BTEC H&S Care Unit 8: Promoting Public Health assignment 1. Up to distinction.

Unit 8 - Promoting Public Health. What is Public Health? According to Smith and Jacobson, 1988, public health ‘involves the promotion of health, the prevention of disease, the treatment of illness, the care of those who are disabled, and the continuous development of the technical and social means for the pursuit of these objectives’. During the past years in Victorian times, outbreaks of cholera, typhoid and influenza killed thousands and the Great Stink of London, when raw sewage filled the Thames, forced politicians to move Parliament. Edwin Chadwick demonstrated the link between poor living conditions and disease and reduced life expectancy. The government realised that they would have to organise a public approach to health and from these beginnings, public health was born. In 1842, Edwin Chadwick one of the Poor Law Commissioners published a report called ‘Report on the Sanitary Conditions of the Labouring Population of Great Britain’ highlighting the dreadful conditions people were living in. People refused to work and go outside due to infectious diseases, most of them were from working class. Due to the little attention given by the government to controlling diseases, he concluded that it would be cheaper to spend local taxes on improving housing and hygiene instead of running workhouses. The report also suggested the provision of access to clean water, removal of sewage and rubbish from the streets. However, the report also received negative comments from the middle-class taxpayers saying they ‘did not see why their money should be spent on better living conditions for the poor who did not pay anything towards the improvements themselves’. In 1854, there was another outbreak of cholera. The outbreak convinced Dr John Snow to investigate a theory. He concluded that cholera was spread through water. He marked on a map all the deaths in one particular area of London’s East end and later discovered that there was a clear concentration of deaths around a water pump on Broad Street. Snow had the handle removed so people couldn’t use the infected water. As a result, the number of deaths fell dramatically. Snow’s investigation had a massive impact on public health as it helped people change their minds about Chadwick’s suggestion of providing clean water. In 1942, the Beveridge Report produced by Sir William Beveridge identified five ‘Evil Giants’ in society. These are as follows: Squalor (Dirtiness), Ignorance, Want (Poverty), Idleness and Disease. These has impacted most of the poor people negatively. The report was published during the World War II, but in 1945 when the war ended, the government decided to act on Beveridge’s suggestions. In order to overcome (1) Squalor, they built council houses with bathrooms and flushing toilets. To overcome (2) Ignorance, they introduced free education up to the age of 15. To overcome (3) Poverty, the government introduced a system of benefits. People in work had to contribute, as did employers, but in exchange people got sick pay when they were too ill to work. To overcome (4) Idleness, the government introduced Labour Exchanges, now called Job Centres. Finally to overcome (5) Disease, they set up the National health Service (NHS). In 1875, an act was promoted to ensure that local councils provide the best for people’s health. This includes the provision of clean water, public toilets, rubbish removal, sewers and drains. By then, councils also managed to check food shops around the areas to ensure food safety, ensuring quality of new housing and enforcing laws against polluting rivers. As technology and the understanding of disease control were refined, interventions against health threats were developed by public organisations and agencies. Public authorities introduced new tasks including sanitation, immunization, regulation, health education, and personal health care to the public. EDWIN CHADWICK () Photo reference: JOHN SNOW () Photo reference: (AP1) Explain the strategies used to develop public health policy in order for it to meet its aims. It is not easy to handle a large number of population receiving healthcare needs which is why planning and developing health policies and procedures is very necessary. To ensure that people in the United Kingdom would receive free healthcare that meets each and every individual’s needs, the government launched the National Health Services (NHS) on July 1948. It is the first healthcare service in the world that is available to all regardless the wealth. It started to provide a more accessible health service to meet the aim of public health policy by ensuring fair and impartial health services. The NHS remains free at the point of use for all UK residents. This currently stands at more than 64.6 million people in the UK and 54.3 million people in England alone. As the demography of a certain area changes from time to time, public health policy needs to be responsive to meet the needs of the population. The government needs to gather statistical data and commission reports into current trends in health within the nation as well as attempting to predict future developments in the health status of the nation. Lifestyle choices, unemployment, education, housing, prevalence of disease and poverty: all of these factors that influence health and its informations help to shape the planning process for health provision. During and ten years after the Second World War, extreme shortage on