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| Health Promotion: Global Perspectives Health Promotion: Global Perspectives, a
supplement to the American
Journal of Health Promotion, is published bimonthly by the American
Journal of Health Promotion, Inc., 1660 Cass Lake Road, Suite 104, Keego
Harbor, Michigan 48320. Annual subscriptions are FREE when you subscribe
to The Art of Health Promotion or American Journal of Health
Promotion. |
American Journal of Health Promotion American Journal of Health Promotion is the largest peer-reviewed journal devoted exclusively to health promotion. Published 6 times per year, The Journal publishes original research and reviews on the health and financial impact of health promotion programs, as well as editorials, abstracts from other journals, and critiques of other published studies. Michael P. O'Donnell, Ph.D., MBA, MPH, serves as editor-in-chief. Subscription price for individuals is $99.95 in the United States, $108.95 in Canada and Mexico, and $117.95 in all other countries. Institutional prices are $20 higher. To subscribe; Phone: 800-783-9913 |
The Art of Health Promotion The Art of Health Promotion newsletter provides practical information to make programs more effective. Each issue is devoted to a specific topic, such as increasing program participation, increasing management support, cost benefit analysis, use of newer technologies, characteristics of industry experts. Larry S. Chapman, MPH, serves as newsletter editor. Published 6 times per year, the subscription price for individuals is $89.95 in the United States, $98.95 in Canada and Mexico, and $107.95 in all other countries. To subscribe; Phone: 800-783-9913 |
The Contribution of Health Promotion to Healthy Aging – A View From GermanyBy Kerstin Baumgarten
| "To resist the frigidity of old age one must combine the body, the mind and the heart - and to keep them in parallel vigor one must exercise, study and love." |
Demographic Dimensions in Germany
The process of aging in Europe will be tremendous in the coming decades. Besides Japan and the United States, 18 European countries are among the 20 countries with the highest percentage of elderly worldwide. Between 13 to 18% of their population is over 65. At the moment 22% of the 82 million Germans are younger than 20 years and 21% are over 60 and older. Respective figures of this ratio for the year 2010 are 18% and 25% and for the year 2040 15% and 37%. Elderly people are growing older, increasing the number of the very old, 80 years and above. The majority of elderly people are women, most of them poor and widowed.
The Contribution of Health Promotion Strategies
Aging is an opportunity for the society to develop appropriate policies and interventions for an aging population. The definition of health promotion indicated in the Ottawa Charta focussed on complex strategies to reach health as a resource for everyday life. In perspective of the aging trend, health promotion strategies should focus more on the aging trend of the population. Some key elements of health promotion, with important impact on healthy aging, are prevention, health education and healthy public policy. How can these strategies contribute?
The Contribution of Prevention and Health Education Strategies
Health and activity in older age are a summary of the experiences and actions of an individual during the hole span of life. Many chronic diseases, which reduce functional capacity, are the result of an unhealthy lifestyle. Maintaining health and quality of life across the lifespan will do much towards building fulfilled lives and ensuring the highest possible level of quality of life for as long as possible. So the contribution of prevention and health education strategies starts earlier. The challenge for these strategies is to provide programs and information about skills on healthy lifestyles for children and adults.
The Contribution of Healthy Public Policy
Social factors also effect functional capacity. Poor education, poverty and harmful living and working conditions contribute to a reduced functional capacity in later life. Policies that reduce social inequalities and poverty are essential to complement individual efforts towards active aging. Policy decision makers should take social factors into account.
In view of the fact that the majority of older persons are female, it is crucial that aging policies reflect this situation, informing and empowering adult woman. Inequal-ities in income and wealth in earlier life mean that older women tend to be poorer than older men. For women the income from pensions and social security still lower than that of older men, because women more often than men interrupt their careers to take care of children and other family members. There is a need for a policy that reviews the framework for discrimination between men and women. A main issue is for example equal access to education for boys and girls.
Model of Good Practice - Councils of Seniors in Germany
In view of the demographic transformation, there is an urgent need for the public policy to respect the needs of elderly in all decisions. Policy for elderly should also be policy with elderly. In Germany, councils of seniors represent the problems and interests of the elderly at the community, state and federal level. These councils function on a voluntary, democratic and independent basis. They collaborate with policy decision makers, the public and administration offices and the economy. As an example for concrete regional action, the senior councils developed a certificate for an elderly friendly service. Shopping centers and branch banks can get this certificate if they provide barrier-free access and offer special advisement and service for seniors. Furthermore, the representatives discuss questions of senior policy at the state parliament. The senior councils stand for the safeguarding of interests and the empowerment process of elderly in the society of a developed country.
