Assignment 1:
Keeping us well
Public health
As defined by Public Health England, public health is ‘the science & art of preventing
disease, prolonging life and promoting health through organised efforts of society.’
Ultimately, it is to prevent disease and promote health. In order to do this by meeting
population needs, public health requires multi-agencies working together to create policies,
legislation & strategies.
People have always been interested in their own health & those in their community which
showed concern over the public’s health. Things such as poor health, poor
sanitation/hygiene, war related injuries and poor living conditions made the UK think they
need to improve the health of the nation. Before the NHS in 1948, many people could not
afford to pay for healthcare treatment. This had serious consequences on people's health
such as lower infant survival rates, death from diseases which could be treated but the cost
was too expensive & poor dental health. Some could access healthcare if they were
considered living in poverty. This came under the ‘Poor Law’ which was funded by the
middle & upper classes. The government commissioned Sir William Beverdige to report on
the state of UK health to support radical changes to be made in order to improve health. He
published his report in 1942. It influenced the biggest reforms in the welfare state. The report
identified 5 giants or evils in society:
- Want (poverty)
- Disease (ill health & early mortality)
- Ignorance (lack of education)
- Squalor (poor housing)
- Idleness (unemployment)
The public welcomed this report as epidemic risks increased. In 1940, measles became a
notifiable disease in England & Wales and at the same time there was an epidemic with
approximately 400,000 cases reported where approximately one in twenty babies died
before their 1st birthday and every year people died of infectious diseases such as
pneumonia, meningitis and polio. Aldworth et al 2016
To defeat the 5 giants, Beveridge proposed introducing the welfare state with social security,
National Health Service (NHS), free education, council housing & full employment.
The overall aim of public health is to monitor, improve & prevent ill health whilst also
promoting health and wellbeing. The government has an overriding moral aim to make sure
that the health of its citizens is most important, creating conditions in society that the entire
population can enjoy good health on equal terms and this is regardless of their differences
like social class and geographical locations.
The Department of Health and Social Care (DHSC) is a government department & supports
ministers in leading the nation’s health & social care. This helps people live more
independently and healthier lives for longer. (DHSC 2024) They set overall strategies, funds &
oversees the system. This is through its 28 agencies & public bodies. It is also responsible
for identifying the population's health needs. The DHSC works with other organisations such
as Public Health England, CQC, NHS and those doing medical research.
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,Public health aims & strategies
The National Institute for Health Protection (NIHP) aims to protect the public against external
threats such as biological weapons and this covers all 4 nations. The NIHP joins the health
protection & resilience functions of Public Health England (PHE) and Track and Trace.
In order to improve public health, the government set out aims alongside the strategies to
meet these aims. One public health aim is to develop screening programmes. The strategy
developed by public health to meet this aim is by creating programmes to reduce risk and
screen for early disease. Screening is a way of finding out if people have a higher chance of
having a health problem. This is so early treatment can be offered or info can be given so
service users can make informed decisions. For example, breast screening is offered to
older people to potentially identify breast cancer. (Screening 2024)
A second public health aim is identifying & monitoring needs of the population. The strategy
to meet this aim involves planning and evaluating the national provision of health and social
care target planning. This includes local and national provision. Health & care leaders have
come together to develop a Long Term Plan to make the NHS fit for the future and getting
the most value for patients from taxpayers investment. One way The NHS Long Term Plan
will deliver for patients is supporting people to age well. They will do this by increasing
funding for primary and community care by at least £4.5bn and also bringing together
different professionals to coordinate care better.
