Social Political & Environmental Issues in International Healthcare

This report discusses the key risk factors, diagnosis, and management of COPD, as well as the impact of social, political, and environmental issues on its diagnosis. It also covers the strengths and limitations of global strategies implemented by organizations such as WHO.

Social Political & Environmental
Issues in International Healthcare

Table of Contents
INTRODUCTION...........................................................................................................................1
Task 1...............................................................................................................................................1
Task 2...............................................................................................................................................3
TASK B...........................................................................................................................................5
TASC C............................................................................................................................................6
REFERENCES ...............................................................................................................................7

INTRODUCTION
Respiratory diseases are life threatening, may be caused by infection, smoking, tobacco
and radon. Respiratory diseases includes COPD, asthma, pneumonia, lung cancer and
pulmonary fibrosis. Chronic obstructive pulmonary disease is a respiratory disorder that causes
obstruction in air flow and make difficulties in breathing. COPD destructs the lungs sacs and
thus damages walls and causes difficulty in breathing. This report highlights the key risk factors
for COPD and the key features of COPD in terms of aetiology, diagnosis and disease
management. The impact of international, economic environmental and political issues on the
diagnosis is also going to be discussed. This report will also cover the strength and limitations of
global strategies implemented by organisations such as WHO.
Task 1
Coronary obstructive pulmonary disease is a long term lung disorder that causes
difficulty in breathing. This is one of most challenging diseases is being faced by the citizens of
UK. Exposure to irritants and pollutants damage the lungs and airways and it causes chronic
pulmonary obstructive disease. Risk factors of COPD includes smoking, pollutants, tobacco and
radon. Non smokers also get affected by this disease as they come in exposure of irritants or
pollutants. Symptoms of coronary obstructive pulmonary disease includes shortness of breathe,
wheezing, lack of energy, respiratory infection, unintended weight loss and chest tightness.
There are two types of COPD including emphysema and chronic bronchitis. Emphysema is
caused when the person comes in exposure of irritants and damage lungs air sacs and results
merge into one giant air sac. This causes less oxygen absorbed by the lungs and the patient get
less oxygen in blood. Lungs looses their springiness as the alveoli get destroyed and lungs are
stretched out. Patient start feeling short of breathe as air get trapped in airway because of
obstruction of lungs. Chronic bronchitis causes thickness of mucus lining results coughing and
shortness of breathe. Bronchial tubes are totally covered by the hair like structures called cilia
and these fibres help to move out the mucus. In chronic bronchitis patient start loosing cilia thus
it is difficult to rid of the mucus causes coughing and mucus get increased.
80% of COPD patient are suffering just because of cigarette smoking which has totally
damaged their lungs. A person burns cigarette, gives rise to more than 7000 harmful chemical
which destroys the wall of lungs. Lungs get weak because of toxin present in cigarette and can
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not defend against infections thus cause narrowing air passages results swelling in air way.
Cigarette totally destroys air sacs which causes shortness of breathing. Environmental factors
also affects the respiratory system as a person work or live in exposure of pollutants and irritants
the airway get infected and causes obstruction. Alpha-1 deficiency related emphysema is a rare
from of COPD by which people suffer caused by genetic factor and the secretion of alpha protein
get reduced which helps to protect the lungs. Other risk factor includes working with chemicals,
dust and fumes, exposure to air pollution, A genetic condition called Alpha-1 deficiency,
breathing second hand smoke and a history of childhood respiratory infection. There are certain
steps required to be taken to prevent COPD includes if a patient is chain smoker he need to stop
smoking otherwise he can not live a longer and healthier life. There are number of programs
being conducted by government of UK which help to get rid of smoking. Smokers need to avoid
exposure to second-hand smoke. Less exposure to pollutants and irritants also helps to get rid of
COPD. Patient having symptoms like dyspnoea, chronic cough, sputum production and
wheezing can be victim of COPD. To make a diagnosis of COPD spirometry is required and
existence of persistent airflow limitation is confirmed by presence of a post- bronchodilator
FEV1/FVC < 0.70 . Diagnosis of COPD also involves physical examination which includes
listening to your lungs and heart, examining nose and lungs, checking feet and ankles for
swelling and checking blood pressure and pulse. Spirometry test is conducted to examine the
lungs that how they are working. In this test a machine is connected to blow air into a tube and
breathing rate is calculate to examine lungs capacity. Other test includes arterial blood gases,
electrocardiogram, chest x-ray and exercise testing. Pulse oximetry calculate the amount of
oxygen present in blood where as electrocardiogram examines the function of heart. Chest X- ray
is a type of imaging test which gives a diagram of lungs and chest. Exercise testing evaluates
either the amount of oxygen drops in blood. Arterial blood gases determines the amount of
oxygen and carbon dioxide present in the blood (Agusti and et. al., 2018). COPD has four stages
such as mild COPD, moderate to severe COPD and very severe COPD. In first stage of COPD
the patient feel shortness of breathe even after little exercise or may be walking up stairs.
