Health Promotion for Older People in the Czech Republic in a European Perspective

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SUMMARY

This article describes health promotion for older people in the Czech Republic from the European perspective1. It is based on findings from the European project healthPROelderly. Implementation of health promotion in the Czech republic as a new public health concept is outlined from the historical point of view. Structures and processes of health promotion in the Czech Republic are described in the context of social policy, demography and health. The European project healthPROelderly is presented and the outcomes of an international literature search statistically analysed. Participating countries were divided into three macro-regions according to their geographical location and political and historical tradition - Mediterranean, West-European and formerly East-European macro-regions. The outcome of correspondence analysis partially confirms the hypothesis on the cultural background of the health promotion activities and strategies. Concerning themes addressed by health promotion projects most countries belonging to the Mediterranean or "Western European" macro-regions have concentrated on similar themes whereas this is not valid for the countries of the "Former Eastern European" macro-region. The hypothesis on macro-regional similarities in relation to settings of health promotion projects was not confirmed. In the conclusions the location of the Czech Republic in an international perspective is discussed and three Czech selected best practice projects are evaluated in relation to the statistical findings.

Keywords: health promotion, older people, international comparison, European research healthPROelderly, social policy, health status, demography

INTRODUCTION

Health Promotion as a New Agenda of the Czech Public Health in the Early 1990s

Health promotion as a theoretical concept started to be systematically studied and presented in the Czech Republic in full accordance with the most progressive approaches given by the Ottawa Charter from 1986 only after the political change in 1990. In former Czechoslovakia a well-functioning and effective system of public health control and disease prevention was established during the 20th century. In the 1 96Os, health education and health information as new approaches addressing the behavioural aspects were added. Health promotion as the historically most recent and hierarchically utmost notion began to emerge only in the late 1980s. Czech health education experts have conveyed their new orientation towards health promotion by renaming the National Institute of Health Education to the National Centre of Health Promotion2 in 1991. This new institute has successfully developed health promotion in theory and formed a platform of experts, who have taken on board new concepts which were developed in the advanced democratic world. By opening the borders, Czech experts were given the chance to attend international meetings, workshops, conferences and had access to literature and training courses like the "Luneburger" for example, a six weeks training course organised by the Lüneburg Fachhochschule3 under the auspices of the WHO. As a result, health promotion as a theoretical concept has now been set apart from the rather traditional concepts of prevention and health education. A consensus about the specific contribution that health promotion can bring has been reached through a thorough debate, at least among those people engaged in the subject. As a consequence of this theoretical discourse, numerous health promotion projects using the social settings approach and networking have successfully been implemented, the most relevant among them were Healthy School and Healthy City networks, and to a lesser extent, Healthy Workplace projects. Healthy Family and Healthy Hospital projects were not so successfill, even though recently approved by the National Programme on Health - Health Promotion Projects. The explanation for this might be that since the Czech Republic is a post-totalitarian society, people might fear public intervention into their private sphere. …