Enriching Knowledge for the Health Management and Social Care Curriculum Series ：
Community Health
Booklet 9
Building a Healthy City
September 2016
S5 – Macro Level
Health Management
Booklet (6) (8) (9) (10 )
Social Care Booklet (7) (11)
S4 – Holistic Health
Booklet (3) Physical Booklet (4)Mental Booklet (5) Social
S4 – Concepts and Framework
Booklet (1) Personal development Booklet (2) Health and well-being
Round-up：Booklet(13) Health and Social Care Policies
Macro Level
Health Management
Disease Prevention / Medical Care
Booklet 6 Healthy Community
Booklet 10 Healthcare
System
Health Promotion
Booklet 8 Ecology and
Health
Booklet 9 Building a Healthy City
Social Care
Booklet 7 Caring Community
Booklet 11 Social Welfare
System
3
BEING ILL WELL
BEING
Learning Targets
• Promote a culture of positive health and safety
Values and Attitudes
• Practise safe behaviours in different settings
• Demonstrate behaviours that minimise risk to oneself and others
Skills
• Differentiate different concepts related to health promotion
• Understand the concepts of risk and safety
• Apply safety guidelines and procedures in different settings
• Understand the importance and concepts of risk assessment and health management
Knowledge
9.1Different Models on Health Promotion
Topic 3 – Responding to the Needs in the Areas of Health (care, promotion and maintenance) and Social Care
3A The notion and practice of health promotion, health maintenance, ill-health prevention, social care, welfare and community services
3A3 Health promotion
Definition and trends of health promotion
Different models of health promotion
Health promotion in Hong Kong
To understand the concepts and models of health
promotions
9.1Different Models on Health Promotion
Health Promotion
Individual level
Health Belief Model
Stages of Change Model Across levels Health
Promotion
9.1Health Belief Model
Health Belief
Determinant factor contributing to the acceptance of advice, changes of behaviour and adoption of healthy behaviour
Individual perception and knowledge
Individual perceptions comprising perceived susceptibility or perceived severity of a specific disease
Modifying factors
Demographic variables (age, sex, race and ethnicity); socio-
psychological variables
(personality, sense of control, social class, peer and group pressure) and knowledge about and prior contact with diseases
The likelihood of action the possibility of taking action and the perceived
barriers
Death of the pop star Anita Mui
Cervical Screening Programme launched by Hong Kong
Government
Health education on cervical cancer
Personal feeling on cervical cancer and the consequence of suffering cervical cancer
Anticipated cost in terms of time and money
Impacts on work, family and social relationships
Individual
level
9.1 Stages of Change Model
Stages Features Work Focus
Pre-
contemplation Not yet recognise the problem behavior and the needs to be changed
To help targets realize the hazards of the risk behaviours and assess the positive and negative
consequences of behavioural changes in order to develop the intention and motivation to change Contemplation Acknowledge that there is a
problem but not yet ready or wanting to make a change in short term
Preparation/
Determination Ready to change and have made
some initial attempts To facilitate the self-determination and replacement of risk behaviour with the healthy behaviour
Action Practise new behaviour To change the environment to
eliminate or reduce the temptation of the risk behaviour. The new
behaviour can be supported
through strengthening the self and developing self-confidence.
