Welcome to Health Promotion (Unit AS 3: Health and Well-Being)
Hello and welcome to your revision notes for Health Promotion! Health promotion is a core topic in Unit AS 3: Health and Well-Being for CCEA AS Level Health and Social Care. Don't worry if this topic feels broad at first—we are going to break it down into clear, bite-sized sections so you feel completely confident heading into your exam.
In this chapter, you will learn how health is defined, explore the five distinct approaches used to improve public health, and examine the organisations that put these approaches into practice across Northern Ireland.
---1. Foundational Definitions: What is Health and Health Promotion?
Before exploring how health is promoted, we need to understand what "health" actually means. Examiners often look for official definitions, so memorising these key phrases will earn you easy marks!
The World Health Organization (WHO) Definitions
• Health (WHO, 1948): "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."
• Health Promotion (Ottawa Charter, 1986): "The process of enabling people to increase control over, and to improve, their health."
Understanding Holistic Health: The PIES Model
In Health and Social Care, health is viewed holistically (looking at the whole person, not just a physical illness). When evaluating health promotion campaigns, you must link their impact back to all four PIES needs:
• P – Physical needs: Biological health, diet, fitness, avoidance of disease, and physical safety.
• I – Intellectual needs: Acquiring knowledge, understanding health risks, problem-solving, and literacy.
• E – Emotional needs: Self-esteem, stress management, feeling in control, and emotional resilience.
• S – Social needs: Relationships, community support, interacting with peers, and feeling included.
Key Takeaway: Health is not just about avoiding sickness. Health promotion is about giving people the power and tools to improve their physical, intellectual, emotional, and social well-being.
---2. The Five Approaches to Health Promotion
The CCEA specification requires you to know five specific approaches to health promotion. For each approach, you need to understand its aim, focus, strengths, and limitations.
Memory Trick: Remember the acronym M-E-B-F-S (Medical, Educational, Behaviour Change, Fear Arousal, Social Change).
---Approach 1: The Medical (Biomedical) Approach
Aim: To prevent disease, reduce morbidity (illness) and mortality (death), and eradicate infectious or physiological conditions.
Focus & Methods: Clinical interventions led by medical experts. Examples include routine immunisation/vaccination schedules (e.g., MMR, flu vaccines) and screening programmes (e.g., cervical, breast, and bowel cancer screening).
Strengths:
• Highly evidence-based and scientifically proven.
• Delivers high public trust because interventions come from top-down medical experts and doctors.
• Highly effective at eradicating specific infectious diseases.
Weaknesses / Limitations:
• Reactive rather than proactive; tends to treat the physical body like a machine rather than addressing lifestyle factors.
• Reinforces patient dependency on doctors and medical professionals.
• Ignores the wider socioeconomic causes of illness (e.g., poverty, poor housing).
Approach 2: The Educational Approach
Aim: To provide objective information, facts, and understanding so individuals can make their own voluntary, informed choices about their health.
Focus & Methods: Sharing neutral facts without judging or coercing people. Examples include nutritional food labelling on packaging, sexual health leaflets in clinics, and classroom-based health education lessons.
Strengths:
• Respects individual autonomy and personal freedom of choice.
• Empowers people with the knowledge needed to make healthier decisions.
Weaknesses / Limitations:
• Assumes that knowledge automatically leads to action (this is known as the "knowledge-action gap"; for example, people know smoking is harmful, but still smoke).
• Ineffective if materials contain complex language or jargon, creating barriers for people with lower literacy skills.
Approach 3: The Behaviour Change Approach
Aim: To actively encourage and persuade individuals to adopt healthier lifestyle habits and abandon harmful behaviours.
Focus & Methods: Changing personal habits. Examples include smoking cessation services, campaigns encouraging 30 minutes of daily exercise, reducing alcohol intake, or eating five portions of fruit and vegetables a day.
Strengths:
• Directly tackles the leading avoidable causes of major non-communicable diseases (such as coronary heart disease, stroke, and type 2 diabetes).
• Gives individuals personal responsibility for their lifestyle choices.
Weaknesses / Limitations:
• Can result in "victim-blaming" by assuming people have total freedom to change their habits.
