Public Health Report: Diabetes Analysis in the UK and Hounslow Borough

This report examines diabetes as a significant public health issue, providing a detailed analysis from global, national, and local perspectives. It begins with an introduction defining public health concerns and highlights the increasing prevalence of diabetes worldwide, citing statistics from the World Health Organization. The report then delves into the UK context, analyzing national data and policies, including the National Service Framework (NSF) and local initiatives in Hounslow Borough. It explores the impact of diabetes, risk factors, and policy initiatives aimed at prevention and management. The analysis includes statistical data, demographic insights, and evaluations of the effectiveness of current strategies. The report underscores the urgency of addressing diabetes and the need for effective interventions at various levels to mitigate its impact on individuals and the healthcare system. The report also discusses the local policy analysis of diabetes in the Hounslow Borough, including the healthcare services provided, the funding, and the challenges faced by the NHS program. The report also analyses the public health issue of diabetes in the UK, including the statistical data, the risk factors, and the policy initiatives, with the aim of reducing the incidence of diabetes in the UK.

PUBLIC HEALTH AND HEALTH PROMOTION
Diabetes
Name of the Student:
Name of the University:
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Introduction
Public health concern is defined as the method to protect or save and improve
the quality of health of different communities using education, research for diseases,
interventions for preventing injuries and making different policies. There are several
issues that the world is currently facing including malnutrition, overweight, excessive
usage of tobacco, HIV/AIDS, mental health, violence, environmental quality and so on.
Therefore, the need of public health issues to be discussed in public forum has become
more important and crucial (Sørensenet al. 2012). Diabetes is one of the major public
health problem worldwide and according to the current global estimates there are more
than 415 million people in the world, who are suffering from diabetes and the results are
estimated to escalate 600 million mark by the Year 2040. Furthermore, according to the
current Global estimates 200 million people with diabetes are still under diagnosed due
to their mild asymptomatic nature of the disease. Diabetes is a physiological condition in
which the metabolic functionality of the body gets affected and the blood glucose level
becomes Ultra-high (Bloom et al. 2012). Two of the very common symptoms of the
diabetes mellitus includes frequent urination increased hunger, thirst, and if the disease
remains under treated can cause many crucial complications to the body, which can
lead to cardiovascular diseases, chronic kidney diseases and so on. According to the
data of the UK Government diabetes, Diabetes is one of the fastest growing public
health concern in European Union. From the 1996, the number of people affected with
diabetes has doubled and according to the estimation of the UK Government, the
number is going to cross the 5 million mark in near future. This assignment is going to
discuss this Public Health issue, theoretical, Global and policy analysis in details in the
context of the United Kingdom. Firstly, the public health issue that is diabetes will be
discussed and rationale for selecting this public health policy issue will be given.
Further, theoretical analysis will include the way Public health policy for diabetes
becomes affected due to the issues of gender. Furthermore, how the theoretical
concept is considered or overlooked within the relevant policy documents will be
discussed. Finally, in the policy analysis a coherent discussion of policy documents will
be discussed with evidences from across the level of actions such as international

national and local. For the local evidences about diabetes, the area of Hounslow
Borough will be taken.
Statistical analysis
Global analysis
Global burden of diabetes can be estimated from the data of the World Health
Organization, which states that more than 422 million people in the world were suffering
from diabetes in the year 2014 compared to 108 million people in 1980. It can be easily
estimated from the statistics that the number of people affected with diabetes has been
double since 1980 and the adult population has been risen from 4.7% to 8.5% (World
Health Organization 2018). This data of diabetes also increases the risk factor for other
associated diseases such as obesity or overweight. World Health Organization also
reported the fact that the rise in diabetes prevalence has been seen in low or middle-
income countries then the high-income countries. More than 1.5 million people were
died in the year 2015 due to diabetes and an additional 2.2 million people were died
because of cardiovascular diseases caused by diabetes (WHO facts 2018). Within this,
majority of the people were affected with type 2 diabetes, which used to occur entirely
among adults but now occurs in children's too. there are several direct or indirect impact
diabetes causes on the national economy and according to one study, from the year
2011 to 2013 there are many countries who will lost the GDP worldwide duty both direct
and indirect costs of diabetes which is estimated in US dollar 1.73 trillion (World Health
Organization 2018). The World Health Organization has started wh0 diabetes program
to prevent diabetes how to minimize its complications and increase the quality of the
life. The core functions of the WHO include promotion and contribution to the
surveillance of diabetes complications and its risk factors. They also want to contribute
in building capacity for the prevention and control of diabetes by increasing awareness
indifferent Global Public Health campaigns.
National analysis
According to the data from the medical research Council of United Kingdom,
there are more than 3.9 million people living with diabetes in UK and every 1 in 16

