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Health Care Analysis

01.12.2010 | Original Article

Health Promotion and Disease Prevention: Logically Different Conceptions?

verfasst von: Per-Anders Tengland

Erschienen in: Health Care Analysis | Ausgabe 4/2010

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Abstract

The terms “health promotion” and “disease prevention” refer to professional activities. But a “health promoter” has also come to denote a profession, with an alternative agenda compared to that of traditional public health work, work that by some is seen to be too medically oriented, too reliant upon prevention, risk-elimination and health-care. But is there really a sharp distinction between these activities and professions? The main aim of the paper is to investigate if these concepts are logically different, or if they are just two extremes of one dimension. The central concepts, health promotion and disease prevention, are defined, and it is concluded that health promotion and disease prevention are logically distinct concepts, although they are conceptually related through a causal connection. Thus, logically, it is possible to promote health without preventing disease, even if this is not so common, in practice, but it is not possible to prevent disease without promoting health. Finally, most health promoting interventions target basic health, not manifest health, and often also thereby reduce future disease.
Fußnoten
1
For criteria governing such a discussion see [7, 8].
 
2
Note that [51] does not discuss disease but disorder. It is clear, however, that these concepts can have the same function.
 
3
Were we to find a more plausible theory of disease we could perhaps pursue this path. However, the alternative theory of disease proposed in this paper has another relation to health.
 
4
The idea is found already in Galen’s [15] writings.
 
5
Most likely something also happens on the level of basic health.
 
6
Note that a specific instance of manifest health, which helps support some other instance of manifest health, will not count as basic health, e.g., regularly walk the stairs, and thereby enhancing one’s general fitness, does not make the ability to walk the stairs an instance of basic health.
 
7
We could perhaps also add as a separate group those people who are healthy, and do not have a disease, but have some kind of increased risk, e.g., non-exercisers and smokers. They would of course also be of concern for public health.
 
8
Sometimes we find that whole communities are in poor states of manifest health. Supporting these people to gain health should probably also count as health promotion, unless the measures used are narrowly medical (and will, thus, count as treatment or care). Providing nutritious and sufficient food for the population would probably count as health promotion, whereas treating a population with antibiotics would not.
 
9
It is likely that here too we need other distinctions in order to prevent disease prevention collapsing into treatment. This can no doubt be done. I will, however, not pursue this issue here.
 
10
However, some disease preventive programs might have positive effects on many diseases. Smoking cessation programs might target reduced lung cancer, but will in effect also reduce a number of other diseases where smoking is a contributing cause.
 
