Promising Paths: Health Promoting Higher Education - Reflections, Challenges & Future Frontiers

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


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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

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“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


“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.”


A co-benefits ‘win-win’ approach to education and health

Mutually Beneficial ‘Win-Win’

Relationship

Education, Learning & Widening

Participation

Health, Wellbeing,

Empowerment & Social Justice


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 can do more for universities:

Enhance core business.





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

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The Healthy Settings Approach: What?

The healthy settings approach involves:


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.


Salutogenic

Ecological

Systemic

Whole System ChangeAdapted from: Dooris, 2005

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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.


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

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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?

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students

lecturers

caterers & venue

operators

wider

community

families

support services

…connecting between people

Sourc

e:

adapte

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rom

D

ooris,

2005


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


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


academic

development

finance &

investment

campus

development

local plan

food &

procurement

sustainability &

carbon reduction

…connecting between policies

Sou

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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





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

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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.


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UK Healthy Universities Network:Website


Since 2010 launch:

19,000 visitors

145 countries

upwards trend


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

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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



German Network of Health Promoting Universities10 Quality Criteria

www.gesundheitsfoerdernde-hochschulen.de/E_GF_HS_international/E1_GNHPU.html






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

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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

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Reflections: Lessons Learned and Principles for Practice

Adapted from Poland & Dooris, 2010

Reflections: Lessons Learned and Principles for PracticeStart Where People Are

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Reflections: Lessons Learned and Principles for PracticeBuild on What’s in Place – Strengths, Assets, Successes

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Reflections: Lessons Learned and Principles for PracticeRoot Practice in Place

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Reflections: Lessons Learned and Principles for PracticeImplement Research and Evaluation

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Reflections: Lessons Learned and Principles for PracticeLive and Apply Underpinning Values

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Reflections: Lessons Learned and Principles for PracticeHold on to a Big Vision – Take Incremental Steps

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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

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Professor Mark Dooris,University of Central Lancashire

[email protected]© M

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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/