Cases: Lifestyle, Work and Health in the EU – EPH2022
Case 1, Inequalities in working and behaving in a healthy way
The PRECEDE-PROCEED model
The model has provided moral and practical guidance for the fields of health
education and health promotion.
Precede–Proceed today remains the most comprehensive and one of the most used
approaches to promoting health.
Structure that supports the planning and implementation of health promotion or
disease prevention programs.
Precede–Proceed has promoted public health and health promotion practice in five
ethically and practically important ways:
1. By advancing the ecological perspective on health that, today, has come to
dominate public health practice
2. By remaining population-centred, rather than focusing on individuals
3. By demanding democratic and participatory approaches to health promotion
4. By setting quality of life, rather than behaviour change or even health, as the
goal for health promotion
5. By being deeply grounded in practice
Precede: Predisposing, reinforcing, and enable constructs in Educational Diagnosis
and Evaluation, it assesses…
o Social assessments→ Determine social problems and needs of a given
population and identify desired results
o Epidemiological assessment→ Identify the health determinants of the identified
problems and set priorities and goals
o Ecological assessment→ Analyse behavioural and environmental determinants
that predispose, reinforce, and enable the behaviours and lifestyles are identified
o Identifies administrative and policy factors that influence the implementation and
match appropriate interventions that encourage desired and expected changes
o Implementation of interventions
Proceed: Policy, Regulatory, and Organizational Constructs in Educational and
Environmental Development, it involves the identification of desired outcomes and
program implementation…
o Implementation→ Design intervention, assess availability of resources, and
implement program
o Process evaluation→ Determine if program is reaching the targeted population
and achieving desired goals
o Impact evaluation→ Evaluate the change in behaviour
o Overcome evaluation→ Identify if there is a decrease in the incidence or
prevalence of the identified negative behaviour or an increase in identified
positive behaviour
,Precede–Proceed guides practitioners in bridging health promotion goals of enabling
people to control and improve their own health with larger public health goals of
creating the conditions where people can be healthy.
It also provides an ethical guide to promoting health in democratic and participatory
ways.
Micro- and meso-level determinants
Micro = individual health determinants lifestyle, demographics, genetics
Meso = community level determinants work, school, occupation
How lifestyle influences health
Lifestyle always relates to behaviours, and behaviours can influence your health.
The better your lifestyle, the better your health.
Lifestyle is not only prevention but also cure, and it can highly influence your health.
Lifestyle, work conditions, and SES are intertwined.
,Predisposing factors: demotivates people to take control over own health and
behaviour
Enabling factors: higher SES, thus more resources and easier access to health
Reinforcing factors: social part, social norms and values, education, about the
contact with other people
Inequalities related to SES, health, and work
, Studies show that work and lifestyle factors are strongly intertwined.
There is a contribution of physical and psychosocial work factors to socioeconomic
health inequalities, this is larger than the contribution of lifestyle factors.
Psychosocial work factors, lack of job resources (eg, less autonomy) seem to
contribute to health inequalities.
It has been shown that people in lower socioeconomic positions incur higher working
risks.
Workers in the lowest SES have a higher risk of poor self-rated health than workers
in the highest SES.
Lower-level occupational roles and poor working conditions have been more
common among people with a lower level of education and lower position in the
social gradient.
Low occupational-skills jobs have often been associated with dangerous work and
with worse work-related exposure.
People who are discriminated against at work according to age, gender, ethnicity,
and contracts of hire should be considered more vulnerable workers than others.
Low SES people often work more physically harming jobs with lower pay.
Low SES = low education = worse work condition = worse health.
Low SES is a cycle, people often stay in the same social class they grow up in.
It’s difficult to get in a higher SES class (e.g. education is expensive).
Mediation effect
The strength of association between SES and health is
influenced/enhanced by work characteristics.
Moderation effect
Effects of work are stronger in low SES positions.
Precarious jobs
Jobs without much safety nets (seasonal jobs, part time jobs, etc.)
It is known that occupational mortality and morbidity are not equally distributed
across the world. About 65% of global work-related mortality is estimated to occur in
Asia, followed by Africa (11,8%), Europe (11,7%), America (10,9%) and Oceania
(0,6%).
This reflects the distribution of the world’s working population, differing levels of
national economic development and hazardous work.
Often the individual is blamed for work stress instead of the organizations the
individual is working for.
