Charlie Roberts, a pharmacy student and our student ambassador, recently led a lively webinar, organised jointly with IHPE and the University of Nottingham (UoN). The event aimed to increase recognition of the Determinants of Health.

What do we mean by ‘Determinants of health’? And does it matter? Charlie himself kicked off the webinar with a clear explanation of the ‘rainbow’ model of health determinants, outlining the many influences on health: from our home, school, work and wider environment.

IHPE provided a discussion panel, with diverse interest and experience:

  • Karen Neil, pharmacology, public health and mental health;
  • Katherine Whittingham, BSc Health Promotion course lead at UoN;
  • Robin Lansman, osteopathy and health promotion;
  • Sylvia Cheater, dental public health, nutrition and settings based approaches.

Each shared their own stories of first insight into the way that life conditions are so integral to people’s health. For some it was seeing the challenges of deprivation, ability to access healthy food and support services, or needs for changed circumstances. Katherine said that whatever we try to do in acute care, ‘wider determinants of health make more challenging’ and Sylvia noted, day to day work can be ‘pointless unless we look at the bigger picture’. As healthcare professionals, we must proactively take account of the wider context, promote access and advocate for people’s health circumstances.

Reaching people. The panel responded to Charlie’s questions and to many posted by attendees. They talked about meeting people where they are; exploring what health means to each and what is needed; engaging and sharing ownership of aims and goals to find health individually; thinking about health holistically and across the whole lifespan. The panel pointed out the current challenges of disinformation and the value of accessible, quality resources for health. Pharmacists, other professionals and the IHPE can help build understanding.

What strategies can we use? What knowledge and skills do we need? To take account of health determinants, pharmacies can be positioned in the local community, alongside community services. Public facing roles and non-pharmacological management (eg social and green prescribing) can be developed.

Looking at the benefits of collaborative working, we heard an example of work in an area of deprivation with high rates of teenage pregnancies, where services were underused but engaging with young people’s preferences made a difference. Collaborators can work towards common goals but will have differing priorities and requirements. We need skills for partnership working and communicating, so that agencies can ‘get on the same page’ and contribute to healthy outcomes. This can be encouraged from the top down and through creating structures to encourage multi-agency collaboration.

How can we strengthen health promotion for the future? There’s great value in working together and sharing cross-disciplinary encounters. This can start in learning together. Evaluating the work that we do is really key; reporting and recording positive health indicators will help to build effective practice. In the workplace, efforts to remove barriers, provide funding and resource for health promotion, with a holistic approach to health at every level will carry us forward. This needs everyone’s input and as Sylvia highlighted ‘the health promotion job is never done’. The principles enshrined in the Ottawa Charter in the 1980s stand true, with the concepts of social determinants of health at the heart of the picture.

Students and teachers need to look for understanding and relevant skills integrated across course curricula.

The Institute of Health Promotion and Education has a huge role to play in ensuring that practitioners in diverse roles across health, social care, education and beyond have health promotion at the forefront of our thinking, continuing professional development and practice.

 

More about the ‘rainbow model’ of the determinants of health: The Dahlgren-Whitehead model of health determinants: 30 years on and still chasing rainbows – ScienceDirect (rgu.ac.uk)

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