Phlegmy cough is also experienced in first stage of COPD which always gives trouble in
morning. In second and third stage of COPD patient develop shortness of breathe even after
daily activities. Discolouration of phlegm and advanced shortness of breathe also may
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experienced in second and third stage of COPD. In forth stage COPD gets severe and patient
may need supplemental oxygen from a portable tank.
Task 2
Severe respiratory diseases such as coronary obstructive pulmonary disease gets less
attention and thus get less funding for intervention. As it is one of the most challenging health
issue in UK and sometimes it is also a silent killer as patient having no symptoms before death.
The environmental, socio- economic and political issues affects the diagnosis of COPD. The
diagnosis gets difficult because of variability in patterns of clinical presentation. The government
is making policies for intervention but plans are not getting executed because of corruption.
Funding plays an important role for the execution of such programs but because of corruption
these strategies are not being implemented. A health care professional or a doctor conduct more
practical research and plans who knowns about the political dimensions. The challenges faced in
COPD intervention policy can be influenced by political issues. In this case understanding and
resolving conflicts and eliminating the barriers is very compulsory to improve the chances for
successful implementation. Failure of implementation of such strategies and plans results
increasing prevalence of COPD and cause increase rate in morbidity. The guidelines are also
released by the government for COPD management in order to reduce the prevalence. It is
analysed that the prevalence have become more comparable, spontaneous and consistent.
Management of COPD is done by suitable pharmacotherapy which is administration of
appropriate medicines. Promotion of smoking cessation is also helpful in COPD management.
Exposure to irritants and pollutants always triggers the symptoms experienced in COPD and now
a days as because of indoor and outdoor air pollution in high and low income countries is
continuously triggering the exacerbation. Working in such environment where a person getting
the exposure of pollutant can harm his lungs and can suffer from lung infection. Long term
exposure of fume, dust and chemicals destroys the wall of lungs and causes obstruction in
airways. Occupational hazards such as exposure to harmful chemicals and poor nutrition are also
biggest risk factor for COPD. Poor nutrition weakens our immune system and the ability to fight
with antigens get decreased and lungs get infected by virus and antigens inhaled while breathing.
Environmental factor which causes COPD includes air pollution (Daccord, Touilloux and Von
Garnier, 2020). Air pollution has negative impacts on human health because it creates
obstruction in airways and patient may experience shortness of breathe. Harmful gases released
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through industries get mixed with the fresh air and get inhaled by a healthy person and damage
the alveoli sac causes COPD. It is concluded in a report that prevalence of COPD is 5% in
females and 3.7% in males. Initiatives taken for COPD guidelines are not being followed in real
life practices because most of the patients administered corticosteroids and some of them receive
slow release theophylline. Global initiatives for COPD has published a consensus report in 2011.
In this report global strategies for the diagnosis and management of COPD has mentioned. In
January 2013, an another report published and it was based on discussion on treatment and
management of COPD (Peiffer, Underner and Perriot, 2018). Management of COPD is also done
by pulmonary rehabilitation which is treatment programs tells patient how to manage the COPD
when it gets severe and how to receive quality health care. This program is conducted to tell
about diet plans and exercises which are essential during the management (Mirza and et. al.,
2018). Patient also get to know about how to save the energy and can breathe better. There are
specific vaccines available in the market for the management of COPD caused by pneumonia
and flu. Administration of certain antibiotics are also helpful for the treatment of lung infections.