Kerstin Baumgarten, University of Applied Sciences Magdeburg /Germany.

Constitutional Characteristics of Para-Old People
in Shanghai, China and Fitness Counter-MeasuresBy Shen Xun-Zhang
With more than 100 million people aged over 60, China possesses the largest population of old people in the world. Moreover, the number of aged Chinese is estimated to increase to 280 million by 2025. Older Chinese now comprise a significant percentage of the urban population, for example, 14% of the total population of the city of Shanghai is over 60 and the city’s aging index has reached 41.9%.
Para-old Chinese
At the same time, in Shanghai there are 250,000 to 350,000 thousand para-old people (men 56 to 60 years of age, and female 51 to 55 years old). These para-old Chinese are nearing old age with rich life experiences and an increasingly failing physical constitution. Though they have a strong desire to return to their youth, the spirit is willing, but the flesh is weak.
In recent research, 13,335 para-old volunteers had their
fitness tested according to Chinese criteria
and
also answered a questionnaire.
The volunteers came from a variety of occupational backgrounds, including labor,
peasantry, offices, science, education and the managerial layer. Results
indicated that many para-old people showed signs of more advanced aging, such
as, decreasing height, notable impairment of heart and lung function, loss of
hearing and sight, thinning hair, skin wrinkling, failing memory, low efficiency
and a higher rate of illness.
However, test and questionnaire results also showed that the constitution of Shanghai para-old people was sometimes better than that of younger adults’ in many respects, and that this was a direct result self-initiated fitness training. The physiological and psychological health of para-old people who took part in frequent fitness training was 5% higher than that of younger adults. Thus, it became clear that regular physical exercise promotes the health of Shanghai’s para-old, and that regular fitness activities slows the onset of conditions associated with advancing age.
The Way Forward
China has paid great attention to the aging problems of its population for many years. All levels of governments are required to achieve a general target, which is "keep old people in good health and long life, encourage them to learn more knowledge and support them to serve the society."
For para-old Chinese, four tactics are necessary to achieve this general target. The first tactic is to devote major efforts to carrying out the National Program for Physical Training Plan as a way of serving the promotion of health for the aged. The second tactic is to bring two levels of adult constitution assessment into full play, thus serving old peoples’ constitution and health. Old people can choose one to two training items according to their own interests and hobbies, so enhancing quality of life and contributing to the development of good living habits. Additionally, every para-old person should receive constitution assessment at least once a year. Experts will evaluate their constitution and health and give them advice. The third tactic is to ensure that the fitness equipment of each unit and sub-district is up to date and well-maintained in order to promote good environmental conditions for para-old people to undertake physical training. Constitution assessment stations have already been founded. Their functions are testing, evaluating and consulting. They give para-old people advice about how to fitness scientifically and reasonably. The fourth tactic is to propagate exercise knowledge widely. We should promote the knowledge that for para-old people frequent exercise is more important and more effective than money and medicine.
Shen Xun-Zhang is Associate Professor at the Shanghai Chang-Ning District Adolescent Sport School Gu-kai Shanghai Municipal Center for Disease Control and Prevention. He may be contacted via e-mail at: shenxz@kali.com.cn
Country
Profile: Health Promotion in EstoniaBy Mai Maser
Estonia is one of the smallest Baltic States. The population of the country is about 1.5 million. After the collapse of the Soviet Union, along with the other Baltic States (Latvia and Lithuania) Estonia reestablished its independence in 1991.
Estonians are not very healthy people. The average life expectancy is 70.4 years (females: 77 years, and men: 65 years.) Cardiovascular disease is the most common cause of mortality in Estonia (405,6/100 000), cancer is the next, with accidents and injuries in the third place.
On the basis of Estonian Adult Population Health Behavior Surveys, which have been carried out biannually since 1990, about 10% of respondents consider their health status to be lower than average. About one third of Estonians smoke on a daily basis, while 30% of male and 9% of female respondents drink vodka or other strong alcoholic beverages at least once a week. Nutrition is not well balanced. Estonians’ eating habits are high in fat consumption and low in consumption of vegetables.
Health Promotion Efforts
In spite of unhealthy lifestyles, preventive or promotional health was both insignificant and disorganized until the very early 1990’s. It was not until after Estonians regained their independence for the USSR that the first step in health promotion was ventured with the establishment of the Public Health Department in the Ministry of Social Affairs in 1993. In the same year, the Estonian Center for Health Education and Promotion was founded and later became a member of the Board of the International Union of Health Promotion and Education.