Occupational health and its importance
Case 1, Inequalities in working and behaving in a healthy way
The PRECEDE-PROCEED model
The model has provided moral and practical guidance for the fields of health
education and health promotion.
Precede–Proceed today remains the most comprehensive and one of the most used
approaches to promoting health.
Structure that supports the planning and implementation of health promotion or
disease prevention programs.
Precede–Proceed has promoted public health and health promotion practice in five
ethically and practically important ways:
1. By advancing the ecological perspective on health that, today, has come to
dominate public health practice
2. By remaining population-centred, rather than focusing on individuals
3. By demanding democratic and participatory approaches to health promotion
4. By setting quality of life, rather than behaviour change or even health, as the
goal for health promotion
5. By being deeply grounded in practice
Precede: Predisposing, reinforcing, and enable constructs in Educational Diagnosis
and Evaluation, it assesses…
o Social assessments→ Determine social problems and needs of a given
population and identify desired results
o Epidemiological assessment→ Identify the health determinants of the identified
problems and set priorities and goals
o Ecological assessment→ Analyse behavioural and environmental determinants
that predispose, reinforce, and enable the behaviours and lifestyles are identified
o Identifies administrative and policy factors that influence the implementation and
match appropriate interventions that encourage desired and expected changes
o Implementation of interventions
Proceed: Policy, Regulatory, and Organizational Constructs in Educational and
Environmental Development, it involves the identification of desired outcomes and
program implementation…
o Implementation→ Design intervention, assess availability of resources, and
implement program
o Process evaluation→ Determine if program is reaching the targeted population
and achieving desired goals
o Impact evaluation→ Evaluate the change in behaviour
o Overcome evaluation→ Identify if there is a decrease in the incidence or
prevalence of the identified negative behaviour or an increase in identified
positive behaviour
,Precede–Proceed guides practitioners in bridging health promotion goals of enabling
people to control and improve their own health with larger public health goals of
creating the conditions where people can be healthy.
It also provides an ethical guide to promoting health in democratic and participatory
ways.
Micro- and meso-level determinants
Micro = individual health determinants lifestyle, demographics, genetics
Meso = community level determinants work, school, occupation
How lifestyle influences health
Lifestyle always relates to behaviours, and behaviours can influence your health.
The better your lifestyle, the better your health.
Lifestyle is not only prevention but also cure, and it can highly influence your health.
Lifestyle, work conditions, and SES are intertwined.
,Predisposing factors: demotivates people to take control over own health and
behaviour
Enabling factors: higher SES, thus more resources and easier access to health
Reinforcing factors: social part, social norms and values, education, about the
contact with other people
Inequalities related to SES, health, and work
, Studies show that work and lifestyle factors are strongly intertwined.
There is a contribution of physical and psychosocial work factors to socioeconomic
health inequalities, this is larger than the contribution of lifestyle factors.
Psychosocial work factors, lack of job resources (eg, less autonomy) seem to
contribute to health inequalities.
It has been shown that people in lower socioeconomic positions incur higher working
risks.
Workers in the lowest SES have a higher risk of poor self-rated health than workers
in the highest SES.
Lower-level occupational roles and poor working conditions have been more
common among people with a lower level of education and lower position in the
social gradient.
Low occupational-skills jobs have often been associated with dangerous work and
with worse work-related exposure.
People who are discriminated against at work according to age, gender, ethnicity,
and contracts of hire should be considered more vulnerable workers than others.
Low SES people often work more physically harming jobs with lower pay.
Low SES = low education = worse work condition = worse health.
Low SES is a cycle, people often stay in the same social class they grow up in.
It’s difficult to get in a higher SES class (e.g. education is expensive).
Mediation effect
The strength of association between SES and health is
influenced/enhanced by work characteristics.
Moderation effect
Effects of work are stronger in low SES positions.
Precarious jobs
Jobs without much safety nets (seasonal jobs, part time jobs, etc.)
It is known that occupational mortality and morbidity are not equally distributed
across the world. About 65% of global work-related mortality is estimated to occur in
Asia, followed by Africa (11,8%), Europe (11,7%), America (10,9%) and Oceania
(0,6%).
This reflects the distribution of the world’s working population, differing levels of
national economic development and hazardous work.
Often the individual is blamed for work stress instead of the organizations the
individual is working for.
Occupational health and its importance