Patient suffering from COPD need to carry a oxygen tank because they may get severe attacks
causing death. Less exposure to pollutants and irritants also helpful for the management of
COPD. Consumption of tobacco, nicotine and smoking are biggest risk factors for COPD thus it
is required to avoid all these risk factors (Soler-Cataluña and et. al., 2020). It is estimated that the
prevalence of COPD is 15 million people have COPD , 14.1 million people had chronic
bronchitis and 1.8 million people are suffering from emphysema and thus COPD has became a
major health issue. The COPD also deceases the potential of an individual to perform and thus
decreases self esteem. In UK, Roflumilast is recommended as an treatment for severe COPD
which can not be treated by others. Roflumilast is one day tablet which eliminates the impact of
irritation and swelling and most of the citizens of UK are able to access of this treatment.
Approaches made by India for the management of COPD includes lungs surgery which is
helpful to improve breathing. The cost load related to emphysema and chronic bronchitis,
altogether also called as chronic obstructive pulmonary disease (COPD). The disease affects not
only on society and patients but also affects the caregivers . An approximately sixteen million
human beings in the US are presently determined with COPD, the more number of people having
chronic bronchitis. Death rate linked with the chronic obstructive disease, is on the upheaval, as
is its occurrences in the the elderly and women population . It is now a days the fourth most
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general cause of death both in the US and worldwide. To date, the only proven cost-effective
therapies for the disease are the cessation or prevention of smoking, which is the single most
common reason of COPD, and vaccination to stop pneumococcal and influenza infection.
Hospitalisation and related prices show the greatest healthcare spending for human beings with
the infection. Very long-term oxygen treatment is also among the very high price interventions in
regards of total currency consumed on direct medical prices for COPD therapy, although this is
possibly cost-effective due to its effective impact on the pace of death rate. In actual fact, oxygen
therapy is the single interference to date that has been represented to slow down the pace of death
because of COPD. Accurate treatment with appropriate medical practice has the effective to slow
down the use of resources but does not emerge to affect pace of death. As like as, pulmonary
rehabilitation programs emerge to provide benefit to patients in terms of good quality of life;
however, long-term effectiveness of costs and effects on death rate have yet to be illuminated.
Indirect prices also put up a considerable part of the economic load of the infection but are more
harder to asses.
TASK B
The strengths and limitations of the global strategies for COPD are: It improvise the
respiratory health and well being of all communities and make people aware about the harmful
effects of smoking and inhaling harmful gases. But the strategy does not seems to increase its
reach to the rural areas (Hussain and et. al., 2018). People at rural areas are not educated and they
are not likely to follow the instructions so strategies need to frame which can convince rural
people to quit smoking. Some strategies are made to provide effective medical support to all the
people who suffer from Asthma and COPD at minimum price to promote health equality but
some people like Torres Strait Islander who are not able to access the facility due to
unavailability of service at their region denotes the practice of health inequality. The strategies
are framed for the purpose to reduce the number of population who get effected from COPD by
make them aware about the importance of good health and good lung's functioning. Addicted
people are unable to control themselves just by understanding the risk factors but they need to
get some alternative way so that they can help themselves to satisfy their addiction without
actually causing harm to their body. The lack of therapy centres and rehabilitation centres for
smoking at rural areas is also a limitation of the strategies for COPD. In order to reduce the cases
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of COPD, it is important to diagnose the disease at early stage and to follow preventive
interventions, consider proactive care and management of the developing disease at all stages.
Early identification and diagnosis of any disease is possible only when the hospital is
well-instrumented to avail the approaches of the early diagnosis and timely beginning of the
treatment. But limitation of resources, funding, and staff does not allow to implement proactive
approach for intervention, treatment, care, and management of the disease at the high prevalent
areas and to the people of disadvantaged groups (Welch and et. al., 2020). The strategies are to
ensure the quality of life of the people suffering from COPD to enable them to experience
support and care as well opportunity to access the right o end of life. End of life concerns with
the right to be treated well, with respect and dignity during the course of the treatment. Under
this right the patient can claim to receive quality care and can demand for extraordinary services.
