European Health Promotion Indicator Development

(EUHPID Project)

John Kenneth Davies & Caroline Hall

on behalf of the EUHPID ConsortiumJ.K.Davies@brighton.ac.uk

Caroline.Hall@brighton.ac.uk

This project is funded by the European Commission (DG SANCO)

EUHPID Project Aims• To establish a European Health Promotion

Monitoring System, including a set of common health promotion indicators

• To recommend suitable methodology and systems to collect the above data on health promotion indicators and activate the monitoring system

• To recommend dissemination strategies to policy makers and practitioners at Community level and within Member States

EUHPID Consortium• Universities

– Athens

– Bergen

– Brighton

– Brussels

– Galway

– Graz

– Jyvaskyla

– Maastricht

– Magdeburg

– Marseille

– Perugia

– Southern Denmark

• Nordic School of Public Health - Goteborg

• National School of Public Health - Lisbon

• Regional School of Public Health -Valencia

• Flemish Centre for Health Promotion -Brussels

• International Union for Health Promotion & Education – Paris

• Also colleagues from

– University of Vienna

– University of Zurich

– Health Promotion Switzerland

EUHPID Working Groups

• Data-driven- – Links with HP Source, EUROSTAT, etc.

• Policy-driven- – Links with Health Promoting Schools,

Workplace Health Promotion & Health Promoting Hospitals

• Theory-driven– EUHPID Health Development Model

Focus on key perspectives of HP field (model specifications)

• health development = interaction between individual/population (health/health capacities) and environment (health opportunities)

• distinguish health development & intentional interventions

• health of individuals/populations at centre

• health defined by three interacting dimensions

• distinguish health and health capacity

EUHPID Model Specifications

• distinction between pathogenic & salutogenic health development

– negative health (disease) vs. positive health (wellbeing)

– Risk factors vs. resources

• Ottawa Charter action areas define

– Health promotion actions (interventions)

– Health promoting areas (targets of interventions)

Detailed sub-levels of classification system

• structure vs. processes• functional systems vs. environment

– not generalizable distinction– context-specific, to be defined by user -

“health promotion user window”– possible to propose key settings and sectors

for HP

1) HEALTH DEVELOPMENT MODEL

HEALTH

DISEASEPOSITIVE HEALTHWELLBEING

PATHOGENESISSALUTOGENESIS

RISK FACTORSRESOURCES

SOCIO-ECOLOGICAL ENVIRONMENT

INDIVIDUAL(S)

mental

physical

socialHEALTH CAPACITIES

HEALTH

HEALTH OPPORTUNITIES

ANALYTICAL PERSPECTIVES ON HEALTH DEVELOPMENT

3) EUHPID HEALTH PROMOTION MODEL

HEALTH PROMOTION ACTIONS

- socio-ecological context development

- policy development

- organisational/network development

- community development

- competency building/health education

- empowering- participatory- holistic- intersectoral- equitable- sustainable- multistrategy

HEALTH PROMOTION PRINCIPLES

HEALTH PROMOTION INTERVENTION(HP Process indicators)

HEALTH DEVELOPMENT(HP Outcome indicators)

- advocate- enable- mediate

HEALTH PROMOTION APPROACHES

HEALTH

DISEASEPOSITIVE HEALTHWELLBEING

PATHOGENESISSALUTOGENESIS

RISK FACTORSRESOURCES

SOCIO-ECOLOGICAL ENVIRONMENT

INDIVIDUAL(S)

mental

physical

socialHEALTH CAPACITIES

HEALTH

HEALTH OPPORTUNITIES- socio-ecological context

- policy- organisation/network

- community

ANALYTICAL PERSPECTIVES ON HEALTH DEVELOPMENT

Health Promotion Policy & Practice

• Policy formulation

• Infra-structure development

• Implementation

• Campaigns & programmes

• Evaluation

• Funding

Settings Based Health Promotion User Windows

• Hospitals

• Work places

• Schools

Endpoints of health

disease positive health/wellbeing

Sub-dimensions

social social isolation amongst staff Information is available on patient organisations and those related to his/her condition.

mental % of staff smoking Suicide attempts (staff and

patients)

Patient and staff need for health promotion intervention are assessed.

physical % of patients educated about risk factor modification and disease treatment options in the management of their condition.

% of work related injuries

% of patients educated about specific actions in the self-management of their condition.

% of discharge letters sent to GP within 2 weeks.

Classifying Indicators of health (level: individual(s))

Endpoints of health capacities

riskfactors resources

Sub-dimensions

social Social withdrawal Opportunities and resources for leisure allocated to staff and patients

mental Resignation rates staff awareness of content and location of health promotion policies.

physical Morbidity rates Immobility rates

% of patients assessed for disease specific risk factors according to guidelines

% of patients assessed for generic risk factors

Classifying indicators of health capacities (level: individual(s))

Endpoints of health opportunities

riskfactors resources

Sub-dimensions

socio-ecologicalcontext

Number of snack machines for staff and patients.

Non-smoking environments Environmental determinants of

physical activity

policy Hire and fire culture. Access to healthy food Existence/adherence to an

equal opportunity policy.

organisation/network

Multi-level hierarchy of staff. % budget dedicated to staff health promotion activities

Resources allocated to the processes of implementation, evaluation and regular review of health promotion policy.

community Regularity of strike action by work force.

social support amongst colleagues

Classifying Indicators of health opportunities (level: environment)

Current Status• Final report submitted April 2004

Outcomes

• Influence overall European Health Monitoring and Information System

• Enhance ECHI framework: settings, policy and practice indicators

• Concept of EUHPID Health Promotion User Window

Recommendations:• Use of the EUHPID Health Promotion

model: construction, selection and classification of European HP indicators

• Develop indicators: integrated settings approach; policy and practice

• Testing concept of user windows

• Links to ‘key players’/ dissemination• Complex task and further work

required- Phase 2…

http://www.health.brighton.ac.uk/

euhpid /International Health Development

Research Centre, Faculty of Health, University of Brighton, Mayfield House,

Falmer, Brighton BN1 9PH, UK