Public Health Essay: England's Health Inequalities

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Changing Perspectives in Public Health
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Table of Contents
Introduction................................................................................................................................3
Part A – Essay............................................................................................................................4
Part B – Reflective Account.......................................................................................................8
Conclusion................................................................................................................................11
Reference List..........................................................................................................................12
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Introduction
The concept of public health has been undergoing major changes over the lifetime because
the definition of health has undergone considerable changes. Previously, health was mainly
determined by the presence or absence of a “disease”. However, with time, people’s
understanding about health matters has changed and the focus is now given on physical as
well as psychological wellbeing. In this study, the Marmot Report 2010 has been considered
to review the changing perceptions of health inequalities in England. In the beginning, the
development of concepts regarding public health and the influence of research shall be
highlighted. It will be outlined in an essay format. The impact of current policies on current
practice shall be considered as well. Thereafter, a “public health concern” affecting England
shall be chosen for fulfilling the study purpose. Lastly, a reflective account shall be prepared
to analyse own role as a healthcare assistant.
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Part A – Essay
Title: The influences of historical antecedents on the development of contemporary
research, policy and practice in public health
Introduction
The essay shall be written by considering the background or “history” of public health that
has fairly contributed towards current practices in public health. Here, evidences shall be
analysed that has positively helped in the development of health policies for the population in
England. The health issues faced by the population shall be analysed as well. Lastly,
“obesity” has been chosen as a public health issue in England.
Discussion
Historical antecedents shaping service provisions of recent public health
The concept of public health has been derived from various historical ideas, recent
developments in biological sciences, epidemiology and technological advancements. In 1756,
the British sailors were suffering from scurvy and James Lind’s has conducted various
clinical trials and has thereby developed dietary treatments. Thereafter, in 1796, Edward
Jenner discovered treatment for smallpox by developing cowpox vaccination (Rosen, 2015).
Gradually, it has been noted by healthcare institutions that the health issues faced by
communities should be dealt collectively and by following a scientific approach.
Consequently, in various countries, the importance of immunization and nutrition has been
inculcated within the population. Consequently, recent developments in nation’s public health
provisions have been influenced by the mentioned historical antecedents. For instance, the
NHS made provisions for improving the health of the public and promoting healthier
lifestyles. In case of severe, health hazards it is the responsibility of the NHS to protect the
population from the epidemic. The “PHE’s strategic plan” is focussed on reducing health
inequalities within 2020.
Evidence regarding health improvements in the population as a consequence of current
health policies
In UK, there have been improvements in the overall health of the population as the life
expectancy of females has increased and it is now 81 years (Mathers et al., 2015).
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Additionally, the life expectancy of men has increased to 76 years in this current century.
Hence, it can be stated that due to effective disease prevention strategies, the people are able
to lead a prolonged life. Health protection has been given by the healthcare organisations in
UK and people are now consuming safe food and water. Since the last 4 years, the rates in
food poisoning has also reduced by 18% and it has been noted that immunisation
programmes for treating childhood infections has been quite successful in UK (Tang et al.,
2017). Previously, Rubella Vaccine and Measles Mumps have been introduced in the year
1988 and UK has been successful at eradicating polio from its population. The vaccination
programmes has been effective and played a pivotal role in treating these health concerns.
Recent health issues affecting England
In England, at present the rate of communicable diseases has considerably reduced however,
due to changing lifestyles and various other determinants the health of the public has been
affected. For instance, the health issues within the country are related to smoking, diabetes,
cardio-vascular diseases, alcoholism, pollution, tobacco usage, dementia, mental health
issues, drug abuse and HIV among others (GOV.UK, 2019). Dementia is one of the biggest
mental health conditions affecting women. The country has been facing major changes
regarding the healthcare needs. For example, apart from dementia, smoking and obesity are
also considered as the major causes of death and ill-health. As per the reports of PHE, one in
four people are likely to suffer from obesity. Previously, the population was affected by
infectious diseases bout now, the population suffers from other risk factors like stressful jobs,
isolation or financial constraints. Consequently, these factors are causing severe mental
health conditions.
