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Choosing health, constrained choices

Chee Khoon Chan

Glob Health Promot, 2009 Dec;16(4):54-7.
PMID: 20028669 DOI: 10.1177/1757975909348131

In parallel with the neo-liberal retrenchment of the welfarist state, an increasing emphasis on the responsibility of individuals in managing their own affairs and their well-being has been evident. In the health arena for instance, this was a major theme permeating the UK government's White Paper Choosing Health: Making Healthy Choices Easier (2004), which appealed to an ethos of autonomy and self-actualization through activity and consumption which merited esteem. As a counterpoint to this growing trend of informed responsibilization, constrained choices (constrained agency) provides a useful framework for a judicious balance and sense of proportion between an individual behavioural focus and a focus on societal, systemic, and structural determinants of health and well-being. Constrained choices is also a conceptual bridge between responsibilization and population health which could be further developed within an integrative biosocial perspective one might refer to as the social ecology of health and disease.
Fulltext Health promotion preparedness for health crises - a 'must' or 'nice to have'? Case studies and global lessons learned from the COVID-19 pandemic

Levin-Zamir D, Sorensen K, Su TT, Sentell T, Rowlands G, Messer M, et al.

Glob Health Promot, 2021 06;28(2):27-37.
PMID: 33775167 DOI: 10.1177/1757975921998639

The current COVID-19 pandemic has exposed missing links between health promotion and national/global health emergency policies. In response, health promotion initiatives were urgently developed and applied around the world. A selection of case studies from five countries, based on the Socio-Ecological Model of Health Promotion, exemplify 'real-world' action and challenges for health promotion intervention, research, and policy during the COVID-19 pandemic. Interventions range from a focus on individuals/families, organizations, communities and in healthcare, public health, education and media systems, health-promoting settings, and policy. Lessons learned highlight the need for emphasizing equity, trust, systems approach, and sustained action in future health promotion preparedness strategies. Challenges and opportunities are highlighted regarding the need for rapid response, clear communication based on health literacy, and collaboration across countries, disciplines, and health and education systems for meaningful solutions to global health crises.
Factors influencing medication label viewing in Malaysia

Cheah YK, Chong YW

Glob Health Promot, 2018 Mar;25(1):63-72.
PMID: 27406823 DOI: 10.1177/1757975916649135

The misuse of medicine is a serious public health issue worldwide. An important factor that contributes to the misuse of medicine is the lack of medication label viewing by consumers. The objective of the present study is to examine the socio-economic, demographic and lifestyle factors associated with medication label viewing among Malaysian adults. The empirical analysis is based on a nationally representative data set of 30,992 respondents. An ordered probit model is used to examine different types of medication label viewers. The results of this study suggest that socio-economic (i.e. age, income level, education level, location of residence), demographic (i.e. gender, ethnicity, marital status) and lifestyle factors (i.e. physical activity, smoking) have significant effects on medication label viewing. It is found that age, low-income and low-education level reduce the likelihood of viewing medication label. Based on these findings, several policy implications are suggested. The present study provides policy makers with baseline information regarding which cohorts of individuals to focus on in efforts to increase the frequency of medication label viewing.
Fulltext Emerging stronger from COVID-19 through arts

Ong CY, Wai Ching Deanna L

Glob Health Promot, 2023 Jun;30(2):28-34.
PMID: 36052969 DOI: 10.1177/17579759221118256

OBJECTIVES: To assess art initiatives and programmes communicating health messages and during the COVID-19 pandemic in Malaysia from 2020 to 2021.
STUDY DESIGN: Qualitative narrative study.
METHODS: Grey literature on COVID-19 art initiatives and programmes in Malaysia was reviewed.
RESULTS: The art initiatives and efforts in Malaysia to promote health and wellness during the COVID-19 pandemic were compelling and notable. These initiatives can be classified into five major categories, namely performing arts, visual arts, culture, literature and digital art. The main health messages conveyed through these initiatives included public education regarding COVID-19, health precautionary steps recommended for the public, and solidarity in the fight against COVID-19. These art initiatives cultivated positive responses from the public and increased their awareness of COVID-19.
CONCLUSION: From the public health perspective, the use of arts to educate and create awareness of COVID-19 in Malaysia were encouraging. The public is made more informed and prepared to face the challenges ahead.
Fulltext Exploring the impact of COVID-19 movement control orders on eating habits and physical activity in low-resource urban settings in Malaysia

Lim SC, Kataria I, Ngongo C, Usek VS, Kudtarkar SR, Chandran A, et al.

Glob Health Promot, 2022 May 16;29(4):17579759221091197.
PMID: 35578553 DOI: 10.1177/17579759221091197

BACKGROUND: The COVID-19 pandemic led Malaysia to introduce movement control orders (MCOs). While MCOs were intended to slow the spread of COVID-19, the effects of such measures on the noncommunicable disease (NCD) risk factors have not been fully explored. This exploratory study aimed to understand the effect of the MCO on the eating habits and physical activity levels of the urban poor in Malaysia as well as potential health promotion interventions during the COVID-19 pandemic.
METHODS: This rapid assessment used a mixed-method approach in three low-cost public flats in Kuala Lumpur targeting the B40, which is the bottom 40% of the economic spectrum. A total of 95 community members participated in a quantitative phone survey, while 21 respondents participated in a qualitative phone survey, including 12 community members and nine community health volunteers (CHVs).
RESULTS: The movement restriction imposed during the MCO significantly reduced the frequency and duration of respondents' physical activity. At the same time, respondents reported significantly increased consumption of home-cooked meals. More than half of respondents reduced their consumption of packaged snack foods (53.7%), street desserts (54.7%), fast food (50.5%), soft drinks (50.5%), and 3-in-1 or instant drinks (50.5%) due to limited access during the MCO. B40 communities were receptive to potential interventions to encourage healthier eating and physical activity leveraging digital approaches under the 'new normal'. Reported concerns included internet accessibility and affordability, functionality, and digital literacy.
CONCLUSION: The COVID-19 pandemic requires innovation to address diseases and risk factors at the community level. While movement restrictions reduced physical activity, they created opportunities for low-income individuals to have greater control over their diet, enabling them to adopt healthier eating habits. Lifestyle changes experienced by vulnerable populations provide an opportunity for creative and technology-enabled interventions to promote healthy eating and exercise.