In Estonia, state financing of health promotion is often looked at as investment in the population’s health and well-being. In 1994 the World Bank Expert Commission decided to give a loan to the Estonian Ministry of Social Affairs to carry out nation-wide programs for prevention of cardiovascular diseases and injuries, family planning and anti-smoking. The loan was given on condition that local funds for health promotion were found. In the same year, the State Health Insurance Fund gave 0.5% of its moneys to finance health promoting projects, and in subsequent years the Health Insurance Fund’s support for health promotion projects in Estonia has been one percent of its income. The funding of the Foundation of Health Promoting Projects by the Health Insurance Fund is thus the cornerstone of health promotion in Estonia.
One important initiative in the promotion of Estonians’ health was the appointment of public health specialists in most counties in 1995. Prior to working in the field, the public health specialists underwent an 18 month training program in cooperation with the Education Authority of England. There, they trained in the basic concepts of health promotion, methods of local analysis, planning, implementation and evaluation of health promotion programs. This joint project was called "Partnership in Building Effective Local Delivery of Health Promotion" and in 1997 it was selected winner in the international category of the Healthier Communities Award in San Francisco.
In 1995, the Estonian Parliament passed the Public Health Law and accepted the Health Policy Document upon which the activities of the Estonian Center for Health Education and Promotion are based. Then a Chair of Health Promotion was established at Tartu University Faculty of Medicine in 1996, thus representing one of the most important actions in changing the attitudes and approaches of medical doctors and in preparation of specialists in health education and promotion.
Projects and Programs
Today, Estonia has numerous different projects and state programs oriented to health promotion. Projects are of two categories: local and nation-wide, but most of the projects are short-term local projects. Project financing takes local needs and possibilities into account and are financed by the Health Insurance Fund on the basis of a competition and acceptance by the Public Health Development Council in the Ministry of Social Affairs. The coordinators of the projects are health promotion specialists in the counties.
Nation-wide health promotion projects are mostly carried out by the Center for Health Education and Promotion. Presently there are five national projects: the AIDS and STD Prevention Program; the National Health Program for Children and Adolescents; the Tuberculosis Prevention Program; the Narcotics Prevention Program; and the Program for Improvement of Public Health.
During the years 1995–1999 health promotion projects addressed the prevention of injuries, heart diseases, hypertension, and promoted sexual health and antismoking activities. In 1998, schoolchildren were added as a target group of health promotion efforts, and Estonia’s 2001 priorities are physical activity, healthy nutrition and innovations in health promotion delivery. The number of financed projects this year is 312 with local projects having 60% of the total health promotion projects budget (6.72 million Estonian Crowns).
Estonia’s goals for the next period on the field of health education and promotion are on the level of societal institutions, settings and individuals:
• To improve effectiveness and quality in health promotion;
• To involve and empower individuals, groups and institutions in health promotion;
• To create equal opportunities and access to health promotion information for population;
• To build community capacity in health promotion;
• To advocate for health.
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|
"Health promotion is the science and art of helping people change their lifestyle to move toward a state of optimal health. Optimal health is defined as a balance of physical, emotional, social, spiritual and intellectual health. Lifestyle change can be facilitated through a combination of efforts to enhance awareness, change behavior and create environments that support good health practices. Of the three, supportive environments will probably have the greatest impact in producing lasting change." (American Journal of Health Promotion, 1989, 3, 3, 5) |
"A Hero for the People"
By Wolf Kirsten
Adhemar Ferreira da Silva, Brazil’s most successful Olympic athlete, died on January 12 of pneumonia at the age of 73 in a hospital in São Paulo. The International Institute for Health Promotion (IIHP) and the international academic community knew Adhemar as a representative of the Universidade Sant’Anna in São Paulo, however, Adhemar was mostly known to people worldwide for his two Olympic gold medals in triple jump. He was the only Brazilian to win two Olympic gold medals, taking the first in Helsinki in 1952 and the second fours years later in Melbourne. He also broke the world record in triple jump seven times in the 1950’s. But Adhemar accomplished so much more in life than his amazing athletic career.
