CHAPTER 5

HEALTH PROMOTION

1. Reading
Focus
A. Before you read

1. Do people have similar levels of health?

2. Is health one of your basic needs?

3. What will happen to you if the health needs are not met?

4. How do you promote or improve the level of your health?

B. Read the text carefully

Due to many reasons, people experience different levels of health, they suffer
differently from diseases and disability, and they die at different ages.
Inequality in health is a fact of life. Some of the inequalities in health within
and between societies are due to forces beyond an individual’s control, such
as variations in natural resources and geography. However, some health
inequalities are due to social injustice – unfair circumstances that society
should not tolerate. Examples include discriminatory practices based on race,
gender, and culture, and a society’s failure to provide basic health care to all
people irrespective of their economic circumstances. Health inequity arising
from social injustice should not be tolerated. Health is a basic human and
societal need, and health equity is therefore a basic human right. One’s ability
to function physically, mentally, socially, and, in many cultures, spiritually
has critical implications for one’s autonomy. Furthermore, the health of a

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society’s members has important implications for the quality of functioning of
the society as a whole.
Thus an important aim – many would say the main aim – of health
promotion is the elimination of health inequity and a narrowing of health
inequality to the smallest possible margin. The practical challenges in this
undertaking are daunting, to say the least. One could conceive narrowing the
health inequality gap by a reduction in the level of health among the healthiest,
as well as by improving the level of health of those with poor health, but the
former approach would be absurd. Further, the determinants of health have
much to do with how resources are distributed in a society. Any redistribution
of resources intended to reduce health inequality requires political action,
taking health promotion beyond the confines of what is usually thought of as
public health practice.
There is no simple answer to the question ‘What is health promotion?’
People who consider themselves health promoters may have very different
professional roles, backgrounds, and perspectives on the nature of health itself.
The definition of health promotion given by the World
Health Organization (WHO) in 1986 is in the Ottawa Charter for Health
Promotion, and reads:
Health promotion is the process of enabling people to increase control
over, and to improve, their health. To reach a state of complete
physical, mental and social wellbeing, an individual or group must be
able to identify and to realize aspirations, to satisfy needs, and to
change or cope with the environment. Health is, therefore, seen as a
resource for everyday life, not the objective of living. Health is a
positive concept emphasizing social and personal resources, as well as
physical capacities. Therefore, health promotion is not just the
responsibility of the health sector, but goes beyond healthy lifestyles
to wellbeing.

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 The definition of health promotion given by the American Journal of
Health Promotion (AJHP) in 1989 stands in contrast on several points of
comparison:
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 Jour nal of Health Promotion:
http://www.healthpromtionjournal.com)

Thus, the ‘legitimate’ territory of health promotion can range from

empowerment to the prevention of birth defects. Many critics decry the present
lack of precision and agreement about the definition of health promotion, but
it is clear that one view is growing in influence worldwide – that of the WHO
as expressed in the Ottawa Charter for Health Promotion.
Although the terms are often used in tandem, health promotion is
distinguishable from disease prevention. Disease prevention has in practice
mostly to do with reducing the burden of chronic and infectious diseases by
preventing their expression in the first place, by reducing the levels of risk
factors for the diseases, and by intervening at early stages so diseases do not
progress to more serious stages. Since unhealthy lifestyles can increase risk
for many diseases, lifestyle modification is an important element in disease
prevention. Education about the lifestyle-disease link, and ways to live a
healthier lifestyle, aim to help individuals make healthy choices. There is also
some attention to making changes in peoples’ environments, to facilitate
healthy lifestyles. Disease prevention efforts tend to be compartmentalized,
with specialists working exclusively or almost exclusively with heart disease
prevention, cancer prevention, diabetes prevention, and so on. This situation

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is often criticized, because many of the same risk factors underlie a large
number of diseases. It is argued that a whole-person approach to disease
prevention is more logical than a disease-specific approach.
Health promotion is less concerned about specific diseases, although
much of what is labeled as health promotion does include disease prevention
as characterized above. However, health promotion places great emphasis on
how individuals’ choices are limited by circumstances beyond their control. It
is believed that policies are needed in all societal sectors, including the private
sector, that create environments that support healthy living. There is also
emphasis on empowering people to control their own health, and building
individuals’ and communities’ capacities to identify and solve the health
issues that are their own priorities. Because health inequalities within and
between societies are exacerbated by social injustice, health promotion is
compelled to enter the political arena, and advocacy for social change is an
important health promotion strategy.
(Adapted from M B Mittelmark, Kickbusch, I Rootman, K Tones, in
International Encyclopedia of Public Health)

