PSYCH 103 UNIT 8 PROMOTING PUBLIC HEALTH,100% CORRECT

PSYCH 103 UNIT 8 PROMOTING PUBLIC HEALTH Inton, Maria Sophia Ernestine L3 Health and Social Care YR 2 Bryan Smikle Introduction 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 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. (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. One of the biggest cause of inequality in death rates between rich and poor in the UK is smoking. Statistics has shown that smoking accounts over half of the difference in risk of premature death between social classes. Death rates from tobacco are two to three times higher among disadvantaged social groups than among the better off. Long-term smokers are the most likely to suffer from cancer-related diseases. Figure 3. Relationship between cigarette consumption by men and lung cancer incidence in men Mental health disorders have a significant impact on the ability of people to lead fulfilling lives and contribute to society. There is developing evidence that the risk factors for a person’s mental health are shaped by various social, economic and physical environments including family history, debt, unemployment, isolation and housing. Locally mental health is the most common reason for sickness absence. Only 7% of people diagnosed with serious mental illness (such as schizophrenia and bipolar) will ever have paid work and mental ill health is the number one cause of health-related unemployment. Common mental illness such as anxiety and depression affects around 1 in 6 people at any one point in time and are one of the leading causes of disability nationally. Prevalence is increasing any yet only a quarter of people with anxiety and depression receive treatment compared to 90% of people with diabetes. The Department of Health estimate that the economic costs of mental illness in England are £105.2 billion each year. The London Borough of Hammersmith and Fulham had the 6th highest population with severe and enduring mental illness known to GPs in the country in 2012-13. People with serious and long-term mental illness have the same life expectancy as the general population had in the 1950s, one of the greatest health inequalities in England. People with mental health problems also face significant physical health problems and live significantly shorter lives as a result. Figure 4. Chronic conditions in Hammersmith & Fulham (BP4) Explain the impact of public health policy in minimising these factors in relation to a specific demography. We have discussed earlier the various factors that may have a massive impact on current patterns of health and ill health and how it affects a specific area. Reports and statistics showed that discrimination, child obesity, media and smoking are the common factors present in the London Borough of Hammersmith and Fulham (LBHF). These affects the overall life expectancy in the area. Factors cannot be diminished, however, it can be minimised – through effective public health campaigns, policies and legislations. In 1980, The Black Report was published confirming social class health inequalities in overall mortality and that inequalities in health has widened. Health inequalities was considered based on: healthy people are more likely to get promoted while unhealthy people are more likely to lose their jobs, individuals in the lower social classes indulge in comparatively more health damaging behaviour (such as smoking), poverty causes poor health. In addition, the report highlighted the impact of social and economic circumstances on individual’s health, particularly on ill health. Healthy people spend more, making the economy richer. Businesses prosper when workers are healthy, as reported by the World Health Organisation (WHO). Since the occurrence of unwanted events, the government is concerned about the expense of health and social care services. The National Health Services (NHS) exposed that caring for individuals with diabetes (for example) alone, costs the country almost 9 billion a year. This led for the government to introduce public health campaigns focusing on healthy living. Campaigns such as Sport for All and media campaigns about healthy eating like Change4Life enabled the government to reduce risks of ill health. Reducing health and social inequalities – If social inequalities were reduced, then the population would become healthier. A healthier population works better, has less time off sick, and has increased productivity, which leads to a wealthier nation. Evidence shows that being employed without social boundaries can help improve health and wellbeing and reduce health inequalities, while unemployment is linked to higher levels of sickness and psychological morbidity. As part of the borough’s health promotion agenda, long-term unemployment is a serious barrier to good health. To minimise and prevent social inequality in the area, they aim to continue giving out support with tailored employment, targeting those who will benefit the most. Improvements in more disadvantaged communities – Improving health outcomes for more disadvantaged communities depends on the availability of resources and facilities. Help may be provided by local or national funding of from a funding programme. Usually the services are offered by voluntary groups who may arrange and/or