DIABETES

Diabetes-health promotion and wellbeing



Diabetes-health promotion and wellbeing

Introduction

Chronic disease is now a major concern for the western world. No longer are infectious and acute diseases the leading causes of death in the UK, but chronic diseases such as cancers and obesity related disorders have now taken over as the biggest health threats to the general population. Many chronic disorders are a result, to some degree, of behavioural factors like lifestyle choices or diet. Lung cancer from smoking and Type II Diabetes through poor diet (obesity) and sedentary lifestyle are prime examples of the link between modern life and a shift towards chronic disease. As a result of this partially behavioural foundation to illness, there is the opportunity to change open to many people, and ultimately the ability to improve health and health outcomes such as life expectancy or quality of life.

Health can thus be seen to be potentially determined by our actions. One way of letting people know what they should be doing to stay healthy or to improve their health is through health promotion. As set out in the Ottawa Charter for Health Promotion (WHO, 1986), health promotion can be defined as 'the process of enabling people to increase control over, and to improve their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.'

Discussion

The strategies used in health promotion programmes have been reported as diverse, through engaging in; awareness, information provision, influencing social policy, fighting for change and intervention type programmes. (Speller et al 1997) Traditionally health promotion has focused around education, prevention and protection interventions (Tannahill, 1985) and has been designed, implemented and evaluated from a top-down approaches and programmes. This is where behaviour change is generally the focus of outcome, and the issues that are being investigated are set by some form of authority, like a local health authority or even at a national level through the Government. Top down is thus where a small number of select people make the choices for people lower down the chain - effectively a minority with power over the majority.

Health promoters who operate in this capacity can thus be seen to hold and exert power over the population or different communities through their setting of the health promotion programmes, and through acting as gatekeepers of the information they choose to share. People in such decision-making positions may also have control over issues such as resource allocation and funding or who is given decision-making responsibilities (Laverack & Laonte, 2000) and all of these factors work to take away power from the grass-roots / individual level. 'Real power is possessed by those who define the problem.' (McKnight, 1999) Decision makers such as health promoters or authorities that dictate what people need, and what they can and cannot have in relation to health information, promotion and intervention also exert power over the population through creating individual ...