people in UK has been affected with diabetes. Since 1996, the number of people
affected with diabetes has been doubled and according to the estimation, by the year
2025 more than 5 million people will be affected with diabetes in United Kingdom (UK
Diabetes facts 2018). Therefore, the UK government has set up a national service
Framework (NSF), a program, which was established to improve services by setting up
several national standards to accelerate the service quality and tackle vulnerable
situations of care. Every NSF setup helps to set national standards, works to identify
different interventions and actions that is going to help healthcare professionals to meet
those standards. Through these NHS service Framework the UK Government helps to
create different regulations that will be implemented in local regions of the United
Kingdom to spread awareness and to prevent diabetes from occurring in people having
lower social economic status (UK Government 2018). The NHS and its partner
organizations are reviewing local strategies for improving their diet nutrition, increase
physical activity and reduce overweight and obesity and this way they are going to help
people combating diabetes. They are also providing different health professionals in
local premises with information about the risk factor for diabetes and the way
modification of those risk factors can help in preventing diabetes. The UK Government
has set up 12th standards under this NHS framework to help people with diabetes and
all the provinces or states are determined to use these NHS policies for diabetes-
affected people (National Diabetes Treatment and Care Programme 2018).
Local policy analysis for diabetes (Hounslow Borough)
Hounslow borough is one of the high ethnic and diversified places of London, UK and
majority of the population is British. The census of this region demonstrated that there
were 254,000 people used to live in 2011 and the population increased by 20 percent
since 2001(Borough of Hounslow 2018). According to the data from Urbs.London
(2018), Hounslow Borough is one of the highest diabetes rated area in the capital. The
website also estimated that the number would increase by 8.915% in next 20 years.
Therefore, the local Health Services and the public health service of England are under
high pressure. According to the demographics of the area there are 20984 people
affected with diabetes. The primary factor, which works as inducer for type 2 diabetes

in the people living in the area is their unhealthy lifestyle and link to obesity. Therefore,
these problems need to be prevented to combat for the fundamental health services.
Hence, taking preventive measures are important as according to the estimations, there
will be 895 889 sufferers of diabetes by 2035 and 3.3% of them will belong to Hounslow
borrow (London Borough of Hounslow Census 2011, 2018). An NHS framework works
for diabetes-affected people in Hounslow Borough. This community Healthcare covers
maximum area of services that are being provided outside the hospital or General
physician surgeries. The help the diabetes affected people with high quality care and
provide their services to a wide range of people starting from adults to children and in
different communities. the services they provide includes health visiting,
physiotherapies, diet and nutritional help, health promotional camps, smoking
preventive camps, language therapy and different occupational therapies (London
Borough of Hounslow Factsheet of Diabetes 2018). Their mission is to provide
information about diabetes to each community of Hounslow Borough so that the disease
can be eradicated from this area. They received their funds from different
commissioners Hounslow clinical commissioning group, clinical commissioning group
and the Government of UK to provide healthcare interventions in diabetes affected
people in the area. The total estimated cost to the nation for diabetes is £8.8 billion per
annum. However, the NHS program is not been able to stop this disorder from
spreading to people with higher as well as lower socio-economic status (National
Diabetes Audit 2012-2013, 2018). Therefore, further effective steps need to be taken by
the local, as well as national authorities for compliance with the national and global
framework for eradicating diabetes (Goran, Ulijaszek and ventura 203).
Analysis of public health issue
Diabetes in UK is the fastest growing public health issue that is posing as a
threat to the lives of UK citizens. Considering the present day stats, the number of
people who were living with diabetes has doubled in comparison to the year 1996. If the
present health condition is not intervened, then nearly 5 million UK people may have
diabetes (Diabetes UK 2018). Currently, in England over 3 million people are suffering
from England. If the health conditions of the people are managed well then people can