Maintenance Maintain the practice of the new behaviour in a period of time
Individual
level
9.1Health Promotion
Health
• the consequence of the
interdependence between the
individual and the family, community, culture, physical and social
environments
Health Promotion
• to develop
interventions that target on the
interpersonal, organizational, community and public policy factors which influence health
Ottawa Charter
• Building healthy public policy
• Create supportive environments
• Strengthen
community action
• Develop personal skills
• Re-orientate health services
Across
levels
Ottawa Charter
• Puts health on the agenda of policy making, considering the health consequences of the decisions and the
responsibilities for health (Booklet 10,11,13)
Building healthy public
policy
• Conservation of natural resources throughout the world as a global responsibility (Booklet 8)
• Generates safe living and working conditions (Booklet 9)
Create supportive environments
• Enhance self-help and social support (Booklet 7)
• Promote mutual help and establish the community bonds (Booklet 7)
Strengthen community
action
Ottawa Charter
• Provides information / education for health and
enhances life skills aiming to increase people’s ability to exercise more control over their own health and over their environments, and to make choices conducive to maintaining health (Booklet 1-5,8)
Develop personal
skills
• No longer be confined to clinical treatment of diseases but extended to disease and health promotion(Booklet 6,9,10)
• Promotes holistic health (Booklet 1-5)
Re-orientate health
services
9.2 Healthy Cities
Topic 4 - Promotion and Maintenance of Health and Social Care in the
Community
4BHealth and safety
4B2 2. Health and safety in different settings
Healthy city
To promote a culture of positive health
and safety
Ottawa Charter - Create supportive environments
Healthy Cities – Features
Examples
Self-
sufficient The meeting of basic needs (for food, water, shelter, income, safety and work) for all the city's people
Healthy
ecology A clean, safe physical environment of high quality (including housing quality)
An ecosystem that is stable now and sustainable in the long term Health care An optimum level of appropriate public health and sick care services
accessible to all
High health status (high levels of positive health and low levels of disease) Economy
and culture A diverse, vital and innovative city economy
The encouragement of connectedness with the past, with the cultural and biological heritage
Social
relationship A strong, mutually supportive and non-exploitive community
The chance for a wide variety of contact, interactions and communication
Participation A high degree of participation and control by the public over the decisions affecting their lives, health and well-being
Ottawa Charter - Create supportive environments
Healthy Cities – How
Seven guiding principles
Community
participation to encourage local people and organizations to voice out their opinions and actively participate in building up a healthy community
Health promotion
to enhance health education that ‘prevention is better than cure’
to promote healthy living environment and lifestyles Primary health
care
to strengthen the network of community clinics to reduce the need for hospital care
Equity in
health to advocate that every individual should have an equal opportunity to attain their full health potential regardless of age and gender etc
Inter-sectoral collaboration
to facilitate collaboration across government departments and service organizations for better services tailored to community needs
Effective use of resources
to identify and meet real demands through validated measures,
followed by proper evaluation procedures to ensure optimum use of limited resources
International cooperation
i.e. to share knowledge and experiences with other Healthy Cities around the world
9.3 Healthy Settings
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B2 Health and safety in different settings
To practise safe behaviours in different settings
To apply safety guidelines and procedures in different settings
To promote a culture of positive health and safety
Ottawa Charter - Create supportive environments
Healthy Settings
Setting
• Environment which people use and shape, including schools, work sites, hospital, villages and cities.
Level
• Where people live, work, learn and play, related to health and social care systems
Feature
• Apply a set of holistic and multi-disciplinary strategies to a variety of risk factors, diseases and health issues, so as to maximize disease prevention via a “whole system’
approach
9.5 Risk Assessment and Management
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B1 Concepts of risk and safety
To understand the concepts of risk and safety
4C Aspects of risk assessment and health management
4C1The concepts of risk assessment and health management
To understand the importance and concepts of risk
assessment and health management
Create supportive environments
Generates safe living and working conditions
9.5 Risk Assessment
Risk Hazards Consequence
Injuries Mechanical Contact with moving parts of machinery or equipment
cuts, bruises and punctured skin , crushed limbs, amputation and death
Physical Obstacles on the ground where
individuals walk (on wet or damaged flooring), poor visibility
slips, trips and falls
Electrical Contact with live parts at even normal mains voltage
severe shock and burns
Poisoning Chemical Hazardous chemical substances skin or eye irritations, respiratory problems, poisonings and long term
health problems such as cancers Physical
illness
Biological environmental conditions allow the rapid growths of certain types of micro-organisms
Infectious diseases
Lifestyle Risk behaviours such as unhealthy diet, sedentary lifestyles, tobacco smoking, alcohol addiction, drug abuse,
unprotected sex, unhygienic practices
Communicable and non- communicable diseases
Mental illness
Stress Related to life events
Related to working environment
Insomnia, depression and high blood pressure
9.5 Risk Management
• To empower people to avoid health risk of unhealthy lifestyle
• Such as：providing information about food labelling and occupational health
Empowerment
• To remove or reduce hazards to an acceptable level
• Such as：wearing a surgical mask, washing hands, providing a healthy tuck-shop
Precaution
• To control exposure to hazards through policy setting, equipment and controlling measures
