# Presentation: 087701

## KEY FACTORS IN HEALTH

***KEY FACTORS IN HEALTH***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Premier’s Council on Health Strategy (1987-1991)**

**November 1996**

- income
- education
- work
- physical
- environments
- public policies

- health behaviours: smoking; drinking; driving; physical; eating, etc.

- child development
- social support: family and friends
- caring communicaties

- inherited tendency and response to disease

## MOVING INTO THE FUTURE

***MOVING INTO THE FUTURE***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Ottawa Charter**

**November 1996**

**Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love.**

## Ensuring equity in health

**Adding life to years**
**Adding health to life**
**Adding years to life**

***FOUR INTERRELATED THEMES***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source::  Health for All Targets)**

**November 1996**

## LIFESTYLES CONDUCIVE TOHEALTH

***LIFESTYLES CONDUCIVE TOHEALTH***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

**Goal**

**Strategies**

**Support**

**Healthy lifestyles**
- Target 16 Healthy living
- Target 17 Tobacco, alcohol and psychoactive drugs

**Healthy promotion in action**
- Target 14 Settings for health promotion
- Target 15 Health competence

**Policy**
- Target 13 Healthy public policy

## THE HEALTH FOR ALL TARGETS

***THE HEALTH FOR ALL TARGETS***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

**Equity in health**
- Target 1
**Quality in life**
- Target 2
**Better health status**
- Targets 3 - 12

**Lifestyles conducive to health**
- Targets 13 - 17
**Healthy environment**
- Targets 18 - 25
**Appropriate care**
- Targets 26 - 31

**Health for all development strategies**
- Targets 32 - 38

***Goal***
*(Chapter 3)*

***Strategies***
*(Chapters 4, 5 and 6)*

***Support***
*(Chapter 7)*

## HEALTH FIELD CONCEPT

***HEALTH FIELD CONCEPT***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  WWC 1987**

**November 1996**

**biological factors**

**physical environment**

**social environment**

**lifestyle **
**factors**

**health status of the population**

**health care services**

**Healthy**
**Policy**

## CAUSES OF DEATH:  1990

***CAUSES OF DEATH:  1990***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

- *  Source:National Center for Health Statistics, “Advance Report of Final Mortality Statistics, 1990,” Monthly Vital Statistics Report, Vol. 41 No. 7.
- **Source: McGinnis, J.M., and Foege, W.H. “Actual Causes of Death in the United States,” The Journal of the American Medical Association, 1993. 270:2207-2212.

**November 1996**

- Health disease	720 058
- Cancer	505 322
- Cerebrovascular disease	144 088
- Unintentional injuries	91 983
- Chronic lung disease	86 679
- Pneumonia and influenza	79 513
- Diabetes	47 664
- Suicide	30 906
- Chronic liver disease	25 815
- HIV infection	25 188
**TOTAL****	****1 757 216**

- Tobacco	400 000
- Diet/inactivity patterns	300 000
- Alcohol	100 000
- Certain infections	90 000
- Toxic agents	60 000
- Firearms	35 000
- Sexual behaviour	30 000
- Motor  vehicles	25 000
- Drug use	20 000
**TOTAL****	****1 060 000**

**10 Leading Causes of Death***

**Actual Causes of Death***

## 12 indicators of the “GLOBAL HEALTH FOR ALL”strategy that were to be assessed by all countries in the world

***12 indicators of the “GLOBAL HEALTH FOR ALL”******strategy that were to be assessed by all countries in the world***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Bull’s Eye or Achilles’ Heel**

**November 1996**

- HFA policy endorsed at the highest official level;
- Mechanisms for involving people in implementation of functioning strategies;
- At least 5% of the Gross National Product to be spent on health;
- A reasonable percentage of the national health expenditure devoted to local health care;
- Equal distribution of resources;
- Number of developing countries receiving support from rich countries for sound HFA strategies;
- Primary health care available for the whole population, with at least
- safe drinking water and adequate sanitary facilites in or near the home;
- immunization (diphtheria, tetanus, whooping cough, measles, poliomyelitis and tuberculosis);
- local health care (including at least 20 essential drugs) within one hour’s walk or travel;
- trained personnel to guide pregnancy, childbirth and child care;
- Nutritional status of children adequate (90% of newborns weigh at least 2500g; weight of 90% of children corresponds to reference values);
- Infant mortality for all identifable subgroups is below 50 per 1000 live births ;
- Life expectancy at birth is over 60 years;
- The adult literacy rate for both men and women exceeds 70%;
- The Gross National Product per head exceeds US$ 500.

