Ground pillars of a method for quality assurance of public health work. (13th November 2019)

• Record Type: Journal Article
• Authors: Magnusson, M; Hallmyr, M; Wretlind, K
• Is Part Of: European journal of public health. Volume 29(2019)Supplement 4
• Publication Date: 2019-11-13
• Subjects: Epidemiology -- Europe -- Periodicals; Public health -- Europe -- Periodicals; 362.109405
• DOI: 10.1093/eurpub/ckz185.561
• Languages: English
• ISSNs: 1101-1262

Abstract

Abstract: Socioeconomic position, expressed in terms like educational level, income, wealth or origin, is a strong predictor of most health outcomes. Sustainable efforts for good and equitable health need to draw on theories that consider power relations as well as scientific methods for health promotion, prevention and /or treatment. Systematic planning and documentation is required. The perspective should include not only life style habits but also issues like discrimination and stigmatization. Control and influence from participants are necessary to assure that goal-setting and measures taken are adequate. Health inequity emerges from structural issues and is mediated by mechanisms on different levels, mechanisms of which some are difficult to describe and analyze. Regrettably, health care systems, including public health interventions, in many cases reinforce this inequity. Health care staff's personal perspectives and prerequisites (e.g regarding education and income) often differ from the corresponding ones in groups with the less favorable health outcomes. That is one reason why efforts for equitable health need to involve perspectives, prerequisites and health motives of "targeted" individuals and groups as salient parts of interventions, from the planning stage and throughout. A complementary way to prevent intervention procedures from consolidating current positions of power is to allow for professionals to continuously perform critical reflection of their own presuppositions and prejudices in relation to actions and results. The use of determinants from Social Cognitive Theory (SCT) (self- efficacy, observational learning, facilitating, expectations of outcome, reciprocal determination) enables planning that consider not only individuals and groups but also their social context. Systematic use of strategies from SCT, critical reflection and formative as well as summative evaluations allow for quality assurance and knowledge development.