organise and run classes, for an instance, nutrition advice classes or exercise classes such as Zumba or yoga. Local community groups can influence and empower their local community to set up and maintain facilities, such as safe play areas for children. They can also represent the local community at local authority level in issues such as improving availability and condition of local authority housing. In order to create a safe and accessible place for learning, schools in LBHF are ensured to be located at the central to the lives of children and families. The borough works with schools and other educational establishments to give children, young people and families the support they need to achieve and maintain good health and wellbeing. Life expectancy and quality of life – In accordance to the ONS, life expectancy has increased significantly in the last 30 years in Britain as a whole. In England, a boy’s life expectancy at birth increased by 5.9 years and a girl’s by 4.1 years. The NHS has contributed to people surviving major illnesses and improved the quality of life for people living with illness. A person’s quality of life depends on their physical, psychological, emotional, social and occupational wellbeing, disorder or disruption of any of these factors can lead to ill health. Figure 1. Increase of life expectancy in England and Wales Reduced demand for or pressure on health and social care services – Individuals are living longer. More elderly individuals may wind up frailer, more diseased and require more health and social consideration than younger individuals. The requirement for private and nursing care for the elderly has expanded, particularly with the change to customary family designs, which implies that family may not exist or have the capacity to think about elderly relatives. Lifestyle decisions by younger individuals may likewise affect the future requests set on the medicinal services framework. For an instance, there were overwhelming cases of diabetes in under 19’s in 2016. This disease is commonly seen in adults aged over 40’s, however, due to unhealthy lifestyle choices by young children, diseases appear in the early stage of life. Supporting young people to make healthy lifestyle choice is one way of improving not just a local area’s health but the whole nation if health is promoted effectively. Concerns includes: alcohol consumption, sexual activity, diet and exercise and illegal drugs. These concerns will help to reduce the pressure on health and welfare services. In connection with mental disorders such as depression and anxiety being the main concern of LBHF in relation to chronic diseases rising in the area, the Borough actively improves mental and physical wellbeing through designing and delivering services that have the capacity to have the biggest impact on prevention, early intervention and positive health promotion. Looking at the way services are provided will also have an impact on the pressure on health and social care services. More treatment in the community could reduce the number of expensive hospital admissions, larger specialist services could create centres of expertise and improve the quality of care. The health and social care services are going through big changes, to ensure that they can provide economically efficient services now, and also in the future. Private care sector is also growing to meet demand. References: (Year 2) Lecture Notes (CP5) Explain how approaches to health promotion and protection have been applied in a selected health promotion campaign. The government is responsible for making changes in relation to public health policy. For an instance: creating new laws, providing funds for health education, promotion campaigns and establishing organisations to work in different aspects of public health. DHSSPS – The Department of Health, Social Services and Public Safety is made up of these strands which helps people to live better for loger. They lead, shape and fund health and care in Northern Ireland. It is the agency’s responsibility to ensure that people receive support, care and treatment they need, with compassion, respect and dignity they deserve. They provide leadership across health and care by creating national policies and legislations, providing the long-term vision and ambition to meet current health trends and future challenges, putting health and care at the heart of government and being a global leader in health and care policy. There are numerous groups that influence the health of society. Pressure groups are organisations of people who believe in the same cause. They have strongly held views and wish to influence some aspect of society. These groups has a lot more impact than individuals working alone. An example of pressure groups that can influence public health policy is Oxfam. Such groups has a right to criticise the government, the right to hold meetings, the right to protest and the right to make their views known by using the media (for an instance: networking sites, web advertisements and campaigns). The reason why pressure groups try to influence public health policy is to put pressure on the government for them to make an action on a specific issue. They do this through using the media like video footage, online articles, in magazines, newspapers, protest/rallies, petitions