• Such as: industrial safety equipment, no smoking policy
Monitoring
9.3A Health and safety at school
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B2 Health and safety in different settings
Health and safety at school
Protection against harassment, e.g. sexual harassment / bullying
others: e.g. hygiene, healthy lunch, peer relationship
To practise safe behaviours in different settings
To apply safety guidelines and procedures in
different settings
Ottawa Charter - Healthy Schools
• Setting the school health and safety policies
Building healthy public
policy
• Creating the healthy school environment
• Building a positive social environment Create
supportive environments
• Developing the community relationship Strengthen
community
action
Ottawa Charter - Healthy Schools
• Enhancing personal health and safety skills
Develop personal
skills
• Providing school health services - to safeguard students’ and staff’s health, hence allowing them to have physical and mental strength to meet the demand of school work and helping them establish good interpersonal relationship
Re-orientate health
services
2. Healthy Eating
Risk Assessment A rising trend of obesity among primary school students Cause Unhealthy Diets
Impact Chronic diseases such as diabetes, heart disease, cancer and obesity
Risk Management Examples
Empowerment 'Nutritional Cooking Training Workshop for Chefs' for school lunch suppliers, chefs and staff of school lunch caterers to understand the nutritional needs of students
Precaution Handbook of Selection of Lunch / Snack Suppliers, Nutritional Guidelines on Lunch / Snack for Students for reference of schools Monitor Monitor nutrition quality of school snacks provided by school snack
suppliers as well as the lunch provided by snacks suppliers
• Setting the school health and safety policies -School healthy eating policy - school management and other stakeholders (e.g.
teachers, parents, etc.) draft a healthy eating policy tailored to their school
Building
healthy
public policy
3. Sexual harassment
Risk
Assessment
Sexual harassment – Sex Discrimination Ordinance - a sexual harassment act committed by any person that "creates a hostile or intimidating environment" also applies to educational settings.
behaviour Unwelcome sexual behavior or conduct which is offensive, humiliating or
intimidating , imcluding put up pornographic pictures 、made sexual jokes or talking about issues of a sexual nature, or making a sexual advance
Impact Cause harm to the victim's mental and physical health and significantly compromise his/her academic or work performance
Risk
Management
Examples
Empowerment Set specific targets (such as number of people and/or regular period of time) for training and education programmes on gender equality, respecting others and enhancing awareness on the prevention of sexual harassment for students and staff members
Precaution Schools should promulgate the policy to all students, parents and staff members on a regular basis. The sexual harassment policy should be distributed and
explained to all new students and staff members
Monitoring Designate staff members of particular positions in school to implement specific measures for the prevention of sexual harassment, with a clear lineation of responsibility to ensure proper implementation of the policy.
4. Bullying
Risk
Assessment
Types of bullying
Physical assault
Verbal harassment
Exclusion from social situation
Coercion
Causes a group of children may single out one child because they think he or she is different
Interpersonal conflicts
Imitation of violent behavior Impacts On the victims
Physical injuries
Emotional health affected when being offended, humiliated or intimidated
Stressful when being threatened to keep silent
Being isolated and unable to build good interpersonal relationship
the victimized child to commit suicide
Bullying
Risk
Management
Examples
Empowerment Supporting victims and encouraging them to speak up
Providing training to victims to help them to be strong
Teaching bullies about emotional control
Help bullies differentiate what is wrong and learn to make an apology Precaution Training of senior form students to take part in life education activities
Development of a whole school anti-bullying policy
Organising violence prevention programme
Programmes on anti-bullying & prevention of bullying, control of assaultive behavior / rage-management
Monitoring Schools, parents and NGOs cooperate and provide a pleasant and positive environment
Provide basic knowledge about bullying such as its popularity and seriousness to parents/schools and the community
• Different parties may establish the policy of providing harmonious family & school
• Schools should develop clear education objectives and policies
Building
healthy
public policy
9.3B Health and safety in sports and leisure
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B2 Health and safety in different settings
Health and safety in sports and leisure
health and safety practices in sports
lifestyle changes and new leisure activities create new risks
To practise safe behaviours in different settings
To apply safety guidelines and procedures in
different settings
B. Health and safety in sports and leisure
Risk Assessment Examples
Causes no proper training and protective equipment
the use of the facilities, such as grass and artificial playing surfaces
the toxic effects of chemicals used to purify water in a swimming pool
physical contact occurring between competitors
sedentary mode of leisure
new leisure activities such as Wiimote
Impacts Soft tissue injuries, broken bones, tendon, cartilage damage and head injury
Risk Management Examples
Empowerment
learning proper techniques
Precaution
warming up
wearing essential equipment
Monitoring
a procedure for estimating and evaluating the levels of risk
implementing adequate control measures in order to
reduce the risks of the sport to acceptable levels
9.3 C. Health and safety abroad
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B2 Health and safety in different settings
Health and safety abroad
To practise safe behaviours in different settings
To apply safety guidelines and procedures in
different settings
C. Health and safety abroad
Risk Assessment Examples
Causes various form of stress may reduce the resistance to disease: crowding, long hours of waiting, disruption of eating habits, changes in climate &
time zone etc.
