Health Promotion for the Elderly in Peru, Bolivia and Chile SONIA VASQUEZ THESIS FOR DEGREE OF MASTER IN HEALTH PROMOTION SPRING 2005 HANDLEDARE: PROFESSOR BO J A HAGLUND KAROLINSKA INSTITUTET Institutionen för folkhälsovetenskap Avdelningen för socialmedicin 2 Report series of Master theses in Public Health These reports come from the Board of Education in Public Health Sciences at Karolinska Institutet. The master education of Public Health at KI is a collaborative work of mainly three departments: Department of Public Health Sciences, The Department of Biosciences at Novum , Division of Preventive Nutrition, and The Institute of Environmental Medicine. These reports are presented as pdf files on the webbpages of Master of Public Health Education at Karolinska Institutet Leif Svanström Professor and Programme Director 3 ABSTRACT 5 DEFINITIONS 5 LIST OF ABBREVIATIONS 7 1. INTRODUCTION 7 2. BACKGROUND 9 2.1 GLOBAL OVERVIEW 9 2.2 GOALS FOR HEALTH PROMOTION IN OLDER PEOPLE 12 2.3 APPROACHES TO HEALTH PROMOTION FOR OLDER PEOPLE 12 2.3.1 The cultural change approach 13 2.3.2 The structural change approach 14 2.3.3 Intersectoral approaches 14 2.3.4 Community-based approaches 14 2.3.5 Family-based approaches 15 2.3.6 The individual approach 15 2.4 THEORETICAL MODELS FOR HEALTH PROMOTION IN OLDER PEOPLE 15 2.4.1 Individual-Level Models 16 2.4.2 Community-Based Models 17 2.5 METHODS OF IMPLEMENTING HEALTH-PROMOTION APPROACHES 17 2.5.1 Advocacy 18 2.5.2 Social Support 18 2.5.3 Empowerment 18 3. AIM 19 4. QUESTIONS 19 5. MATERIAL AND METHOD 19 5.1 CRITERIA FOR INCLUSION 19 5.2 SEARCH STRATEGIES 20 5.3 SELECTION OF ARTICLES IN THE DATABASE SEARCH 20 5.4 ANALYSING PROCESS 21 6. FINDINGS 22 6.1HEALTH PROMOTION PROGRAMMES IN WORLD HEALTH ORGANIZATION 23 6.1.1 Oral Health 23 6.1.2 Physical Activity 23 4 6.1.3 Non communicable Diseases 24 6.1.4 Mental health 24 6.1.5 Diet and physical activity 24 6.2 HEALTH PROMOTION PROGRAMMES IN THE PAN AMERICA HEALTH ORGANIZATION 25 6.2.1 Elderly People and Family 25 6.2.2 Promotion of Active Life 25 6.3 HEALTH PROMOTION PROGRAMMES IN CHILE 26 6.4 HEALTH PROMOTION PROGRAMMES IN BOLIVIA 28 6.5 HEALTH PROMOTION PROGRAMMES IN PERU 29 7. DISCUSSION 30 7.1 MATERIAL AND METHOD 30 7.2 FINDINGS 31 8. CONCLUSION 34 9. CHALLENGES 35 APPENDIX 1 35 REFERENCES 37 FIGUR 1: APPROACHES TO HEALTH PROMOTION FOR OLDER PEOPLE 13 TABELL 1: DEMOGRAPHIC TRANSITION AND TYPOLOGY OF THE CELADE FOR COUNTRIES OF LATIN AMERICA AND THE CARIBBEAN; 1980 9 TABELL 2: DEMOGRAPHIC INDICATORS FOR CHILE, PERU AND BOLIVIA 10 TABELL 3: SOCIOECONOMICS INDICATORS FOR CHILE, PERU AND BOLIVIA 11 TABELL 4: NUMBER OF SOURCE ARTICLES 20 TABELL 5: PROGRAMMES HEALTH PROMOTION FOR ELDERLY PEOPLE IN CHILE, PERU AND BOLIVIA 22 TABELL 6: PROGRAMMES HEALTH PROMOTION FOR ELDERLY PEOPLE IN CHILE, PERU AND BOLIVIA APPLY BY LEVELS 22 5 !! "# $%&$% '( " ) %**+ # $%)&$% , $ - .& $/ 0# $%*1234 5 * 6 0 6 07 8 &9 :; 2 (9 <=> ?- ' " 04 5" 45@A 9 @A9 B@A 9 - @ 0? / C 0 - 3 .- = !"!= 7 "DE EE= ""D & ? 1 # $%# $%? &$%&$%? $ $ && 0 'A / *A 0-/ 8A 8 ** 0 - *6 ( $? 0 <- - = - <-- .& .& - *8 9 &E, # @A 06A6'*6 @A 06AA62AA@A 6A6'32A CA .& E *2 ? :C';:*; #$% D. &,*13A Group 1: Countries of initial transition High birth rate and high mortality Bolivia and Haiti 10 Group 2: Countries of moderate transition High birth rate and moderate mortality El Salvador, Guatemala, Honduras, Nicaragua and Paraguay Group 3: Countries in full transition Moderate birth rate and moderate and low mortality Brazil, Colombia, Costa Rica, Ecuador, Mexico, Panama, Peru, Republic Dominicana and Venezuela Group 4: Countries of advanced transition Low birth rate and moderate and low mortality Argentina, Chile, Cuba, Uruguay, Bahamas, Barbados, Guadalupe, Jamaica, Martinica and Puerto Rico The demographics indicators are different through out whole Latin America region, being observed clearly between Chile, Bolivia and Peru; Chile is the country with the highest life expectancy at birth (see table 2) #$&' () LAST AVAILABLE INDICATORS CHILE BOLIVIA PERU *'E'31 3ECA' 6@E'68 : ; CEC6A 2E88' *8E*'* :<; CE3@1 2E8C* *8E8C6 :>; 3@8 @8' C8' :<; 62 81 6@ . C'@ @8' @1' . : ; C8 @*1 @C8 . C1 @'8 C62 [...]...: < ; # $% $ D " 0 D & > 6AA6 : 8; , $ # $ * ( ) LAST AVAILABLE INDICATOR CHILE BOLIVIA PERU 1@ * ! B 1' 1 6A+= 3A 3 3@ 8 6 8@A AA 2 @@A AA 62 8* *3 ' *6 8 ** @ *2 2 *' ; !D $ 1' * ; 0 & 16 C 1 *AA AA : < 1@ 6 6A : 1A @ '2 3@ C + 6A+ ( ' , -' &//& & = / 4$ # = & =& *' . Health Promotion for the Elderly in Peru, Bolivia and Chile SONIA VASQUEZ THESIS FOR DEGREE OF MASTER IN HEALTH PROMOTION SPRING 2005. Active Life 25 6.3 HEALTH PROMOTION PROGRAMMES IN CHILE 26 6.4 HEALTH PROMOTION PROGRAMMES IN BOLIVIA 28 6.5 HEALTH PROMOTION PROGRAMMES IN PERU 29 7. DISCUSSION