Health, 2002.Google Scholar
Teutsch, S, Churchill, R (eds.). Principles and Practice of Public Health Surveillance, 2nd edn. Oxford: Oxford University Press, 2000.Google Scholar
Van Lerberghe, W, Evans, T, Rasanathan, K et al. The World Health Report 2008 – Primary Health Care (Now More than Ever). Geneva: World Health Organization, 2008. Available at: .Google Scholar
Rose, G. Rose’s Strategy of Preventive Medicine. Oxford: Oxford University Press, 2008.CrossRefGoogle Scholar
Institute of Medicine (IOM) Committee on Assuring the Health of the Public in the 21st Century. The Future of the Public’s Health in the 21st Century. Washington DC: Institute of Medicine, 2003. Available at: .Google Scholar

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