Promoting Health in Rural Transylvania, Romania. a Descriptive Analysis of Health Promotion Activities

Article excerpt

SUMMARY

Even though efforts are made to reduce health disparities, promote health for all social groups and improve health outcomes, inconsistencies still exist. Existing evidence shows that lack of funding, lack of properly trained workforce, as well as heavy workload on health care workers, are the most employed explanations for the limited number of health promotion interventions in the area. This paper presents the results of a descriptive study that pursues to render a comprehensive image of health promotion efforts undertaken in rural Transylvania, Romania. This descriptive analysis is conducted on data extracted from a larger dataset, obtained through a study which pursues a cross-sectional design, with a quantitative strategy of inquiry on access to health information in rural Transylvania. The instrument used for data collection is a questionnaire administered by telephone to a sample of medical doctors working in rural medical offices in the studied area (n=226). Results show overall low rates of health promotion activities in the area, as well as low levels of collaboration with other local actors. In the context of behavioral risk factors, this study clearly shows the need of targeted health promotion activities in rural Transylvania in order to improve health outcomes and mitigate health disparities.

Key words: health promotion, rural, Transylvania, Romania, access

INTRODUCTION

Health is an important dimension of quality of life, and is determined by an array of socio-economic, cultural, environmental, behavioral and biological factors (1 ). Health promotion is critical in the advancement of public health; it is most commonly defined as the process which enables individuals to increase control over their health, as well as offers instruments for improving it (2). Even though efforts are made in reducing health disparities, promote health for all social groups and improve health outcomes, inconsistencies still exist. The Jakarta Declaration on Leading Health Promotion in the 21st Century draws the priorities for health promotion, which are the promotion of social responsibility for health, increasing investments in health development, consolidation and expansion of partnerships for health, increased community capacity and empowerment, and finally the development of a health promotion infrastructure (3).

There is a health divide between Western and Eastern European Union countries, in terms of overall mortality and morbidity rates (4). In Romania, the life expectancy at birth was 72.69 years in 2006, with 7.62 years below the EU 15 average, and with a probability of dying before the age of 5 of 16.48 per 1,000 live births, which is 3.48 times higher than the EU 15 average (5). High neonatal and perinatal deaths, 7.74 (EU 1 5: 2.7) respectively 10 (EU 15: 5.94) per 1,000 live births, as well as high maternal death rates of 15.49 per 100,000 live births are observed, while the EU 15 average is 5.43 (5). The major causes of mortality are ischemic heart disease, cerebrovascular diseases, hypertensive heart disease, diseases of the respiratory system, as well as malignant tumors (5). Furthermore, external causes of mortality like injuries and poisonings still account for a significant number of yearly deaths and disabilities (6).

Risk behaviors are still at alarming levels, with a per capita alcohol consumption among adults of 9.7 liters of pure alcohol in 2003, as well as a smoking prevalence of 24.5 among women and 40.6 among men in 2005 (7). Modifiable risk behaviors are significant while they constitute burdens on the individual, as well as on the healthcare system. Studies show that physical inactivity, increased body mass index, smoking status, and history of tobacco use have an impact on short-term s healthcare charges (8) as well as long-term health effects (9). Even so, most eastern European countries lack the needed infrastructure or capacity needed for a sustainable development of health promotion interventions to tackle health risks, especially limited resources health systems like the one of Romania. …