HealthPromotionStrategiesAnOverview

ProfessorBettinaBorisch,MD,MPH,FRCPathInstituteofGlobalHealthUniversity ofGenevaAnnecy,July4th,2019

EASOSummerSchool:TrainingtheTrainers inthePrevention andManagementofObesity – LesPensières 1-5July2019

Prof.BettinaBorisch,ExecutiveDirector

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GlobalCharterforthePublic’sHealth

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OttawaCharterforHealthPromotion

• TheOttawaCharterisaclearstatementofactionforhealthpromotion,widelyusedbythehealthpromotionsector.• TheOttawaChartercameoutofthefirstInternationalConferenceonHealthPromotionheldinOttawa,Canada,inNovember1986.Theconferenceaimedforactiontoachieve‘Healthforall’bytheyear2000andbeyond.• TheChartergavehealthpromotionasolidframework,andhealthpromotersanidentity.

Models ofHealthPromotion

• Tannahilll 1985• CaplanandHolland 1990• Beattie’s 1991• Tones andTilford’s 1994• Naidoo andWills 2000

Tannahill 1985

CaplanandHolland1990

Beattie1991

Tones andTilford 1994

• Empowerment model• Goal:enabling peoplegaincontroloftheir health• HP=publichealth policy Xhealth education• Educationis keytoempowerment• Empowerment is aim ofHP• Enhances individual autonomy

Naidoo andWills2000

1. Medcial2. Education3. Behaviour4. Empowerment5. SocialChange

Remember therole SocialDeterminantsofHealth play inhealth andthat ofpolitics,powerandreponsability!

Theparadigmofevidence-basedpublichealthwhichgrewfromevidence-basedmedicinehasbroughtwithitbothanawarenessoftheneedtoapplyrigorousevidencemoresystematicallytopublichealthandanawareness thatpublichealthinterventionsareusuallymorecomplexthanclinicalinterventionsandlesssusceptibletorandomized,controlledtrials.

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

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

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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

We would improve leadershipand increase female leadership

atthe sametime!

Thank you – Grazie– merci!

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