VULNERABLE GROUPS

Evita Leskovsek, M.D., Evita Leskovsek, M.D.,

spec. of social medicinespec. of social medicineInstitute of Public Health of the Republic of Institute of Public Health of the Republic of SloveniaSlovenia

Urb Health workshopBratislava, 31.5.2006 to 3.6.2006

INTRODUTCTION OF THE SPEAKER

INSTITUTE OF PUBLIC HEALTH OF THE REPUBLIC OF SLOVENIA

Central public health institution in Slovenia.

Established in 1923 as Institute of Hygiene, which was the first national public health institution.

Fields of work: Health promotion, environmental health, communicable diseases, health and health care research, health care organization, economics and informatics, laboratories.

1. Centre for health and health care research 2. Centre for health care organization, economics and informatics 3. Centre for health and environment 4. Centre for health promotion

Health statistic unit Information unit for illicit drugs Unit for drug purchase and distribution

THE HEALT PROMOTION CENTRE

cooperation with other centres-units-services at the institute expertise for Ministry of Health intersectorial collaboration development of health promoting activities and health education cooperation with other areas of expertise and sectors, international

relationships

Main activities raising awareness of public education of educators HE / HP materials development of HE / HP programs World health days working with media evaluation of HE / HP programs

Projects WHO projects

Health Promotion Schools HIV AIDS prevention Halt in prisons

International Projects

Health behavior in school aged children HBSC Health impact assessment Capacity Building Data Food Networking Correlation AIDS and mobility…

WHO DEFINITION OF HEALTH PROMOION

Health promotion is the process of enabling people to increase control over, and to improve their health.

Health promotion represents a comprehensive social and political process. It not only embraces action directed at strengthening the skills and capabilities of individuals but also action directed towards changing social, environmental and economic conditions so as alleviate their impact on public and individual health.

HP programs

tobacco prevention alcohol prevention healthy nutrition physical activity sex education program prevention of depression in different target groups health promotion in vulnerable groups

Hp scope

It focus on specific diseases, illness and injury prevention.

It identifies the significance of underlying social determinants of health .

It uses a range of approaches to address factors that determine the health of individuals and populations.

It includes approaches like socio environmental, preventive medicine, lifestyle, behavioral approach.

KEY DOCUMENTS OF STRATEGIES AND PRIORITIES WITHIN HP

1. Alma Ata Declaration 1978

2. Jacarta Declaration 1997

3. Ottawa Charter for Health Promotion 1986

4. Bangkok Charter for Health Promotion in a Globali tied World 2005

WHAT ABOUT HEALTH ?

Health contributes to sustainable development

Health is a good tool for regional cooperation

Health brings results and log term benefits

PUBLIC HEALTH

Public health is a broad term and has no universal international definition.

Public health is what we as a society do to assure the conditions in which people can be health.

Public health is the art and science of preventing disease, promoting health and prolonging life end its quality through the organized efforts of society.

CHANGES IN PUBLIC HEALTH

During the last fifteen years Europe have been witnessing tremendous changes in our society by globalization, economic and demographic transition and all of them were detrimental to health

Previously dominant infectious diseases problems continue to require involvement

The wide specter of non communicable diseases and global health threats such as harmful environmental changes in great challenges of modern public health

The prevention and control of these challenges requires a population wide and intersectoral approach

Problems are numerous, population demands and expectations are increasing, resources are limited…

COMPEX HEALTH ISSUES OF THE COMMUN ITY

violence, poverty social and health exclusion pollution, depression substandard housing the unmet needs of elderly and young people homeless people and migrants unhealthy spatial planning unsustainable development unemployment, especially among young workers stress alcohol tobacco and substance misuse…

WHAT TO DO?

There are two types of responses:

1. The centralized, national, the response of Ministries

2. The “bottom up” approach Promoting and enabling the “grass root” services

THE VALUE OF THE COMMUNITY

Communities are greater than the sum of individuals within them.

assessing health needs in a participatory manner prioritizing assessment of adequacy of existing public health resources consensus building cooperation and networking among different sectors assurance of provision of the type and quality of services tailored to local

health needs measurements of achievements introducing qualitative approach and deep understanding consensus building among politicians, administration, public health

professionals and community

STEPS OF SOLUTIONS

There is a gap between needs and services offered

Opening dialog and establishing communication between political decision makers, communities and professionals

Reorientation of formal health and social welfare services

Community empowerment and planing interventions

VULNERABLE GROUPS IN EUROPE

young people older people disabled people migrants homeless people illicit drug users prisoners victims of violence victims of trafficking social and health excluded …

INEQUALITIES IN HEALTH

Cities are less healthy Contentration poor health in deprived neighbourhoods Differences in life expetancy between neighourhoods more than 10 years Poor health is an important element in acmulation of problems

DIMENSIONS OF HEALTH PROMOTION IN VULNERABLE GROUPS

Population mental health and well-being Public Education and Awareness Prevention, Care, treatment and Support Addressing stigma and discrimination Protective and Supportive Legislation Social inclusion

POLICIES OF HEALTH PROMOTION IN VULNERABLE GROUPS

Age Based Policies - Early Years Children and young people Older people

Setting based policies Pre-School Settings Schools Communities Specialized institutions Prisons Drop In Centers…

Social justice and Equalities, Rights

Equality of opportunity Addressing discrimination

Health Policy

CHILDREN AND YOUNG PEOPLE

Schools based programs

Social competence approaches )self management, problem solving,

communication, Avoiding risk, health promoting behaviors

Live Skills approaches

Involvement and participation

Social support

Opportunities for arts, creativity, exercise

Pre-retirement planning

Intergenerational work

Involvement and participation

Older people

Schooling and workplace integration organizational approaches

(support for staff, job control, involvement, effort/reward balance, policies to tackle stress, bullying

Positive approach to integrate disabled people

Supportive environment (architecture, settings)

DISABLED PEOPLE

OTHER VULNERABLE GROUPS

Health and social exclusion

Risk of transmission of blood borne, STD diseases and TBC

Discrimination

Violation of human rights

OTHER VULNERABLE GROUPS

Health and social exclusion

Risks of transmission of blood borne, STD diseases and TBC

Discrimination

Violation of human rights

HOW TO ACHIEVE POSITIVE CHANGES IN MY COMMUNITIE ?

DO NOT FORGET THE BASIC STEPS

Identify problems Identify target groups Collect data – your decision are evidence based Identify partners Articulate the needs and propose a program Build partnerships and commitments

- Get support of the community - Work with media and learn on your own mistakes and - continue…