POLITICSS OF HEALTH

PROMOTION
Dr. Fowzi omer elamin
Learing out come
 Explore the diversity of social and political
philosophies, to understand who health promoiton
works
 How own value help us to see the logical
consequences for health promotion
 The political dimension of health promotion in
relation to its organization, its methods and the
content of health promotion activity
What is politics
 It is: the study of the distribution and effects of
power in society.
power
 Power includes not only material or physical resources but also
psychological, and cultural aspects (effective in limiting or channelling
people
 Not one is totally devoid of power and no one is all powerful.
 Power is not equally distributed even in demogratic societies, because it
is affected by other factors like:
 Gender
 Race.
 Age
 Social class
 Wealth
 Disability
 This inconsistant distribution of power affects health.
power

 Is it possible to predict power relation between

people?
power
 No, because it depends on
 The interrelation between the different mentioned
factors
 Personal power (charisma, e.g. Receptionest or
secretary who run the office)
Political ideologies
 Social policy: (def) planned governmental activities
designed to maintain, intergrate and regulate
society.
 This include both welfare and ecnomic polices both
national legislation and local policy.
Political ideologies
 Political idiologies range in a spectrum from
 those advocating a free market ecnonomy with minimal state
intervention. Her they blief in

 To those advocating a planned economy with maximum state

intervention.
 Conservatives or socialist who advocate a mixed ecnonomy and
wellfare state occupy the middle of the spectrum.
 Promoting health reflect a complex mix of value and belief with in
turn reflect different ideologies.
 This can result in having different explanation and responces to
social and health problems.
Political ideologies
 This result in having different explanation and responces
to social and health problems.
 E.g.
 The sedentary condition of the pupulation can be seen as:
 A consequence of individual laziness
 Or the lack of an integrated transport policy which would encourage
people to walk and cycle.
 So people would differe depending on:
 The extent of personal esponsibility
 The reole of government legislation and intervention
 Legitimate means to encurage coices and decisions
 The nature of society and the extent to which people are connected to
each other
Political ideologies
 marxism:
 Role of state:
 collectivist
 Veiw of economy:
 Planned economy
 Veiw of society:
 Present class socity characterized by calss
 conflict will be superseded by socialism characterized by from each according to their ability; to
each according to their need
 View of health:
 Universal and free state provision
 Core value:
 Equality
 Collective resonsibility
 Freedom from material want
Political ideologies
 Fabian socialism:
 Role of state:
 collectivist
 Veiw of economy:
 Mixed economy
 Veiw of society:
 Equality of opportunity
 Economic and political freedom is safeguarded by the state
 The state should enable individual self fulfilment and social justice through distribution

 View of health:
 Universal and free state provision to promote social chohesion and redistibution plus individual provision if desired
 Core value:
 Equality
 Collective resonsibility
 Humanitarianism
 Socia harmony
 Social justice
Political ideologies
 conservatism:
 Role of state:
 Reluctant collectivist
 Veiw of economy:
 Mixed economy
 Veiw of society:
 Inequality is inevitable but there should be equality of opportunity
 The state’s role is to porvide for the vulnerable and needy, but indiviual freedom of choice must be protected

 View of health:
 Paternalistic
 State should provide a safety net of health care provision, along side individual reponsibility

 Core value:
 Indiviualism
 Freedom
 Responsibility
 authority
Political ideologies
 liberalism:
 Role of state:
 anti collectivist
 Veiw of economy:
 Free market
 Market liberals

 Veiw of society:
 Inequality in wealth are inevitable
 Market forces ensure people’s needs are met in a satisfactory manner

 View of health:
 Individual responsibility and freedom of choice
 Needs are best met through the free market
 consumerism

 Core value:
 Indiviualism
 Freedom
 Choice
 competition
Political ideologies

 Now
 Where should health promotion
politics should be?
Political ideologies
 Health promotion activities are structured by the
prevailing policy frame work which has the effect of
legitimizing certain approaches and exclude others.
 E.g.
 The combination of free market economics with
authoritarianism favour:
 medical preventive approaches (dicrease morbidity and mortality)
 those which focus on individual lifestyle (education, and lifestyle
intervention).
 Consevative converntment, favour collective action like
accident prevention.
Politics of health promotion methods

 Methods used by health promoter are can be

viewed as technical choice.
 But they are not political neutral decision
 Method can classified according to:
 the mode of intervention (paternalist—participatory)
 and the focus of intervention (individual– collective)
 Health promtion method and political philosophies
Mode of intervention: paternalist

conservative: Fabian socialists/

People need help and reformist
support to take care of The governmarnt needs
their health vut health to plan waus to protect
problms are essentially the public health and
an individual reduces inequalities
reponsiblity Legislation,Policy
Advice, Information, making, Reulation,
educaction Health survillance
Focus of intervention Focus of intervention
individual collective
Libertarian/ radical:
Local concerns are what
libertarian matter to people.
Everyone should have People need to understand
the opportunity to what they have in common
determine their own and that their health is
lives and health affected by similar factors
Counselling, Grup work ,Community
development, Lobbying,
Education, Group work Action reseach, Skills
sharing and trainfing

Mode of intervention: paticipatory

Being bolitical
 Dose your profession conflect with your political
belief and values?
 Collective health goals
 Need to empower poeple to take control over factors
affecting health
 Critical understanding of health issue inorder to
identify ooptins and priorities
Politics of health promotion
 Methods adopted by practioners in responce to
paricular issues reflect political values about:
 Humanity (the right of people)
 Responsibility (of individual or social construct of certian social
policies)
 Role of the practioner: porfessional role or share knowledge
with poeple
 The role of convernment
HIV prevention
 What political values are being reflected in each followin
approach:
 Enhancing self-esteem
 Peer edcucation
 Educational media campaign
 Young poople’s sexual health clinic run by nureses
 Funding for a telephone helpline run by a voluntay self-help group
 Easier and more open access to condoms
 Oppportunities tor young poeple to gain work experince and skills
 Creation of hostels and sheltered housing for holeless young poeple
Political philosophy
 The following statements reflect particular political pilosophy. Can you idnetify
these? Which one you agree with
 There should be a system of the economic and social support for the needy
 Energy and enterprise should be rewarded, not stifled by high taxation
 All people in a society have a commitment and resopnsibility to others
 Inequality is a inevetable result of the differences between poeple
 High levels of benefits make pople dependent on support
 No group. Business or labour should allowed to vecome too poweful
 There is no such thing as class in the modern uk
 Poeple should be able to choose the type of level of health care or education they wish
 Certain sevices are essential and should be run by the state
 Macro politics is of lesss significant than issues , particularly those affecting local
communities
 Businesses and sevices shoud be accountable to the poeple using them
 People can not be equal, but everyone should have the same chances