Importance of Equity-Focused Health Promotion for Empowering Individuals and Communities
akhlāq-i pizishkī i.e., Medical Ethics,
Vol. 18 (1403),
29 July 2024
,
Page 1-15
https://doi.org/10.22037/mej.v18i-.45774
Abstract
Background and Aim: Health promotion is most effective when it addresses the diverse needs and unique challenges of various communities. Equity-focused health promotion emphasizes fair access to resources, healthcare and support, particularly for marginalized and underserved populations. By reducing health disparities, this approach empowers individuals and communities to take control of their health and well-being. Prioritizing equity not only enhances health outcomes but also fosters empowerment, resilience and community cohesion, laying the groundwork for sustainable health improvements across all segments of society. This study examines the critical role of health promotion in empowering individuals and communities, highlighting the importance of a justice-based approach.
Methods: This article presents a systematic review of the key principles and strategies underlying effective health promotion initiatives, drawing on relevant literature and examples of community-based programs. A comprehensive search of Persian databases (SID and Magiran) and English databases (PubMed, Embase and CINAHL) identified articles, reports and texts related to justice-focused health promotion and its effects on empowerment, with no time limit until August 2024. Articles were assessed for relevance to the research topic, leading to the exclusion of unrelated content. Ultimately, 75 articles (41 in Persian and 34 in English) were reviewed, with 22 articles selected for detailed analysis.
Ethical Considerations: In this research, the principles of trustworthiness, honesty, neutrality and originality of the work have been respected.
Results: The findings indicate that the effectiveness of health promotion is contingent upon five key factors: Core Focus Areas (preventive care, early intervention and health education), Community-Based Approaches (culturally relevant and accessible programs tailored to local needs), Consideration of Social Determinants of Health (socioeconomic status, education, environmental factors), Stakeholder Collaboration (multi-stakeholder cooperation, comprehensive strategy development) and Focus on Marginalized and Vulnerable Populations (prioritizing marginalized groups for justice-based, equitable health outcomes). These elements collectively aim to empower individuals and foster inclusive health improvements across communities.
Conclusion: The Ottawa Charter provides a comprehensive framework for global health promotion, emphasizing principles such as individual empowerment, community participation and the development of healthy public policies. A review of various studies underscores the critical role of education and skill development, especially for vulnerable groups, in facilitating informed decision-making and promoting behavioral changes. Community involvement in the design and implementation of health programs, coupled with the use of digital technologies, serves as a powerful means to enhance the effectiveness of health interventions. Emphasizing social justice and addressing health inequities are essential for achieving sustainable improvements in quality of life. The coordinated implementation of these principles, supported by inter-organizational collaboration and active community engagement, is vital for attaining social welfare and sustainable health outcomes at all levels.
- Health Promotion
- Community-Oriented Approaches
- Empowerment
How to Cite
References
World Health Organization. Achieving Well-Being. A Global Framework for Integrating Well-Being into Public Health Utilizing a Health Promotion Approach [Internet]. Geneva: World Health Organization; 2023 [cited 2024 Oct 18]. Available from: https://www.who.int/publications/m/item/wha-76---achieving-well-being--a-global-framework-for-integrating-well-being-into-public-health-utilizing-a-health-promotion-approach.
Hill-Briggs F, Adler NE, Berkowitz SA, Chin MH, Gary-Webb TL, Navas-Acien A, et al. Social determinants of health and diabetes: a scientific review. Diabetes Care. 2020;44(1):258.
Subica AM, Link BG. Cultural trauma as a fundamental cause of health disparities. Social Science & Medicine. 2022;292:114574.
Mabuza MP. Disease Control and the Promotion of Public Health Equity. In: Evaluating International Public Health Issues. Singapore: Springer; 2020. p.105-254.
Taylor NR. Can You Hear Us Now? A Narrative Inquiry of Elementary Educators’ Professional Learning Perceptions in Pursuit of Educational Equity [Doctoral dissertation on the Internet]. San Diego: Northcentral University; 2021 [cited 2024 Nov 30]. Available from: https://www.proquest.com/openview/b3f62fc19f6985065314f3234ec36b4d/1?pq-origsite=gscholar&cbl=18750&diss=y.
Hadley S, Heidelberg B, Belfiore E. Reflexivity and the perpetuation of inequality in the cultural sector: half awake in a fake empire?. Journal for Cultural Research. 2022;26(3-4):244-65.
Maroto M, Pettinicchio D. Relational inequality and the structures that disadvantage. In: Brown R, Maroto M, Pettinicchio D, editors. Oxford Handbook of the Sociology of Disability. New York: Oxford University Press; 2022. p. 389-413.
