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The Role of Media in Public Health. Professor SH Lee Emeritus Professor of Community Medicine The Chinese University of Hong Kong. What is Public Health?. Definition of Public Health.
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The Role of Media in Public Health Professor SH Lee Emeritus Professor of Community Medicine The Chinese University of Hong Kong
Definition of Public Health ‘The science and art of promoting health, preventing disease, and prolonging life through the organized efforts of society.’ (Acheson Report, London, 1988)
The New Public Health Movement
“Up-stream” Approach
Determinants of Health • Personal health practices and coping skills • Biological and genetic endowment • Environmental risk factors • Social and economic factors • Health Services
Personal health practices and coping skills • Smoking • Diet • Obesity • Lack of exercise • Stress • Alcohol abuse • Drug misuse • Sexual practices
Smoking 1994 Source: HKCOSH
Substance Abuse 1990 - 1999
Substance Abuse 1992 - 1999 Population
Obesity Student Survey 95/96 - 98/99
Biological and genetic endowment • Gender differences • Physiological, anatomical and mental capacities
Environmental risk factors • Physical environment • Radiation exposure • Workplace hazards • Infectious agents • Home hazards • Traffic • Product design
Social and Economic factors • Income and social status • Social support networks • Education • Employment and working conditions • Social disintegration • Overpopulation • Geography and Transportation
Health Services • Accessible preventive and primary care services • Healthy child development services • Personal health services e.g. • Student health • Women health • Elderly health
Genetic Influences Health and Medical Services Lifestyle HEALTH Social, Economic Cultural & Environmental Conditions The Health Field Concept
The Ottawa Charter for Health Promotion and the Jakarta Declaration
U.S. Department of Health Education and Welfare (1979) “A combination of health education and related organizational, political and economic programmes designed to support changes in behaviour and in the environment that will improve health.”
Nutbeam (1985) “The process of enabling people to Increase control over the Determinants of health and Thereby improve their health.”
WHO (1984) (1986') “The process of enabling people to increase control over their health. ‘and thereby to improve their health.”
Health Promotion • Targets towards whole population • Basically healthy • Involvement of community and individual measures • Promotion of healthy lifestyle • Goal to enhance state of well being
Disease Prevention • Activity in the medical field • Dealing with a disease or environmental threat • Protects individuals or groups of population at risk • Aims to conserve health
Disease Prevention Primary Prevention Prevention of disorders before they occur e.g. vaccination, healthy lifestyles
Disease Prevention Secondary Prevention Early diagnosis and treatment e.g. screening programmes
Disease Prevention Tertiary Prevention Reducing burden of disability to individual and society e.g. treatment and rehabilitation
Five Priority Actions Of Ottawa Charter for Health Promotion • Build Healthy Public Policy • Create supportive environment for health • Strengthen community actions for health • Develop personal skills • Re-orient health services
Ottawa Charter for Health Promotion An International Conference on Health Promotion The move towards a new public health November 17-21, 1986, Ottawa, Ontario, Canada
The Jakarta Declaration on Leading Health Promotion into the 21st Century (1997): Five priorities for action • Promote social responsibility for health • Increase investments for health development • Expand partnerships for health promotion • Increase community capacity and empower the individual • Secure an infrastructure for health promotion
The meaning of Mass Media Two key features: • Mass audience • Message is mediated Source: Health Promotion – effectiveness, efficiency and equity, Keith Tones and Sylvia Telford
Mass Media in Health Promotion • The difference between health marketing and commercial marketing: • Health promotion, ethical and professional goals • Difference in size of budgets • Health education programmes set standard often too high
Mass Media in Health Promotion • The nature of the product in offer is different • The health education product frequently intangible and gratification seen only at distant future • Deep seated attitudes not easy to change
Mass Media in Health Promotion • Ten key marketing concepts in health promotion • Market philosophy • The “four Ps” of marketing: product, price, place, promotion • Hierarchy of communication effects • Audience segmentation
Mass Media in Health Promotion • Understand all the relevant markets • Feedback • Interpersonal and mass communication interactions • Commercial resources • Competition • Expectations
‘Public health advocacy’ • Sometimes called ‘public health lobbying’ • Process of over coming major structural barriers to public health goals • Such barriers could be political, economic or cultural
What are the components of an effective public health advocacy campaign? • Information • Health Professionals • Skilled Professionals • Partnerships or Coalitions • Champions or Leaders
Skills required in effective public health advocacy • Competency and understanding of subjects and roles • Political science, sociology of mass communication • Structuring of media • Health issues • Networking techniques
Skills required in effective public health advocacy • Community educators and organizers • Journalists • Lawyers and political analysts / advisers • Research • Evaluation
Does it work? Governments (and organizations) tend to adopt policies only in activities of public headiness, using the principles that Governments (organization) should not move far from what is perceived to be public opinion
What are the conditions for success in public health advocacy? • A recognized constituency • Building community agreement that an issue is a priority for action and that the proposed solutions are acceptable
What are the conditions for success in public health advocacy? • Empowered communities • A feasible solution (a feasible solution is not necessarily based only on, for example, epidemiological evidence. Many different types of “evidence” can be used by politicians, and managers when mainly policy decisions)
Mass Media The mass media, by definition, reach mass audiences, including key political and bureaucratic decision makers. If well informed about the process of news reporting, public health advocates may be in the position of influencing journalist to report issues in ways more consonant with public health objections.
Case Studies in Public Health Advocacy in Health Education and Health Promotion
Case Study 1 Smokeless Tobacco
Case Study 2 Tobacco advertising in printed media and outdoor advertising