Justification of Health Promotion

Wellbeing has been center of promotion, driving a holistic approach towards a positive overall health combining body and mind rather than dividing neutral state of mind from the physical. Health and wellbeing has been recognised as inconsistent, total health is not constant but ever interchangeable from circumstance and environmental factors therefore, overall health is valued to adaptation. It is the adaption of the individual that evidences overall health and wellbeing, framing health and wellbeing as a human aspiration not destination (Diener, 2009.) The concept of health and wellbeing has evolved holistically to incorporate both values of physical and mental health, unlike the traditional medical model which defines health as the absence of illness or disease and emphasises clinical diagnosis and intervention (Mcleod, 2018.) Public health England (PHE) published strategic objectives focusing on health improvements within the next four years, aiming for success by 2020 and incorporating the NHS five year forward view. Public Health England published strategic objectives focusing on the wider determinates of health, promoting a bio psychological theory to apply developments in primary intervention and prevention. Largely engaging with initial prevention rather than cure, promoting liaison and inclusion of local communities and authorities as assets to join alliance of services, bridging socioeconomical inequalities, encouraging holistic working in the application of working together in providing better care (Public Health England, 2016)

The world’s health organisation (WHO), definition of health mirrors models such as the biopsychological model that incorporates values of health to psychological, physical and social factors as dominates to overall health and wellbeing. WHO states health and wellbeing as being “a state of complete mental, physical and social wellbeing and not merely the absence of disease or infirmary” (WHO, 1948.) This definition is consistent with the biopsychological model and considers factors of interaction between factors for overall health and wellbeing. The WHO definition links health explicitly to wellbeing evidencing holistic evolvement and elements for optimal health to maintain and achieve (Crinson and Martino, 2007.) Modified from the late publication of the Ottawa Charter in 1886, which describes “a Link between health and participation in society” Analytically incorporating social inclusion and environment as a factored value to health and wellbeing (World Health Organization, 2019.)

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Alternatively, this view can be seen as counterproductive and unrealistic as no one person experiences complete full mental, physical and social health at all times, as previously stated overall health and wellbeing is constantly changing in response to external stimuli, the environment and experiences leaving health and wellbeing subject individualisation, critically eliminating factors such as mental state, physical disability, individual external pressures, stress and also disregarding inequalities that are present throughout health and prominent within multicultural Britain (Crinson and Martino, 2007.)

Therefore, health and wellbeing are applied subjectively and individually. Many factors incorporate perception such as age, environment and social class, all of which fall under sub-categories of health inequalities. The major criticism of applying health and wellbeing as a generalisation to a whole population that it is unrealistic because it would leave “Most of us unhealthy most of the time” (Smith, 2008.)

Argumentatively, it fails to account for temporary spells of ill health, but also the growing number of mental illnesses; temporary or longstanding (Crinson and Martino, 2007.) Further to the debate it could be disputed that marketing complete health as a goal contributes to the overmedicalisation of society by selling suboptimal health states (Crinson and Martino, 2007.) Huber et al (2001) first proposed health and wellbeing to be newly defined as the ability to adapt and self-manage expanding opportunity for individual application to specific triggers for example, situational, which factors to temporary emotional or mental ill health (Huber et al, 2001) Marketing adaptation and self-management skills is acknowledgement of the responsibility of the individual which can however, be managed collectively.

Recent training opportunities within organisations such as the National Health Service Piloting Health aim to educate its staff to better coach patients in managing goal setting and recognising limitations and solutions (The King's Fund, 2015.) Although this approach to health and wellbeing recognises the subjective element of health, differing in context of means from one individual to another, limitations appear when individualistic measures are placed and are unable to be objective or measured against value (Crinson and Martino, 2007.)

The failure to identify wider determinates or health, in which responsibility is placed upon individual value rather than collectively leaves little scope for generalised applications (Diener, 2009.) Broadening the definitions of health has been beneficial to the improvement and understanding of psychological dimensions of individual health and wellbeing (Crinson and Martino, 2007.) Increasing recognition is integral to public health connecting the relationship between physical health and mental health partnering to measure wellbeing. Since highlighting health and wellbeing, publication of Government strategies such as “no Health without mental health” published in 2011 and “#AskTwice” promoted by Time to change.org in 2019, the national health service in partnership with the government have been working to apply equality in respect to the relationship between mental and physical health (The King's Fund, 2015.)

The current aim piloting recognition and remoulding the delivery, development and provision of health amongst varied care services and domains, aims to improve nationally on the populations’ mental health and wellbeing, recognising the relevance in the hopes of preventing the onset of mental and emotional distress, increasing resilience and improving inequalities amongst age, race and gender (The King's Fund, 2015.)

Key aspects of public health today monitor the health status of the UK and identify needs using the health belief model. The physiological behaviour change model was developed within the 1950’s to determine and predict health relatable behaviours to predict and forecast uptake of services. The model suggests beliefs and issues, perceived benefits of action and predicted barriers to assume effectiveness and engagement in health promotion (Health belief model, 2012.) There were reportedly 8.2 million cases of anxiety across the UK 20% of which were adolescents and 10% were children between ages of 5-16years (NoPanic, 2019.) Critically health promotion has had to target a large and varied of audience leading to promotion of a wide variety resources such as the pyramid of transformation, the 5-tier cake of change, and the circle of self-help.