A third aim is addressing specific national health problems over a period of time. Public
health's strategy is to identify the health needs and promote the health of the population. For
example, public health has set out initiatives & targets to reduce obesity. An example of this
initiative is the sugar reduction programme. This programme aims to take out 20% of sugar
in products by 2022 and also tax sugary drinks. Eating too much sugar can lead to weight
gain increasing the risk of heart disease, type 2 diabetes & some cancers. (Obesity 2024)
Health monitoring
Health monitoring is important as it helps identify current trends & predict future changes and
this influences provision & services provided. In order to help monitor the population, the
government looks at demographics; data from specific groups. Epidemiology also helps in
monitoring health status; study of how often diseases occur in specific groups of people &
why. There are various sources of information for determining patterns of health such as
health studies which are Govt commissioned reports on health, international groups such as
World Health Organisation, pressure groups like the British Heart Foundation and Govt
Agencies like DHSC. Other national sources of statistics include the Labour Force survey
which surveyed more than 40,000 households about work related illnesses which was
completed by the Office of National Statistics. The Office for Health Improvement and
Disparities (OHID) works across the DHSC, rest of the government and healthcare system
about shifting focus towards preventing ill health, particularly in locations/communities where
there are the most significant disparities. OHID will identify & address health disparities, take
action on biggest preventable factors for ill health and work with the NHS/local government
to improve access to services with detect/act on health risks/conditions as early as possible.
(OHID 2024)
Through health monitoring, work-related ill health and occupational disease has been
identified. For example 12,000 lung disease deaths each year estimated to be linked to past
exposure at work. This is reported by the Health and Safety Executive who are Britain’s
national regulator for workplace health and safety. (HSE 2024) There are 1.8 million workers
suffering from work-related ill health either new or long standing in 2022/23. 27% is due to
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, musculoskeletal disorders. Estimates of work-related ill health are based on self-reports from
the Labour Force Survey (LFS). (Ill-health 2024)
An example of how the government monitors the health of the population is by looking at
inequalities in mental health. Prevention is better than cure is a government plan to rework
healthcare with more emphasis on prevention. For example, to create the right conditions of
good health and wellbeing, it will take a holistic approach which addresses the root causes
of poor health amongst people with mental illness and empowering those people to make
informed choices. For good planning, it's important to understand the local population's
needs. Addressing the social determinants of poor health and building stronger communities
and social interactions is vital too to tackle inequalities in mental health. The FYFVMH
emphasises the need to better meet the physical health needs of people with mental illness.
To meet this need, a new initiative has been created; Equally Well UK which is led by the
centre for Mental Health which seeks to promote and support collaborative action to improve
physical health among those with a mental illness whilst reducing inequalities and offers a
range of useful resources. An example of this is physical health checks for people with
severe mental illness. (Mental health inequalities 2024)
Once information is gathered, the data is used to monitor and respond to public health such
as informing debate, inform decision making e.g Nationally, commission specific research,
increase public knowledge and ensure delivery of appropriate health supplies and health
care. Up-to-date information is crucial in preventing the spread of diseases and to support
service users with the necessary medicines. Health practitioners use data to help people
decide on sensible health precautions when travelling e.g charts for GP practices that show
appropriate vaccinations for destinations. Aldworth et al 2016
Needs are then identified with target setting. The NHS Long Term Plan is an example of
targets set from identified needs that the government have gathered and assessed. The plan
has a strong focus on treatment and prevention of illness by supporting patients to adopt
improved healthy behaviours. This will help people to live longer, healthier lives and also
reduce the demand for and delays in treatment and care. In the NHS Long Term Plan,
prevention refers to preventing disease or injury before it ever occurs which means working
with partners such as Government, Public Health England and local government. An
example of the NHS work on prevention is the treatment of tobacco dependency. Through
the NHS Long Term Plan commitment, it will support the NHS to ensure that every person
admitted to hospital (both physical and mental health sites) who smokes will be offered NHS-
funded tobacco dependence treatment by 2023/24. (Prevention of ill health 2024)
The government uses monitoring to develop & plan public health policy. They regularly
analyse data about the prevalence & incidence of disease, distribution of health risk factors
and how health services are used. This identifies trends and patterns in public health which
can later inform policy. For example, The Marmot Review 2010 looked into health
inequalities in England. It proposes an evidence based strategy to address the social
determinants of health, the conditions in which people are born, grow, live, work and age
and which can lead to health inequalities. Some of the findings of this report include that
people living in the poorest neighbourhoods in England will on average die seven years
earlier compared to people living in the richest neighbourhoods. Another finding is that
health inequalities are largely preventable. An estimated £36bn to £40bn is the annual cost
of health inequalities through lost taxes, welfare payments & costs to the NHS. To address
health inequalities, it needs to create conditions for people to take control of their own lives,
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