Pronk N, Kleinman DV, Goekler SF, Ochiai E, Blakey C, Brewer KH. Promoting health and well-being in healthy people 2030. Journal of Public Health Management and Practice. 2021;27(Supplement 6):S242-8.
Edelman C, Kudzma EC. Health promotion throughout the life span [Internet]. 10th edition. Amsterdam: Elsevier Health Sciences; 2021 [cited 2024 Nov 24]. Available from: https://evolve.elsevier.com/cs/product/9780323761406?role=student.
Pulimeno M, Piscitelli P, Colazzo S, Colao A, Miani A. School as ideal setting to promote health and wellbeing among young people. Health Promotion Perspectives. 2020;10(4):316.
Fong P, Cruwys T, Robinson SL, Haslam SA, Haslam C, Mance PL, et al. Evidence that loneliness can be reduced by a whole-of-community intervention to increase neighbourhood identification. Social Science & Medicine. 2021;277:113909.
Iqbal A, Anil G, Bhandari P, Crockett ED, Hanson VM, Pendse BS, et al. A digitally capable mobile health clinic to improve rural health care in America: a pilot quality improvement study. Mayo Clinic Proceedings: Innovations, Quality & Outcomes. 2022;6(5):475-83.
Griffiths F, Watkins JA, Huxley C, Harris B, Cave J, Pemba S, et al. Mobile consulting (mConsulting) and its potential for providing access to quality healthcare for populations living in low-resource settings of low-and middle-income countries. Digital health. 2020;6:2055207620919594.
Gómez CA, Kleinman DV, Pronk N, Gordon GLW, Ochiai E, Blakey C, et al. Addressing health equity and social determinants of health through healthy people 2030. Journal of Public Health Management and Practice. 2021;27(Supplement 6):S249-57.
Matranga D, Restivo V, Maniscalco L, Bono F, Pizzo G, Lanza G, et al. Lifestyle medicine and psychological well-being toward health promotion: a cross-sectional study on Palermo (Southern Italy) undergraduates. International Journal of Environmental Research and Public Health. 2020;17(15):5444.
World Health Organization. Working for a Brighter, Healthier Future: How WHO Improves Health and Promotes Well-Being for the World's Adolescents [Internet]. 2nd edition. World Health Organization; 2024 [cited 2024 Oct 18]. Available from: https://iris.who.int/bitstream/handle/10665/376861/9789240093966-eng.pdf?sequence=1.
Kumar S, Preetha G. Health promotion: an effective tool for global health. Indian Journal of Community Medicine. 2012;37(1):5-12.
Lambrinou E, Hansen TB, Beulens JW. Lifestyle factors, self-management and patient empowerment in diabetes care. European journal of preventive cardiology. 2019;26(supplement 2):55-63.
Parker E, Fleming ML. Health promotion: Principles and practice in the Australian context [Internet]. 3rd edition. London & New York: Routledge; 2020 [cited 2024 Oct 18]. Available from: file:///C:/Users/HP/Downloads/10.4324_9781003115892_previewpdf.pdf.
Kris-Etherton PM, Petersen KS, Després J-P, Anderson CA, Deedwania P, Furie KL, et al. Strategies for promotion of a healthy lifestyle in clinical settings: pillars of ideal cardiovascular health: a science advisory from the American Heart Association. Circulation. 2021;144(24):e495-e514.
McKenzie JF, Neiger BL, Thackeray R. Planning, implementing and evaluating health promotion programs. 8th edition. Burlington: Jones & Bartlett Learning; 2022.
Penman-Aguilar A, Talih M, Huang D, Moonesinghe R, Bouye K, Beckles G. Measurement of health disparities, health inequities, and social determinants of health to support the advancement of health equity. Journal of Public Health Management and Practice. 2016;22:S33-S42.
Sohrabi MR, Tahmoreszadeh S, Mohammadi F, Kolahi AA. Research priority setting for social determinants of health research center of Shahid Beheshti University of Medical Sciences in 2013. Community Health. 2014;1(1):32-44. [Persian]
Khodayarian M, Mahmoodabad SS, Moori MK, Yoshany N. Research Priority Setting by Health Research Center regarding Effective Social Determinants on the Health. The Journal of Tolooebehdasht. 2022;21(4):1-19. [Persian]
Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, et al. Positive psychological well-being and cardiovascular disease: JACC health promotion series. Journal of the American College of Cardiology. 2018;72(12):1382-96.
Snelling AM. Introduction to health promotion. 2nd edition. Hobboken: John Wiley & Sons; 2023.
