Introduction
Health promotion has gained increased application in the management of health problems at individual and community levels.
Health promotion is the process that enables individuals and communities to have greater control over their overall health wellbeing with the sole aim of improving it. In recent times, health promotion has enabled populations to realize their aspirations and satisfy their health needs (World Health Organisation, 1986). The environment plays a major role in determining the physical and mental well-being of individuals. To bridge the knowledge gap in the understanding of health, health promotion is applied to enable individuals to identify and cope with the health problem. Therefore, this essay will explore a health promotion priority with regard to its significance, population at risk, and the determinants of physical activity and active communities.
The Department of Health Services in Victoria, Australia has set health promotion priorities aimed at improving health and reducing the level of inequalities in health matters. To enhance the understanding of the process and theoretical frameworks, the promotion of physical activity and active communities in Victoria will be discussed. The promotion of physical activity and active community is one of the seven priorities in health promotion (Australian Institute of Health and Welfare, 2002). The underpinning principles of the framework are imperative in tackling health problems in society. This involves a better understanding of all the health determinants based on evidence in order to chart a better and informed course of action (Department of Human Services, 2006, p.4).
The social determinants of health vary depending on the geographical location and vulnerability of the population. Edmonton Social Planning Council (2005) asserted that education, housing, and employment are important determinants of health that predispose the human body to foreign invasion. The social, economical and physical factors predispose humans to risks that result in deviation of the body from normal processes. This ultimately causes diseases that place a heavy burden on the individual and the society (The Royal Australian College of General Practitioners, 2006).
Significance of physical activity and active communities
Physical activity entails activities such as sport, active recreation, active transport, and work-related activities which help in maintaining a healthy body. The physical health benefits of indulging in physical activity are lower blood pressure and cholesterol, healthy body weight, and reduced risk of experiencing bone fractures. Physical inactivity causes obesity, especially in women and girls. Obesity-related diseases such as type 2 diabetes, osteoporosis, coronary heart disease and gestational diabetes may affect the individuals. In 2008, around 316,000 women had type 2 diabetes while another 12, 400 pregnant mothers had gestational diabetes in Australia (Australian Bureau of Statistics, 2009). Chronic diseases associated with physical inactivity account for around 1.9 million related deaths globally (World Health Organization, 2009). It is estimated that around 30% of Australian women are overweight while a further 24% are suffering from obesity. Victorian women are at a higher risk of developing a hormonal disorder, polycystic ovary syndrome, which is believed to directly affect more than 9% of Australian women (The Jean Hailes Foundation, 2009). The total cost to health care for treating disorders associated with physical inactivity is around $ 1.5 billion.
The percentage of the population involved in physical activity and the numbers of active communities are dismally low. This is supported by data from National Health Surveys in the last decade. Lack of physical activity is a societal determinant with the capability of producing dangerous risks to individuals and the population. Experimental studies have shown the existence of a great relationship between physical activity and health (American College of Sports Medicine, 1990, p.268). It has been observed that sedentary adults are more likely to suffer from cardiovascular disorders and other chronic diseases compared to physically active people. The most common disorders in physically inactive people are hypertension, osteoporosis and anxiety (Morris et al, 1966, p.535). Physical inactivity also causes depression, coronary heart diseases, diabetes mellitus and colon cancer. Documented evidence denotes that physical activity is vital in conferring protective effects to individuals against chronic diseases and cardiovascular disorders (Leon et al, 1987, p.2834).
According to the Victorian Population Health Survey (2007), the levels of physical activity in Victoria showed that 35 % of males and about 39% of women participated in little or no physical activities. Gippsland recorded lower figures of 36 % in males and 38% in females. Participation in physical activity was high in several adult age groups: 25-34 (67%), 45-54 (63%) and 55-64 (68%).
The survey also noted that 64.2% male and 61.2% of females spent ample time in physical exercises and activity. The participation rate was 15.5% for organized sport and 36.6 % for unstructured participation for the general population. Data on inactivity based on the hours spent at work showed that 20.5% of the population was inactive for 20-34 hours while 13.7% were inactive for less than 19 hours (Australian Bureau of Statistics, 2009). The main methods of determining physical activity in children were through participation at school and in specific activities, and transportation mode to and from school. In particular, statistics showed 70% of children used vehicles as their mode of transport to school in 2003 compared to 23% in 1973. (Australian Bureau of Statistics, 2009).
Priority groups
Based on the above barriers to physical activity, several categories of the population may be considered as target groups. However, the main populations at risk include low-income children and families, women and young people (5-20 years). Females recorded lower levels of participation in physical activity and organized sport as compared to males. According to the Victorian Population Health Survey (2007), 57.6% of females compared to 61.4 % of males had regular activity. This concurred with a study carried out by Leon et al (1987) which noted that men were more likely to be involved in physical activity and sports than women. The main barriers to physical activity in women and young people from 5-15 years are inadequate time, parenting demands, lower socioeconomic status, body image, rapid urbanization, existing health conditions, lifestyles and sexual orientation. Their increased risk of inactivity is due to financial resources and time to undertake specialized services such as attending gyms, riding and cycling. The women, particularly housewives, are more susceptible due to limitations to home care thus lacking time to carry out exercises like walking and jogging. The women are also affected by the attitudes that are associated with physical activity. Negative attitudes and perceptions that physical activities like attending gyms are a man affair are also responsible for the decline in women participating in exercises.
