Promoting health, preventing disease – making it happen

Abstract

Countries around the world have developed strategies to address the challenge of achieving more in prevention. For example, at the time of writing the US has an established (if languishing) national strategy, England is undertaking public consultation on a draft strategy, and Australia is at an early stage in the development of a new strategy to prevent disease and improve health in their populations. 1,2,3 Motivations for this are broadly common, partly social -recognising the need to support citizens to live longer, healthier lives -and partly economic, to reduce pressures on the health system and enable people to productively engage in the workforce. There is also an equity focus, with strategies that seek to improve everyone's health while also closing the health gap between different population groups.

Exploring the Health Literacy and Health Situation of School Principals and Vice Principals in Punjab, Pakistan: Insights from an Online-Based Survey during the COVID-19 Pandemic

“…The instrument exhibited excellent internal consistency (α = 0.96). The responses to all items were computed and categorized into three levels: inadequate HL (0-12), problematic HL (13)(14)(15)(16)(17)(18)(19), and su cient HL (20)(21)(22). For the purpose of analysis, the categories of inadequate and problematic HL were combined into insu cient HL.…”

“…Additionally, HL has been associated with the receipt of healthcare screenings, utilization of various health services, and compliance with different therapeutic treatments [8][9][10][11]. Conversely, low levels of HL are found to be linked to negative health outcomes and poor self-management [12][13].…”

Building a Prevention System: Infrastructure to Strengthen Health Promotion Outcomes

“…Systems practice requires many interventions to generate multiple pathways of causality as change does not happen from one isolated point in the system, but is decentralized and the product of rippling processes occurring in concert over time [78,79]. One way to do this is via the synergy that comes from distributed and complementary interventions that influence a system's self-organising ways [6,80], by working within it, to affect the contextual interactions that alter forces such as values, norms, practices, power, resources, policies, regulations and mental models [21,81,82]. Integrated multi-faceted interventions addressing these intrinsic leverage points, for example for healthy eating or physical activity, were not apparent in HTC micro level health promotion actions.…”

“…The first is the micro level where health promoters are working in the system, achieving change with the local application of systems practices to tackle public health challenges [4,5]. The context in which this community-based implementation exists is nested within the second broader or macro level where organisations are working on the system, to develop a structure to coordinate effective whole-of-population strategies [6,7]. This infrastructure is referred to as a prevention system.…”

“…In Australia, in 1996, reductions in mortality from HIV/AIDS, smoking and road traffic injury were attributed to a national structure, which was recently deemed as having a crucial role in preventing the spread of COVID-19 [9,10]. Success was attributed to the entire system's performance, not to any single individual components, for instance, good strategy or generous funding individually do not necessarily lead to the desired outcomes [6,11]. A prevention system includes the people, processes, activities, settings and structures, as well as the changing relationships between them, which work together to improve the health of a community [12].…”