and conducting research to support their cause. In addition to the NHS, agencies such as NICE and the Health Protection Agency there are also groups which can provide information which may influence public health policy such as, Cancer Research UK. Formed in 2002, Cancer Research UK is based in the United Kingdom. Raising awareness in preventing cancer and conducting research regarding the disease. It is the charity’s aim to reduce the number of deaths from cancer. As the world’s largest independent cancer research charity it conducts research into the prevention, diagnosis and treatment of the disease. These research activities are being carried out in institutes and universities across the UK. They fund scientists, doctors, and researchers in order to conduct research, It also provides information about cancer and runs campaigns aimed at raising awareness of the disease and influencing public policy. Aside from local pressure groups, there are also international groups that handles the population’s health globally. The World Health Organization (WHO) is a specialised agency of the United Nations (UN) that acts as a coordinating authority on international public health. The organisation was first established on April 1948 in Geneva, Switzerland. WHO collects information about health trends and the causes of ill health and proposes actions to improve health across the world. It influences the public health policy in various ways such as: providing assistance e.g. employing people to work in deprived areas of the world, to provide medicines, facilities and equipments for delivering care services, applying pressure on government. By 2030, WHO aims to eliminate poverty and hunger, achieve good health and well being, quality education, gender equality, clean water and sanitation, decent work and economic growth, reduce inequalities, action on climate change and make partnerships to achieve these goals. After the World War II in 1945, the nations were in pieces. People wanted peace and better living. That is when the United Nations was formed. The central mission of the UN is to maintain international peace and security. They do this through preventing conflict and helping parties in conflict make peace. Since the declaration of Human Rights Law in 1948, the organisation has been promoting and protecting the human rights and this became their key purpose and guiding principle. As stated in United Nation’s charter, one of their key purposes is “to achieve international cooperation in solving international problems of an economic, social, cultural, or humanitarian character.” This has been applied since the devastating effects of the Second World War. From solving international problems in relation to economy, social and cultural class, the UN then aimed to encourage respect for human rights and for fundamental freedoms for all without distinction as to race, sex, language, or religion. Improving people’s well being continues to be one of the main focuses of the UN. The global understanding of development has changed over the years, and countries now have agreed to maintain sustainable development that promotes greater protection and prosperity - improving the lives of people globally. Overall, as individuals work together may it be as an organisation or as a group, it is easier to make an influence and encourage the government to take actions and implement legislations for the better living of the community. Book (Year 2) Lecture Notes (CP6) Explain how approaches to prevention and control have been applied in a selected campaign. Founded in 1934, Diabetes UK is a British-based patient, health care professional and research charity that focuses on giving care and support for individuals affected by and at risk of Diabetes. The charity campaigns for improvements in the care and treatment of people with the disease. For a campaign to be successful, it is important to ensure that the type of disease is identified and that prevention and control guidelines are met. Diseases are divided into two groups called: Communicable and Non-Communicable Diseases. Communicable Diseases are diseases that can be transmitted to another individual whilst Non-Communicable Diseases are the opposite. Diabetes is considered as a Non-Communicable Disease (NCD). Other NCDs includes cancers, chronic respiratory lung disease, heart disease and failure, which are the most common causes of death worldwide. Apparently, mental illness is also included as an NCD as data from the Department of Health suggests that mental health illness shortens life expectancy, which may be because people with mental illnesses do not look after their physical health. In 2014, NCDs has been accounted for 557,000 deaths in UK alone. Since then, the government declared their objective to prevent and control NCDs to the World Health Organization. Factors contributing Type 2 Diabetes are: 1. Obesity – Researchers studied that the more fatty tissues you have, the more resistant your cells become to insulin. 