This study material provides a detailed analysis of the health profile of Lewisham, including demographic characteristics, deprivation, health status, and health indicators. It is suitable for courses related to health and community development.
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LEWISHAM HEALTH PROFILE 1 Lewisham Health Profile Course name Student Name Date
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Lewisham Health Profile2 Introduction.................................................................................................................................................3 Need assessment......................................................................................................................................3 Health profile...............................................................................................................................................4 Health Monitoring and surveillance systems...........................................................................................4 Lewisham health profile..............................................................................................................................5 Health summary......................................................................................................................................5 Demographic...............................................................................................................................................5 Deprivation..................................................................................................................................................6 Deprivation table.....................................................................................................................................6 Deprivation chat......................................................................................................................................7 Health status................................................................................................................................................7 Life expectancy table...............................................................................................................................8 Life expectancy chat................................................................................................................................8 Health indicators on injuries and ill health..............................................................................................9 Health indicators on injuries and ill health chat.......................................................................................9 Health indicators on child health.............................................................................................................9 Health indicators on child health chat....................................................................................................10 Demographic characteristics..............................................................................................................10 Behavior risk factors mortality chat.......................................................................................................11 Health status on health protection..........................................................................................................11 Health status on health protection chats.................................................................................................12 Indicators on demographic characteristics.............................................................................................12 Health determinants chats......................................................................................................................13 Priority public health needs of the community..........................................................................................13 Vulnerable and disadvantaged groups.......................................................................................................15 Theories of health need..............................................................................................................................15 Population trends and transitions...............................................................................................................16 Community asset-based.............................................................................................................................17 Conclusion.................................................................................................................................................17
Lewisham Health Profile3 Introduction In a population there major issues that are major concern for the ruling government and local authorities’ need to solve and maintain effectiveness in the population. One of the key concerns is on health issues; this concern of wellbeing of the population ensures that the population of a given state or republic health is maintained to prevent consequences that may affect the economy of the state. In this case I will focus on the health issue in Lewisham in England. I will focus on the factors contributing to health issues for better understanding of the prevailing health issues in the region. To manage the national health in England, the local health provides health profile which I will use to manage health of the England population. Through the provision of health profile, the information provided in health profile will enhance the easy management of health issue in small areas which affect the England population (Archer, & Colhoun2018, p.24). There are various approaches I will use in the data collection which guide in the implementation and improvement of health standards in England. Need assessment Need assessment is the approach to identify how much knowledge, ability or the interest a group of people have about a given problem or topic of study (Sara2018, p.1217). This is done to identify the key issue affecting the society in order of implementing and improving the system and standards of the prevailing needs in the society. Need assessment also enables will enable me to understand what has been done and what has not been done in order to formulate a plan on how to fill the gaps.
Lewisham Health Profile4 Health profile Community health profile on the other hand, is an important tool that I will use to provide the information data about a given community (Yüksel 2018, p.300). The profile entails the community characteristics, health status, quality of life, health risk factors and resources relevant for most communities in a given areas of study. The health profile provides descriptive information that I will use to set priorities and interpretation of health issues in given community (Boden & Rees, 2010). The health profile and need assessment are both tools to identify health issues affecting the society. I will use the health profile to address health issues affecting the community in Lewisham. I will use the data provided to set priority on major health issue affecting the community. Health Monitoring and surveillance systems To facilitate effective health systems in a given society health monitoring and surveillance is done to ensure that there is continuity improvement of health standards (Terroba, Frövel, & Atienza 2019, p.25). Health monitoring ensures that health problems in a society are identified and solved. This includes diagnosis of health status, identification of health threats, and assessment of health service’s needs. I will use Health monitoring to manage risks and risks mitigations (Hui, Charlebois, & Sun 2018, p.55). To meet the expected health and accurate results health surveillance is done on daily basis in community health care. This involves collection of health data, data analysis and interpretation of findings. I will use The interpreted for health planning and implementation and evaluation of health services in the society ( Michael, et al.2018, p.1358).