Tough Beginnings
Growing up in an impoverished neighborhood in São Paulo,
Adhemar learned early about responsibility and hard work as his parents spent
the entire day at work leaving him in charge of delivering his father’s lunch
and bringing his mother bundles of clothes which she would wash. But Adhemar
also found
time
to follow his two favorite activities in childhood: soccer and singing in the
church choir. Nevertheless, his parents were intent on providing him with a
sound education, leaving a lasting impression on Adhemar. He got his first
degree in sculpture and fine arts in 1944. A gifted singer, he also competed in
numerous talent shows, winning many prizes singing. At the age of 20, Adhemar
joined the São Paulo Football Club (SPFC) to participate in track and field
activities. After experimenting with a number of disciplines, in 1947
Adhemar’s talent in the triple jump was discovered. From that moment on things
went very quickly, and Adhemar found himself at the 1948 Olympics in London
competing for Brazil. One must keep in mind that he could only rush to training
at lunchtime and weekends as he was still holding a clerical job downtown. His
first trip outside of Brazil (into war-torn Europe) and the 120,000 spectators
at Wembley Stadium were too overwhelming for Adhemar to make a real impact in
the standings. This would not happen to him again.
An Olympic Star is Born
Adhemar established a close relationship with his German coach, Dietrich Gerner, who he called his "German dad", and worked tirelessly on perfecting his technique. By 1951, he had broken the world record. The 1952 Olympic Games in Helsinki brought the first gold medal and another world record. However, the manner in which he accomplished this feat and the surrounding events propelled him to enormous popularity. Adhemar had learned some Finnish (including a Finnish love song) before his trip, and the moment he stepped foot on Finnish soil the people were enchanted by this charming, exotic looking athlete from Brazil. This open admiration culminated after winning the gold medal when he was asked to run around the track to greet the audience in the stadium as they chanted his name over and over again. This is the moment in Olympic history when the first (now common) victory lap was performed. The 1956 Olympic Games in Melbourne, confirmed Adhemar Ferreira da Silva as Brazil’s greatest Olympic athlete of all time as he won a gold medal for the second time. In the meantime, Adhemar had become a professional journalist, city hall employee and physical education instructor. The 1960 Games in Rome were his last, and due to illness (it was later found that he had ganglion tuberculosis) he performed poorly. The highlight of these Olympics for Adhemar was the honor to be the standard-bearer of the Brazilian delegation.
Capacity for Hard Work and Enormous Charisma
Although most of Adhemar’s countless activities were linked to advocacy for amateur sport, he was quite successful in numerous other areas. For example, he became an actor in 1956 and performed on stage in Rio de Janeiro ("Orfeu da Conceição"). This performance led to a role in the now famous movie film, "Black Orpheus", which won an Oscar for Best Foreign Language Film in 1960. Adhemar played the character, Death, in the film. In 1964, Adhemar was appointed cultural attaché at the Brazilian Embassy in Nigeria (until 1967), for which he had to interrupt his law studies. Once again, he made many friends and captivated the people. He used sports, music and popular culture to open many doors for the Brazilian Embassy and focused his work on publicizing the origins and influences of the African people in Brazil. During the following years, Adhemar devoted much of his time to bringing physical education and sports to poor children. While doing this he emphasized the significance of education: "Never neglect studying. Study is the base of life." In addition, Adhemar continued a busy schedule with writing, teaching, lecturing, initiating numerous track and field competitions and representing the country on many occasions. Adhemar himself explained best what sport had given him in life:
"I didn’t make any money as an athlete, but I got something much more important out of athletics…I got a life. Through sport, I was able to meet people from all over the world. Sport brought happiness to my parents and social betterment to me."
In closing, I would like to point out the importance of sharing the life story of Adhemar Ferreira da Silva, especially for those of us who have a strong desire to improve the quality of life through sport and physical education. Brazilian’s President Fernando Cardoso summarizes this thinking in one simple sentence: "Adhemar was an example for all of us."
East-West Conference on Health and Well-Being The purpose of this conference is to bring together scholars from the East and West interested in health and well-being from eastern and western perspectives in order to establish a dialogue between them. The conference is March 23-25, 2001 in Katmandu, Nepal. For more information: http://www.auburn
.edu/~olearvi/eastwestXVII World Conference on Health Promotion and Health Education: "Health: an investment for a just society". The 50th anniversary conference of the International Union of Health Promotion and Education. Paris, France. July 15-20, 2001.
6th Annual Congress of the European College of Sport Science. Hosted by the German Sport University, Cologne, Germany. July 24-28, 2001.