The hospital administration is always responsible to protect the rights, privacy and dignity of the
patient. If any hospital staff is found to exploit the privacy of any patient without patient's
concern, it would be considered as infringement of law and the staff member can be sentenced to
jail or can be charged with fine as punishment. People of disadvantaged groups are not aware of
their rights and policies like end-of-life, so they are not able to access all these facilities and
remain unaware of their rights which is a matter of health inequality.
TASC C
Health inequality refers to the unequal distribution of health and medical services due to
lack of resources, knowledge, employment status, income level, partiality on the basis of wealth,
prestige, power, position, etc. I think every individual have equal right of health and health
inequality is a wrong practice against which strict actions should be taken (Ho and et. al., 2019).
Every individual should have fair opportunities to access the medical and a healthcare
professional should not be partial at any cost. From above learning we get to know that patient of
COPD already suffers from shortness of breathing and any ignorance in attention by professional
can even cause death to the patient. A healthcare professional should always be sensible and treat
and respect all their patients equally. I experienced health inequality when I was working as a
staff in a multi speciality hospital. A case has arrived who needs minor medical services and the
patient was belong to a prestigious family. The doctor at the time of duty started gave special
attention and treatment to that particular patient only that was clearly signified the feeling of
inequality among patients which was absolutely a wrong behaviour reflected by the professional.
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Health accessibility refers to the ease of providing health services in cost-effective, time-
effective manner and access the availability of qualified professionals at different geographical
areas (Yin and et. al., 2022). There are five considered dimensions of health accessibility and
they are: Approachability, Accessibility, Affordability, Appropriateness, and Availability. At
many geographical areas people are unable to access the medical facilities. I would like share my
reflection on health accessibility. People of backward groups who used to live far from urban
areas are not able to reach the hospitals at the time of emergency related to a COPD case. So
once hospital team had to reach to the rural area with all the facilities at the locality. Patient and
family were so sensitive about their culture and they does not allowed team to take preventive
actions related to the medical treatment and care. So then medical team managed to convince the
family anyhow and started the treatment for the welfare of the patient. From this case I
experienced and felt the importance of awareness and education to all groups of society and
community.
Effectiveness of an intervention can be measured by evaluate and analyse the outcomes
of the preventive measure been taken to reduce and control the cases of the disease. Interventions
are the crucial part of any treatment in order to get effective outcomes (Quaderi and Hurst,
2018). Sometimes people with addiction face many problems in following preventive ,measures
recommended to them by professionals. In case of COPD, some nursing interventions are learnt
by patient and family members to control and self manage the disease. All these
recommendations are based on to achieve airway clearance, to improve breathing pattern, to
imp[rove activity intolerance, to assess and mange potential complications. The effectiveness of
the interventions and related care plans are observed at the end of the treatment and patient
supposed to be out of the danger if patient find to quit the smoking, enrols in smoking cessation
programs, fulfil the needs of the fluids in body, free of infection, start practising breathing
practices, switched to healthy diet and proper physical exercise, seems to perform activities
effectively without feeling shortage of breath (Zafari and et. al., 2021).
REFERENCES
Books and Journals
Agusti and et. al., 2018. Precision medicine in COPD exacerbations. The Lancet Respiratory
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Al-Yousif and et. al., 2021. Comparing Diagnostic Workup and Management in COPD Patients
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Attaway, A. and Hatipoğlu, U., 2020. Management of patients with COPD during the COVID-19
pandemic. Cleveland Clinic journal of medicine.
Daccord, C., Touilloux, B. and Von Garnier, C., 2020. Asthma and COPD management during
the COVID-19 pandemic. Revue médicale suisse, 16(692), pp.933-938.
Grabicki and et. al., 2018. COPD course and comorbidities: are there gender differences?.
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Welch, L., Orlando, R., Lin, S.X., Vassilev, I. and Rogers, A., 2020. Findings from a pilot
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Lai, T., 2022. The burden of COPD in China and its provinces: Findings from the Global
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Zafari, Z., Li, S., Eakin, M.N., Bellanger, M. and Reed, R.M., 2021. Projecting long-term health
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