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Lewisham Health Profile5 Lewisham health profile According to Unitary authority health profile, the population of Lewisham has almost 300,000 total populations. Out of these, the number of old people aged 65 and above ranges between 8% – 9 %, majority of the population are young people with the highest percentage of 52% while children under 18 years range between 23%. The population has a sharp decrease with age which is a strong indicator of deprivation of life expectancy in Lewisham (PHE 2019). Health summary The health of people in Lewisham varies with the average health the England population at 20%. The total number of children living in deprived condition is 23% of the England children population. These rates make it one of the most deprived districts in England. Life expectancy for men is almost 6 years lower and 4 years lower for women. The rate of children health is worse than the average of England. The rate of child obesity is at 23% compared to the England children population. The rate of child mortality is high for as compared to the average child population in England. The adult health accounts the highest number of count in the hospital as compared to the average in England population. The health related to alcohol, self-harm and sexual related problem are among the highest problem reported by the local authority (PHE 2019). There major health indicators in the Lwisham population as indicated by the health profile. Demographic Lewishing has a total population of 292,000 people which is expected to rise with318000 in year 2021. A quarter of this population is under 19. The region has the highest number of mortality
Lewisham Health Profile6 rate with over 27% above average of the total population in London. 46% of the population is black and minority ethnic groups (John & Chinouya 2018, p.13). The determinant of demographic is independent of the population practices which include religion, language and economical practices. The majority of the populations are Christian with the highest percentage of 52%. Followed by non-religious group with 26%, Muslims forms 6% while other religions have less than 2%. The common language spoken by the majority is English Deprivation Deprivation is the lack of or denial of basic necessity such as basic education, shelter, food, health care among other needs considered as basic. Among all the 326 local authority, Lewishing rank as 48thposition of the most deprived region in England. It has the highest number of children and young people ranking at 29% and older people at 25% of the economic deprivation. According to Trust London poverty profile, Lewisham is the worst among the beneficiaries and welfare reform and education. The number of people living in low income house is higher than the average of the England population. The number of child poverty being higher followed by the number of older people. Deprivation table(PHE 2019). Inequalitie s indicator nameperiod local count local value eng value eng wost Deprivation score (IMD 2015)20151337022.716.830.5 Smoking prevalence: routine and manualoccupations2017019.125.748.7
Lewisham Health Profile7 Deprivation chat(PHE), (2019). local valueeng valueeng wost 0 10 20 30 40 50 60 22.7 16.8 30.5 19.1 25.7 48.7 Deprivation score (IMD 2015) Smoking prevalence: routine and manualoccupations Health status The health status in the region indicates that there many health problems in Lewisham than any other part of England. These problems are associated with the level of depravity in the region. It is estimated that the majority of older people under 75 years die from cancer and respiratory diseases. Life expectancy for women is higher than of the men in the region. Birth expectancy for a female is higher than birth expectancy for male children. Also, health and disability life expectancy for a female child is higher than for male children.
