Health Promotion Practice : Power and Empowerment

by Glenn Laverack

• ISBN13: 9780761941804
• ISBN10: 0761941800
• Edition: 1st
• Format: Paperback
• Copyright: 2004-03-06
• Publisher: SAGE Publications Ltd

Summary

'This book written from an international perspective and thus eminently readable by a wider audience, draws on the author's considerable experience and is amply supplied with a good range of illustrations from real-life practice'¦The logical structure and accessible style makes this a useful addition to the personal library of anyone who has an interest in "bottom-up" empowerment-based approaches to health promotion' - RCN Research Headlines'The author draws on a wealth of personal experiences in the field, giving the book both readability and credibility. Good examples from different international contexts, illustrated in relevant case studies, let the reader relate theory to practice and bring the concepts to life. The author takes the central thrust of health promotion for the past few decades and unravels it for the reader in a clear, comprehensive way' - Health MattersIn health promotion, the concept of power can be defined as the ability to create or resist change, and this is an important foundation for individual and community health. By enabling people to empower themselves, health promoters can provide the capacity for the individual or community to change their lives and their living conditions, and therefore their health. Health Promotion Practice explores the issue of how such an approach to health promotion practice can improve a community's success towards achieving healthier conditions through its own actions.Placing empowerment at the heart of health promotion practice, and offering advice for health promoters who accept the challenge to work in such a way, Health Promotion Practice defines key concepts of health, health promotion and community empowerment. It also:Introduces readers to a 'social' model of health promotion practice, one that attempts to get at the underlying social determinants of disease;Helps readers understand the importance of power relations and their transformation in this practice;Introduces readers to a new 'community capacity-building' approach to plan,implement and evaluate health promotion programmes.Health Promotion Practice is an invaluable resource to students and practitioners of health promotion who want to help empower the communities that they work with.

Table of Contents

List of Figures, Tables and Boxes	viii
Foreword	x
Ronald Labonte
Preface	xii
Acknowledgements	xiv
An Overview of the Book	xv
Health Promotion in Context	1	(15)
Health professional as political activist	1	(2)
Lessons from the past	3	(2)
What is health promotion?	5	(2)
Health promotion: two variations on a theme	7	(1)
Health promotion and New Social Movement Theory	8	(1)
Health promotion and health education	9	(3)
What is community empowerment?	12	(1)
Health promotion programming: it's all about power transformation	13	(3)
Promoting Health: it all Depends on What we Mean by `Health'	16	(17)
Our experiences of health	16	(1)
Health, health promotion and social capital	17	(1)
The World Health Organisation's definition of health	18	(2)
Contemporary health approaches in health promotion	20	(3)
The overlap between health promotion approaches	23	(2)
What determines health? An analytical framework of health determinants	25	(1)
Risk conditions	26	(1)
Psychosocial risk factors	27	(3)
Behavioural risk factors	30	(1)
Implications to an empowering health promotion practice	30	(3)
Power Transformation and Health Promotion Practice	33	(10)
What is power?	33	(1)
Zero-sum and non-zero-sum forms of power	34	(2)
Three faces of power	36	(4)
Powerlessness	40	(3)
Community Empowerment and Health Promotion Practice	43	(15)
The concept of community	43	(3)
Three levels of empowerment	46	(1)
Community empowerment as a five-point continuum	47	(11)
Addressing the Tensions in Health Promotion Programming	58	(15)
Health promotion in a programme context	58	(2)
Top-down health promotion programmes	60	(5)
Bottom-up health promotion programmes	65	(5)
Addressing top-down and bottom-up tensions in health promotion	70	(3)
`Parallel-tracking' Community Empowerment into Health Promotion Programming	73	(13)
Top-down and bottom-up approaches are not wholly separate practices	73	(2)
`Parallel-tracking' community empowerment into top-down health promotion programmes	75	(11)
The Domains of Community Empowerment	86	(15)
Participation	86	(2)
Leadership	88	(2)
Organizational structures	90	(1)
Problem assessment	91	(2)
Resource mobilization	93	(1)
Asking why	94	(1)
Links with other people and organizations	95	(2)
The role of outside agents	97	(1)
Programme management	98	(3)
Building Community Empowerment Approaches in Health Promotion	101	(13)
Case study example: Empowering heart health	102	(1)
Case study example: Empowering the victims of domestic violence	103	(2)
A new methodology for building and evaluating community empowerment	105	(4)
Case study example: Experiences of empowering rural Fijian communities	109	(2)
Common themes for successful implementation	111	(1)
A free flow of information: sharing ideas and visions	112	(1)
The need for follow-up: fostering encouragement and support	112	(2)
Evaluating Community Empowerment Approaches Empowerment evaluation	114	(12)
Measures of an empowering health promotion practice	116	(1)
Evaluation that empowers	117	(1)
Measuring community empowerment	118	(1)
Methods for measurement	118	(1)
Determining the rank	119	(1)
Assigning the rank	120	(1)
Validating the rank	121	(1)
Work-shopping the ranking scheme	121	(1)
Using visual representations of the rank	122	(4)
Implications for an Empowering Health Promotion Practice	126	(13)
The influence of the political context	127	(4)
The influence of the economic context	131	(2)
The influence of the socio-cultural context	133	(1)
The influence of the organizational context	134	(1)
Power through health promotion	135	(4)
Bibliography	139	(16)
Index	155