lead a long fulfilling life. However, it has been seen that people with diabetes that are
not receiving the medical support are unable to manage their health condition (Diabetes
UK 2018). New sets of data released from the Public Health England reveal that around
3.8 million people of England who are above the 16 years of age were diabetic, and it is
9% of all the adult population. A diabetic prevalence model introduced by national
Cardiovascular intelligence network (NCVIN) is able to estimate both the type 1 and the
type 2 diabetes among the adult population in England. Whereas, the 3.8 million people
are however projected to have both the type of diabetes. A majority of the population,
that is 90% of the population will have the type 2 diabetes. The best part is that the
disease is preventable and manageable if the required changes are implemented in the
life style. The likeliness of increasing the type 2 diabetes is due to the people becoming
overweight. However, age, ethnicity and family history can also increase the risk. The
model also suggests that 1 among 4 people are diabetic, although around 1 million
people are not aware of the health condition. Diabetes leads to serious complications
which include kidney disease, foot amputation, and is also associated with increased
incidence of heart attack and stroke. Through an estimation it has been found that by
2035, type 2 diabetes will cost 8.8 billion pounds each year and 4.9 million people will
get infected through the disease. Whereas, tackling the increase in the levels of the
disease is important for a healthy sustainable future (Diabetes UK 2018). The proportion
of people who are suffering from diabetes rise with age. It has been found that 9% of
the people who are aged between 45- 54 years have diabetes. Whereas, the 23.8% of
the people who are aged above 75 years are diabetic. People who are older and aged
are more vulnerable to the diabetes because they are more likely to suffer from other
diseases like cardiovascular diseases. Diabetes is seen to be more common in men in
comparison to the women (7.6% in women and 9.6% in men). The incidence of diabetes
is twice more in people belonging from black ethnic and south Asian groups in
comparison to the whites (15.2% in comparison to 8%) (Diabetes UK 2018).
Policy initiatives
Reduction of the incidence of diabetes on the people involve the reduction in the
risks that is actually responsible for the disease. However, it has to be accepted that

some of the factors cannot be modified. There is well established evidence that losing
weight is an effective way to reduce weight. There are two different approaches which
can be utilized to reduce the incidence of the diabetes which are as follows:
interventions are targeted to those who are at a high risk; broader measures that can be
effectively used to reduce risk among the general population. the National Institute for
Health and Clinical Excellence (NICE) has provided the guidelines for the above
mentioned approaches. Interventions for the individuals at the high risk- the National
health service program started a program which aims to access the 15 million UK
citizens within the age group of 40 to 74 years and are at the risk of diabetes, heart
attacks and stroke. Interventions at the population level- the another aim of NHS is to
reduce the overall impact of diabetes upon the general population which also give an
added advantage in reducing the other associated diseases because many affected
individuals report the risk factors like the physical activity and obesity
(Pathways.nice.org.uk 2018).
National strategies/policies
In the year 2011, UK government published a strategy called healthy people and
healthy lives: an action plan on obesity. This is plan which aims to reduce the
tendencies of obesity and overweigh within 2020, and also focus on the overall
reduction of calorie intake with a target of 5 billion a day. The department of health has
two major policies or strategies that emphasize on the inactivity and obesity: change for
life is a social marketing strategy which was started lately in 2009 and it has a target to
encourage people to eat healthy food and have physical activity; A deal was introduced
in the year 2011 called the public health responsibility deal. This has a series of targets
that focus on the activities taken up by the charities, industries and government.
Different food businesses have pledged to produce food that will have low calorie and
will also sport calorie labels upon them. Although there are evidences that these
pledges are creating conflicts among the various charity organizations that even
includes the Diabetes UK (Researchbriefings.files.parliament.uk, 2018). Education
Campaigns like change for life are most used strategy to tackle obesity in the EU
countries. These campaigns are considered important because it helps the people to

stay active and eat healthy food. Change in eating behavior- a report called tackling
obesity revealed that the incidence of obesity is inevitable in a country like UK which
exhibit the obesogenic environment. Simply asking the people and encouraging them to
adopt to a healthy lifestyle will not be an effective way to reduce obesity. The reason
due to the failure is because the behavior of people is based on the psychological,
habitual, economic and emotional factors. Thus, better strategies are used like:
restricting advertising- it is known that advertising has the capability to influence the
minds of the people. There is as such no ban on advertising food to the adults.
However, there is a ban in UK on food that contain high quantities of sugar, salt and fat
on the television. Better nutritional labelling- there was debate regarding the labelling on
food to provide information about the calorie content for the consumers. The food
industry suggests to put the percentage of the contents on their products whereas
charities want to see traffic light depiction of the contents. Regulating portion sizes-
portion sizes are found to impact the eating tendency of people. Because reducing the
portion size is found to effectively reduce over eating. Reformulating foods-
reformulation of the food items in order to reduce the sugar, fat and salt content
positively reduced the consumption of salt and trans-fat. Introduction of food taxes- in
theory putting taxes on certain food items can be an effective plan to reduce
consumption of food which are high is salt, sugar and fat
(Researchbriefings.files.parliament.uk, 2018).