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Lewisham Health Profile8 The health status of the service provision in general health care is worst and below the expected standards. The living standards are lowered by the rate of increased poverty whereby the poor health is fueled by overcrowded homes and the while pensioners are living alone. The status of children with obesity is very high as compared to the England average. The children hospital attendance and admission in the hospital is high or almost equal to the England average. Health indicators life expectancy Life expectancy table((PHE), 2019) life expectanc y and cause of death indicator nameperiod local count local value eng value eng wost Life expectancy at birth (Male 2014- 2016079.179.574.2 Life expectancy at birth (Female) 2014 - 16083.383.179.4 Under 75 mortality rate: all causes 2014- 161887371.1371.1333.8 Under 75 mortality rate: cardiovascular 2014- 1639581.873.5141.3 Under 75 mortality rate: cancer 2014- 16701148.8136.8195.3 Suicide rate 2014- 16607.29.918.3
Lewisham Health Profile9 Life expectancy chat 0 50 100 150 200 250 300 350 400 local value eng value eng wost Health indicators on injuries and ill health((PHE), 2019) injuries and ill health indicator nameperiod local count local value eng value eng wost Killed and seriously injured on roads 2014 - 1618320.539.7110.4 Hospital stays for self−harm26084.2185.3578.9 Hip fractures in older people (aged 65+121427.1575854.2 Cancer diagnosed at early stage37852.452.639.3 Diabetes diagnoses (aged 17+)065.377.154.3 Dementia diagnoses (aged 65+135170.967.945.1
Lewisham Health Profile10 Health indicators on injuries and ill health chat Killed and seriously injured on roads Hospital stays for self−harm Hip fractures in older people (aged 65+ Cancer diagnosed at early stage Diabetes diagnoses (aged 17+) Dementia diagnoses (aged 65+ 0 200 400 600 800 local value eng value eng wost Health indicators on child health((PHE), 2019) Child health indicator nameperiod local count local value eng value eng wost Under 18 conceptions201610022.118.836.7 Smoking status at time of delivery2016/172009.810.728.1 Breastfeeding initiation2016/17381486.174.537.9 Infant mortality rate 2014 - 16493.43.97.9 Obese children (aged 10−11)2016/1772923.72029.2
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Lewisham Health Profile11 Health indicators on child health chat Under 18 conceptionsSmoking status at time of delivery Breastfeeding initiationInfant mortality rateObese children (aged 10−11) 0 10 20 30 40 50 60 70 80 90 100 22.1 9.8 86.1 3.4 23.7 18.8 10.7 74.5 3.9 20 36.7 28.1 37.9 7.9 29.2 local value eng value eng wost Demographic characteristics(PHE) (2019) Behavio r risk factors indicator nameperiod local count local value eng value eng wost Alcohol−specific hospital stays (under 18s 2014/15- 16/173215.834.2100 Alcohol−related harm hospital stays2016/171254522.3636.41151.1 Smoking prevalence in adults (aged 18+)20173578015.514.924.8 Physically active adults (aged 19+)2016/17064.96653.3 Excess weight in adults (aged 18+)2016/17057.861.374.9
Lewisham Health Profile12 Behavior risk factors mortality chat((PHE), 2019) Alcohol−specific hospital stays (under 18s Alcohol−related harm hospital stays Smoking prevalence in adults (aged 18+) Physically active adults (aged 19+) Excess weight in adults (aged 18+) 0 200 400 600 800 1000 1200 1400 15.8 522.3 15.564.957.834.2 636.4 14.96661.3 100 1151.1 24.853.374.9 local value eng value eng wost Health status on health protection health protectio n indicator nameperiod local count local value eng value eng wost Excess winter deaths 2013 - 201629621.117.930.3 New sexually transmitted infections201738721825793.83215.3 New cases of tuberculosis 2014- 201619521.910.969
Lewisham Health Profile13 Health status on health protection chats((PHE), P. 2019) local countlocal valueeng valueeng wost 0 500 1000 1500 2000 2500 3000 3500 4000 4500 Excess winter deaths New sexually transmitted infections New cases of tuberculosis Indicators on demographic characteristics The demographic characteristics are affected by social behaviors which lead to deterioration of health in a society. Lewisham has the highest rate of various social behaviors. These include alcoholic, sexual related crime and self-harm behaviors. These behaviors can be rooted due to the highest rate of deprivation which leads to depression resulting to the high rate of negative social behaviors (Molloy 2017, p.17). Smoking prevalence in manual occupation rate is high which results to increase of TB related diseases in the hospital. Children low income families under 16 which has 22.1 worse than England with 16.8 this is seen where families lack basic necessities. Performance in school is greater than the England population with 54.8. Employment rate for young people is higher than England average and also rate of violence is higher than Average England average population 24.5 and 20.0 (Cary 2016).
