Occupational Therapy / OT Without Borders / Public Health

OT & Public Health

OTs have a role in public health, as in helping people stay healthy and preventing illness or injury through health promotion (as an aside the WHO defines health as not just the absence of disease or illness, but rather a state of well-being). The following quotes sum up the shift that is necessary however amongst OTs who traditionally work with and treat individuals (and sometimes groups though usually group therapies are only in mental health settings) to working with populations in order to promote healthy lifestyle adaptations to help people on a larger scale. One health promotion area that the AOTA (aka American Occupational Therapy Association) is big on is fall prevention amongst the elderly population. To help prevent falls from ever occurring, OTs provide education on simple home adaptations like ensuring there is adequate lighting and no rugs around that one could trip on, as well as helping people fit their homes with tools like grab bars or raised toilet seats in bathrooms to help prevent falls.  Another example is an oft cited research study done at USC a few years ago used a program called Lifestyle Redesign to promote activity to a well-elderly population to help keep them healthy. Lifestyle Redesign is something that is being applied to other populations as we speak.

We are occupational beings – occupations are what we do as humans. We are exercising, we are eating, we are playing games, we are socializing with friends, we are sleeping and so on. So it definitely makes sense to try to teach people the healthiest ways to live while doing those occupations, and furthermore by using the occupations themselves as ways to stay healthy. Imagine the impact on our societies if we targeted populations and communities, rather than just one person at a time…

“Health promotion has been described as “the process of enabling people to increase control over, and to improve, their health” (World Health Organization, 1986). It is one of the five intervention approaches of the Occupational Therapy Practice Framework (American Occupational Therapy Association [AOTA], 2002, 2008). As early as the 1970s, there were calls for occupational therapy to become active in health promotion (Brunyate Weimer, 1972). More recently, AOTA articulated a role for occupational therapists in health promotion (AOTA Commission on Practice, 2001), charging practitioners to promote health and wellness in both individuals and communities through engagement in human occupation to promote healthy lifestyles. Occupational therapy practice traditionally focuses on individuals, but to evaluate the impact of occupational therapy health promotion programs, the profession will need to assume a greater public health focus.

A major difference in perspective between public health and occupational therapy is that public health focuses on groups of people (populations), whereas occupational therapy traditionally focuses on individuals. In addition, public health interventions are prevention oriented (AmericanPublic Health Association, 2007). Thus, adoption of a public health focus requires occupational therapy practitioners to expand their vision of practice to address population health. Scaffa (2001) articulated this paradigm shift as one that integrates the health of individuals and communities. Incorporating this broad perspective requires a reconceptualization of occupational therapy interventions and their outcomes.”

– By Trudy Mallinson, Heidi Fischer, Joan C. Rogers, Linda Ehrlich-Jones, & Rowland Chang in Human Occupation for Public Health Promotion: New Directions for Occupational Therapy Practice With Persons With Arthritis in The American Journal of Occupational Therapy, March/April 2009, Volume 63, Number 2

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