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HealthPromotionStrategiesAnOverview
ProfessorBettinaBorisch,MD,MPH,FRCPathInstituteofGlobalHealthUniversity ofGenevaAnnecy,July4th,2019
EASOSummerSchool:TrainingtheTrainers inthePrevention andManagementofObesity – LesPensières 1-5July2019
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Prof.BettinaBorisch,ExecutiveDirector
Borisch-13.4.18-Maastricht 2
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GlobalCharterforthePublic’sHealth
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OttawaCharterforHealthPromotion
• TheOttawaCharterisaclearstatementofactionforhealthpromotion,widelyusedbythehealthpromotionsector.• TheOttawaChartercameoutofthefirstInternationalConferenceonHealthPromotionheldinOttawa,Canada,inNovember1986.Theconferenceaimedforactiontoachieve‘Healthforall’bytheyear2000andbeyond.• TheChartergavehealthpromotionasolidframework,andhealthpromotersanidentity.
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Models ofHealthPromotion
• Tannahilll 1985• CaplanandHolland 1990• Beattie’s 1991• Tones andTilford’s 1994• Naidoo andWills 2000
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CaplanandHolland1990
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Tones andTilford 1994
• Empowerment model• Goal:enabling peoplegaincontroloftheir health• HP=publichealth policy Xhealth education• Educationis keytoempowerment• Empowerment is aim ofHP• Enhances individual autonomy
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Naidoo andWills2000
1. Medcial2. Education3. Behaviour4. Empowerment5. SocialChange
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Remember therole SocialDeterminantsofHealth play inhealth andthat ofpolitics,powerandreponsability!
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Theparadigmofevidence-basedpublichealthwhichgrewfromevidence-basedmedicinehasbroughtwithitbothanawarenessoftheneedtoapplyrigorousevidencemoresystematicallytopublichealthandanawareness thatpublichealthinterventionsareusuallymorecomplexthanclinicalinterventionsandlesssusceptibletorandomized,controlledtrials.
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WhyaGlobalCharterforthePublic’sHealth?
• NewchallengesforPHinaglobalizedworld• ContextoftheSustainabledevelopmentgoals• Classicaldeterminantsofhealth:poverty,food,water,inequity;butalsoenvironment,climate,economy• HowshouldtheglobalPHcommunitypositionthemselvestoinfluenceallactorsacrossthewholespectrum• ”Public’sHealth”
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AGlobalCharterforthePublic’sHealth
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TheGlobalCharterforthePublic’sHealth
• IsbasedontheAlmaAta,OttawaandShanghaiDeclaration• ReadsinthecontextoftheSustainableDevelopmentGoals• IsatoolforallPHactionsandnotdevotedtoaspecialtopic
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Allignsectors
Empowerpeople
MissionHealthandwellbeing
ValuesEquityAccess
21st centuryhealthleadership
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Leadershipinpublichealth
• 21st centuryleadershipinvolves• Buildingcoalitionswithotherpeopleandorganizationssothattogethertheycanachieveobjectivesthattheycouldnotachieveontheirown;• Forgingsuchcoalitionswithinandacrossthepublicandprivatesectors,civilsocietyandNGOs(collaborativegovernance)• Areasofaction:inequalityreduction?
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Areasofaction
1. Moreequitableandadequatelyresourcedpublicservicesandinstitutionscontributetogreatersocialinclusionandfairerdistributionofresourcesandopportunitiesinsociety
2. Accesstohealthservicesshouldbebasedonneedratherthenontheabilitytopay
3. Taxationofunhealthycommodities,taxationsystemingeneral4. Protectionofminorities5. Reducinginequalitythroughsocialspending6. PHtoadvocatefor,provideandsupportgoodgovernance
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Institutionsmatter/governance
• Governanceisabasicmeasureofthestabilityandperformanceofasociety• Thewaypublicfunctionsarecarriedout,publicresourcesaremanagedandpublicregulatorypowersareexercised,…
• Needs newforms ofleadership
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Negotiatingthepoliticalchoiceforhealthinthefaceofotherinterests
Creatingalliancesfor
healthoutcomes
Improvingrelationships
betweenactorsthroughhealth
Contributingtohealthsecurityandpeacebuilding
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NewFunctionsinPublicHealth
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ChallengesforPublicHealthtoaddressinequity:canwemeetthem?
• Wehaveto!Inequity(exclusion)willdestroyoursocieties- instability• Thebestpredictorofastate'sstability,peacefulnessandhealth ishowitswomenandother“minorities”aretreated.(WomenStatsDatabase,VMHudson).• Populistmovementsgainsupportbyproposingashamversionofsolidarity:solidaritywithonlysomepeople– notall.• Donotletpoliticalmovementssplitpeople,thoseandthe“others”!
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PublicHealthWorkforce -ValueofFemale Leadership
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Womenmakeup75%oftheglobalpaidhealthworkforce
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4%Womencomprise
ofhealthcarecompanyCEOs
DiversitygapsinhealthcareBorisch-Erice-2019
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ImpactofdiversityintheFortune500
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Fortune500companieswithatleast3womendirectorshaveexperiencedan:
Increaseinreturnoninvestedcapital
Increase in return on sales
Increase in return on equity
66% 42% 53%
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Where’sdiversity?Thetop10leadershipcompetencies,rankedby195globalleaders
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Percentageofrespondents
Strongethicsandsafety 67% Has high ethical and moral standards
Self-organizing 59 Provides goals and objectives with loose guidelines/direction
56 Clearly communicates expectations
Efficientlearning 52 Has the flexibility to change opinions
Nurturesgrowth 43 Is committed to my ongoing training
Connectionandbelonging 42 Communicates often and openly
39 Is open to new ideas and approaches
38 Creates a feeling of succeeding and failing together
38 Helps me grow into a next-generation leader
37 Provides safety for trial and error
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We would improve leadershipand increase female leadership
atthe sametime!
Thank you – Grazie– merci!
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