From Disease Prevention to Health Promotion
It is undeniable that advancements in the 19th and 20th centuries have played a critical role in improving the occurrence and prevalence of diseases, helping the world population to quadruple. All scientists agree that the development of new disease prevention techniques, especially vaccines, in the 20th century did play a key role in helping humans fight deadly diseases like leprosy, diphtheria, tetanus, poliomyelitis, Hepatitis B, and many others; and in the process increase the world population. Because of these new innovations in disease management, the U.S. Census Bureau estimates (2018) that the world population increased from just 1.6 billion to nearly 6 billion between 1900 and 2000. However, it is important to note that this period marked an error in care that was primarily focused on the prevention of diseases rather than the promotion of health – a new concept that has emerged in the 21st century. This article will, therefore, first differentiate between disease prevention and promotion and then explain two important turning points that marked this transition: the Jakarta Declaration and the Ottawa Charter. The article will also define the term ‘determinants of healt’ and how they influence health, and how they are being addressed in Healthy People 2030.
Why the Jakarta Declaration and the Ottawa Charter are Critical Turning Points in the Shift from Disease Prevention to Health Promotion?
Before delving into the role played by the Jakarta Declaration and the Ottawa Charter in marking the transition from preventing illnesses to promoting, it is essential to define the terms prevention and promotion. Disease prevention refers to the process of treating people, especially those identified as having the highest risk, to stop the illness from occurring. The CDC (n.d.) classifies disease prevention into three categories: primary, secondary, and tertiary. Primary prevention usually occurs when the individual is healthy before symptoms appear. Vaccination or immunization is a typical example of primary prevention. Secondary prevention involves screening to determine the etiology or cause of the disease during the early stages, particularly before symptoms and signs first appear. Regular blood pressure tests and cancer checks through mammography are some common examples of secondary prevention tools. On the other hand, tertiary prevention entails managing diseases, especially chronic ones like blood pressure and diabetes, post-diagnosis to prevent illness progression or slow down the symptoms. Examples of tertiary preventive measures include screening for complications, rehabilitation, and chemotherapy.
Whereas disease prevention focuses on cure and treatment, health promotion tends to concentrate on addressing the root causes of diseases in their entirety. According to the World Health Organization (2016):
Health promotion enables people to increase control over their own health. It covers a wide range of social and environmental interventions that are designed to benefit and protect individual people’s health and quality of life by addressing and preventing the root causes of ill health, not just focusing on treatment and cure.
In the late 90s, because of the declining efficiency of disease prevention, the U.S. and other leading superpowers resolved to find a lasting solution to address the rising cases of chronic diseases, such as HIV, cancer, diabetes, and heart diseases. The first step to realizing this dream occurred during the First International Conference on Health Promotion in 1986 in Ottawa, Canada. In the Ottawa Charter, member states agreed to concentrate on five key health promotion areas – including building human skills, fostering community action, creating supportive health environments, re-orient healthcare services, and developing a healthy and effective public policy – through enabling, mediation, and advocacy. Eleven years later, the international community met again for the fourth time in Jakarta. In what has now become known as the ‘Jakarta Declaration,’ member states resolved to develop new healthcare promotion principles for the 21st century. The declaration recapped the essence of the treaties made in Ottawa on health promotion. The meeting emphasized five health promotion strategies: securing infrastructure, building more community capacity, expanding and consolidating partnerships, investing more in health development, and encouraging social responsibility (WHO, n.d.).
Determinants of Health and How They Influence Health
The term ‘determinants of health’ refers to a series of environmental, economic, social, and personal elements that affect the health status of an individual, community, group, or population. The interaction of these factors influences the population of individual health; therefore, interventions targeting a range of health determinants are more likely to be efficient and effective. Characteristically, determinants of health extend beyond the usual borders of traditional public and primary care settings; and incorporate the environment, agriculture, transportation, housing, and education (HealthyPeople.gov, n.d.).
Determinants of health fall into five main categories: genetics and biology, individual behavior, health services, social factors, and policymaking. Social factors are the physical states of the environment and the social factors in which individuals are not only born but also live, age, play, work, and learn. Examples of social factors include social attitudes and norms (like discrimination) and the presence of resources for individuals to meet daily needs (such as healthy foods, living wages, safe housing, and job opportunities). Policymaking refers to the policies or laws (federal, state, or local) that directly or indirectly influence population and individual health. For example, the Affordable Care Act has significantly improved access to care among low-income families. Individual behavior refers to a person’s repeated actions, such as hand washing, smoking, physical activity, and dieting (HealthyPeople.gov, n.d.).
How are the Determinants of Health Being Addressed in Healthy People 2030?
Healthy People 2030 is a 10-year health plan released by the U.S. Department of Health and Human Services in August 2020 to address the country’s critical public health concerns, challenges, and priorities. It features about 355 measurable or core objectives to be achieved within the next ten years, new youth electric cigarette use and opioid-use disorder objectives, as well as the essential resources for tailoring the ‘Healthy People 2030’ plan to meet emerging health threats such as the coronavirus 2019. Core objectives are derived from reliable, valid, and countrywide representative data/information, as well as baseline data from 2015, and are designed to reflect the first-priority public health concerns (Healthy People 2030, n.d.). They are also linked with interventions derived from evidence. Within the ten-year period, data sources will be used to keep track of these objectives by measuring whether or not the targets have been met or exceeded by comparing yearly data with baseline data (what is present now).
References
CDC. (n.d.). Quick facts: Prevention. Retrieved from https://www.cdc.gov/pictureofamerica/pdfs/picture_of_america_prevention.pdf
Healthy People 2030. (n.d.). About objectives. U.S. Department of Health and Human Services. Retrieved from https://health.gov/healthypeople/objectives-and-data/about-objectives
HealthyPeople.gov. (n.d.). Determinants of health. Office of Disease Prevention and Health Promotion. Retrieved from https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health
U.S. Census Bureau. (2018, July 5). Historical estimates of the world population. Retrieved from https://www.census.gov/data/tables/time-series/demo/international-programs/historical-est-worldpop.html
WHO. (n.d.). Health promotion; Jakarta Declaration on leading health promotion into the 21st century. Retrieved from https://www.who.int/healthpromotion/conferences/previous/jakarta/declaration/en/
World Health Organization. (2016, August 20). Health promotion. Retrieved from https://www.who.int/news-room/q-a-detail/what-is-health-promotion
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Question 
From Disease Prevention to Health Promotion
Assignment Overview
As a new health educator, you have just been asked to write an article for your health department’s newsletter. The article should be about the transition from disease prevention to health promotion, with a focus on determinants of health.
Case Assignment
From Disease Prevention to Health Promotion
Please write a paper that addresses these points:
- Discuss why the Ottawa Charter and The Jakarta Declaration are important turning points in the transition from disease prevention to health promotion.
- What are determinants of health? How do they influence health? Please provide at least 3 examples.
- How are determinants of health being addressed in Healthy People 2030?
Assignment Expectations
- Length: 2-3 pages
- Assessment and Grading: Your paper will be assessed based on the performance assessment rubric. You can view it under Assessments at the top of the page. Review it before you begin working on the assignment. Your work should also follow these Assignment Expectations.
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