Theoretical analysis
The medical model of healthcare is an indispensable and highly successful in
several contexts. The medical model of healthcare involves case history, physical
investigation, tests if required, diagnosis, effective treatment and prognosis. The
medical model of healthcare includes certain basic assumptions regarding the
medication and the research studies based on the psychological and physical difficulties
(Engel 2012).
The government policies and strategies basically focus on the prevention of
diabetes that in turn relates to control of obesity both through control on food
consumption and physical activity. The major focus here are the causes of obesity,
which includes high calorie food consumption consisting of elevated levels of sugar, salt
and fat. From that perspective, the medical model of healthcare puts a physician at the
top and the patients are expected to be complying with the advice of the physician. This
same perspective can be correlated with the policies framed by the government. Here,
government wants to reduce the incidence of the obesity within the people of the
country, and for that reason it is framing policies and strategies that will help the
common people to follow a certain plan in order to stay fit and fine (Vartanian and
Smyth 2013). Government policies focus on the reduction of calorie consumption, and
for that purpose it has framed policies that emphasize on the reduction of obesity
related to amount of calorie intake. Putting a restriction of the uptake of calorie can
effectively prevent the incidence of obesity and in that similar fashion, if the common
people reduces the intake of food that have excess calorie, then it will effectively
prevent them from becoming overweight. Because it has been found that in 80 to 85%
of the cases, people who are obese are at a risk of developing type 2 diabetes. Along
with this there are other findings that suggests that people who are overweight, are 80
times more prone to develop type 2 diabetes than the people who have a BMI of 22
(Diabetes.co.uk, 2018). Whereas, the causes of type 1 diabetes are more related to a
person’s family history that involves the genetic makeup. Thus government policies
cannot be any help towards the reduction of such issue. Thus, the major part of the

medical model of health focus on the reduction of incidence of type 2 diabetes which
has a close relation with obesity and overweight.
The policies related to the maintaining the physical activity are framed to reduce
the weight gaining tendency. There are several policies like promoting active travel
which include active cycling and walking. Other strategies include the creation of
healthy home environment which will promote to use the stairs. At the same time
exploring all the possible ways through which physical activity can be increased.
Medical model of healthcare also deals with the psychology of the humans. Thus,
promoting a positive though and psychology that even without the medications people
can stay healthy if they accept a kind of life style which will incorporate physical activity.
This thought will help to bolster and enthuse people to take up activities that will help
them to overcome laziness and inactivity (Malhotra, Noakes and Phinney 2015). This
type of treatment although is devoid of any medication will help the people that are
having depression and are under stress. This is a sort of medical psychiatry which can
mitigate the issues of obesity and it direct relation with diabetes. The process can be
described as happens within the people who are obsessive and are experiencing social
stigma. Such people often tend to avoid engaging with people, and at the same time
stay under depression and stress of getting bullied. For such people, person centered
care is helpful in order to reduce their stress and depression. The increase of
awareness and promotion of physical activity will help to reduce the issues of obesity
not only among the children but also among the adults and aged people. Food taxing is
a similar type of medical psychiatry because, the more the food will cost the less the
people will but it. Imposing taxes on food items that generally contain more than usual
amount of calorie, salt, sugar and fat can deter the human attraction from buying
expensive food items that will neither benefit their body nor will be available at cheaper
prices (Mytton, Clarke and Rayner 2012). This policy will benefit not only the middle
aged people that do less physical activity but also for the teenagers that prefer to eat a
lot of fast food that contain an excessive amount of calorie. It has been seen that the
incidence of diabetes is more common in men than in women. And the above
mentioned strategies and medical psychiatry can effectively reduce the incidence of the
same among the men. Finally, the central part of the medical model of health states that

treatment must exactly focus on the underlying reasons of a disease. Thus, the policies
in correlation to the medical model of healthcare effectively identifies the cause of the
diabetes as obesity and suggests the various mitigation strategies that reduce the
incidence of diabetes and obesity.
Conclusion
The prime aim of this assignment was to establish the fact the public health is
one of the major concern from global or national point of view. Several health
complications that are increasing continuously nowadays because of the unhealthy
lifestyle and dietary habits of people worldwide. Diabetes is one of the critical public
health concern the world id facing and the assignment provided all the facts and
statistics about the global burden of diabetes. The United Kingdom is also suffering from
the complications of diabetes and this report provides the important facts. Several steps
that has been taken by the government such as banning advertisements of calorie rich
food, increased taxes on food that can lead to diabetes or obesity, promoting physical
exercises. These steps are important in combating this health complication. Further, the
government, national and local policy has been analyzed. Finally, it can be said that, to
prevent any health complication, it is important to spread the awareness in the society
and the aim of the public health concern is to spreading the awareness with proper
interventions.

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