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Lewisham Health Profile14 wider determinant s of health indicator nameperiod local count local value eng value eng wost Children in low income families (under 16s)20151337022.716.830.5 GCSEs achieved 2015/1 6148254.857.844.8 Employment rate (aged 16−64) 2016/1 7 16310 077.474.459.8 Statutory homelessness 2016/1 7770.60.8 Violent crime (violence offences) 2016/1 7727624.52042.2 Health determinants chats((PHE), P. 2019). Children in low income families (under 16s) GCSEs achievedEmployment rate (aged 16−64)Statutory homelessnessViolent crime (violence offences) 0 10 20 30 40 50 60 70 80 90 22.7 54.8 77.4 0.600000000000001 24.5 16.8 57.8 74.4 0.8 20 30.5 44.8 59.8 42.2 local value eng value eng wost
Lewisham Health Profile15 Priority public health needs of the community The profile indicates that there is an increase in sexually transmitted infections in the year 2017. This implies that this a major health risk which requires health attention by the authority (Wayal, et al.2018, p.13). The indication of the active number of young people over 19 years may be the results of the sexual abuse in the region. Cases of alcohol-related harm and self-harm have also increased; this is likely to be rooted due to the highly increased rate of employment and change of behavior among the young people in the region (Lopez-Morinigo 2014, p.14). The profile indicates that there are violent crime offenses in the region. As a result of deprivation in the region, crime can be associated with poverty. Lack of basic necessities in the area may result in these crimes. Also, the high rate of employment due to better school performance may also increase the crime by the less fortunate people in the region. The rate of the child living in a depredated condition is very high than the average rate of children in the same condition in England. The children health is also another factor to be considered as a health priority. Despite the high number of children growing and increased of child development, the region experience high child mortality. This is a concern in the region, the finding indicates that the demographic smoking practices by pregnant mothers are the major cause of child mortality. There is a high rate of obese children and young people in the region. The rate of active people in the region is very low which may lead to this obese condition. Also, high employment can increase the change eating behavior which encourages unhealthy eating habits.
Lewisham Health Profile16 Older people are experiencing health challenges of hip fracture which indicate that the incidents are on the rise in the region than other regions in England. Majority of people are likely to die at 75 years or less due to chronic diseases. This is a major priority for the health authority. Majority of people are dying due to cancer-related diseases such as breast cancer, prostate cancer, respiratory and heart diseases. The rate at which cancer is diagnosed indicates that the early rate of a cancer diagnosis is low. Vulnerable and disadvantaged groups The world health organization indicates that the most vulnerable people in society are the elderly and young people. The factors that contribute to health issues especially respiratory and cardiovascular disease affect greatly those people with such conditions. The aged people are likely to be the most affected by factors that affect health due to their vulnerability. Exposure of pregnant mother to behaviors that lead to chronic sicknesses can affect the unborn baby resulting in problem in development and health risk in the future life of the baby. They also result in childhood asthma, low birth weight, and intrauterine growth retardation. Theories of health need Bradshaw’s taxonomy of need is the theory of identity and making a need possible. These four methods of identifying needs these include; Normative needs which are identified by experts. They require specific standards lay down by experts. For example, an expert may advise a patient that they need surgery; a child needs to be
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Lewisham Health Profile17 vaccinated. It also includes a perceived need by an individual (Carver, Ward, &Talbot 2018, p.30). Felt need is the need identified by a community to make a different pertaining a problem at hand. This involves ranking the needs in their importance and strategizing on the measures to solve those needs. The expressed need is taken as equal to demand or an unmet need. It is the need that is met when there is a demand for it. The justification outline that people with fewer resources are the one who has demand for social services but they unlikely to voice their demand. If people do not demand these services it is taken as if there is no demand for the services. The comparative need is measured by reference to the person receiving the services. The comparison comes in if there is a person requiring the services with the worst need than the person receiving the same services. This ensures that social services are prioritized where they're needed most in the region to enhance and improve health conditions (Catherine2019). Population trends and transitions The population trend is determined theory of demographic trends. This measures the changes that occur in birth and death rates. The changes that take place between birth and death rate are determined by economic development. Demographic population growth cycle begins with the fall of death rates and continues with population growth and start falling with population growth. Economic growth enhances growth in population leading to less death in a given demographic (Guo 2017, p.25).