food occurred which caused for the ‘food rationing’ to be implemented. Health officials concluded that people’s health improved due to the food rationing. By that time, local authorities started to help and support illness and conditions brought on by war through introducing health care departments such as, Children’s Mental Health Department. In 1946, the World Health Organization (WHO) introduced health as a separate issue in which governments must be involved, to the benefit of people’s physical, mental and social well being, and not just for treating diseases. The role of the public in raising awareness continues to be active in mid 1970s and 1980s. Due to prevalence of social influence such as the media and peer pressure, public health policy needs to become more responsive which led to raising awareness in certain health issues such as campaigns and advertisements. It was not until 1974 that the NHS was responsible for the majority of public health. Along with that, the NHS was being established, spreading across the nation and reclaiming responsibility for the health of all citizens. However, as the health needs of the population differs between the rural and industrial areas, inequalities in provision cannot be avoided. For an instance, establishing local authorities was found to have more of an impact on the provision of appropriate health services. Although there are more aims of public health to be discussed, stated above were the main three aims of public health in order to improve the nation’s health. (1) Planning national provision of health care and promoting the health of the population; (2) Identifying and monitoring needs; (3) Identifying and reducing inequalities. Health promotion enables people to improve or have greater control over their health. The aim of this is to help an individual to reach a state of complete physical, mental and social well being. In addition, promoting health makes it possible for people to increase control over the determinants of health and thereby improve their health. Health is promoted in different areas. May it be in environmental health (e.g. reusable bags), health education (e.g. sexual health and drug education in schools), organisational developments (e.g. health promoting schools), public policies (e.g. banning smoking in public areas such as restaurants, pubs and bus stops), preventative health screenings (e.g. breast cancer screening) and economic regulatory activities for an instance, restrictions on the sale of alcohol. Health promotion is not just a responsibility for the health sector. Individuals, school groups and organisations, health professionals and institutions, the community should work as a whole and contribute to further promote an effective health for all. Health promotion is aimed at improving the health of an individual or community or changing behaviour that may have a negative influence on health. Promoting approaches and strategies ranges from posters with positive health messages all the way through national health promoting policy. Lifestyle and behavioural approaches – are concerned with individuals or groups whose behavioural or social situations place them at greater risk of developing unhealthy lifestyles. Based on a theory, a change in behaviour of a small group of the whole population is way more efficient and significant as it leads to effective results of more people changing behaviours. These approaches target smaller group of people within a population to change their behaviour. Lifestyle and behavioural approaches are directed at improving the health of groups whose behaviours are at risk such as smokers, people with poor nutrition and are physically inactive. These approaches use social marketing, health education and media campaigns in promotion. Individual lifestyle approach – this approach is based on the principles that the major causes of morbidity and mortality within the UK are diseases resulting from poor lifestyle behavioural choices. It tends to put the blame on individuals for their poor health. With relevant informations from health campaigns, individuals will change their behaviours and way of thinking to improve their health. However, no study can explain why people still opt for unhealthy choices and fails to recognise the factors that influence their behaviour such as social, economic and environmental factors. Socio-environmental approach – promotes health by addressing the social determinants of health such as access to food, housing, income, employment, education and transport and factors such as addiction and social isolation. Health promotion actions that are used in this approach include: creating environments that are health-friendly, working with communities to allow improvements and strengthen development, advocating for public policy. Harm-minimisation approach – despite raising efficient awareness to the public, there are still individuals that will choose to engage in harmful behaviours such as intake of illegal drugs and/or unsafe sexual activity. The harm-minimisation approach aims to reduce the adverse health, social and economic consequences of harmful behaviours through minimising or limiting the harms for individuals and the community as a whole. This approach involves a variety of strategies: demand reduction, supply control, controlled use and safer use of drugs. To sum up, public health approaches focuses on providing the maximum benefit for the largest number of people. They are mainly concerned with preventing