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What is health
Session 3
Health in SEA
Drugs
Older people
Food Safety
Smoking
Meningitis
Blood
Pressure
Accidents
Waiting
Lists
Suicide
Family
Bad Housing
Diabetes
Dog
excrement
Parenting
Water
Fluoridation
Feeling good
HIV/AIDS
Teenage
Pregnancy
Positive health
Exercise
Heart Disease
Exercise: What does health mean?
– Which factors are most important for health?
• For you
• For your town/city/county
– With your group, how can this factor be acted
upon to improve health?
– Can you turn this into a Health Objective for an
SEA?
– Discuss this as a group and pick 3 to share
Definition of Health
WHO Constitution 1948
‘A state of complete physical,
mental and social well-being and
not merely the absence of disease
and infirmity’
Definition of Health
‘A state in which people are able to
work towards attaining their realistic
chosen and biological potentials’
Seedhouse (1986) Health: the foundations for achievement Chichester. John
Wiley
Definition of Health
‘Health is the person’s capacity to function
to the greatest capacity, to maintain a
balance appropriate to age and social
needs; to be reasonably free of gross
dissatisfaction, discomfort, disease or
disability; and to behave in ways that
promote survival as well as self-fulfilment
or enjoyment’ (Blum 1972)
(Blum H.L. 1972, p213 in Goldsmith S.B. (1972) The status of Health Status Indicators. Health Service
Reports, 87(3), 212-220)
Understanding Health
• Variety of definitions and interpretations
• Complex and contested concept
• Need to extend boundaries beyond
consideration of the health service and ill
health
• Health vs Health and wellbeing?
General socioeconomic, cultural and environmental conditions
Living and working conditions
Social and community influences
Individual lifestyle
factors
Age, sex &
hereditary
factors
Statements of
Health Inequalities
• People living in the most deprived neighbourhoods will:
die on average 7 yrs earlier than those in the richest
neighbourhoods
 spend more of their lives feeling unwell
• Those living in the greenest areas have longer life
expectancy
• Those with no or poor quality employment have a higher
risk of poor physical and mental health
• Those with low perceived social support have lower health
status measures
Health Inequalities
• Douglas Black
report on inequalities
in Health, 1980
• Paperback edited
version published
1982
• Growing concern for
major social causes of
ill health and
inequalities in health
• Published 1998
• Call for action on a broad front to tackle health inequalities
• Close collaboration with Local Authorities and other sectors
to promote health and prevent disease
• Basis for other policy documents
Strategic review of
Health Inequalities in
England post 2010
• Strategies to
reduce health
inequalities in
England
• Action on social
determinants of
health
• Local Authorities
have a key role
Marmot Review
Policy Objective E
Create and develop healthy and
sustainable places and communities
Reducing health inequalities compatible with climate
change mitigation, health benefits from:
• sustainable neighbourhoods
• active transport
• sustainable food production
•
zero carbon houses
Integrate planning, transport, housing, environmental and
health policies to address the social determinants of
health
Health inequalities
• Government policy is to reduce health
inequalities
• Logic of this is that where negative impacts
are unavoidable they should fall on
populations most able to bear them
• But is this politically acceptable?
Screening questions
Will the proposal:
• Have an impact on the physical or mental health and well being
of the whole population or of particular sub groups in the
population?
• Affect individual ability to improve their own health and
wellbeing?
• Proposal produce a change in demand for or access to health and
social care services?
• Have an impact on social, economic or environmental conditions
that could affect health?
• Have an impact on global health?
One or more positive response indicates need for HIA
Watch Out For
Health Checklist
• Housing
• Access to public services
• Opportunities for physical
activity
• Air quality, noise,
neighbourhood activity
• Social cohesion and social
capital
• Accessibility and transport
• Crime reduction and
community safety
• Access to healthy food
• Access to work
• Resource minimisation
• Climate change
For example
Yes
Does the proposal provide opportunities for local businesses?
No
N/A