Literatur
1.
Beaglehole, R., & Bonita, R. (2004). Public health at the crossroads: Achievements and prospects. Cambridge: Cambridge University Press.
2.
Boorse, C. (1977). Health as a theoretical concept. Philosophy of Science, 44, 542–573.CrossRef
3.
Boorse, C. (1997). A rebuttal on health. In J. Humber & R. Almeder (Eds.), What is disease? (pp. 3–134). Totowa, NJ: Humeana Press.
4.
Brülde, B. (1998). Vad är hälsa? Några reflektioner kring hälsobegreppet. [What is health? some reflections about the concept of health]. Göteborg: Filosofiska institutionen.
5.
Brülde, B. (2000). On how to define the concept of health: A loose comparative approach. Medicine, Health Care and Philosophy, 3, 305–308.
6.
Brülde, B. (2000). More on the looser comparative approach to defining ‘health’: A reply to Nordenfelt’s reply. Medicine, Health Care and Philosophy, 3, 313–315.
7.
Brülde, B. (2003). The concept of mental disorder. Philosophical communications, web series, no. 29. Sweden: Department of Philosophy, Göteborg University.
8.
Brülde, B., & Tengland, P.-A. (2003). Hälsa och Sjukdom: En begreppslig utredning [Health and illness: A conceptual investigation]. Lund: Studentlitteratur.
9.
Buchanan, D. (2000). An ethic for health promotion: Rethinking the sources of human well-being. Oxford: Oxford University Press.
10.
Culver, C. M., & Gert, B. (1982). Philosophy in medicine. Oxford: Oxford University Press.
11.
Davies, M., & Macdowall, W. (2006). Health promotion theory. Maidenhead: Open University Press.
12.
Downie, R. S., Tannahill, C., & Tannahill, A. (2000). Health promotion: Models and values. Oxford: Oxford University Press.
13.
Dubos, R. (1959). Mirage of health: Utopias, progress, and biological change. New York: Harper and Row.
14.
Eriksson, M., & Lindström, B. (2008). A salutogenic interpretation of the Ottawa Charter. Health Promotion International, 23(2), 190–199.CrossRefPubMed
15.
Galen, A. (1997). Selected works (The art of medicine). Oxford: Oxford university press.
16.
Holland, S. (2007). Public health ethics. Malden, MA: Polity.
17.
Kendell, R. E. (1975). The concept of disease and its implications for psychiatry. British J Journal of Psychiatry, 127, 305–315.CrossRef
18.
Korp, P. (2004). Hälsopromotion [Health promotion]. Lund: Studentlitteratur.
19.
20.
Lalonde, M. (1974). A new perspective on the health of Canadiens. Ottawa: Information Canada.
21.
Laverack, G. (2004). Health promotion practice. Power and empowerment. London: Sage.
22.
Laverack, G. (2005). Public health: Empowerment and professional practice. London: Palgrave Macmillan.
23.
Lilienfeld, S. I., & Marino, L. (1995). Mental disorder as a Roschian concept: A critique of Wakefield’s “Harmful dysfunction” analysis. Journal of Abnormal Psychology, 104(3), 411–420.CrossRefPubMed
24.
Lindstrand, A., Bergström, S., Rosling, H., Rubenson, B., Stenson, B., & Tylleskär, T. (2006). Global health: An introductory textbook. Lund: Studentlitteratur.
25.
Lindström, B., & Eriksson, M. (2006). Contextualizing salutogenisis and Antonovsky in public health development. Health Promotion International, 21(3), 238–244.CrossRefPubMed
26.
Lupton, D. (1995). The imperative of health: Public health and the regulated body. London: Sage.
27.
MacDonald, T. (1998). Rethinking health promotion: A global approach. London: Routledge.CrossRef
28.
Marmot, R. (2004). The status syndrome. London: Bloomsbury.
29.
Medin, J., & Alexanderson, K. (2000). Begreppen hälsa och hälsofrämjande:en litteraturstudie. [The concepts health and health promotion: A literature study]. Lund: Studentlitteratur.
30.
Murphy, D., & Woolfolk, R. L. (2000). The harmful dysfunction analysis of mental disorder. Philosophy, Psychiatry and Psychology, 7(4), 241–252.
31.
Murphy, D., & Woolfolk, R. L. (2000). Conceptual analysis versus scientific understanding: An assessment of Wakefield’s folk psychiatry. Philosophy, Psychiatry and Psychology, 7(4), 271–293.
32.
Naidoo, J., & Wills, J. (2005). Public health and health promotion: Developing practice (Vol. 2). London: Baillère Tindall.
33.
Nordenfelt, L. (1991). Towards a theory of health promotion: A logical analysis. Linköping: Linköping university press.
34.
Nordenfelt, L. (1995). On the nature of health: An action-theoretic approach, second revised edition. Dordrecht: Kluwer.
35.
Nordenfelt, N. (1998). On medicine and other kinds of health enhancement. Medicine, Health Care and Philosophy, 1, 1–12.CrossRef
36.
Nordenfelt, L. (2001). Health science and ordinary language. Amsterdam: Rodopi Press.
37.
Nordenfelt, L. (2003). On the evolutionary concept of health: Health as natural function. In L. Nordenfelt & P.-E. Liss (Eds.), Dimensions of health and health promotion. Amsterdam: Rodopi Press.
38.
39.
Pörn, I. (1984). An equilibrium model of health. In I. Lindahl & L. Nordenfelt (Eds.), Health, disease and causal explanations in medicine (pp. 3–9). Reidel: Dordrecht.
40.
41.
Raeburn, J., & Rootman, I. (1998). People-centered health promotion. Chichester: Wiley.
42.
Rose, G. (2008). Rose’s strategy of preventive medicine. Oxford: Oxford University Press.CrossRef
43.
Seedhouse, D. (1997). Health promotion: Philosophy, prejudice and practice. Chichester: Wiley.
44.
Seedhouse, D. (2001). Health. Chichester: Wiley.
45.
Tengland, P.-A. (2006). The goals of health work: Quality of life, health and welfare. Philosophy, Medicine and Health Care: A European Journal, 9(2), 155–167.CrossRef
46.
Tengland, P.-A. (2007). Empowerment: A goal or a means for health promotion? Philosophy, Medicine and Health Care: A European Journal, 10(2), 197–207.CrossRef
47.
Tengland, P.-A. (2007). A two-dimensional theory of health. Theoretical Medicine and Bioethics, 28(4), 257–284.CrossRefPubMed
48.
Tengland, P.-A. (2008). Empowerment: A conceptual discussion. Health Care Analysis, 16(2), 77–96.CrossRefPubMed
49.
50.
Tones, K., & Green, J. (2004). Health promotion: Planning and strategies. London: Sage.
51.
Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 4(3), 373–388.CrossRef
52.
Wakefield, J. C. (1999). Evolutionary versus prototype analyses of the concept of disorder. Journal of Abnormal Psychology, 108, 374–399.CrossRefPubMed
53.
Whitbeck, C. A. (1981). Theory of health. In S. L. Caplan, H. T. Engelhardt, & J. J. McCartney (Eds.), Concepts of health and disease: Interdisciplinary perspectives (pp. 611–626). Reading, Massachusetts: Addison-Wesley.
54.
WHO. (1948). Official records of the world health organization (Vol. 2). Geneva: WHO.
55.
WHO. (1986). Ottawa charter for health promotion. Geneva: WHO.
Metadaten
Titel
Health Promotion and Disease Prevention: Logically Different Conceptions?
verfasst von
Per-Anders Tengland
Publikationsdatum
01.12.2010
Verlag
Springer US
Erschienen in
Health Care Analysis / Ausgabe 4/2010
Print ISSN: 1065-3058
Elektronische ISSN: 1573-3394
DOI
https://doi.org/10.1007/s10728-009-0125-0