A-Z of Health Promotion

Glenn Laverack

• Publisher: Bloomsbury Academic
• Year: 2013
• ISBN:
  9781350312784
• Edition: 1
• Topic: Medicine
• Subtopic: Public Health, Administration & Care

If you are looking for the definitive short guide to the theory and practice of health promotion, then you need look no further. Written by a leading international expert, this concise text offers, for the first time, a comprehensive explanation of key concepts, terms and definitions used in health promotion. Glenn Laverack explains over 70 key concepts and many other guiding principles, theoretical models and approaches that frame health promotion. He also explains the many tools and strategies that enable practitioners to work more effectively. This handy sourcebook has been written by the author in a typically accessible style that will provide readers with a superb overview of the subject. Numerous cross-references signpost the connections between different ideas, allowing you to explore conceptual relationships and linked approaches in an order that suits the reader. Whether you are studying, training or are already working, this book will be an indispensable source of information, evidence and analysis for deepening your understanding and for extending your practice. A companion source book in the same series, entitled the 'A to Z of Public Health', is intended to further extend the range of definitions and terms.

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harm reduction

SEE ALSO lifespan approach; lifestyle approach; mental health promotion; peer education; risk factors

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Harm reduction is a pragmatic approach to reduce the harmful consequences of high-risk behaviours by incorporating strategies that cover safer use, managed use and abstinence (Ritter and Cameron, 2006).

High risk behaviours that have been included in harm reduction interventions are needle exchange, opioid substitution therapy, substance use prevention for adolescents, smoking cessation, homelessness and sex work. The principles of harm reduction are often firmly rooted in humanistic ideals, in immediate and attainable goals and the recognition that risky behaviours have always been and always will be a part of society (Ritter and Cameron, 2006). The primary goal of most harm-reduction approaches is to work with individuals on their terms in their context and not to condemn their harmful behaviours. The goal is to work with the individual or community to minimize the harmful effects of a given behaviour. Unlike the moral approach of addiction, which tends to enhance the user’s shame, guilt and feelings of stigma, the harm-reduction approach is based on acceptance and the willingness of the provider to collaborate with clients in the course of reducing harmful consequences (Marlatt and Witkiewitz, 2010).

Harm minimization is often used interchangeably with harm reduction. However, any intervention or policy that is intended to reduce harm and problem behaviour can be considered harm reducing. The term harm minimization is intended to reflect an overall goal of policies to minimize harm (Weatherburn, 2009).

An example of one harm reduction intervention used brief motivational interviews to reduce alcohol-related consequences among adolescents (aged 18–19 years) treated in an emergency room following an alcohol-related event. An assessment of their condition and future risk of harm and the motivational interviews were conducted in the emergency room during or after the patient’s treatment. Follow-up assessments showed that patients who received the motivational interviews had a significantly lower incidence of drinking and driving, traffic violations, alcohol-related injuries and alcohol-related problems than patients who only received the standard care at the emergency room (Monti et al., 1999).

There is an opposition to harm reduction strategies by some professionals that want to eliminate high risk behaviours by enforcing abstinence-only policies. This is despite widespread evidence that harm-reduction programmes can be effective and cost efficient, for example, in slowing down the spread of HIV and other communicable diseases, overdose prevention programmes, emergency room screening and workplace substance use prevention programmes (Marlatt and Witkiewitz, 2010).

In practice, harm reduction is most viable as an approach in health promotion when it is used in combination with other strategies, such as peer education, to manage high-risk behaviours.

KEY TEXTS

• Marlatt, G.A. and Witkiewitz, K. (2010) ‘Update on Harm-Reduction Policy and Intervention Research’, Annual Review Clinical Psychology, 6: pp. 591–606

• Marlatt, G.A., Larimer, M.E. and Witkiewitz, K. (2011) Harm Reduction. Pragmatic Strategies for Managing High-Risk Behaviors. 2nd edn (London: Guildford Press)

• Weatherburn, D. (2009) ‘Dilemmas in Harm Minimization’, Addiction, 104 (3): pp. 335–339

health activism

SEE ALSO advocacy; boycotts; empowerment; health social movements; lobbying

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Health activism involves a challenge to the existing order whenever it is perceived to influence peoples’ health negatively or has led to an injustice or an inequity (Plows, 2007).

Activism is an action on behalf of a cause, an action that goes beyond what is routine (Martin, 2007). What constitutes as activism therefore depends on what is ‘conventional’ in society as any action is relative to others used by individuals, groups and organizations. In practice, activist organizations employ a combination of both conventional and unconventional strategies to achieve their goals. In systems of representative government, conventional actions include election campaigning, voting, advocacy and lobbying politicians. Organizations that use these types of actions are not (and do not consider themselves as) activists because they operate using conventional means. Civil and human rights, such as the freedom of speech and expression, privacy and the right to health, are fundamental principles in many activist organizations. They are also central to the manifestos of many political parties and with whom, therefore, activist organizations are sometimes able to form an alliance (Laverack, 2013).

Activism has an explicit purpose to help to empower others and this is embodied in actions that are typically energetic, passionate, innovative and committed. It has played a major role in protecting workers from exploitation, protecting the environment, promoting equality for women and opposing racism. To some, an activist is a freedom fighter, but to others he/she is a protagonist, trouble maker, vandal or terrorist. Activism is not always used positively as the actions of some minority groups can oppose human rights and the beliefs of the majority through violent means.

The types of actions that activist organizations engage in can be broadly sub-divided into two categories: indirect and direct.

1. Indirect actions are non-violent and conventional and often require a minimum of effort, although collectively they can have a significant effect. Indirect actions include voting, signing a petition, taking part in a ‘virtual (on-line) sit-in’ and sending a letter or e-mail to protest you...

Table of contents

• Cover
• Title Page
• Copyright Page
• Contents
• Acknowledgements
• How to use this book
• Introduction
• advocacy
• behaviour change communication
• civil society
• declarations and statements
• empowerment
• foundations
• gender and health
• harm reduction
• individualism and health
• lay epidemiology
• marginalization
• needs assessment
• parallel-tracking
• risk factors
• salutogenesis
• theory and models
• zero and non-zero-sum
• References
• Index