Barriers to community development

• Resource allocation, funding, skills and knowledge to implement policy change ect, conflict within leadership (cultural values ect)
• Activism and anti-health advertising (ads, protests)

empowerment strategies that a health promotion practitioner might undertake to increase citizen power.

Participation, community-based organisations, local leadership, resource mobilisation, assessment of problems within the community

What is required for a health promoter to work effectively within communities?

They need to spend time with community members and demonstrate that they can help supply some of the needs or wants of the community

health promoters must become known and trusted by the community

The different levels of citizen participation

• (Non-participation) Manipulation, Therapy
• (Tokenism) Informing, consultation, placation
• (Citizen power) Partnership, delegated power, citizen control

Ethics based values consider why those specific actions are the right actions not only for individuals but as a whole. Individual values may see that specific policies are better for themselves than others eg: no smoking policies, safe injection clinics, sex education.

Health ethics encompasses all parties involved with the health intervention. Policy maker, health professionals, medical system, governments, individuals and population groups

Take into consideration the principles of ethics based health promotion as a professional

Data quality assessment template detailed in Table 3 outlines each of the 7 elements and the specific questions you should be asking yourself in relation to the data you are analysing to see if it meets the data quality criteria.

Does it use common methodologies? Is it consistent with its data collection? does it use standard concepts, classifications and target populations?

Coherence means it consistently uses the same methods in data collection.

Is it accurate. Does it correctly describe the condition? Major sources of errors detailed in Box 2. show how certain factors impact overall validity of the information.

Does it portray the measured concepts/data in a manner that is easily interpreted. Measurements of accuracy, metadata?

Does it allow users to easily access all required information. Cost to access?

Time between collecting the data and presenting the information. ( is the data recent? )

Does it meet specific needs in relation to measurements, populations.

Assess data origin and quality (who/what governed the collection). Influences validity and reliability

Fig 2. details the process in which the 7 elements are used during the assessment process

7 elements of of data quality. All are considered in the assessment process however some are more important than others

Does the gathered data meet the specific research requirements ie; what was their methodology for data gathering, does it cover a broad amount of variables. is it limited to only specific population groups, age groups ect.

Monitoring areas for data sources vary depending on what type of disease/condition is under investigation. This may mean specific data sets will be left out and additional ones may be included.

Table 1. provides useful information on the specific information needed to be gathered from data to see whether or not it will be viable against the topic in question

bottom up pressure.

It is important for all parties concerned in health equity understand the multiple facets involved with this change and how one cannot work without the others.

Nutcracker effect: where politicians and policy makers implement policy to effect change within societies on the SDoH (Top down) and the individuals come together to implement those policies at a community level (Bottom up) This is pertinent as the nutcracker effect will only cause change when both work simultaneously as if only one is to implement change then the nutcracker will not work.

Living in areas with access to healthy food choices, as well as affordable strongly dictates the choices individuals and societies make.

Having a strong community makes it easier for individuals to implement change.

Modern medicine takes an individual approach instead of a population. making it easy to treat individual conditions multiple ways but hard (expensive) to implement for whole populations.

Target the entire population, but utilise strategies to further target those at the lower end of the social gradient

Unless policies are well planned to combat health determinants, they may be more beneficial for people of higher socioeconomic status. This is due to the SDoH, eg; social conditions, born, grown, live, work, age.

in certain circumstances if health promotion is looked at with an equality lens and not equity then policy change may further increase the gap between the most and least healthy within certain population and health groups.

For policies to provide substantial change it is up to societies to implement these changes at an individual level which will then provide a greater impact at a group and community level

Knowing that there are a multitude of viable options to remediate health inequities that lie outside of the health sector. It is therefore up to policy makers to ensure that sectors outside of health understand they can play an important role and must work with the health sector in implementing strategies.

Inability to take decisive action on SDoH policies is why equity gaps within certain population groups is not changing.

Evidence on the inequalities that in turn form inequities within countries allows for specific changes to be made to certain groups and societies.

Practical action both individually and as a society is fundamental in creating change within the SDoH.

Joined the Hypothes.is group