Principper og strategier for sundhedsfremme i det 21. århundrede
Igennem de seneste to årtier er der fremkommet nye principper og strategier for fremme af sundheden, især takket være arbejdet inden for folkesundhedsvidenskaben og internationale sundhedsorganisationer såsom Verdenssundhedsorganisationen. Det udvidede sundhedsbegreb, som foruden sygdommes biomedicinske egenskaber også omfatter livskvalitetsdimensioner, har stimuleret udviklingen af nationale sundhedspolitikker, der indbefatter sociale sundhedsdeterminanter. Evidens inden for oral sundhedsfremme er vokset betydeligt i de seneste tre årtier og udfordringerne i at omsætte viden til handlingsprogrammer er store. Oral sundhedsfremme omfatter politiske initiativer inden for f.eks. fødevare- og tobaksindustrierne, miljø i form af f.eks. sikkert vand og sanitære forhold, og effektiv anvendelse af fluor til forebyggelse af caries. Sunde miljøer for sundhed såsom skolesundhedsprogrammer er væsentlige for sundhedsfremme og en sund livsstil blandt børn og unge. Sundhedsformidling er et nøgleelement til fremme af sundheden og kræver grundig tilrettelæggelse baseret på teorier om sundhedsrelateret adfærd. Endelig er der over hele verden, selv i de nordiske lande hvor der i de senere år er sket forbedringer i kvalitet af sundhedspleje, et udpræget behov for omlægning af sundhedstjenesterne hen imod sundhedsfremme og sygdomsforebyggelse. Denne rapport understreger, hvorledes de grundlæggende principper og strategier i sundhedsfremme ligeledes gælder for fremme af oral sundhed. Det er vigtigt at evaluere lokale programmer for oral sundhed som en del af systematisk informationsindsamling om cost-effectiveness og processer, og til erfaringsformidling i oral sundhedsfremme på tværs af landegrænser. Afslutningsvis diskuteres integreringen af oral sundhed i sundhedsfremme og forebyggelse af kroniske sygdomme som foreslået af WHO's Globale Oral Sundhedsprogram.
Principles and strategies for promotion of health in the 21st century: Over the past two decades new principles and strategies for promotion of health have emerged, primarily due to consolidation of public health science and international health organizations such as the World Health Organization. The expanded concept of health, including quality of life dimensions, in addition to the biomedical characteristics of disease and illness, have stimulated the development of national health policies that incorporate social determinants of health. The evidence for oral health promotion has been growing markedly over the past three decades, and the challenges for translation of knowledge into action programmes are great. Oral health promotion comprises initiatives at the policy level as regards the food and tobacco industries, for example, water and safety sanitations, and effective use of fluoride for prevention of dental caries. Healthy settings for health promotion such as school health programmes are important for promoting health and healthy lifestyles of children and youth. Health education is a key element in health promotion and requires sound planning based on theories of health-related behaviour. Finally, reorientation of health services towards health promotion and disease prevention is sorely needed around the globe, even in the Nordic countries where some improvements in quality health care have been shown in recent years. This report emphasizes how the basic principles and strategies in health promotion apply to promotion of oral health. Evaluation of community oral health programmes based on systematic information about cost-effectiveness and processes is valuable for sharing experiences in oral health promotion across countries. The integrated approach to oral health within health promotion and chronic disease prevention, as suggested by the WHO Global Oral Health Programme, is discussed.