disease from occurring and promoting health effectively. Just like aiming a target grade, it is important for you to set your strategies on how you’re going to successfully meet your aims. As for health policy, there are certain strategies they have set in order for them to meet their aims with regard the provision of care and treatment. In accordance to The Ottawa Charter created by the World Health Organization (WHO) there are specific strategies used to meet the aims of health sectors. Create supportive environments – our societies are complex and therefore health shouldn’t be separated from other goals. Globally and locally or as a community, we should all take care of each other and our natural environment. Taking care of the environment we’re living in is a global responsibility that we should take seriously. Strengthen community actions – at the process of health promotion, empowerment of communities is very vital. It is important that their ownership and control of their own endeavours and destinies is being adhered as this will lead to strong decision-making and successful implementation to achieve better health. Develop personal skills – health promotion supports personal and social development through providing information, education for health, and enhancing life skills. By doing this, the options available to people to exercise more control over their own health and over their environments increases and to make choices that are useful for health. Enabling people to learn, to be prepared for coping up with chronic illness and injuries is essential. This promotion has to be facilitated in home, school, work and other community settings. References: L3 Health and Social Care Book (Year 2) Lecture Notes (AP2) Explain how monitoring information to determine patterns of health and ill health is used by government to inform the creation of public health policy. Health policy is defined as a process in which decisions, plans and actions are undertaken to achieve specific health care targets within a society. A clear and straightforward health policy can achieve several things: it defines a vision for the future which in turn helps to establish targets and points of reference for the short and medium term. It outlines priorities and the expected roles of different groups; and it builds consensus and informs people. Monitoring information with regard the population’s health is essentially needed as it is an important way to maintain everyone’s health. This includes monitoring the health status to identify and solve community health problems. When health is monitored regularly, accurate diagnosis of the community’s health status is achieved; threats to health and assessment of health service needs are identified; attention will be given to the vital statistics and health status of specific groups that are at higher risk than the total population; integrated information systems and health benefit plans are managed. To enable health agencies from investigating on why health risks arise, they rely on informations gathered by verified sources. Informations comes from various data sources for an instance in relation to injury and ill health statistics in Britain, the Health Safety Executive (HSE) is a government agency that directly reports injuries, illnesses and disease related to work to the government. It obtains its data from the agencies with which it works. Reporting incidents and ill health at work is a legal requirement as this allows the HSE and other health agencies to investigate serious incidents and plan prevention. The World Health Organization (WHO) is an agency of the United Nations. The main concern of this organisation is for the nation to have a better health and living. It is responsible for the World Health Report. As a global organisation, the WHO collects data about health concerns from associated members around the globe. Global dissemination of informations allows appropriate resources and advice which can help with certain health concerns. In the UK, the government gathers information and statistics from scientific and valid research, including from the WHO and each country within the UK. This is to ensure that the local, regional, and national health is monitored. By doing so, resources can be planned focusing on specific needs. The Department of Health (DH) relies on local and regional health authorities to monitor and report on the health of the population in the area for which they have responsibility. Health professionals such as GPs, hospitals and health centres are required to report all diseases and illnesses causing a serious threat to health and local health authorities. For an instance reports in relation to communicable diseases should be reported immediately and accurately so that the local health authority can provide relevant resources and guidance to the medical profession. The data and informations gathered shall be reported by the local authority to the regional health authority as they will provide more guidance or resources if needed. The regional health authority is responsible for monitoring whether the disease spreads and can be managed. After the regional authority monitors the disease, informations will then be reported to the DH. When extra resources has been given, they will need to report the case to the European Union which then reports to the WHO. This ensures that the disease is being well-monitored and so that they can hand out help to the local area affected when necessary. An example for