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Saboga-Nunes, L; Levin-Zamir, D; Bittlingmayer, U; Contu, P; Pinheiro, P; Ivassenko, V; Okan, O; Comeau, L; Barry, MM; Van den Broucke, S; Jourdan, D
A Health Promotion Focus on COVID-19: Keep the Trojan horse out of our health systems. Promote health for ALL in times of crisis and beyond!
EUPHA-HP, IUHPE, UNESCO Chair Global Health & Education.
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The COVID-19 pandemic plunges the world into a crisis that is touching all sectors of society. In a desperate attempt to contain the further spread of the disease, governments across the world have taken unprecedented measures, closing schools, universities, houses of worship, shops, restaurants, theatres and other non-system relevant settings but where people usually meet and interact and spend their time. Travel and economic activity are limited, and severe restrictions are being imposed on physical contacts, limiting them to the very essential. Never before in modern history has a health problem had such an overwhelming impact on society, thus challenging our views of what a healthy society means. The pandemic comes at a time when the global financial crisis of 2008 and the austerity that followed in many countries, led to a decline of resources in the public sector, including the health care sector. In this already precarious situation, COVID-19 is like a Trojan horse that entered our hospitals and health care systems, our very lives. The disease not only compromises the sustainability of the health care system, but sends a shock wave across all sectors, further compromising the resilience and sustainability of our care and social systems. These systems, which are already under stress, now must deal with a new crisis. The impact of which is of such a magnitude that all known response mechanisms seem inadequate. In the absence of a known treatment for COVID-19, the only option is to protect citizens and health workers against infection by the SARS-CoV-2 virus, which brings a heavy burden on the already fragile public health systems and stretched public health care and hospital professionals. As such, COVID-19 not only tests the health and care system’s 3 resiliency, but also puts into question the relevance of the hospital centric perspective that in most western countries has dominated the health care system for decades. In this context, it is important to consider the role of health promotion in dealing with the COVID-19 pandemic. Although at first sight, this pandemic and the way to address it may not appear to be a core concern for health promotion, we would argue that health promotion may be more important in this time of crisis than ever. Indeed, this crisis underscores the need for strong public systems, as well as the critical role of health literacy in promoting population health, and the need for effective communication and community mobilization efforts to enhance protective and self-care behaviors and measures at a societal, community and individual level. At the heart of a health promotion response to the COVID-19 crisis is the need to increase people’s control over their health, to enhance social cohesion and solidarity, and to (re)build public trust and collective responsibility for population health and wellbeing. Successful community engagement, supported by digital opportunities for safe communication, is key to coping successfully with this crisis and its many disruptive consequences at a societal level. As such, health promotion actions have a central role to play in empowering communities and individuals in adopting effective responses and managing the psychosocial impacts of the multi-layered consequences of this pandemic. The health promotion community also has an advocacy role to play in arguing for sustained investment in public health systems, so that nations are better prepared for future crises and recognize the value of supporting health and well-being at all times. To launch the debate on how health promotion can effectively deal with the COVID-19 pandemic, we would like to propose five discussion points to broaden the spectrum of our actions. These five points are centered on even key principles of health promotion: intersectorality, sustainability, empowerment and public engagement, equity and a life course perspective. As “discussion points” they are not final words: they are initial arguments to open the discussion with further contributions from the health promotion community. As the world must deal with the pandemic, we need to critically consider its implications for population health, and especially the positive contribution that health promotion can make to addressing the current crisis, while also re-thinking and enlarging the spectrum of our vision and actions.
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