Lewisham Health Profile18 Nutrition transition is the change in diet consumption and energy expenditure. These affect the economy due to the high risk of health issues such as diabetes, obesities, and other food-related diseases. It also affects the demographic trends due to the rise of deaths and births. Epidemiology transition is a phase of increased population growth due to the increase in innovation in public sectors and improved food security, followed by the leveling of the population due to a decrease in fertility. Community asset-based Asset-based community development defines community asset as an approach to developing a community in groups through their strengths and assets. It focuses on eliminating the perception of deficit and community problems. Through facilitating the community in problem-solving, knowledge from what the community knows is important and enhances quick decision and problem-solving. In need assessment involving the community is a key measure that encourages community participation and helps in cost saving due to the utilization of available resource among the communities David (2016). Conclusion The profile has well elaborated on the health issues facing the region but has not outlined the availability of health facilities and resources available which would be the key reason for the high mortality rate. The profile has not captured unemployment status in the region which may be triggering the crime in the region due to lack of life sustainability resources. With the rate of the homeless group in the report, the profile has not captured the cause of these factors. Other
Lewisham Health Profile19 information I would like to know in the profile is about the economic practices and cultural practices in the profile. These could be the leading factors contributing to the health issues despite the intervention of the authority to improve the health sector. Cultural practices differ from one community to another, despite the majority of the population being Christians, what are the cultural practices of other non-religious group indicated in the profile. This knowledge can shed more light in the profile and help in improving the health sector in the region.
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Lewisham Health Profile20 List of references Archer, G. and Colhoun, A. (2018) ‘Incident reporting behaviours following the Francis report: A cross‐sectional survey’,Journal of Evaluation in Clinical Practice, 24(2), pp. 362–368. doi: 10.1111/jep.12849. Boden, P. and Rees, P. (2010) ‘Using administrative data to improve the estimation of immigration to local areas in England’,Journal of the Royal Statistical Society: Series A (Statistics in Society), 173(4), pp. 707–731. doi: 10.1111/j.1467-985X.2009.00637.x. Carver, N. A., Ward, B. M. and Talbot, L. A. (2008) ‘Using Bradshaw’s Taxonomy of Needs: Listening to women in planning pregnancy care’,Contemporary Nurse: A Journal for the Australian Nursing Profession, 30(1), pp. 76–82. doi: 10.5172/conu.673.30.1.76. Cary, M.(2016) ‘Human trafficking and severe mental illness: an economic analysis of survivors’ use of psychiatric services’,BMC Health Services Research, 16, pp. 1–8. doi: 10.1186/s12913-016-1541-0. Catherine P(2019) ‘Progress and Priorities in Research to Improve Outcomes for Students With or at Risk for Emotional and Behavioral Disorders’,Behavioral Disorders, 44(2), pp. 85–96. doi: 10.1177/0198742918808485.