## SETTING HEALTH OBJECTIVES

***SETTING HEALTH OBJECTIVES***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**November 1996**

- Health
- For All:  Equity
- 2000:  Timeframes and accountability
- Intersectorality
- Participation

**Health for All 2000 introduced three key principles for health policy and two strategies:**

## 5 key action areas:

***OTTAWA CHARTER******FOR HEALTH PROMOTION***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

**Healthy Public Policy**
**Supportive Environments**
**Community Action**
**Personal Skills**
**Reorienting Health Services**

**5 key action areas:**

## Second Generation Objectives

***Second Generation Objectives***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**November 1996**

**Theoretical premise:****	****health**
**Public health premise:****	****investment**
**Practical premise:  community development, organizational development, participation and partnerships**

## Definition of health adopted by the government of British Columbia, Canada:

***OTTAWA CHARTER******FOR HEALTH PROMOTION***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

**Definition of health adopted by the government of British Columbia, Canada:**
***“******Health is the extent to which an individual or group is able, on the one hand, to develop aspirations and satisfy needs; and on the other hand, to change or cope with the environment.  Health is therefore seen as a resource for everyday life, not the objective of living; it is seen as a positive concept emphasizing social and personal resources, as well as physical capacities.”***

## ”Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love.”

***OTTAWA CHARTER******FOR HEALTH PROMOTION***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**November 1996**

***”******Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love.”***

## Hints for the second generation

***Hints for the second generation***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**November 1996**

**Three lead questions:**
**Where is health created?**
**Which investment creates the largest health gain?**
**Does this investment help reduce the health gap and ensure human rights?**

## Quebec Policy on Health and Wellbeing

***Quebec Policy on Health and Wellbeing***

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

**Three principles:**
***Interaction between the individual and the environment***
***Shared responsibility for creating health***
***Public health and wellbeing is a fundamental investment that creates ***

## Quebec Policy on Health and Wellbeing

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

***Quebec Policy on Health and Wellbeing***

**5 priority areas:**
***social adjustment***
***physical health***
***public health***
***mental health***
***social integration***

## Quebec Policy on Health and Wellbeing

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

***Quebec Policy on Health and Wellbeing***

**Integrated strategic approach:**
***encourage the reinforcement of the individual’s potential***
***provide support in social settings and develop healthy and safe environments***
***inprove living conditions***
***act for and with groups at risk***
***coordinate public policy and action to promote health and wellbeing***
***orient the health and social services system towards the most effective and least costly solutions***

## Goals - Where we will concentrate our efforts

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**November 1996**

***Goals - Where we will concentrate our efforts***

**Goal 1****	*****Foster positive and supportive living and working conditions in all our communities.***
**Goal 2****	*****Support all individuals to develop the capacities, skills and attitudes we need to thrive and meet life’s challenges.***
**Goal 3****	*****Ensure an environment that is naturally diverse and has clean, healthy and safe ecosystems of air, water and land for humans and all living things, now and for future generations.***
**Goal 4****	*****Ensure that our public policies and investments recognize all of the important influences on our health, and result in the best possible health outcomes.***
**Goal 5****	*****Reduce preventable illness, injuries and premature deaths.***
**Goal 6****	*****Foster joint action to improve the health of Aboriginal peoples.***

## Six principles forsecond generation objectives:

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**November 1996**

***Six principles for******second generation objectives:***

**Social model of health**
**Investment goals**
**Reducing health gaps and social gradients**
**Policy relevant data indices**
**Partnerships and alliances**
**International and sustainable development dimensions**

## Policy Papers

**         ****World Health Organization**
**Division of Health Promotion, Education and Communication**

**Source:  Health for All Targets**

**November 1996**

***Policy Papers***

***Targets for health for all.  *****World Health Organization, Copenhagen 1991**
***The policy on health and well-being, *****Quebec  1992**
***The Health of the Nation, *****London 1992**
***Nurturing Health*****, Ontario 1993**
***A strategic direction to improve and protect the public health, *****Wellington, New Zealand, 1993-1994**
***Better Health Outcomes for Australians*****, Commonwealth of Australia, 1994**
***Healthy People 2000*****.  Midcourse review, 1995**
***Health Goals for British Columbia*****, November 1995**