2. Lack of Physical Activity – The less active you are, the greater the risk. Physical activity, deny it or not, is essential as it helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin. 3. High Blood Pressure – Having blood pressure over 140/90 millimeters of mercury (mm Hg) is linked to an increased risk of Type 2 Diabetes. Early detection and management of Diabetes can help delay more complicated health problems and reduce to the cost to the NHS. Non-communicable diseases such as Diabetes can be prevented by individuals adopting healthier lifestyles, which can be achieved through education and support from health care professionals, organisations and charities like Diabetes UK. Diabetes UK aims to support people across the UK to find out their risk and take action to reduce it. However, this problem is too big to tackle alone, which is why they’re working to make it easier for people to make healthy choices every day. Through the use of campaigns that raise awareness about risk, this encourages individuals to take action with their lifestyles, creating a healthier environment and funding ground-breaking research. The National Diabetes Inpatient Audit (NaDIA) report credits Diabetes UK’s Putting Feet First Campaign for having led more hospitals than ever having specialist foot care teams that can help prevent amputations. According to them, the percentage of hospitals without one of these teams, which the National Institute for Health and Clinical Excellence says every hospital should have, has fallen from 41.7 per cent in 2011 to 28.2 per cent at the present. The lack of these specialist teams in 2011 led for Diabetes UK to work in partnership with local services and individuals with diabetes in areas without them to highlight why they are so vital. The success of Diabetes UK’s campaign has shown enough evidence on why we should take more part on raising awareness in relation to the condition. It also informs and encourages associations, organisation and other healthcare teams to focus on every aspect of diabetes foot care, from making sure everyone with diabetes gets good quality annual foot checks in primary care all the way through to the approach of surgeons once diabetic foot disease has set in. (DP7) Explain how models or theories that justify behaviour change can be used to overcome barriers in relation to a selected health campaign. The importance of influencing behaviour in order to achieve positive policy outcomes is increasingly recognised and has led to a number of reviews and reports. Some of these tackles the use of behaviour change models in general whilst other focus on behaviours relevant to specific contexts such as change in lifestyle or the impact of promoting on lifestyle behaviour. Behavioural theories and models of behavioural change cannot bring about behaviour change, nor can they predict with certainty what changes in behaviour will occur. Nonetheless, they can inform policy makers, implementers and others involved in trying to bring about change about the issues to consider and the likely success of initiatives and interventions. In 1950’s, social psychologists developed a model that enabled them to study people’s attitudes and beliefs and to determine their behaviours – called the health belief model. The model came up with a conclusion that people would change their attitudes towards their own health if they were told by threat of disease that they considered would cause health problems for them and that they would take action to find out about the signs and symptoms and the best way to treat it. Yet, if people do not feel they are at serious risk, they will choose to continue with their unhealthy lifestyle believing that they won’t be facing any health consequences. Figure 1. The Health Belief Model In mid-1970’s, a theory of reasoned action was first developed. It focuses with behaviour but recognises that situations have an effect on it. For an instance, a teenager’s attitude towards the behaviour of drugs may be either favourable or unfavourable. Much will depend on their existing knowledge learned from their parents or from education. The teenager’s behaviour about doing illegal drugs or not doing it is formed from their attitude towards the behaviour, their own reasons and peer pressure. The teenager may be pressured socially (friends and acquaintances) in terms for perception from these people whether to do this unlawful behaviour or not. The theory is broke down in two parts: the ‘attitudes’ and the ‘norms’ which both predict the intentions of behaviours. Attitudes lead a person to want to do something, norms on the other hand persuade the person to do something else. If an attitude is stronger in a person than the norm, then the attitude part will win, and vice versa. In 1980’s, the theory of planned behaviour was developed in connection to the reasoned action theory. It has been used successfully to predict a person’s health behaviour and intention that includes smoking, drinking, substance misuse and other health concerns. It is the belief of the theory that behavioural intentions depend on motivation and the ability to control their behaviour. In the 1990’s, as researchers worked toward the study of alcoholism they developed a six-stage change model to help alcoholics overcome their addiction. It was studied that when a person understands their readiness to change they could use the six-stage model to choose the appropriate action to take. It was seen that this model can be successfully used in all areas of health care. The six stages include: precontemplation, contemplation, determination/preparation, action, maintenance and termination. Figure 2. The wheel of Change The social learning theory was developed in the 1970’s by Albert Bandura. It is based on theories about conditioning and is linked to cognitive learning. Bandura’s observations stated that children learn through observing and copying the behaviours of people around them. Influential models in the life of a child includes parents, family, characters seen in media, friends and teachers. Models may provide positive or negative behaviours to imitate. He believed that children will imitate behaviour regardless of whether the behaviour is appropriate or not. This process carries on into adulthood. This theory explains the continuous development of behaviours all throughout an individual’s life. The social learning theory can have a massive impact on health. For an instance, in secondary school students are taught by teachers not to smoke as smoking can have a negative effect on one’s health. However, the teacher has been witnessed having a cigarette. Therefore, the student will think less about the risks as they seen someone taking the action and nothing risky happened to them really. In this theory, the behaviour will make a greater effect than the words. (DP8) Explain the features of a selected health promotion campaign and the approaches used to increase public awareness. In order to improve the health of the community, health awareness campaigns and activities are being sponsored by the government. This helps to reduce the future cost of health care and helping people to have a good quality of life. As modernity kicks in, our generation is believed to be less participative on physical activities due to many opportunities to watch television and/or play computer games and with so much convenience and fast food available, we tend to eat and settle with what’s easy yet unhealthy food. Change4Life is a campaign in England and Wales, sponsored and run by the NHS, that aim to make people more aware about healthy eating and the food they eat. It also provides information about regular exercise. Figure 1. The Change4Life campaign logo One of the many influential campaigns they do includes the Eatwell Guide which provides guidance about the quantities of food a child or adult should consume, including the ‘Eatwell plate’. This is part of the school curriculum to educate children in healthy eating. Figure 2. The Eatwell Plate, A revised healthy model Eat at least 5 portions of variety of fruit and vegetables a day – fruits and vegetable are a good source of vitamins, minerals and fibre and are supposed to make up over a third of the food we eat each day yet most of us still are not eating enough fruit and vegetables. Eatwell plate encourages people to eat at least 5 portions of a variety of fruit and veg each day may it be fresh, frozen, canned, dried or juiced. Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates – starchy foods are a good source of energy and the main source of a range of nutrients in our diet and should make up just over a third of the food we eat. It is recommended to choose higher-fibre, whole grain varieties such as whole wheat pasta and brown rice or simply leave skins on potatoes. Higher-fibre versions of white bread and pasta are also available. Have some dairy or dairy alternatives – dairy is a good source of protein and some vitamins. This can be found in products such as milk, cheese and other dairy alternatives like soya drinks and yoghurts. Dairy is also an important source of calcium which helps keep our bones strong and healthy. If possible, try to go for lower-fat and lower-sugar products which contains less fat such as 1% fat milk, reduced-fat cheese or plain low-fat yoghurt. Eat some beans, pulses, fish, eggs, meat and other protein – these are good sources of protein, vitamins and minerals. Pulses such as beans, peas and lentils are good alternatives to meat because they’re lower in fat and higher in fibre and protein, too. Eatwell recommends you to choose lean cuts of meat and mince and eat less red and processed meat like bacon, ham and sausages. Aim for at least 2 portions of fish every week (1 of which should be oily, such as salmon or mackerel). Choose unsaturated oils and spreads, and eat in small amounts – unsaturated fats are healthier fats and include vegetable, rapeseed, olive and sunflower oils. All types of fat are high in energy and should be eaten sparingly. Eat foods high in fat, salt and sugar less often and in small amounts – this group of food is not really necessary in the diet and so should be eaten less often and in smaller amounts. Includes: chocolate, cakes, biscuits, sugary soft drinks, butter, ghee and ice cream. Drink plenty of fluids – we may hear this couple of times already but we have to take drinking water seriously, the government recommends 6 to 8 cups of glasses a day. Water, lower-fat milks and lower-sugar or sugar-free drinks including tea and coffee all count. Fruit juice and smoothies also count towards your fluid consumption, however they contain free sugars that can damage teeth therefore only consume a combined total of 150 ml per day. In the 1970’s, selling just the products wasn’t enough to convince the society’s interest which is why social marketing approach was established. This