C. Translate this text into Indonesian

New Vocabulary :

well-being = kesejahteraan attitude = sikap

companionship = persahabatan value(s) = nilai

infancy = masa kecil cope(-ing) = menangani

adolescence = masa remaja

achieve = mencapai

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 2. Vocabulary Focus

A. Complete the blank spaces with the words in the box.

companionship infancy adolescence Well- being

achieved attitude value cope

1. It is a relief to have _______our goals.

2. She clearly has a good _______ towards health and fitness.

3. After being hospitalized for a few weeks, he realized the ________ of health for

his life.

4. I think he missed the _____ of his colleagues in a clinic.

5. His ______ was not a happy time for him. He was abandoned by his father at the

age of 15.

6. We must try to _____with our stress.

7. There are a number of factors which affects our_______, one of which is the

degree of our health.

8. He came to Jakarta in his ______, around five years of age.

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B. Match the words on the left with their synonym.

1. Companionship A. strain
2. Infancy B. opinion
3. Adolescence C. do successfully
4. Well-being D. friendship
5. Cope E. indifference
6. Anxiety F. childhood
7. Attitude G. manage
8. Stress H. worry
9. Apathy I. puberty
10. Achieve J. Welfare

3. Grammar Focus

MODAL AUXILIARIES

A. Learn the following sentences.

1. At times of stress our normal ways of coping may not be adequate, and
mental disorder can be the result.

2. Because of illness or lack of breast milk, a mother has to feed her baby with
a bottle.

3. After the feeding, the bottle should be emptied and then washed
thoroughly.

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 The sentences above illustrate the use of modal auxiliaries or modals. A
modal is used to add special meaning to the main verb, eg to indicate ability,
permission, possibility, obligation, etc. The modals that we are going to focus on :

MUST/HAVE TO, SHOULD/OUGHT TO, MAY/MIGHT, CAN/COULD

PERMISSION

(CAN, COULD, MAY, MIGHT)

1. Can/Could I buy this medicine freely ?

2. I wonder if the patient who suffers from coronary heart disease may/might
eat fatty food.

OBLIGATION/NECESSITY

(MUST, HAVE TO)

1. People must keep their body and sanitation clean and healthy.

2. A patient has to be informed his prognosis and diagnosis.

ABILITY

(CAN, COULD)

1. The public health students can discuss this medical information with their
lecturer.

2. The patient could not move his legs when he was taken to the emergency
unit.

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 ADVICE

(SHOULD, OUGHT TO)

1. In order to avoid boredom and repetition, one should make health

education session entertaining, with local music, or songs.

2. A person ought to drink plenty of fluids to prevent kidney stones from

occurring.

B. Complete these sentences by using must, hould, or may/might/could with the

expressions in the list. The answer can be more than one possibility.

(a) do relaxation exercises (b) take regular exercises (c) feel terrible
(d) have a hypertension (e) swallow the tablets easily (f) ask a doctor
2. A patient has to be informed his prognosis and diagnosis.

(g) see a doctor (h) have enough protein intake (i) boil
(j) have their blood pressure checked

1. A : you’re coughing and sneezing, blowing you nose, and running a fever.
You Should see a doctor

B : I do.

2. A : You seem to have a stress.

You__________ to relieve your stress.

B : I think so.

3. A : He has had a headache for a few days.

B : He ________ immediately.

4. A : I have a heart disease.

B : I think you ____________.

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5. A : You are overweight. You need to lose weight.

In this case, you _______to recommend a suitable diet.

B : Exactly.

6. High blood pressure can increase your risk of having stroke or heart attack.

Every adult ____ every few years by their GP.

7. One __________ if his systolic is greater than or equal to 140 and his diastolic

pressure is greater than or equal to 90.

8. She ________ even though they are bitter.

9. Children _______________every day.

10.To eliminate bacteria, people __________their drinking water.

C. Use either should or must/have to in the following.

1. A person ______ eat in order to live.

2. A person _____ eat a balanced diet.

3. If you want to become a public health practitioner, you _____go to public health

school for a few years.

4. People who have a stress ______smile and laugh more often.

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5. The man who is seriously injured because of the accident _____be taken to the

hospital as soon as possible.

6. Children under five years of age ______come to the clinic with their parents.

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