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www.healthyuniversities.ac.uk
Promising PathsHealth Promoting Universities &
Colleges: Reflections, Challenges
and Future Frontiers
Mark DoorisProfessor in Health & Sustainability
Director, Healthy & Sustainable Settings Unit University of Central Lancashire
www.healthyuniversities.ac.uk
Ph
oto
Cre
dit, D
avid
Nib
lack, im
ag
eb
ase
.net
Background, Context & Vision
Theory & Practice: What, Why & How?
Reflections: UCLan & UK Experience
Challenges, Lessons Learned Opportunities & Future Frontiers
Background, Context & Vision
Theory & Practice: What, Why & How?
Reflections: UCLan & UK Experience
Challenges, Lessons Learned Opportunities & Future Frontiers
Background: Health Promoting Higher Education JourneyA
1986 • Ottawa Charter for Health Promotion
1994/5 • First HPU Initiatives – Lancaster & UCLan, UK
1995 • German HPU Network
1996-8 • International HPU Conference [UK] & WHO Book
2003 • 1st International HPU Congress & Chilean HPU Network
2005 • 2nd International HPU Congress/Edmonton HPU Charter
2006 • English HPU Network & Spanish HPU Network
2007 • Ibero-American HPU Network
2009 • Swiss HPU Network & Austrian HPU Network
2013 • UK Healthy Universities Network
2015 • WHO: Health in All Policies and Cross-Sector Action• This Conference!
Higher Education: The Context
Universities play an increasingly important role in society:
2012: 32% of adults entered higher education – up from 18% in 1999
2030: 414.2 million university students, up 314% from 99.4 million in 2000
But…what are universities for?
UNESCO http://data.uis.unesco.org/
http://www.universityworldnews.com/article.php?story=20120831155341147
© M
ark
Doo
ris
“We should be preparing students
for the work of the world, not just
the world of work.”Porritt, 2012
Health Promoting Higher Education: The Vision
Health Promoting Higher Education: The Vision
“A Healthy University aspires to
create a learning environment
and organisational culture that
enhances the health, wellbeing
and sustainability of its
community and enables people
to achieve their full potential.”
www.healthyuniversities.ac.uk
A co-benefits ‘win-win’ approach to education and health
Mutually Beneficial ‘Win-Win’
Relationship
Education, Learning & Widening
Participation
Health, Wellbeing,
Empowerment & Social Justice
Health Promoting Higher Education: The Vision
Hammond, 2002
Education is good for health…
Education and learning are positively associated with physical
and mental health and wellbeing – widening participation in
education will reduce inequalities, challenge prejudices and
empower people to keep on learning.
Beyond this, universities can do even more for health…
Wellbeing of students, staff & community.
‘Generator’ of health, justice and sustainability in society –
corporate responsibility and shaping.
Health Promoting Higher Education: The Vision
Health can do more for universities:
Enhance core business.
Background, Context & Vision
Theory & Practice: What, Why & How?
Reflections: UCLan & UK Experience
Challenges, Lessons Learned Opportunities & Future Frontiers
The Healthy Settings Approach: Background
Health Promoting Universities – one application of the
healthy settings approach:
“Health is created and lived by
people within the settings of their
everyday life; where they learn,
work, play and love. Health is
created…by ensuring that the
society one lives in creates
conditions that allow the
attainment of health by all its
members.”
WHO, Ottawa Charter for Health Promotion, 1986
“The ‘settings approach’ became the starting point for WHO’s lead health
promotion programmes…shifting the focus from the deficit model of
disease to the health potentials inherent in the social and institutional
settings of everyday life.” Kickbusch, 1996
© M
ark
Doo
ris
The Healthy Settings Approach: What?
The healthy settings approach involves:
The Healthy Settings Approach: What?
focus on structure and agency – place and people
understanding of a setting as context which directly and
indirectly impacts wellbeing
commitment to integrating health within the culture, ethos
structures and routine life of settings.
The Healthy Settings Approach: What?
