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2 results

  • 3 - Health promotion principles and practice: Addressing complex public health issues using the Ottawa Charter

  • from Part 1 - Historical and theoretical perspectives
  • Edited by Pranee Liamputtong
  • Book:
    Public Health
    Published online:
    25 July 2022
    Print publication:
    10 August 2022, pp 43-61

  • Summary

    We live in a world in which we are faced with a myriad of health issues. Addressing our most pressing concerns is a complex task that requires action on several levels, from global to local and from prevention through to treatment. At a global level, the World Health Organization (WHO) is a United Nation’s (UN) agency whose primary role is to lead and coordinate global health efforts. This chapter introduces readers to the discipline of health promotion, a core function of the WHO. The Ottawa Charter for Health Promotion (‘Ottawa Charter’) will be used to frame the chapter's discussion. The Ottawa Charter is the guiding framework that health promotion practitioners use to address the multiple determinants of health through multi-sectoral and multi-level approaches. The Ottawa Charter is guided by three main principles: advocate, enable, and mediate. The three guiding principles facilitate implementation of the Ottawa Charter’s five action areas: building healthy public policy, creating supportive environments, strengthening community action, developing individual skills and re-orienting health services. Each of the action areas is explored in the rest of the chapter.

  • Exposure, probable PTSD and lower respiratory illness among World Trade Center rescue, recovery and clean-up workers

  • B. J. Luft, C. Schechter, R. Kotov, J. Broihier, D. Reissman, K. Guerrera, I. Udasin, J. Moline, D. Harrison, G. Friedman-Jimenez, R. H. Pietrzak, S. M. Southwick, E. J. Bromet
  • Journal:
    Psychological Medicine / Volume 42 / Issue 5 / May 2012
    Published online by Cambridge University Press:
    18 November 2011, pp. 1069-1079
    • Article
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  • Background

    Thousands of rescue and recovery workers descended on the World Trade Center (WTC) in the wake of the terrorist attack of September 11, 2001 (9/11). Recent studies show that respiratory illness and post-traumatic stress disorder (PTSD) are the hallmark health problems, but relationships between them are poorly understood. The current study examined this link and evaluated contributions of WTC exposures.

    Method

    Participants were 8508 police and 12 333 non-traditional responders examined at the WTC Medical Monitoring and Treatment Program (WTC-MMTP), a clinic network in the New York area established by the National Institute for Occupational Safety and Health (NIOSH). We used structural equation modeling (SEM) to explore patterns of association among exposures, other risk factors, probable WTC-related PTSD [based on the PTSD Checklist (PCL)], physician-assessed respiratory symptoms arising after 9/11 and present at examination, and abnormal pulmonary functioning defined by low forced vital capacity (FVC).

    Results

    Fewer police than non-traditional responders had probable PTSD (5.9% v. 23.0%) and respiratory symptoms (22.5% v. 28.4%), whereas pulmonary function was similar. PTSD and respiratory symptoms were moderately correlated (r=0.28 for police and 0.27 for non-traditional responders). Exposure was more strongly associated with respiratory symptoms than with PTSD or lung function. The SEM model that best fit the data in both groups suggested that PTSD statistically mediated the association of exposure with respiratory symptoms.

    Conclusions

    Although longitudinal data are needed to confirm the mediation hypothesis, the link between PTSD and respiratory symptoms is noteworthy and calls for further investigation. The findings also support the value of integrated medical and psychiatric treatment for disaster responders.