Glossary of terms relevant for mental health in all policies

This Glossary is an extended and revised version of a glossary published in “Health in All Policies. Seizing opportunities, implementing policies”, Ministry of Social Affairs and Health, Helsinki 2013.

Capacity: ”the skills, knowledge and resources needed to perform a function” (1).

Determinants of health: ”the range of personal, social, economic and environmental factors that determine the health status of individuals or populations” (2). The determinants of health can be grouped into seven broad categories: socioeconomic environment; physical environments; early childhood development; personal health practices; individual capacity and coping skills; biology and genetic endowment; and health services (3).

Equity: ”the absence of avoidable or remediable differences among populations or groups defined socially, economically, demographically, or geographically” (4). This includes the notions of horizontal and vertical equity (see social justice).

Governance: broadly concerns the agreed actions and means adopted by a society to promote collective action and deliver collective solutions in pursuit of common goals. Governance can be formed at different levels of social organization – local, state/provincial, national, regional and global – and can become closely intertwined (adapted from (5)).

Health for all: ”the attainment by all the people in the world of a level of health that will permit them to live a socially and economically productive life” (6).

Health impact assessment: ”a combination of procedures, methods and tools by which a policy, program, product, or service may be judged concerning its effects on the health of the population” (7).

Health in All Policies (HiAP): an approach to public policies across sectors that systematically takes into account the health and health systems implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity. A HiAP approach is founded on health-related rights and obligations. It emphasizes the consequences of public policies on health determinants, and aims to improve the accountability of policy-makers for health impacts at all levels of policy-making (adapted from WHO Working Definition prepared for the 8th Global Conference on Health Promotion, Helsinki, 2013).

Health (in)equity: differences in health that are unnecessary and avoidable and, in addition, are considered unfair and unjust (8). The CSDH states that such differences must be systematic and considered avoidable by reasonable action globally and within societies (9).

Health promotion: ”the process of enabling individuals and communities to increase control over the determinants of health and thereby improve their health. An evolving concept that encompasses fostering lifestyles and other social, economic, environmental and personal factors conducive to health” (Ottawa Charter, cited in (10)).

Health sector: ”organizations that are held politically and administratively accountable for the health of the population at various levels: international, national, regional and local” (Chapter 14).

Health service: ”a formally organized system of established institutions and organizations, the multi-purpose objective of which is to cope with the various health needs and demands of the population” (11).

Health system: ”All the organizations, institutions and resources that are devoted to producing health actions” (12).

Healthy public policy: is characterized by ”an explicit concern for health and equity in all areas of policy, and by accountability for health impact. The main aim of healthy public policy is to create a supportive environment to enable people to lead healthy lives. Such a policy makes healthy choices possible or easier for citizens. It makes social and physical environments health enhancing” (13).

Human rights: ”rights inherent to all human beings, whatever our nationality, place of residence, sex, national or ethnic origin, colour, religion, language, or any other status. We are all equally entitled to our human rights without discrimination. ... All human rights are indivisible, whether they are civil and political rights, such as the right to life, equality before the law and freedom of expression; economic, social and cultural rights, such as the rights to work, social security and education, or collective rights, such as the rights to development and self-determination are indivisible, interrelated and interdependent. ... Human rights entail both rights and obligations. States assume obligations and duties under international law to respect, to protect and to fulfill human rights. The obligation to respect means that States must refrain from interfering with or curtailing the enjoyment of human rights. The obligation to protect requires States to protect individuals and groups against human rights abuses. The obligation to fulfil means that States must take positive action to facilitate the enjoyment of basic human rights” (14).

Intersectoral action for health: actions undertaken by sectors outside the health sector, in collaboration with the health sector, on health or health equity outcomes or on the determinants of health or health equity (adapted from (15)).

Mental health:  is not just the absence of illness. Mental health is a state of well-being in which every individual realizes their own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. (25)

Population health: ”the health outcomes of a group of individuals, including the distribution of such outcomes within the group” (16). Crucial to the concept of population health is Rose’s idea that most cases in a population come from individuals with an average level of exposure (rather than high-risk groups). A small (clinically insignificant) change at a population level yields a greater impact on population health and well-being than an intervention on high-risk groups (17).

Risk conditions: the social, economic, geographical and environmental conditions into which people are born. They encompass the social determinants of health; condition and constrain health opportunities; and are causally associated with an increased probability of a disease or injury, lower self-reported health and with risk factors.

Risk factor: ”an attribute or exposure which is causally associated with an increased probability of a disease or injury” (18).

Strategy: broad lines of action to be taken to achieve goals and objectives, incorporating the identification of suitable points of intervention; ways of ensuring the involvement of other sectors; the range of political, social, economic, managerial and technical factors; as well as constraints and ways of dealing with them (19).

Social determinants of health: The WHO CSDH defined this as the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. The CSDH took a holistic view of social determinants of health, arguing that ”the poor health of the poor, the social gradient in health within countries and the marked health inequities between countries are caused by the unequal distribution of power, income, goods and services.” Further, it said that ”the structural determinants and conditions of daily life constitute the social determinants of health and are responsible for a major part of health inequities between and within countries” (4, 20).

Social justice: ”is not possible without strong and coherent redistributive policies conceived and implemented by public agencies” (21). Social justice theory is generally associated with European societies and, particularly, with struggles during the industrial revolution and the emergence of socialist, social democratic or other models of redistributive welfare states. On the basis that this theory is essentially concerned with equity or fairness, it is argued that social justice (equity) is a universal concern, since all social arrangements, to be legitimate and to function at all, must attend to issues of equality (22). But there are subtleties to how equity is conceived, set within two main dimensions: (i) equality of opportunity, achieved through procedural justice or ‘horizontal equity’ in which equals are treated the same; and (ii) equality of outcome, achieved through substantive justice or ‘vertical equity’ in which people are treated differently according to their initial endowments, resources, privileges or rights (23).

Wellbeing: reflects individuals’ perception and evaluation of their own lives in terms of their affective states, psychological and social functioning (26)

Whole of government: ”denotes public service agencies working across portfolio boundaries to achieve a shared goal and an integrated government response to particular issues. Approaches can be formal and informal. They can focus on policy development, program management and service delivery” (24).
 


References

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22. Sen A (1992). Inequality reexamined. Boston, Harvard University Press.

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24. Management Advisory Committee (2004). Connecting government: whole-of-government responses to Australia’s priority challenges. Canberra, Government of Australia (http://www.apsc.gov.au/__data/assets/pdf_file/0006/7575 /connectinggovernment.pdf, accessed 23 April 2013):1.

25. WHO. Draft comprehensive mental health action plan 2013–2020. WHO: Geneva, 2013. Available: http://apps.who.int/gb/ebwha/pdf_files/WHA66/A66_10Rev1-en.pdf

26. Keyes, C. L. M., & Lopez, S. J. (2002). Toward a science of mental health: Positive directions in diagnosis and interventions. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 45–59). New York: Oxford University Press.