Booklet 9

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Enriching Knowledge for the Health Management and Social Care Curriculum Series :

Community Health

Booklet 9

Building a Healthy City

September 2016

(2)

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

(3)

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

(4)

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

(5)

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

(6)

9.1Different Models on Health Promotion

Health Promotion

Individual level

Health Belief Model

Stages of Change Model Across levels Health

Promotion

(7)

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

(8)

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)

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

(10)

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

(11)

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

(12)

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

(13)

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

(14)

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

(15)

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

(16)

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

(17)

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

(18)

Create supportive environments

Generates safe living and working conditions

(19)

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

(20)

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

(21)

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

(22)

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

(23)

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

(24)

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

(25)

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.

(26)

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

(27)

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

(28)

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

(29)

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

(30)

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

(31)

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

(32)

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

(33)

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

(34)

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

(35)

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

(36)

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

(37)

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

(38)

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

(39)

9.4 Emergency Management

Before

• preparing for accidents before they happen

During

• dealing with and avoiding risks, including emergency evacuation and first aid management, personal safety, reporting and harm reduction

After

• supporting and rebuilding society after disasters

(40)

Examples 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

(41)

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  

(42)

Emergency Management – During Accidents

Step 1:Ensure Personal Safety

Road Fire Gas or

Chemical

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    

(43)

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 

(44)

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.   

(45)

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

To promote a culture of positive health and safety

(46)

9.6 Legislation and Actions

Legislation

• The Smoking (Public Health) Bill

• The Occupational Safety and Health Ordinance

Promotion

• I Love Smoke- free Hong Kong Campaign

• Health

Ambassadors to

Youth Project

Figure

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References

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