sudden and significant changes in altitude, humidity, microbes and temperature
accommodation is of poor quality, hygiene and sanitation are
inadequate, medical services are not well developed and clean water is unavailable
disease outbreaks at specific destinations Impacts Infectious diseases, injuries and death
Risk Management Examples
Empowerment Health education provided by Travel Health Centres
Precaution Health risk assessment, vaccinations and medications that travellers might need to stay healthy while travelling abroad
Monitoring The Port Health Office of the Hong Kong Department of Health provides the Travel Health Service aiming at promoting and protecting the health of travellers as well as preventing the spread of diseases into Hong Kong
9.3D. Health and safety at home
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B2 Health and safety in different settings
Health and safety at home e.g. safety aids, use of equipment
To practise safe behaviours in different settings
To apply safety guidelines and procedures in
different settings
D. Health and safety at home
Risk Hazards Consequence
Injuries Mechanical Contact with moving parts of machinery or equipment
cuts, bruises and punctured skin , crushed limbs, amputation and death
Physical Obstacles on the ground where
individuals walk (on wet or damaged flooring), poor visibility
slips, trips and falls
Electrical Contact with live parts at even normal mains voltage
severe shock and burns
Poisoning Chemical Hazardous chemical substances skin or eye irritations, respiratory problems, poisonings and long term
health problems such as cancers Physical
illness
Biological environmental conditions allow the rapid growths of certain types of micro-organisms
Infectious diseases
Lifestyle Risk behaviours such as unhealthy diet, sedentary lifestyles, tobacco smoking, alcohol addiction, drug abuse,
unprotected sex, unhygienic practices
Communicable and non- communicable diseases
Mental illness
Stress Related to life events Insomnia, depression and high blood pressure
D. Health and safety at home
Risk Management Examples
Empowerment Acquire first aid skills
Precaution Buy a first-aid kit at home and place it in an easily accessible place
Supervise children all the times
Turn off electrical appliances when they are not in use
Never leave cooking unattended Monitoring Fire safety - Fire Safety (Buildings)
Ordinance - requirements to provide fire service installations and
equipment
Household Electrical Safety Handbook
9.3 Health and safety at work
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B2 Health and safety in different settings
•Health and safety at work
occupational health
To practise safe behaviours in different settings
To apply safety guidelines and procedures in
different settings
Health and safety at work
Risk Hazards Consequence
Injuries Mechanical Contact with moving parts of machinery or equipment
cuts, bruises and punctured skin , crushed limbs, amputation and death
Physical Obstacles on the ground where
individuals walk (on wet or damaged flooring), poor visibility
slips, trips and falls
Electrical Contact with live parts at even normal mains voltage
severe shock and burns
Poisoning Chemical Hazardous chemical substances skin or eye irritations, respiratory problems, poisonings and long term
health problems such as cancers Physical
illness
Biological environmental conditions allow the rapid growths of certain types of micro-organisms
Infectious diseases
Lifestyle Risk behaviours such as unhealthy diet, sedentary lifestyles, tobacco smoking, alcohol addiction, drug abuse,
unprotected sex, unhygienic practices
Communicable and non- communicable diseases
Mental illness
Stress Related to work Insomnia, depression and high
blood pressure
Health and safety at work
Risk
Management
Examples
Empowerment • Occupational health and safety training and talks to industrial and commercial sectors as well as launching awards for reinforcement
Precaution • Uses of safety helmets and ear-muffs
• Filters and equipment used for personal eye-protection against laser radiation
• Safety belts for construction and demolition use Monitoring • Building the culture of health and safety at work：
setting up health and safety guidelines or policies using technologies in, work environment and work
