VULNERABLE GROUPS

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VULNERABLE GROUPS

• Evita Leskovsek, M.D.,
• spec. of social medicine
• Institute of Public Health of the Republic of
  Slovenia
• Urb Health workshop
• Bratislava, 31.5.2006 to 3.6.2006

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• INTRODUTCTION OF THE SPEAKER

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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

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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

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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

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• 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.

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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

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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.

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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

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WHAT ABOUT HEALTH ?

• Health contributes to sustainable development
• Health is a good tool for regional cooperation
• Health brings results and log term benefits

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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.

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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

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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

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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

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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

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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

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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

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INEQUALITIES IN HEALTH
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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

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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

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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

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Older people

• Social support
• Opportunities for arts, creativity, exercise
• Pre-retirement planning
• Intergenerational work
• Involvement and participation

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DISABLED 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)

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OTHER VULNERABLE GROUPS

• Health and social exclusion
• Risk of transmission of blood borne, STD diseases
  and TBC
• Discrimination
• Violation of human rights

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OTHER VULNERABLE GROUPS

• Health and social exclusion
• Risks of transmission of blood borne, STD
  diseases and TBC
• Discrimination
• Violation of human rights

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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