An area of public health concern in England
Obesity is now considered as one of prevalent “public health concerns” in England. As per
the Marmot review, obesity in UK is now considered as the new “smoking”. It implies that
previously smoking related issues was the major cause behind ill-health but now obesity is in
the race too. Almost 20% of the children are at high risk of obesity (Ells et al., 2015). As per
the Marmot report, children might be affected by obesity even when they are in their
mother’s womb. Gradually the dietary habits in early childhood might lead to the occurrence
of obesity. It should be noted that England is one of the developed countries and obesity
might occur due to higher incomes of the population. Since 1997, obesity has been common
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among adults and the only exception is women who belong to professional classes. The
health inequality levels in England are high in terms of obesity.
Figure 1: Prevalence of obesity in UK
(Source: Instituteofhealthequity.org, 2019)
Contribution of research in developing new policies in relation to obesity
The issue of obesity has been tackled by the country since 20 years and relevant research has
been conducted by public health bodies because research helps in forming a shared
understanding regarding the implications of a public health issue. Research can further help
in addressing the challenges of a disease and finding out the potential implications of an
action. Moreover, research can contribute towards developing a comprehensive strategy and
ways of developing partnerships with other stakeholders. In England, obesity has been
tackled by a government strategy named “Healthy Weight, Healthy Lives”. By the year 2020,
the aim of the strategy is to prevent the rate of obesity among children. In 2011, a new policy
“A Call to Action on Obesity” has been launched by the UK government after conducting
research on the prevalence rate of obesity (Jebb et al., 2013). This obesity programme has
been launched after unsuccessful implications of several other obesity programmes.
Impact of research on policy development regarding a public health main concern
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One of the health priorities in England is obesity as the disease has affected the lives of
children negatively. Hence, the government has been focussing upon available evidences
before developing a health related policy. The “Commissioned Evidence Reviews” has
helped the government in forming national policies to tackle the issue of childhood obesity
(Hanson et al., 2017). As per the evidences, the impact of physical inactivity and high sugar
consumption are the major reasons behind calorie increase. The commission has also given
certain recommendations to tackle the issue. For instance, the commission suggested that
price promotions in restaurants and cafes should be limited. The marketing of sugary drinks
should be reduced and it is appropriate for the government to increase the price of sugary
drinks by 20% and taxes should also be levied so that people become less interested in buying
those food products (Bellew et al., 2019). Hence, it can be stated that these recommendations
has been given after conducting research on the issue of obesity. Consequently, the impact of
the research has been positive because the government has levied additional taxes to soft
drinks and the PHE is also working with the manufacturers and retailers on “sugar reduction
programme”.
Conclusion
The essay has outlined the development of research and its impact upon developing national
policies that in turn can help in tackling a public health issue. As a health care practitioner,
the issue troubling the population has been demonstrated. The Marmot review has been
considered as well in order to understand health inequalities in England. The prevalence of
obesity has been rising in the country and therefore, the impact of research on developing
national policies to tackle this issue has been assessed as well.
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Part B – Reflective Account
Local public health strategies aimed at integrating approaches to health improvement
in response to priorities identified by a regulatory body
Early detection of the diseases
As commented by Harris et al. (2017), it can be said that the common people needs to be
influenced to detect the diseases and get necessary treatment at earlier stage. Sometimes it
can be seen that people neglect their health issues and in future they need to suffer from
serious problem due to this reason. For example, if people would not receive treatment
related to obesity on early stage then they would suffer from health issues such as kidney
failure in future. In case of Ramsay Healthcare UK, the care home is influencing the local
public for check up on monthly basis so that they do not have to face any serious health issue.
Use of modern techniques to improve quality and effectiveness of the services
As per the strategies of CQC (Care Quality Commission) it can be seen that the organisations
need to use modern technologies so that they are able to provide high quality of care to the
patients (cqc.org.uk, 2019). In context of the Ramsay Healthcare UK it can be seen that the
management of this care home are adopting new techniques so that reliable services can be
offered to the care users. As a result, the quality as well as effectiveness of the health services
can be improved. It can be helpful for the people to overcome any critical diseases as soon as
possible.
User centric care plan
According to Green and Thorogood (2018), the care users need to be offered with their
expected services from the care home. Due to this reason, it is the responsibility of the care
homes to analyse the service requirements of each care user. In case of Ramsay Healthcare,
the care home professionals are instructed by their management to evaluate the service
requirements of each care user. After that it can be possible for them to make an efficient care
plan for those service users.