Lewisham Health Profile21 David, P. (2016) ‘“Now I Know My ABCDs”: Asset-Based Community Development with School Children in Ethiopia’,Children & Schools, 38(4), pp. 199–207. doi: 10.1093/cs/cdw031. Guo, K. and Yu, J. (2017) ‘Gender gap, capital accumulation and the demographic transition’,Economics of Transition, 25(3), pp. 553–572. doi: 10.1111/ecot.12126. Hui, S. (Rob), Charlebois, L. and Sun, C. (2018) ‘Real-time monitoring for structural health, public safety, and risk management of mine tailings dams’,Canadian Journal of Earth Sciences, 55(3), pp. 221–229. doi: 10.1139/cjes-2017-0186. John Aspinall, P. and Chinouya, M. (2008) ‘Is the standardised term “Black African” useful in demographic and health research in the United Kingdom?’,Ethnicity & Health, 13(3), pp. 183– 202. doi: 10.1080/13557850701837294. Lopez-Morinigo, J.-D..(2014) ‘Suicide completion in secondary mental healthcare: a comparison study between schizophrenia spectrum disorders and all other diagnoses’,BMC Psychiatry, 14(1), pp. 34–53. doi: 10.1186/s12888-014-0213-z. Lowrey, M, Otnes, C, & Ruth, J. A. (2018) ‘Exploring the Behavioural Patterns of Knowledge Dimensions and Cognitive Processes in Peer-Moderated Asynchronous Online Discussions’,International Journal of E-Learning & Distance Education, 33(1), pp. 1–28. Available at: http://search.ebscohost.com/login.aspx? direct=true&db=eft&AN=132099422&site=ehost-live (Accessed: 10 April 2019). Maginn, S..(2004) ‘The detection of psychological problems by General Practitioners-- influence of ethnicity and other demographic variables’,Social Psychiatry & Psychiatric Epidemiology, 39(6), pp. 464–471. doi: 10.1007/s00127-004-0751-7.
Lewisham Health Profile22 Mannix, T. R. Austin, S. D. Baayd, L. S & Sara E.(2018) ‘A Community Needs Assessment of Urban Utah American Indians and Alaska Natives’,Journal of Community Health, 43(6), pp. 1217–1227. doi: 10.1007/s10900-018-0542-9. Michael A.(2018) ‘Public Health Surveillance for Zika Virus: Data Interpretation and Report Validity’,American Journal of Public Health, 108(10), pp. 1358–1362. doi: 10.2105/AJPH.2018.304525. Misener, L. and Schulenkorf, N. (2016) ‘Rethinking the Social Value of Sport Events Through an Asset-Based Community Development (ABCD) Perspective’,Journal of Sport Management, 30(3), pp. 329–340. Available at: http://search.ebscohost.com/login.aspx? direct=true&db=s3h&AN=115853522&site=ehost-live (Accessed: 10 April 2019). Molloy, A.(2017) ‘Routine monitoring and assessment of adults living with HIV: results of the British HIV Association (BHIVA) national audit 2015’,BMC Infectious Diseases, 17, pp. 1–7. doi: 10.1186/s12879-017-2708-y. Nel, H. (2015) ‘An integration of the livelihoods and asset-based community development approaches: A South African case study’,Development Southern Africa, 32(4), pp. 511–525. doi: 10.1080/0376835X.2015.1039706. Terroba, F., Frövel, M. and Atienza, R. (2019) ‘Structural health and usage monitoring of an unmanned turbojet target drone’,European Journal of Industrial Relations, 25(1), pp. 635–650. doi: 10.1177/1475921718764082.
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Lewisham Health Profile23 Wayal, S.(2018) ‘Understanding the burden of bacterial sexually transmitted infections and Trichomonas vaginalis among black Caribbeans in the United Kingdom: Findings from a systematic review’,PLoS ONE, 13(12), pp. 1–19. doi: 10.1371/journal.pone.0208315. Yüksel, S.(2018) ‘Analyzing differential item functioning of the Nottingham Health Profile by Mixed Rasch Model’,Turkish Journal of Physical Medicine & Rehabilitation (2587-0823), 64(4), pp. 300–307. Available at: http://search.ebscohost.com/login.aspx? direct=true&db=s3h&AN=133127793&site=ehost-live (Accessed: 10 April 2019). (PHE), P. (2019).Public Health Profiles. [online] Fingertips.phe.org.uk. Available at: https://fingertips.phe.org.uk/profile/health-profiles/data#page/1/gid/1938132696/pat/6/par/ E12000007/ati/101/are/E09000023/iid/90366/age/1/sex/1 [Accessed 12 Apr. 2019].