However, the health belief model comes with limitations, humans are not always rational. Anxiety is its own distortion, manipulating how the brain interprets information. The mind defies logical reasoning where environmental, emotional and physical cues are related to the mind’s psychological expectations, matching and mirroring irrational thinking and distorting an individual’s sense of reality.

Critically relating back to modelled theories of health measurement and assessment, the health belief model does not explain how these variables interact (Health belief model, 2012.) In many cases the sense of reality is distorted beyond function or symptom, paralysing the mindset (Shaikh, M.D., 2019.) The human brain and cognition are much more sensitive and complicated than it may at first appear, fragile to external stimuli environmentally, socially and emotionally. Individually unable to adapt, mental health conditions such as anxiety changes the chemical messenger levels in the brain, and once this process occurs the mind interprets and perceives information from distorted levels, deceiving the individual of a complete natural process (Shaikh, M.D., 2019.)

This can also apply to an individual’s ability to adapt to current situations debated previously. Therefore, applying Maslow’s theory could help specify individual areas of categorized deficiency specifically within an individualistic pyramid of need, such as the Maslow model 1943 (Cherry, 2019.) Applying a humanistic approach theoretically subjectifies the definitions referenced from the WHO 1948, adapted from the Ottawa charter 1886, combining health and wellbeing holistically. This defers from the medical model to provide an individualistic method to combat public health, serving greater significance in clinical practice and treatment. Therefore, which coincides treating the person as a whole, alternatively, to focusing purely on diagnosis and treatment coinciding with the NHS 5 year forward view published in 2014 (The King's Fund, 2015.)

The most recent accessible and reliable data located within the publication of “fundamental facts about mental health 2016”, published by the mental health foundation critically reports outdated statistics of depression and anxiety last measured nationally between 2010-2011. The highest results were amongst those aged between 50-59 and those aged 80 years and older who recorded greater feelings of emotional and mental distress (Mental Health Foundation, 2019.) The fundamental factors that affect health and wellbeing amongst our elderly are most commonly discrimination, participation in meaningful activities, relationships and physical health (Age concern and the Mental health foundation, 2006.)

The age of the population nationally is growing rapidly, with over half the population being aged 65 and over this figure has doubled in the past 30 years, highlighting the need to supply resources into communities and care facilities to improve knowledge and interaction throughout all fundamentals of care. Working within the theory of applying the biophysiological model approach to the resource, it is possible to target specific values such as psychological, physical and social dominates, whilst working within WHO’s 1943 definition of health and wellbeing and applying domains of Maslow’s hierarchy of needs to promote health and wellbeing among the older adult. Provided for resource is the implementation of an accessible leaflet; simple argumentatively effective, easily assessable and generalizable to a wide scope of audiences. The ability for the resource to be vastly applied through its adaptability and basic nature acquires no medical knowledge and accessible from different environments such as GP surgeries and local care homes. I justify the resource by applying a Humanistic approach following Maslow’s hierarchy of needs, therefore, subjective to individualistic interpretation of psychological identification. As targeting retired audience’s predominantly the ability to replace or fill occupational occupancy, therefore applying psychological needs to esteem and accomplishment to domains of Maslow’s theory for self-fulfillment and self-actualization providing creative means through activities. Evidence of theory applied from studies relates meaningful activities to support older adults in retaining purpose, motivation and engagement (Mental Health Foundation, 2019.) Also related to both theory and application and included within studies is the link between social isolation and loneliness, suggested to be more common among older adults. Results collected by Age UK in 2014 found that 2.9 million older adults aged 65 and over felt lonely and forgotten (Age UK, 2014.) Likewise, reports from the international longevity center and WHO stated absence of physical health linked to depression and heart disease (ILCUK, 2019.) Therefore, promoting inclusion of local communities and authorities to join alliance of services, as promoted through the public health England strategic objectives could possibly see the union of communities with local group sessions and interconnections made if promoted within care homes. And so, applying Maslow’s theory applying belonging to psychological needs, consequently factoring social participation from the bio psychological model forming relationships and communities.

Ethical consideration such as language barriers and disabling conditions such as blindness can be overcome making it obtainable, comprehensive, efficient, effective and with minor cost (M. Carter et al., 2011.) Ethical deliberations such as accessibility to health information requires sufficient attention to be ‘Justice’ therefore measurable to a concept that emphasis fairness and equality among individuals, principles of medical framework applied though ethical values of Beauchamp and Childress (Aldcroft, 2012.)

Mirroring values of a biopsychological method to health and wellbeing of the elderly should target the areas of participation in meaningful activities and importance of physical health as factoring contributions to overall health. The influences valued in models, theories, definitions and approaches to evidence coping strategies corresponding with Huber et al in (2001) which debate that a new meaning to health and wellbeing is the ability to adapt and self-manage (Huber et al. 2001) and inclusion to Maslow’s building blocks to determine individual hierarchy of needs. Informal reading of a non - dynamic guide supporting range of movement which can be individualistic or alternatively group lead, additionally supporting social inclusion and community. Promoting engagement and stimulation benefits the physical, cognitive and life satisfaction of older adults retaining the abilities of self-purpose and independence.

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