approach aims to sell ideas, attitudes and behaviours and mainly to change social behaviours for the benefit of the society. It has been used effectively in international health programmes on different health concerns such as contraception, drug abuse, heart disease and organ donation. To successfully catch the society’s attention, the Change4Life campaign looks at the mix of product or service, place, promotion and price. The mass media is a powerful tool in promoting health especially in today’s world as we almost depend with everything on technology. This include television and radio broadcasts, magazine and newspaper adverts and articles, billboard posters, the internet and social media, and the distribution of information leaflets. If a health care campaign effectively uses the mass media, this can have a massive impact on it’s success. The Public Health of England (PHE) engages millions of people to make small changes to improve their health through various ways: national campaigns, major partnerships, digital innovation, supporting local public health delivery, effective targeting to reduce health inequalities, evidence-based campaigns. With Change4Life, campaigns can be seen everywhere voicing out its significance. In schools, posters and leaflets has been provided for the teachers and parents to see, even nutritional activities such as ‘10 Minute Shake Ups’ which enables students to boost their activeness and at the same time get them use to the habit of moving more/exercising daily. Community development approach – it shows that health campaigns set in a community are extremely successful for the needs of the people in that particular area. Health centres, as well as volunteer groups offer information on health matters that are relevant to the local area, which may differ from the needs of other parts of the country. This approach can use local data to pinpoint accurately the health needs of the community. This could depend on the main local employment and health concerns around that. Health campaigns will differ in urban and rural areas, and the average age of a community will also inform health campaigns. By knowing the local community a holistic approach can be used, whereby the overall health of a person can be looked at with regards to their local environment. This approach empowers the local population to participate in health campaigns as they can be seen to deal with local concerns. Health campaigns can be promoted in various ways and in different settings. It could be promoted in schools, health and social care settings, even in the theatres! Charitable organisations such as NSPCC, offer phone services to children to provide counselling and guidance to children who are or have been subject to abuse. Not all people feel and react the same way so some of us may not feel very connected with health promotion campaign which is why being creative about health awareness promotion may be a better approach for these people. There are also applications on devices that are available to enable you to manage your own health and lifestyle however not everyone has the access to it as some may find it too expensive and complicated – or some just don’t want to use it at all. It is important for a health campaign to try different approaches when trying to catch the attention of society as each of us has different point of views. Apparently, Change4Life work in partnership to sponsor national health promotion campaigns that bring attention to less intake of sugary snacks and challenging parents and teachers to encourage and change childrens’ negative lifestyle choices. Change4Life adverts can be seen in supermarkets such as Tesco and Co-op, showcasing its aims and targets. Figure 3. Change4Life health promotion campaign References: (Year 2) (AM1) Analyse how public health policy is influenced by strategies and patterns of health and ill health. “Health policy refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society. An explicit 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.” – World Health Organization (WHO) The Department of Health (DH) is the government department responsible for recognising the nation’s health needs in England, and for developing programmes to reduce risk and screen for early signs of disease. In order to gain an adequate knowledge and understanding of the issues around the nation’s health to create effective policies and legislation, the DH works with other agencies such as: the Care Quality Commission (CQC), the Health and Social Care Information Centre, NHS England, Health Education England. The current policies from the DH include: cancer research and treatment, dementia, drug misuse and dependency, children’s health, health and social care integration, obesity and heating eating. Each of these policy issues is divided into different areas depending on its concern. For an instance, to ensure that students in schools consumes the proper and healthy food, research is undertaken by the Public Health England and Children’s Food Trust to look at caterers introducing healthier foods into school menus. In provision of health and social care services and implementation of effective policies and legislations, it is necessary to plan and evaluate the needs of the population and the support available for them. Other