this is the spread of Zika virus, it was closely monitored and guidelines were being set to ensure that people are kept informed of the risks and infection rates are controlled. The government may also undertake reports on specific health matters such as health provision inequalities. This includes the Black Report, Acheson Report and the Beveridge Report in 1942. Established in 1980 by the United Kingdom Department of Health and Social Security, Black Report focuses on health inequalities. The report highlighted that ill health and death rates were higher in poorer areas in Britain. The report showed in great detail the extent to which ill health and death are unequally distributed among the population of Britain, and suggested that the inequality continues to grow bigger and bigger since the establishment of National Health Services (NHS) in 1948. It was also shown that professional people had a healthier lifestyle than people in working class. The Black Report is considered as an important document that should be given attention as this allows us to know the history of social inequality in terms of distribution of health. In addition, although justice wasn’t served at that time, today, the report led to policy improvements and developments implemented by the WHO in 13 countries. In 1998, the Acheson Report was still showing inequalities in health care based to an individual’s economic status. The report suggested for more funding for nutritional education in schools through the curriculum, and for teaching children, especially those in deprived areas, to budget and cook healthy meals. It also suggested that schools deciding to sell their playing fields and receiving less funding for free school meals had led to a worsening of health for children living in poverty. As a result, the report contained policy suggestions to lessen these health concerns, which influenced the government green paper Our Healthier Nation: A Contract for Health (1998) and the white paper Saving Lives: Our Healthier Nation (1999). In order to deliver the appropriate health care for the community, it is important to collect data as this doesn’t only reveal trends and patterns on health and ill health but it also helps to inform debate on health issues, inform decision making in health care and commission research into a specific illness or diseases causing concern. Public health practitioners are responsible for gathering informations from time to time to prevent the spread of diseases and to support the patients through giving them the necessary medications. Knowing about a health concern in a local area gives people control of their lives and helps to increase their wellbeing. Furthermore, practitioners use data to help people decide on health precautions especially when traveling to other countries. For an instance, for GP practices charts are available to see travel destinations with the appropriate vaccines required when travelling to a certain country. References: L3 Health and Social Care Book (Year 2) Lecture Notes (BP3) Explain factors affecting current patterns of health and ill health in a specific demographic area. In the UK and globally, poor housing affects health as seen in the figure below (In 2015, approximately 1.43 million of deaths in children globally are caused by respiratory infections), children without an appropriate shelter are more likely to suffer from asthma, headaches, and ear infections. Poor housing is linked to an increased risk of cardiovascular and respiratory diseases. In addition, this affects an individual’s mental health as damp, molds, and insufficient heating can lead to depression and other mental health disorders. Figure 1. Childhood deaths from the five most lethal infectious diseases worldwide, % People living in poverty may not be able to afford necessities such as food, clothing, and heating and can be more at risk of developing certain illnesses than families who belong in middle class. Working class are not getting enough money and are becoming ill or depressed due to long hours of work and receiving low pay. Figure 2. Numbers in absolute poverty forecast to grow Discrimination is everywhere, most especially in terms of receiving the appropriate treatment and care. People are discriminated against for many different reasons such as physical appearance, culture, family backgrounds, religion, class, race, sexual orientation, wealth. Gender, age, disability, and also weight. Being discriminated due to reasons stated can lead to low self-esteem, depression and ill health and worse, can lead to death as people suffering from mental ill health are at risk with taking their own life. If an individual follows an unhealthy diet for an instance, eating food that are high in content of fats and sugars, this can lead to an individual being more likely to develop coronary heart disease, high blood pressure, breathing problems and diabetes. As we live on a generation where media has ruled our living and as modernity increases, society’s standards of beauty also rises. Television, magazines, and social networking sites portrays women and men in a certain way, focusing on what is believed to be attractive. This has the effect of creating an image in one’s mind of how they should look like. As an individual tries to meet society’s beauty standards, failure of meeting these can lead to eating disorders such as anorexia and bulimia. In addition, it can lead to stress, anxiety, low self-esteem, depression and other mental health disorders.