Defining Health Promotion

The WHO (1984) defined health promotion as: 'the process of enabling people to increase control over, and to improve their health'. This provides a good starting-point to any discussion on what we mean by health promotion. The definition encompasses an element of empowerment, but assumes that people have full control over the circumstances in which they live and are able to choose healthy lifestyles freely. This is a vital area of debate in sexual health promotion, as it is often the case that clients do not have full control over their circumstances, owing to the very nature of sexual relationships.

Similarly, Seedhouse (2004) suggests that the concept of health promotion is one that implies enablement, in that health promotion activities provide the foundations to enable the achievement of personal and/or group potential. He proposes that health is achieved by removing obstacles and by providing the means by which chosen goals can be obtained.

Health promotion is generally regarded as an overarching term encompassing a range of activities (Tannahill, 1985; Naidoo and Wills, 1998). Tannahill (1985) argues that the term includes health education and environmental, legal and fiscal measures designed to enhance health. He distinguishes health promotion from curative, technological or acute health services as comprising those activities that are health-enhancing, and proposes a model of health promotion that consists of three overlapping spheres; health education, prevention (of ill health) and health protection. Professionals practising in the sexual health field are often involved in all three spheres of activity.

In a similar way Naidoo and Wills (1998) see health promotion as an umbrella term that encompasses four key activities:

  • Disease prevention, for example activities focusing on individuals or groups, such as cervical screening.
  • Health education and information - these are activities that are aimed at preventing disease and enhancing health through education. Examples include sexual health workshops as part of personal and social education in schools, or individual sexual health promotion in a surgery or clinic, or media campaigns to raise public awareness.
  • Public health promotion - activities that promote health through social and environmental measures.
  • Community development - activities that enable individuals to develop personal skills, knowledge and personal networks, for example peer education and buddying schemes.

Many theorists argue that health promotion draws on all activities that seek to improve the health of individuals, groups and the wider population. For instance Tones (1990) argues that 'health promotion incorporates all measures designed to promote health and handle disease' and that:

A major feature of health promotion is undoubtedly the importance of 'healthy public policy' with its potential for achieving social change via legislation, fiscal, economic and other forms of environmental engineering (Tones, 1990, p. 3).

In this definition Tones suggests the close relationship between health promotion activity and public health in stressing the importance of public health policy. Certainly it is difficult to discuss health promotion without examining its relationship with the wider sphere of public health. This is essential when considering sexual health promotion, given the recent government public health strategies relating to sexual health, which clearly indicate the need for sexual health promotion with a range of client groups, including teenagers and young adults, gay men and black and ethnic minority groups.

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