Health Promotion or Health Education?

On Monday 8th June at 8pm (BST) #physiotalk will be discussing Health Promotion including what it is, what it’s not and in what way should physiotherapists be involved? This #physiotalk will be hosted by physiotherapist and current member of the WCPT Health Promotion group Jill Wigmore-Welsh (@wigmore_welsh), see her full (and very interesting!) bio at the end of the pre-chat information.

The following is a brief introduction to Health Promotion and provides some of the questions that will be tackled during #physiotalk for you to consider before Monday. Please share this information with colleagues, friends and followers as this promises to be a interesting and very relevant #physiotalk.

Health Promotion or Health Education?

Over 75,000 allied health professionals work in the English NHS. They have been encouraged to work more flexibly, and develop extended roles across professional and organisational boundaries. This new agenda requires them to promote health and wellbeing, to educate patients, carers and other professionals, and to view every patient contact as an opportunity for health promotion (HP). It is thought, however, that their HP potential has been unrealised, with their role limited to working with patients to alleviate the effects of illness or disability rather than promoting health and well-being in the population in general. Furthermore, relatively little is currently known about the roles they play in public health and HP.

But what is Health Promotion?

Health Promotion made its appearance in the work of Marc Lalonde (1974) and was soon incorporated into the Health for All initiatives of the World Health Organisation. The first conference on health promotion was held in Ottawa in 1986.

Health promotion claims a distinct intellectual territory for itself in several respects.

  • Any large scale attempt to enhance people’s health has to include many aspects which do not involve the biomedical orientation to the specific targeting of disease

  • Health education is certainly an important component of health promotion, but it is neither the same thing nor necessarily is it always in harmony with it. Health education involves the transmission of information relating to health. As such it need not involve the people pro-actively

  • Health promotion involves empowerment, a process whereby individual people are encouraged to assert their own autonomy and self-esteem sufficiently to be able to identify their own health agendas, rather than being told what to do or what is ‘good for your health’

  • Health promotion recognises that health is social as much as individual. Effective and healthy communities are sustained by ‘neighbourhood advocacy’ of various types- people identify their health agendas as individuals and being sufficiently empowered to develop the necessary social and political skills to see how to tie it in with the neighbourhood or social health context.

What Health Promotion is not:

Health education’s brief is to acquaint people with the facts of what health is, in explicit and identifiable terms, even empirically measured terms. Teaching people exercise to reduce their back trouble, improve balance, reduce weight, risk of ‘sitting disease’, is health education.

Healthism uses health education as a repository of facts and information about body processes which can be made the subject of personal responsibility. The implication being that individuals are almost exclusively responsible for maintaining their own health through the exercise of informed choice.

Healthism emphasises personal decision making about lifestyle and tends to see the body and its health as market commodities, which may drive a pre-occupation with sustaining a ‘healthy body’.

The term health ‘promotion’ implies an ongoing process involving both education about health as well as elaboration of strategies which will enhance the effect of such education. Thus it has a strategic aspect which informs us that health promotion involves a collective response and is likely to seek & find expression through political structures and channels.

Health promotion takes into account ecology, holism, equity and social justice and can only make sense in a global context.

Britain has a long history of public health. The old public health looked for legitimacy in defending people’s health from outside germs and toxins. By the 1960’s most of these battles had been won, but people had stopped becoming healthier.

The new public health is characterised by concern with social inequality factors including poor education, poverty, poor housing, gender inequality.

On a big scale these include large and contentious political issues, distorted agricultural priorities in the third world & impact on malnutrition, burning of rainforests to graze cattle, trade agreements.

Equally local constrained neighbourhood issues such as psychological impact of certain types of housing, safety in the workplace, lack of transport provision, employment availability all influence health.

Thoughts for Consideration:

Differences in health outcomes related to social class and other markers of disadvantage have been well documented across a broad range of cultures, as well as in societies with a variety of health care systems.

An increasingly persuasive amount of research is emerging that supports the thoughtful construction of a new framework for health promotion and disease prevention. This model is based on

mounting evidence that the origins of many adult diseases can be found among adversities in the early years of life that establish biological “memories” that weaken physiological systems and produce latent vulnerabilities to problems that emerge well into the later adult years

Health Leaflets : Literacy levels in the UK

Around 16 percent or 5.2 million adults in England can be described as Functionally Illiterate. They would not pass an English GCSE and have literacy levels at or below those expected of an 11 year old. They can understand short straightforward texts on familiar topics accurately and independently and obtain information from every day sources, but reading information from unfamiliar sources or on unfamiliar topics could cause problems.

Food Banks

The UK is the seventh richest country in the world. It is also a deeply unequal country. In May 2014, the Office for National Statistics (ONS) reported that the richest one percent of Britons own the same amount of wealth as 54 percent of the population

Useful links/resources Needle JJ, Petchey RP, Benson J, Scriven A, Lawrenson J, Hilari K. The allied health professions and health promotion: a systematic literature review and narrative synthesis. Final report. NIHR Service Delivery and Organisation programme; 2011


  • What’s the difference between health education & health promotion ?

  • Do you carry out health promotion or health education activities?

  • Health promotion takes account social inequality how does your work address this?

  • What types of health promotion do you do and with which groups?

  • Do you consider Physios should be more involved in health promotion?

  • What advantages & disadvantages exist for Physiotherapists in health promotion ?

  • What barriers exist in your workplace that prevent you from carrying out health promotion ?

  • Do you feel the public think a Physiotherapists role to include health promotion?

  • What can be done to improve Physiotherapists involvement in health promotion ?

We look forward to you joining us at 8pm BST Monday 8th June

About our host Jill Wigmore-Welsh GraddipPhys MSc

Jill Wigmore-Welsh has been a Physiotherapist since 1977 and has worked in a variety of different real world settings. Since the early 1980’s she has been interested in the political and social inequality aspects of good health. Most especially its relationship to ongoing low grade stress, emotional distress, poor tissue healing, low resilience and ill health.

In 1994 Bhuddist based mindfulness & meditation techniques called. In 1995 she lost interest in treating injury and started what turned into 15 years formal study into methods to promote integrated body and mind resilience and healthy use. These studies include Feldenkrais, Hypnotherapy, Neurolinguistics, Coach and Stress Management Trainer. In 2001 she completed a Master of Science in Health Promotion & Public Health at Brunel University.

In recent years she continues to provide clinical work to small numbers of complex cases, delivers health training into the corporate sector and one to one coaching for change. In the past three years Jill has carved out a niche in the catastrophic injury case manager field as a specialist in post-accident rehabilitation management of life changing complex cases of persistent pain, spine injury & brain injury. Currently she is developing links with charities to assist their health promotion programs. She is a member of the WCPT Health Promotion group

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