• Fails to account for major socioeconomic barriers (e.g., lack of affordable healthy food in deprived areas, poverty, high stress levels).
Approach 4: The Fear Arousal Approach
Aim: To shock, scare, or induce anxiety to deter individuals from engaging in dangerous or harmful behaviours.
Focus & Methods: Shock-tactic campaigns using graphic images, alarming statistics, and distressing scenarios. Examples include graphic photos of diseased organs on cigarette packets, and hard-hitting anti-drink-drive or anti-speeding road safety adverts on television.
Strengths:
• High initial impact; creates a memorable and strong emotional response.
• Rapidly increases public awareness about severe consequences.
Weaknesses / Limitations:
• Can trigger psychological rejection or denial (individuals convince themselves: "That won't happen to me").
• People can become desensitised to graphic imagery over time or simply avoid looking at the campaign altogether.
Approach 5: The Social Change (Societal / Policy) Approach
Aim: To change the legal, economic, and physical environment so that making the healthy choice becomes the easiest or default choice.
Focus & Methods: Laws, regulations, taxation, and structural changes. Examples include the smoking ban in enclosed public places, the sugar tax on soft drinks, minimum unit pricing on alcohol, mandatory seatbelt laws, and clean air zones.
Strengths:
• Reaches the entire population regardless of individual motivation or literacy levels.
• Removes sole blame from the individual by targeting structural and environmental inequalities.
Weaknesses / Limitations:
• Can be viewed negatively as "nanny state" interference that restricts personal freedom.
• Takes a long time to pass legislation and can face heavy political or industrial opposition.
• Often expensive to implement and enforce.
3. Organisations That Promote Health
In Northern Ireland, health promotion is delivered by both the statutory sector and the voluntary sector.
Statutory Sector (Government-Funded)
• Department of Health (NI): Responsible for setting overarching public health policies, strategies, and funding.
• Public Health Agency (PHA): The main regional body responsible for protecting and promoting public health in Northern Ireland. They run public health campaigns, commission research, and provide screening guidance.
• Health and Social Care (HSC) Trusts: The operational bodies that deliver healthcare on the ground across specific regional areas (e.g., Belfast HSC Trust, Northern HSC Trust, Southern HSC Trust, South Eastern HSC Trust, and Western HSC Trust).
Voluntary / Charity Sector (Non-Governmental)
Charities focus on raising awareness, supporting research, and providing direct assistance for specific health issues. Key regional examples include:
• Cancer Focus NI: Provides cancer prevention education, smoking cessation support, and patient care.
• Chest Heart & Stroke NI: Works to prevent chest, heart, and stroke illnesses through health checks and lifestyle advice.
• Action Mental Health: Focuses on improving mental health, reducing stigma, and supporting emotional well-being.
4. Common Exam Pitfalls and How to Avoid Them
To secure top-band marks in your 2-hour AS 3 written exam, watch out for these frequent mistakes reported by examiners:
1. Confusing "Educational" with "Behaviour Change":
• Educational: Gives neutral facts and information so the person can decide for themselves.
• Behaviour Change: Actively tries to persuade or modify a person's lifestyle habits.
2. Giving One-Sided Evaluations:
If an exam question asks you to evaluate an approach, always provide both strengths and limitations. Mentioning only the positive side will cap your marks in Level 1 or Level 2.
3. Forgetting the PIES Dimensions:
Do not describe health impacts purely as physical disease. Always consider the Intellectual (knowledge gained), Emotional (stress, fear, confidence), and Social (peer relationships, social isolation) impacts.
4. Mixing up AS 3 and A2 Unit 4:
Remember, in AS 3, you are assessed in a written exam on your understanding and evaluation of theoretical approaches and organisations. You do not need to design your own coursework portfolio campaign here!
Quick Summary Checklist
Make sure you can answer these questions before your exam:
• Can I state the WHO definitions of health and health promotion?
• Can I explain each of the 5 approaches (Medical, Educational, Behaviour Change, Fear Arousal, Social Change)?
• Can I evaluate at least two strengths and two limitations for every approach?
• Can I name statutory bodies (PHA, HSC Trusts) and voluntary bodies (Cancer Focus NI) in Northern Ireland?
• Can I assess a health promotion method across all PIES needs?