Salutogenic
Ecological
Systemic
Whole System ChangeAdapted from: Dooris, 2005
© M
ark
Doo
ris
Universities are large and complex organisations that do not have
health as their main raîson d’être.
Advocate in terms of ‘core business’, appreciating distinctiveness
of a university as a setting:
a centre of learning and development
a focus for cross-disciplinary creativity and innovation
a business, concerned with performance and productivity
a partner and player within local/national/global communities
a setting in which students undergo a major life transition
a context that ‘future shapes’ students – values, ideals, priorities.
Abercrombie, Gatrell & Thomas, 1998 (in Tsouros et al, 1998)
The Healthy Settings Approach: Application
Health Promoting Higher Education: Why?
“Health is created and lived by
people within the settings of their
everyday life; where they learn,
work, play and love.”WHO, 1986
Higher Education Institutions
[HEIs] are an important and
influential setting.
Health Promoting Schools –
whole education spectrum.
Enhanced achievement,
performance & productivity
Impact on wider population health.
Health Promoting Higher Education: Why?
Higher Education Institutions have
served as settings for delivery of
projects on specific issues.
Shift from single topic focus – ‘health
promotion in the setting’ – to develop
holistic/strategic ‘whole system’
perspective.
Little research evidence on Health
Promoting Higher Education; however,
this is promising and it is possible to
draw on learning from other settings.© M
ark
Do
oris
Health Promoting Higher Education: Why?
Embedding a ‘whole system’ commitment to health into university structures/processes results in positive outcomes for students, staff and the organisation as a whole. (Newton, 2014)
Effective programmes are “likely to be complex, multifactorial and involve activity in more than one domain.” (Stewart-Brown, 2006: 17)
“While it is not possible to state with certainty that multi-component, whole-settings approaches are more successful in college and university settings than one-off activities, the evidence points in this direction.” (Warwick et al, 2008: 27)
Health Promoting Higher Education: How?
Sou
rce:
Ad
apte
d f
rom
Do
ori
s et
al,
20
10
Health Promoting Higher Education: How?
students
lecturers
caterers & venue
operators
wider
community
families
support services
…connecting between people
Sourc
e:
adapte
d f
rom
D
ooris,
2005
Health Promoting Higher Education: How?
sexual health
alcohol & substance
use/misuse
physical activity
advertising &
sponsorship
mental
wellbeing
food and diet
…connecting between issues
Sou
rce:
ad
ap
ted f
rom
D
ooris,
2005
Health Promoting Higher Education: How?
formal
curriculum
inter-personal
relationships
student finance
transport
infrastructure
students’
union
campus design
…connecting between components of the system
Sourc
e:
adapte
d f
rom
D
ooris,
2005
Health Promoting Higher Education: How?
academic
development
finance &
investment
campus
development
local plan
food &
procurement
sustainability &
carbon reduction
…connecting between policies
Sou
rce:
ad
ap
ted f
rom
D
ooris,
2005
Health Promoting Higher Education: How?A Whole System Approach
https://www.youtube.com/watch?feature=player_embedded&v=1200TPhLJTc
Background, Context & Vision
Theory & Practice: What, Why & How?
Reflections: UCLan & UK Experience
Challenges, Lessons Learned Opportunities & Future Frontiers
UCLan: Healthy University Initiative
www.uclan.ac.uk/hu
UCLan: Healthy University Action Plan
Theme 1: Healthy, Safe & Sustainable Food
Theme 2: Mental Wellbeing
Theme 3: Relationships & Sexual Health
Theme 4: Smoking, Alcohol & Drugs
Theme 5: Sport & Physical Activity
Theme 6: Development/Communication
www.uclan.ac.uk/hu
Objectives: KPIs / timescales / leads
Links to other themes
Links to other university policies/plans
Links to national and local strategies
…and contribute to policy/strategy consultations
UCLan: Mental Wellbeing –A Whole University Approach
www.uclan.ac.uk/hu
UCLan: Sport and Physical Activity –A Whole University Approach
Ackn
: S
kyR
ide
www.uclan.ac.uk/hu
UCLan: Healthy and Sustainable Food –A Whole University Approach
www.uclan.ac.uk/hu
UK Healthy Universities Network
Established in 2006 with 8 universities
It now has representation from:
73 UK HEIs
12 non-UK HEIs
27 other stakeholder organisations
Bi-annual face-to-face network meetings
& thematic learning workshops.
