The Future for Health Promotion

267 Pages·2018·11.052 MB·English

by  Colin Palfrey

Future_Health_Promo_FINAL 27/09/2017 13:37 Page 1
THE
FUTURE
FOR
HEALTH
PROMOTION
Colin Palfrey
THE FUTURE FOR HEALTH
PROMOTION
Colin Palfrey
First published in Great Britain in 2018 by
Policy Press North American office:
University of Bristol Policy Press
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© Policy Press 2018
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ISBN 978-1-4473-4123-9 (paperback)
ISBN 978-1-4473-4125-3 (ePub)
ISBN 978-1-4473-4126-0 (Kindle)
ISBN 978-1-4473-4124-6 (ePDF)
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Contents
List of abbreviations v
Acknowledgements vii
one Main themes 1
two The origins of health promotion 25
three Evidence base and methods for evaluation 55
four Strategies for health promotion 83
five Health economics and health promotion 113
six Health promotion and mental health 141
seven International perspectives 173
eight The future for health promotion 203
References 225
Index 249
iii

List of abbreviations
ACAS Advisory Conciliation and Arbitration Service
ASH Action on Smoking and Health
BACP British Association for Counselling &
Psychotherapy
BAME Black, Asian and minority ethnic
BMI body mass index
CALM Campaign Against Living Miserably
CAMHS Child and Adolescent Mental Health Services
CBR cost–benefit ratio
CHD chronic heart disease
EBM evidence-based medicine
EP exercise professional
ERS exercise referral schemes
GP general practitioner
HSC Health and Safety Commission
HSE Health and Safety Executive
IAS Institute of Alcohol Studies
IHME Institute for Health Metrics and Evaluation
IMF International Monetary Fund
LA local authority
MOH Medical Officer of Health
NAO National Audit Office
NCB National Children’s Bureau
NCD non-communicable diseases
NERS National Exercise Referral Scheme
NHS National Health Service
NICE National Institute for Health and Care
Excellence
OCD obsessive compulsive disorder
PHE Public Health England
PHW Public Health Wales
PI performance indicator
PISA Programme for International Student Assessment
PPO Prisons and Probation Ombudsman
QALY quality-adjusted life year
RCP Royal College of Physicians
RCT randomised controlled trial
v
The future for health promotion
ROI return on investment
SMART specific, measurable, achievable, realistic and
time-scaled
TB tuberculosis
WHA World Health Assembly
WHO World Health Organization
WHP workplace health promotion
YOI Young Offender Institution
vi
Acknowledgements
My thanks to Ceri J Phillips, Professor of Health Economics at
Swansea University, for enabling me to gain access to certain
key documents.
I am also grateful to Helen Davis, Shannon Kneis, Phylicia
Ulibarri-Eglite and Ruth Wallace of Policy Press for their kindly
and efficient assistance during the preparation of the book.
vii

ONE
Main themes
Defining terms
The purpose of this book is to examine the evidence relating
to the effectiveness and cost-effectiveness of health promotion
policies and projects, specifically but not exclusively in the UK.
First, it is appropriate to clarify, as far as possible, what is
generally understood by the key concepts in the health promotion
literature. Since this book focuses on health promotion, this
phrase needs to be dissected. In addition, definitions – or at least,
interpretations of key terms – will be attempted. These include:
• the ‘new public health’
• civil society
• poverty
• empowerment
Health
Many commentators would consider dictionary definitions
rather bland and inadequate. For example, Chambers (2014)
defines health as ‘sound physical or mental condition’ (p 704),
while the Shorter Oxford English Dictionary (Little et al, 1933)
offers two definitions: ‘soundness of body’ and ‘spiritual, moral
or mental soundness’ (p.878). None of these three definitions
would be acceptable in today’s discussions of ‘health promotion’.
In 1946, the World Health Organization (WHO) referred
to ‘health’ as a state of complete physical, mental and social
wellbeing and not merely the absence of disease or infirmity.
This has been the prevailing definition up to the present day.
There is no mention here of spiritual or moral soundness. These
two attributes are more likely to be seen today as the province
of religious, humanistic or philosophical/ethical discourses.
An additional dimension to health promotion policy has been
an acceptance that factors external to the person’s individual
1