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

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