Changing Behaviour: Health and Healthcare. The annual conferences of the European Health Psychology Society and the Division of Health Psychology, British Psychology Society will be held as a combined event at St. Andrews University, Scotland in September 2001. Full details at the conference website: http://www.st-andrews.ac.uk/academic/psychology/events/health2001.html
2nd International Conference on Movement and Health. Organized by the Faculty of Physical Culture, Palacky University, Olomouc under auspices of ICSSPE. Olomouc, Czech Republic, September 15-18, 2001.
6th Annual IIHP Meeting. Hosted by Palacky University in Olomouc, Czech Republic, September 18-21.
International Institute for Health Promotion Newsflashesby Wolf Kirsten
New Managing Director for the IIHP
The IIHP hired Vivian Blaxell as the new managing director. Vivian was the managing editor of Global Perspectives during the past year. Vivian hails from Australia via Japan, Hawaii, and Vermont. She was a practicing RN (registered nurse) for ten years, and holds a Ph.D. in political science from the University of Hawaii. She has been recipient of numerous academic awards, grants and fellowships for research on Japanese and Southeast Asian topics, ranging from colonialism, through capital punishment, to AIDS education. Prior to moving to Washington, DC, to study for the MFA in Creative Writing at American University, Vivian was Professor of History and Politics at Marlboro College in southern Vermont, USA.
Vivian's e-mail address is vivianuccia@earthlink.net, and she can be contacted by telephone at her office: 1-202-885-6281 or on her mobile number: 1-202-549-3965.
International Health and Productivity Conference
The Health Enhancement Research Organization (HERO) hosted an international conference on the most recent research related to health and productivity issues in Washington, DC on February 12-14. As employers feel the pressures of being profitable in today’s fast-paced world of globalization, increased significance is being placed on the productivity of the organization and the individual. This is especially true of knowledge workers whose numbers are growing exponentially. It has been suggested that a healthy worker is a productive worker. However, the hard data to prove this has been lacking. To this end, a growing number of organizations and scientists have been engaging in a variety of innovative health and productivity research projects. In addition to absenteeism and disability studies, efforts are being made to investigate the phenomenon of "presenteeism", a term which describes present but unproductive workers. Speakers at the conference included Thomas Donohue, President and CEO of the U.S. Chamber of Commerce, Dr. David Satcher, Assistant Secretary of Health and Surgeon General, and Dr. Ronald Kessler of Harvard University Medical School. For more information please see http://www.the-hero.org on the internet.
Building Health Promotion into the National Agenda
The Annual Art and Science of Health Promotion Conference took place in Washington, DC this year and focused on advocating health promotion issues to the US Congress. A large group of participants went to Capitol Hill to speak with their Senators and Representatives and urge them to pass a resolution supporting health promotion. Although more of a national matter, international professionals can learn from this process with regard to health promotion advocacy within their setting (local, national, international). The goal is to make health promotion an integral part of health care in all elements of U.S. society. Fifty percent of premature deaths in the U.S. are related to modifiable lifestyle factors, and chronic diseases related to lifestyle factors account for 70% of the nation’s medical costs. Nevertheless, U.S. Government spends $1,390 per person per year to treat disease and $1.21 to prevent disease. Additional research and development of new programs is required. A broad-based coalition of employers, health-care organizations, advocacy groups and health promotion vendors supports this initiative. For more information please see http://healthpromotionconference.org/2001conf/advocacy_effort.htm.
New Book on Workplace Health Promotion
Delmar Publishers recently published the 3rd edition of Health Promotion in the Workplace by Michael O’Donnell. The book includes a chapter on "Global Perspectives in Workplace Health Promotion", written by Wolf Kirsten. This chapter came together thanks to the contributions of many IIHP members.
The International Institute for Health Promotion (IIHP) is a global center for the development and advancement of health promotion policies, programs, services, and research that maximizes multiple efforts across the globe. It was established in 1994 as an addition to the National Center for Health Fitness at American University in Washington, DC, to assist in leading, facilitating, and coordinating the efforts of many international individuals and organizations. More than 50 cooperating members from 25 nations form an extensive interdisciplinary health promotion network that includes ongoing dialogue, information exchange and project participation. Email the IIHP at iihpaa@american.edu. The IIHP website is http://www.healthy.american.edu/iihp.html.
Individuals and organizations are encouraged and authorized to print one copy, in full, of this issue of the online version of Health Promotion: Global Perspectives. Furthermore, readers are authorized and encouraged to print multiple copies of the issue, in full, and distribute it to colleagues, after permission to reproduce has been secured from American Journal of Health Promotion, Inc. In your request, please specify the number of copies you wish to make and the types of people you will send them to. Under no condition can portions of the issue be reproduced and under no conditions can copies be sold.
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