agencies can also give their feedback to the DH in regard with any improvements needed in health care for their area. Due to many health concerns rising such as high blood pressure, deaths on alcohol consumption, smoking, obesity, cholesterol, poor diet and lack of physical activity this challenges the government to formulate strategies that help the public to help themselves. Obesity is considered as a common problem in the UK that’s estimated to affect around 1 in every 4 adults and around 1 in every 5 children aged 10 to 11. There are many ways in which a person’s health in relation to their weight can be classified, but the most widely used method is the body mass index (BMI). Obesity is caused by the consuming more calories, particularly those in fatty and sugary foods, than you burn off through physical activity. The excess energy is stored by the body as fat. It is an increasingly common problem because for most people, modern living involves eating excessive amounts of cheap, high-calorie food and spending a lot of time sitting down rather than moving around and exercising regularly. Stoutness has as of late overwhelmed smoking as the greatest reason for early passing. With research demonstrating that propensities forever, including dietary patterns, are framed amid youth, the General Wellbeing division that works crosswise over Hammersmith and Fulham, Kensington and Chelsea and Westminster as of late counseled with a scope of experts including the NHS and chamber offices to comprehend what is expected to lessen youth heftiness in the zone. The aftereffect of the discussion is a Joint Strategic Needs Assessment (JSNA) that will be utilized to illuminate the chambers' way to deal with handling youth heftiness. Research showed that in Hammersmith and Fulham, 37.6% of children are overweight or obese by Year 6 (age 11). This issue has reached the government’s concern. To prevent and reduce the risks, the government raises awareness through advising and encouraging local Boroughs to plan and evaluate strategies that can help maintain a healthy environment for people living in the area. An example for this is the implementation of Sugar Tax Policy in which producers and importers of sugary drinks are taxed in the hope of cutting the obesity rates especially in children. Smoking is the biggest cause of preventable deaths in England, accounting for more than 80,000 deaths each year. One in two smokers will die from a smoking-related disease. Smoking increases your risk of developing more than 50 serious health conditions. Some may be fatal, and others can cause irreversible long-term damage to your health. You can become ill if you smoke yourself or if people around you smoke (passive smoking). Since The Health Act was introduced a smoke-free law in 2006, all indoor public places and workplaces, including work vehicles, to be smoke-free. Apparently, it is an offence to: smoke in smoke-free premises, permit others to smoke in smoke-free premises, fail to display warning notices in smoke-free premises. The borough of Hammersmith and Fulham encourage workplaces around the area to develop smoke-free policies for the staff and members to be aware. Alcohol misuse means drinking more than the lower-risk limits of alcohol consumption. This can have short-term risks or long term risks on a person. Short-term risks include: violent behaviour and being victim of violence, accidents and injuries requiring hospital treatment, alcohol poisoning that may lead to vomiting and seizures. Long-term risks include serious health disease such as heart and liver diseases, liver cancer, bowel cancer, mouth cancer, breast cancer, stroke and if worse can lead to death. Public Health of England (PHE) shows that From 2016 to 2017, there were 1.1 million admissions related to alcohol, of which alcohol was the main reason for admission for about 337,000 cases. PHE produce a range of resources and tools. These include tools to support the commissioning of alcohol services, support around social return on investment, the case for investing in alcohol interventions, and the impact of commissioning decisions on outcomes. Adult Alcohol and Drug Treatment Commissioning Tool supports areas in estimating local spend on treatment interventions and cost-effectiveness. The Tool also includes prevalence data for alcohol and opiate users, estimates of met need and a future scenario planning function. NICE pathways set out a structured approach to identify alcohol-related harm through the use of risk factors, screening tools and effective interventions. Epidemiology is the study of the origin and causes of diseases in a community. It is a method of investigation used by disease detectives like epidemiologists, laboratory scientists, statisticians, physicians and other health care and public health professionals to get to the root of health concerns and outbreaks in a community. The survey collected during a study will be used for demographic information, information on symptoms of illness and health care use. After this, epidemiologists will create a database with the information. They will then use what they learnt to prevent future outbreaks from occurring. This will successfully stop the outbreak the affected people are suffering from and vaccines and other medical needs will be