Building a holistic health approach in supported housing for people with intellectual disabilities in Denmark

Abstract

People with intellectual disabilities (IDs) face health issues and barriers to physical activity. Health promotion programmes targeting this group are often short-term. Few programmes have been designed for people with IDs who live in supported housing staffed by social care workers (SCWs). The potential that SCWs hold as health promoters has recently come into focus within literature with a setting approach. Drawing on an ethnographic study, this article explores how SCWs articulate health promotion and enact health promoter roles at supported housing for adults with moderate to severe IDs. Our findings show that SCWs perceive sport and diet as health promotion activities. Because of their background within social education and not health promotion, few perceived themselves as health promoters. However, using the holistic concept of active living, which focuses on everyday lifestyle rather than short-term programmes, our ethnographic data reveal the more unspoken and unconscious practices that SCWs enact to 'build' customized active living routines among residents. Our results suggest that this 'silenced' capacity of SCWs to build healthy routines adds to previous findings by emphasizing that, rather than lacking a health promotion ethos, employees may have the potential to promote health by adapting a more holistic approach to health promotion. We argue the active living approach can contribute to building such a holistic health approach. Such an approach may help SCWs identify with and strengthen their enactment of health promotion roles.

Keywords: active living; disability; health promotion; health-promoter roles; settings approach; supported housing.