E-Newsletters, email/online networking.
www.healthyuniversities.ac.uk
© M
ark
Doo
ris
UK Healthy Universities Network:Website
www.healthyuniversities.ac.uk
Since 2010 launch:
19,000 visitors
145 countries
upwards trend
www.healthyuniversities.ac.uk
UK Healthy Universities Network:Toolkit
www.healthyuniversities.ac.uk/toolkit
UK Healthy Universities Network: Self Review Tool
Leadership & Governance
Service Provision
Facilities & Environment
Communication, Information & Marketing
Academic, Personal, Social & Professional Development
Health Promoting Higher Education: Tools, Frameworks & Declarations
www.healthyuniversities.ac.uk/toolkit
Men
tal/
Em
oti
on
al
Wel
lbei
ng
Phy
sica
l A
ctiv
ity
Hea
lthy
&Su
stai
nab
le
Foo
d
Sub
stan
ce U
se
&M
isu
se
Pers
on
al &
Se
xual
Hea
lth
&
Rel
atio
nsh
ips
Sust
ain
able
En
viro
nm
ent
Governance,Leadership & Management
CriteriaA1
Criteria B1
Criteria C1
Criteria D1
Criteria E1
Criteria F1
Facilities, Environment, & Service Provision
Criteria A2
Criteria B2
CriteriaC2
CriteriaD2
CriteriaE2
CriteriaF2
Community & Communication
Criteria A3
Criteria B3
Criteria C3
Criteria D3
Criteria E3
Criteria F3
Academic, Personal, Social & Professional Development
CriteriaA4
Criteria B4
Criteria C4
Criteria D4
Criteria E4
Criteria F4
Health Promoting Higher Education: Tools, Frameworks & Declarations
Health Promoting Higher Education: Tools, Frameworks & Declarations
German Network of Health Promoting Universities10 Quality Criteria
www.gesundheitsfoerdernde-hochschulen.de/E_GF_HS_international/E1_GNHPU.html
Health Promoting Higher Education: Tools, Frameworks & Declarations
Background, Context & Vision
Theory & Practice: What, Why & How?
Reflections: UCLan & UK Experience
Challenges, Lessons Learned Opportunities & Future Frontiers
Project-ism
Politeness
Playing it safe
Power relations
Playing the game
Positioning
Pathologisation
Parochialism
Challenges: The 8 Ps
Challenges: The 8 Ps - Project-ism
Health
Promoting
University
Challenges: The 8 Ps - Politeness
Challenges: The 8 Ps – Playing it Safe
© M
ark
Dooris
ww
w.d
aily
kos.c
om
Challenges: The 8 Ps – Power Relations
Challenges: The 8 Ps – Playing the Game
Challenges: The 8 Ps – Positioning
Challenges: The 8 Ps – Pathologisation
Challenges: The 8 Ps – Parochialism
© M
ark
Dooris
Reflections: Lessons Learned and Principles for Practice
Adapted from Poland & Dooris, 2010
Reflections: Lessons Learned and Principles for PracticeStart Where People Are
© M
ark
Dooris
Reflections: Lessons Learned and Principles for PracticeBuild on What’s in Place – Strengths, Assets, Successes
© M
ark
Dooris
Reflections: Lessons Learned and Principles for PracticeRoot Practice in Place
© M
ark
Dooris
Reflections: Lessons Learned and Principles for PracticeImplement Research and Evaluation
© M
ark
Dooris
Reflections: Lessons Learned and Principles for PracticeLive and Apply Underpinning Values
© M
ark
Dooris
Reflections: Lessons Learned and Principles for PracticeHold on to a Big Vision – Take Incremental Steps
© M
ark
Dooris
Opportunities and Future Frontiers
Health Promoting Higher Education
Opportunities and Future Frontiers: 1. Working Across Sectors Post-2015
Cross-Sector Action for Health and Health Equity
Health in All Policies
Post-2015 Development Agenda
Opportunities and Future Frontiers 1. Working Across Sectors Post-2015: Implications – Internal
Health in All Policies and cross-sectoral working
Health Promoting Higher Education model influences and
becomes embedded in universities’ planning and policy
processes
Health becoming a core criterion in all decision-making
Potential for universities to harness and channel their
contribution through ensuring healthy lives and wellbeing for
all, providing inclusive and equitable education and lifelong
learning opportunities, and playing their part in building
inclusive, sustainable, resilient and just societies.