provided and strengthened. The information gained from investigations will improve outbreak detection. Demographic data is defined as a statistical data about the characteristics of a population such as age, gender, and income of the people within the population and how the statistics changes over the years. When the census assembles data about people’s ages and genders, this is an example of assembling information about demographics. When working in a health and social care setting, professionals are necessarily required to process informations about the birth and death rates, family and household size, migration and life expectancies through demography. This will allow them know the progress and how the percentage of population changes over the time. Professionals won’t be able to recognise which age group, ethnic culture, are more likely to get health problems if not because of collecting informations and data, demography specifically which is why demographic changes for the health of population is really significant and is really needed in health and social care services. References: L3 Health and Social Care Book (Year 2) Lecture Notes (BM2) Assess the extent to which factors affect current patterns of health and ill health, with reference to a specific demographic area. It has for quite some time been perceived that social and economic background factors influences a person's wellbeing, prosperity and in general future. The World Health Organization (WHO) expresses that the conditions in which individuals are born, develop, live, work and age will decide their wellbeing and prosperity. Moreover, wellbeing and prosperity are influenced by social and financial elements, for example, access to money, power, and assets. These elements cause wellbeing imbalances inside and between nations. A report from the British Medical Association (BMA) reflects that disparities in wellbeing and social consideration are controlled by an individual’s age, salary, training, occupation, sexual orientation, ethnicity and where an individual lives in Britain. The report means to enable specialists to recognise and take activities, which are neither fundamentally medicinal nor requiring therapeutic information to have a beneficial outcome. For an instance, specialists can utilise their position and their ability to advocate for change in territories outside customary medicinal regions and advance examination into anticipation measures. A summary from the Public Health of England (PHE) shows how the health of people in Hammersmith and Fulham is varied compared with the England average. About 24% (6,700) of children live in low income families. It also shows that life expectancy for women is higher than the England average. Figure 1. Life expectancy: inequalities in Hammersmith and Fulham as of 2015 Education is likewise a factor that can influence individuals’ wellbeing, particularly amid the early advancement of physical and emotional health. What children are taught before they go to school has an extraordinary effect, which can influence their wellbeing and prosperity, and even their future child rearing abilities. Despite the fact that data about smart dieting and ways of life is taught in school, in poorer networks the hypothesis isn’t constantly drilled outside school. There are a few purposes behind this, including absence of parental interest, absence of money to buy more beneficial sustenance choices, playing with computer recreations as opposed to playing outside, in addition to worry about giving children a chance to play outside. In urban areas, spots to play might be limited or vandalised where they do exist, in addition to air contamination is presently observed as a noteworthy health concern. A person’s way of life has an effect on their health and prosperity. On the off chance that a person has a less than stellar eating routine and abuses medications and liquor, the individual's wellbeing will be negatively influenced. The Black Report demonstrated that financial and social way of life has either a constructive or adverse effect on a person’s wellbeing. The health of the general population living in poorer networks is less great than the strength of those living in more princely territories, and they likewise have a lower future. Childhood obesity is one of the most serious public health challenges of the modern century. A report shows that an estimated 4,000 children between the ages of 4-15 are currently obese in London Borough of Hammersmith and Fulham. Obese children are at an increased risk of developing social, psychological and other health concerns, with 79% of obese children becoming obese adults resulting in long term personal ill health, lower life expectancy, social stigmatisation, lower chances of employment, increased social care costs, reduced productivity and increased sickness absence. The environment in which a person grows and lives has a massive impact on their health and wellbeing. Air quality monitoring sites, which are situated in several hundred locations throughout the country, record all the different type of pollutants in the air for that area. Research shows that people living in cities are more prone to health concerns than those living in smaller town or villages. Vehicle fumes affect air quality; the closer to a main