LECTURES HEALTH PROMOTION
AND DISEASE PREVENTION
LECTURE 1: INTRODUCTION
TYPES OF PREVENTION
Primary = to prevent development of disease: education
Secondary = screening of disease/early detection: breast cancer screening, hielprik
Tertiary = prevent/reduce the seriousness/or complications of disease: medicine
Palliative care = end of life care, to relieve pain of the patient, mostly for terminally ill people
Universal = designed to reach the entire population, without regard to individual risk factors and are intended
to reach a very large audience.
Selective = target subgroups of the general population that are determined to be at risk for a disease.
Subgroups may be distinguished by traits such as age, gender, family history, or economic status.
Indicated = aims to identify individuals who already exhibit early signs of a disease and other related problem
behaviors associated with a health problem and target them with special programs Hard to pinpoint
INTERVENTION LEVELS
- Individual
- Interpersonal: family
- Organization: VU
- Community
- Society
The more close to the individual, the more you are able to pinpoint your outcome
TOOLS OR INSTRUMENTS
- Education
- Facilities: GGD, sports facilities
- Legislature/law: sugar tax, no smoking, pricing, control & sanction/penalties
MANY HEALTH PROBLEMS
- CVD
- Obesity
- DM2
- Hypercholesterolemia
- High blood pressure
, - STD’s
- Asthma
- Depression
- Etc…
… are determined by both environmental and lifestyle factors (health behavior)
LIFESTYLE FACTORS
BRAVVO:
- Bewegen
- Roken
- Alcohol
- Voeding
- Veilige seks
- Ontspanning/stress
Primary prevention of overweight in preschool children: The BeeBOFT Study (Acronyme)
- Breastfeeding
- Breakfast daily
- Outside playing
- Few sugar sweetened drinks
- TV viewing
Health problems are related to life style factors
Lifestyle factors and risk factors
,HEALTH PROMOTION AND DISEASE PREVENTION
Health promotion = Maintain peoples current health status and ideally a shift towards better health
- ‘Smoking reduction’ with the aim to maintain an optimal respiratory- and CV-system
Disease prevention = To prevent people getting a disease and prevent a shift towards the seriousness of a
disease
- ‘Smoking reduction’ with the aim to reduce the change of getting lung cancer
Relation HP and DP: many lifestyle factors:
, LECTURE 2: UPSTREAM DETERMINANTS OF LIFESTYLE BEHAVIOUR DETERMINANTS AND
CHRONIC DISEASE RISK
You have to look upstream to battle a problem, so that
downstream there are no issues anymore
Route of the problem (causes of the causes): Prices
Social environment lifestyle behavior disease?
Exposome = non-hereditary factors they determine
heath. You are already busy with exposome from when
you are in the belly of your mother
Polar bear & oyster phenomenon:
- Oyster has always food around (plankton)
- Polar bear has only a couple months to eat and store fat to survive
- We humans are more like polar bear: we are looking for fast energy (fastfood)
Angelo framework:
- Socio-cultural
o Micro: tv during dinner
- Physical
- Economic
o International train regulations
- Political
- Micro: classroom, house, workplace
- Meso: Neighbourhood
- Macro: Zoomed out, more international field
Commercial environments (commercial determinants of health) determine what you see
THE EVIDENCE IN A NUTSHELL
Socio-cultural environment
- SEP = socio economic position (was SES) lower SEP, higher chance to be obese
- Social capital lower social capital, higher odds of obesity
- Social network higher social network, lower odds for obesity
Economic environment:
- Evidence mostly from economic field
- Healthier diets are more costly
- Pricing strategies are effective: increase/discounts; especially if it is salient. Most evidence from
controlled settings
- Effect on weight status and disease outcome yet to be determined
AND DISEASE PREVENTION
LECTURE 1: INTRODUCTION
TYPES OF PREVENTION
Primary = to prevent development of disease: education
Secondary = screening of disease/early detection: breast cancer screening, hielprik
Tertiary = prevent/reduce the seriousness/or complications of disease: medicine
Palliative care = end of life care, to relieve pain of the patient, mostly for terminally ill people
Universal = designed to reach the entire population, without regard to individual risk factors and are intended
to reach a very large audience.
Selective = target subgroups of the general population that are determined to be at risk for a disease.
Subgroups may be distinguished by traits such as age, gender, family history, or economic status.
Indicated = aims to identify individuals who already exhibit early signs of a disease and other related problem
behaviors associated with a health problem and target them with special programs Hard to pinpoint
INTERVENTION LEVELS
- Individual
- Interpersonal: family
- Organization: VU
- Community
- Society
The more close to the individual, the more you are able to pinpoint your outcome
TOOLS OR INSTRUMENTS
- Education
- Facilities: GGD, sports facilities
- Legislature/law: sugar tax, no smoking, pricing, control & sanction/penalties
MANY HEALTH PROBLEMS
- CVD
- Obesity
- DM2
- Hypercholesterolemia
- High blood pressure
, - STD’s
- Asthma
- Depression
- Etc…
… are determined by both environmental and lifestyle factors (health behavior)
LIFESTYLE FACTORS
BRAVVO:
- Bewegen
- Roken
- Alcohol
- Voeding
- Veilige seks
- Ontspanning/stress
Primary prevention of overweight in preschool children: The BeeBOFT Study (Acronyme)
- Breastfeeding
- Breakfast daily
- Outside playing
- Few sugar sweetened drinks
- TV viewing
Health problems are related to life style factors
Lifestyle factors and risk factors
,HEALTH PROMOTION AND DISEASE PREVENTION
Health promotion = Maintain peoples current health status and ideally a shift towards better health
- ‘Smoking reduction’ with the aim to maintain an optimal respiratory- and CV-system
Disease prevention = To prevent people getting a disease and prevent a shift towards the seriousness of a
disease
- ‘Smoking reduction’ with the aim to reduce the change of getting lung cancer
Relation HP and DP: many lifestyle factors:
, LECTURE 2: UPSTREAM DETERMINANTS OF LIFESTYLE BEHAVIOUR DETERMINANTS AND
CHRONIC DISEASE RISK
You have to look upstream to battle a problem, so that
downstream there are no issues anymore
Route of the problem (causes of the causes): Prices
Social environment lifestyle behavior disease?
Exposome = non-hereditary factors they determine
heath. You are already busy with exposome from when
you are in the belly of your mother
Polar bear & oyster phenomenon:
- Oyster has always food around (plankton)
- Polar bear has only a couple months to eat and store fat to survive
- We humans are more like polar bear: we are looking for fast energy (fastfood)
Angelo framework:
- Socio-cultural
o Micro: tv during dinner
- Physical
- Economic
o International train regulations
- Political
- Micro: classroom, house, workplace
- Meso: Neighbourhood
- Macro: Zoomed out, more international field
Commercial environments (commercial determinants of health) determine what you see
THE EVIDENCE IN A NUTSHELL
Socio-cultural environment
- SEP = socio economic position (was SES) lower SEP, higher chance to be obese
- Social capital lower social capital, higher odds of obesity
- Social network higher social network, lower odds for obesity
Economic environment:
- Evidence mostly from economic field
- Healthier diets are more costly
- Pricing strategies are effective: increase/discounts; especially if it is salient. Most evidence from
controlled settings
- Effect on weight status and disease outcome yet to be determined