Global Focus on
Cross-Sectoral Action
Post-2015 Sustainable
Development Goals
Opportunities and Future Frontiers 1. Working Across Sectors Post-2015: Implications – External
www.un.org/sustainabledevelopment/
Opportunities and Future Frontiers 1. Working Across Sectors Post-2015: Implications – External
Waage et al, 2015
Opportunities and Future Frontiers 2. Connecting Health and Sustainability
Healthy
Universities
Sustainable
Universities
Avoid perpetuating what Trevor Hancock has called a ‘multiple
silo’ approach, whereby communities and organisations get
overburdened with a multitude of related programmes
Healthy & Sustainable Universities
Orme and Dooris, 2010; Poland & Dooris, 2010
Opportunities and Future Frontiers 2. Connecting Health and Sustainability
Canadia
n P
ublic
Health A
ssocia
tion, 2015
Conclusion
© M
ark
Do
oris
References and Further ReadingHigher Education: Overview and Purpose
http://data.uis.unesco.org/
http://www.universityworldnews.com/article.php?story=20120831155341147
http://www.timeshighereducation.co.uk/176727.article
http://www.theguardian.com/education/2011/oct/10/higher-education-purpose
www.unesco.org/new/en/education/themes/strengthening-education-systems/higher-education/mission/
http://www.unesco.org/new/en/education/themes/strengthening-education-systems/higher-education/reform-and-innovation/
References and Further Reading
Canadian Public Health Association (2015) Global Change and Public Health: Addressing the Ecological Determinants of Public
Health. Ottawa: CPHA.
Doherty, S. & Dooris, M. (2006) The healthy settings approach: The growing interest within colleges and universities. Education and
Health 24 (3): 42-43.
Dooris, M. (2001) The ‘health promoting university’: A critical exploration of theory and practice. Health Education 101 (2): 51-60.
Dooris, M. (2004) Joining up settings for health: a valuable investment for strategic partnerships? Critical Public Health 14 (1): 49-61.
Dooris, M. (2005) Healthy settings: challenges to generating evidence of effectiveness. Health Promotion International 21 (1): 55-65.
Dooris, M (2013) Bridging the Silos: Towards Healthy and Sustainable Settings for the 21st Century. Health & Place 20: 39-50.
Dooris, M., Cawood, J., Doherty, S. & Powell, S. (2010) Healthy Universities: Concept, Model and Framework for Applying the
Healthy Settings Approach within Higher Education in England. Final Project Report – March 2010. Preston: UCLan / London:
RSPH.
Edmonton Charter for Health Promoting Universities http://www.gesundheitsfoerdernde-
hochschulen.de/Inhalte/E_Gefoe_HS_internat/2005_Edmonton_Charter_HPU.pdf
German Network of Health Promoting Universities (2010) Quality Criteria of Health Promoting Universities. Hannover: GNHPU
www.gesundheitsfoerdernde-hochschulen.de/E_GF_HS_international/E1_GNHPU.html
Hammond, C. (2002) Education and Health. Education Journal 65. pp. 26-27.