Youssefi Sadat M, Jamshidi E, Majdzadeh R, Khaefi M, Madani MS, Rajabi F. Developing Empowerment Model of Rural Communities in Community-based Initiatives. Hakim Journal. 2015;18 (3):246-255. [Persian]
Saberifar R. Assessing the Realization of Healthy City Policies Based on Local and Regional Needs, Case Study: South Khorasan Province. Journal of Urban Ecology Researches. 2020;11(21):29-42. [Persian]
Rahimi M, Vahabi DaryaKenari A, Pirkhaefi A. The role of the perception of social and economic inequality on the mental health of women working in health centers in Tehran. Social Psychology Research. 2024;14(53):123-33. [Persian]
Chelak K, Chakole S. The role of social determinants of health in promoting health equality: A narrative review. Cureus. 2023;15(1):e33425.
Kerry B, Pickett KE, Wilkinson R. The spirit level: Why greater equality makes societies stronger. In: Ortiz I, Daniels LM, Engilbertsdóttir S, editors. Child poverty and inequality: New perspectives. New York: United Nations Children’s Fund (UNICEF); 2012. p. 205-210.
Bentley C. Fairer society, healthier lives. In: Tod AM, Hirst J, editors. Health and inequality: Applying public health research to policy and practice. New York: Routledge; 2014. p.29-38.
Damari B, Minaee F, Riazi-Isfahani S. Challenges and Requirements for Achieving Equity in Health in the Islamic Republic of Iran. Hakim Journal. 2019;21(4):266-273. [Persian]
Shirdel E, Akbari H, Javadzadeh SA. Investigating the Social Factors Affecting the Social Health of Zahedan Secondary School Students during the Outbreak of the Corona Virus. Quarterly Journal of Socio-Cultural Development Studies. 2022;10(4):129-50. [Persian]
Ramezankhani A. Public Participation and Promotion of Community Health. Journal of Combat Medicine. 2023; 6(1):48-53. [Persian]
Rastegari S, Baba'iefard A, Niazi M. Understanding Beneficiaries' Experience of the Privatization Process in Iran. Journal of Applied Sociology. 2024;35(2):69-100. [Persian]
Ali Mohammad Zadeh K, Sadr SS, Fayaz Bakhsh A, Tofighi S, Olyaee Manesh A, Pourreza A, et al. Equity in Iran's Health System. Iranian Journal of Culture and Health Promotion. 2022;6(2):292-301.
Zamanimoghadam M, Afshani S A. Empowerment of female heads of households in Iran: A systematic review. Social Welfare Quarterly. 2021;21(80):45-80. [Persian]
Ounagh N, Ghorbani A, Sorzahi M. Analysis of Social Factors Affecting the Phenomenon of Working Children in Mehrestan City. Journal of Applied Sociology. 2023;34(3):65-84. [Persian]
Beheshtian M, Manesh AO, Bonakdar SH, Afzali HM, Larijani B, Hosseini L, et al. Intersectoral collaboration to develop health equity indicators in Iran. Iranian Journal of Public Health. 2013;42(Supple1):31-35.
Keshavarz Mohammadi N, Montazeri A. Evolution of understanding the concept of health: An introduction for designing strategies to improve public health in Iran. Payesh (Health Monitor). 2024;23(3):337-52. [Persian]
Yazdi Feyzabadi V, Mehrolhassani MH, Emami M, Khosravi S. A review of approaches to conceptualize health and its determinants: from biomedical approach to one health initiative. Iranian Journal of Epidemiology. 2018;13:145-54. [Persian]
Zarei F, Taghdisi MH, Keshavarz Mohamadi N, Tehrani H. Health promoting hospital: a pilot study in Bo-Ali hospital, Qazvin, Iran. Journal of Fasa University of Medical Sciences. 2013;3(3):215-23. [Persian]
Nutbeam D, Muscat DM. Health promotion glossary 2021. Health Promotion International. 2021;36(6):1578-98.
Laverack G, Keshavarz Mohammadi N. What remains for the future: strengthening community actions to become an integral part of health promotion practice. Health Promotion International. 2011;26(supplement 2):ii258-ii62.
Milczarski A. Is the Ottawa Charter still relevant? A survey among Health Promotion practitioners and researchers [Master's thesis on the Internet]. Hamburg: Hochschule für angewandte Wissenschaften; 2019 [cited 2024 Oct 18]. Available from: https://reposit.haw-hamburg.de/bitstream/20.500.12738/8878/1/Milczarski_geschwaerzt.pdf.
Kunadt D, Stölzel F. Effective immunosurveillance after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia. Cancer Management and Research. 2021;13:7411-27.
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