Children and the youth are priority groups due to their demanding schedules in schools and the temptation to spend much time in electronic media. Most of the young people were students and pupils who spent most of their time in classrooms. Furthermore, a decrease in the number of students who walk to school is another factor that puts them at higher risk since they lacked time to exercise. In particular, statistics showed 70% of children used vehicles as their mode of transport to school in 2003 compared to 23% in 1973. The advancements in technology and mass media communication have predisposed the young generation to inactivity. Young people are estimated to spend several hours glued to electronic media particularly television, movies and computer games. The utilisation of the internet as a form of entertainment has resulted in children and youth wasting most of their daytime hours in these activities. Lack of interest and emphasis on school-based co-curricular activities especially in female students is another deterrent factor that makes them inactive thus predisposing them to cardiovascular disorders.
Determinants of physical activity
Social determinants play a big role in the understanding of the promotion of physical activity and active communities (O’Hara, 2005). Socio-economic factors such as financial resources increase the level of inactivity in low-income families. Tertiary educated people were more likely to participate in physical activity hence confirming that education influences health behaviours. Persons who achieved tertiary education recorded participation levels of 63.6% compared to 40.6% in the primary category (Vic Health, 2002). Education has the effect of instilling knowledge about the impacts of physical activity on individuals.
The health iceberg model utilises the iceberg, which is 90% submerged, to explain the relationship between the disease and its determinants. The model relies mainly on addressing the symptoms with a special interest in deviations in cellular and metabolic processes. This is the premise that helps in the explanation of the iceberg model of disease management. The lifestyle that is embraced by several people plays an important role in determining their health since the diet and involvement in physical are vital in regulating body processes. The models assert that the achievement of healthy living is dependent on the adoption of the most appropriate choices in diet and lifestyles thus improving the body’s metabolic processes which in turn help address diseases determinants. The correct coexistence of these factors at all levels is pivotal in perpetuating healthy living. The model also acknowledges the need to understand and address the cultural and psychological factors that lead to the embracement of the lifestyles.
Based on the health iceberg model, education and employment levels of the population had positive and negative impacts respectively in the uptake of physical activity as healthy behaviour. Furthermore, limitation in resources has resulted in unhealthy behaviour which has serious implications. Low-income families lack savings to pay for sophisticated services and to enroll in sports clubs in Australia. The strenuous exercises and the resultant need to be on a special diet while engaging in strenuous sporting activities put off many women and low-income families. These factors impact negatively the level of participation in sporting activities. The families and individuals are demotivated thus leading to a high level of physical inactivity in Australia. About 45 % of the Victorian population involved themselves in regular sporting activities while a further 72.2% believed that the population was an active community (Pope, 2006). This translates to physical inactivity in more than half of the population. Physical inactivity leads to diseases that may incapacitate individuals and increase the cost burden to society which is estimated to be around $ 1.5 billion.
Occupation influenced the level of inactivity particularly for workers who spent long hours in offices. It is alarming that 20.5 % of the workforce spent about 20-34 hours being physically inactive (Australian Bureau of Statistics, 2009). This predisposed them to risks such as stress, fatigue and low blood pressure that might have resulted in cardiovascular disorders. The nature of work was the main determiner of the level of activity. The rise of the service industry has resulted in many white-collar jobs has contributed to the rise in physical inactivity. This is because the workers are required to spend most of the time sitting and using efficient technology that lowers movement from their seats. The immobility is detrimental in allowing normal blood flow, proper digestion and water balance in the body (Hancock & Penkins, 1985).
Strains and pressure to perform better in examinations and save time forced 70% of the students to use faster means of transport that predisposed them to physical inactivity. The lifestyles choices adopted by the school-going children are mainly compromised by the restrictions and the pressures from the parents and the school management. For instance, the lack of adequate time allocated for extracurricular activities in Victorian schools has negative implications for the students. It discourages the growth and development of positive behaviours towards physical activity. This makes the children believe that exercising is not overly important in maintaining healthy lifestyles. The insistence of parents to enroll their children in schools far away from home is detrimental since it denies the children walking time, which is a major component of physical activity. Lack of physical activity may lead to obesity which may result in cardiovascular diseases such as coronary heart disease and hypertension (Hancock & Penkins, 1985).
Personal reasons and distance to recreational facilities determined the utilization of the facilities and embracing of physical activity as part of everyday life. Only 15.5 % of the population participated in the organized sport thus depicting personal choice, socioeconomic and distance may have dissuaded people from participating. Personal choice is mainly informed by socioeconomic and cultural factors in society. This may have influenced the majority of the women from participation in recreation activities. (Hancock & Penkins, 1985).
Almost half of the population is over 65 years age group is sedentary thus making them vulnerable to heart conditions. With about 35% of the whole population having little or no time for physical activity, the consequences of inactivity may be huge for society to bear. This is a major contributor to the cost burden of $1.5 billion dollars used by the Australian government in treating disorders related to physical inactivity (Australian Bureau of Statistics, 2009). The social determinants and the psycho-socio-cultural determinants are in play thus contributing to the perceived risk of physical inactivity. Physical activity has protective effects against cardiovascular disorders and polycystic ovary syndrome in women. This is through reducing the risk factors such as high blood pressure and anxiety associated with cardiovascular diseases (Commonwealth Department of Health and Aged Care & Australian Institute of Health and Welfare, 1998).
Conclusion
Health promotion has played a major role in enabling people to identify and control health problems in society. The understanding of the social determinants of health is important in the effective management of health promotion priorities. Promotion of physical activity and active communities is important in the understanding of the social, physical, environmental, and economic determinants of health risks (Glanz, 1996). The number of deaths and the heavy burden on the government make it imperative for a clear understanding of this topic. The main populations at risk include low-income children and families, women and young people (5-20 years). Occupation, distances, personal choices have greatly influenced the level of physical activity in Australia. The application of the iceberg model of health enables a holistic approach in the discussion of the determinants of health. Health promotion priorities are useful and effective in addressing perceived health problems.
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