organization of all procedures to help in achieving occupational health and safety objectives
• Enforcement of legislation through regular workplace
safety inspections, provision of advisory services on
matters concerning occupational health and safety
9.4 Emergency Management
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community 4CAspects of risk assessment and health
management
4C4. Emergency Management
Accidents in schools, on the road, at home
Ways of reporting or obtaining assistance when faced with unsafe situations or accidents
Corrective action e.g. first-aid skills
To explore the ways to manage personal and community health
To demonstrate behaviours that minimise risk to
oneself and others
9.4 Emergency Management
Before
• preparing for accidents before they happenDuring
• dealing with and avoiding risks, including emergency evacuation and first aid management, personal safety, reporting and harm reduction
After
• supporting and rebuilding society after disastersExamples of Emergency Management
Before During After
Accidents in Schools
A well documented list of
“emergency management
procedures” for different accidents and good communication protocol within and outside the school
Form a crisis management team for planning, managing, monitoring and reviewing all emergency crises.
Post classroom emergency procedures in every classroom.
Post in the main office and playground names of staff who have completed First Aid training or other special lifesaving training or expertise.
Post the list of emergency telephone numbers in the main office and the playground.
Notify the crisis emergency team (Teacher / Staff)
Call emergency services if indicated
Notify parents or guardians, spouses or other individuals listed as emergency
contacts
Review of emergency management protocols and making
amendments if necessary
Accidents on Road
Assess the potential risks, traffic condition, number and condition of casualties
Leave the traffic accident scene immediately if the environment is dangerous.
Stay calm and call for emergency services.
Conduct traffic flow if possible to avoid further accidents in the scene.
Make sure that it is safe to perform any rescue or first aid management on site
Improve road user behaviour through education and publicity;
Create a safer driving environment through safety legislation to;
Build better roads
Manufacture of safer cars
40
Emergency Management – Before Accidents
Before Accidents Road Fire Gas or
Chemical
Medical
Risk Assessment (Potential
hazards in environment)
First Aid Training
Health Management (Check-up + understanding on healthy diets and exercises)
Information about emergency
services
Procedures for reporting
accidents
Emergency Management – During Accidents
Step 1：Ensure Personal Safety
Road Fire Gas orChemical
Medical
Leave the scene immediately
Identify any potential risk and eliminate or minimize the risk if possible
Open windows to dilute poisoning
gases
Do not switch on or off any
electrical appliances, make any phone call, or press any door bell as it triggers explosion
Make a thorough assessment of
the situation
Emergency Management – During Accidents
Step 2：Reporting Road Fire Gas or
Chemical
Medical
Stay calm. Clearly state the nature and the location of the incident, the situation at the scene, e.g. people trapped,
number of casualties, the condition and medical history of the patient and
reporter’s contact telephone number
Activate the nearest break-glass fire
alarm switch and alert everyone to leave the premises
Isolate the fire e.g. by closing doors, alert
other people in the immediate area
Emergency Management – During Accidents
Step 3：Harm Reduction Road Fire Gas or
Chemical
Medical
Moving people from possible
danger to safety
Conduct traffic flow if possible to avoid further accidents in the scene
Provide first aid treatment if the
environment is safe
Do not move the injured if any head or /and spinal injury is suspected unless there is
environmental hazard such as gasoline leaks are suspected
Rescue any person in immediate
danger, if it is safe to do.
9.6 Legislation and Actions
Topic 4 - Promotion and Maintenance of Health and Social Care in the Community
4B Health and safety
4B3 Actions to enhance health and safety
Statutory requirements for health and safety
Health and safety promotion, such as anti-smoking campaigns, personal hygiene campaigns