Kickbusch, I. (1996) Tribute to Aaron Antonovsky – ‘what creates health’? Health Promotion International 11(1), pp. 5–6.
Kickbusch I. (1997) Health-promoting environments: the next steps. Australian and New Zealand Journal of Public Health 21: 431-4
Newton, J. (2014) Can a University Be a ‘Healthy University’? An Analysis of the Concept and an Exploration of its
Operationalisation through Two Case Studies. Thesis submitted for PhD. London: London South Bank University.
Orme, J. & Dooris, M. (2010) Integrating health and sustainability: the higher education sector as a timely catalyst. Health Education
Research 25(3): 425-437.
Poland, B. & Dooris, M. (2010) A green and healthy future: a settings approach to building health, equity and sustainability. Critical
Public Health 20(3): 281-298.
References and Further ReadingPoland, B., Dooris, M. & Haluza-Delay, R. (2011) Securing ‘supportive environments’ for health in the face of ecosystem collapse:
meeting the triple threat with a sociology of creative transformation. Health Promotion International 26 (Supplement 2): ii202-ii215.
Poland, B., Green, L. & Rootman, I. (2000) Settings for Health Promotion: Linking Theory and Practice. London: Sage.
Poland, B., Krupa, G. And McCall, D. (2010) Settings for health promotion: an analytic framework to guide intervention design and
implementation. Health Promotion Practice 10(4): 505-16.
Robinson, J. (2012) Regenerative Sustainability: From Damage Control to Improving the Environment.
http://news.ubc.ca/2012/01/03/regenerative-sustainability-from-damage-control-to-improving-the-environment/
Robinson, J. and Cole, R. (2014) Theoretical underpinnings of regenerative sustainability, Building Research & Information, DOI:
10.1080/09613218.2014.979082
Simon Fraser University (2013) A Healthy Campus Community at SFU
https://www.youtube.com/watch?v=1200TPhLJTc&feature=player_embedded
Stewart-Brown, S. (2006). What is the evidence on school health promotion in improving health or preventing disease and,
specifically, what is the effectiveness of the health promoting schools approach? Copenhagen: WHO Regional Office for Europe.
(Health Evidence Network Report http://www.who.dk/Document/E88185.pdf
Tsouros, A., Dowding, G., Thompson, J. & Dooris, M. (Eds.) (1998) Health Promoting Universities: Concept, Experience &
Framework for Action. Copenhagen: WHO Regional Office for Europe. www.euro.who.int/__data/assets/pdf_file/0012/101640/E60163.pdf
UK Healthy Universities Network www.healthyuniversities.ac.uk
UK Healthy Universities Network Toolkit and Self Review Tool www.healthyuniversities.ac.uk/toolkit
United Nations 2015 is the Time for Global Action www.un.org/sustainabledevelopment/
University of Central Lancashire Healthy & Sustainable Settings Unit www.uclan.ac.uk/hssu
University of Central Lancashire Healthy University www.uclan.ac.uk/hu
Waage, J. et al (2015) Governing the UN Sustainable Development Goals: interactions, infrastructures, and institutions. Lancet
http://dx.doi.org/10.1016/S2214-109X(15)70112-9.
Warwick, I., Statham, J. and Aggleton, P. (2008) Healthy and Health Promoting Colleges – Identifying an Evidence Base. London:
Thomas Corum Research Unit, University of London.
World Health Organization (1986) Ottawa Charter for Health Promotion. Geneva: WHO.
World Health Organization (2013) Helsinki Statement on Health in All Policies. Geneva: WHO.
http://apps.who.int/iris/bitstream/10665/112636/1/9789241506908_eng.pdf?ua=1
World Health Organization (2014) HiAP Framework for Country Action. Geneva: WHO.
http://apps.who.int/iris/bitstream/10665/112636/1/9789241506908_eng.pdf?ua=1
World Health Organization (2015) HiAP Training Manual. Geneva: WHO. http://www.who.int/social_determinants/publications/health-
policies-manual/en/