Review different approaches to partnership working that support improvement in
individuals’ health
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As stated by Harrison and Gutiérrez (2016), it can be said that the private organisations can
do partnership with the other organisations so that they can be able to provide accurate
treatment to the care users. In case of Ramsay Healthcare, it can do partnership with any
other private care home of UK. After that they would have enough resources to provide
treatment to the care users. On the other hand, the care home can build partnership with
public or voluntary organisations. As a result, they will have huge number of staffs to provide
treatment to the care seekers on time. In addition to this, the care home has to maintain the
transparency of information while they are doing partnership. A formal agreement needs to
be signed by both the parties at the time of partnership where all rules and regulations related
to the business will be mentioned.
Reflect on the demonstration of how own role supports individuals to be aware of and
participate in local health initiatives
As a healthcare assistance in Ramsay Health Care, UK, it is my responsibility to create
awareness among the public in tackling the issue of obesity. The parents and their children
can be persuaded to participate in “local health initiatives” by making them understand the
implications of the disease. The BMI of the children can be monitored on a regular basis. As
a healthcare assistant, I have conducted research on the appropriate BMI rates of individuals
and I have understood that the BMI of individuals who are 18 years should be beneath 5th
percentile. I can further crate awareness by providing interventions at schools. This in turn,
shall help the parents to make decisions related to health. Education can be an effective way
of tackling this issue (Watson et al., 2018). Moreover, I can easily give feedbacks to the
parents and children via leaflets. It would be appropriate to include the children in various
lifestyle programmes. It has been noted that parents must be engaged in the activities as well
so that children feel supported and guided. Taking initiatives is the only way of allowing the
participation of the children.
Explain the roles and responsibilities of different agencies involved in public health
improvement
In order to tackle a serious public health issue, it is crucial for different health agencies to
perform tasks systematically. The organisations have legislative responsibilities as well. The
PHE works at national as well as regional levels for providing protection to the population. It
plays a statutory role by providing information and advice to the local health authorities. The
CCG commission is liable to follow the “Health and Social Care Act 2012” (Allen et al.,
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2017). The commission is responsible for providing emergency care and creating awareness
regarding mental health among the population. It is also responsible for carrying out
investigations within a care setting in order to measure the process of development. It also
reviews the performance of healthcare staffs such as nurses, doctors or other experts. The
focus of the commission is always upon the needs of the patients and therefore, the service
providers are liable to maintain the standards of CCG (Oates, 2015).
The local authorities in England also play a vital function by educating the public regarding
implications of actions (Mirowsky, 2017). However, the local authorities have to function
within budgetary constraints.
Analyze the role of the public health regulatory body in setting standards in public
health
The “Public Health England” is one of the regulatory bodies that set standards for reducing
the rate of public health issues and Ramsay Health Care, UK is responsible for reducing the
health inequalities within the population. It is accountable for performing a variety of
functions and it also includes various functions of HPA (“Health Protection Agency”)
(Cqc.org.uk, 2019). The organisation sets standards for the care settings and the most
common standards include monitoring the service provisions and understanding the needs of
the service providers as well. Most importantly, the welfare of care users is at the heart of the
organisation and therefore, patient’s feedbacks and complaints are considered vital. Healthier
lifestyles can only be promoted when diversity is encouraged within the population
(Middleton, 2017). Not only individual care settings, PHE is also responsible for working
with community-based settings.
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Conclusion
The study is focused upon understanding the changes in the perspectives of people regarding
public health issues. Previously, merely the absence of disease was considered healthy,
however, with time, it has been established that psychological wellbeing is crucial as well. In
the beginning, the historical development of the concept of public health has been analysed.
The current health related issues occurring in England has been discussed as well. Obesity is
one of the public health concerns in the nation. Following the essay, a reflective account has
been given as well to highlight own role as a healthcare assistant in Ramsay Health Care.
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Reference List
Allen, P., Osipovič, D., Shepherd, E., Coleman, A., Perkins, N., Garnett, E. and Williams, L.,
2017. Commissioning through competition and cooperation in the English NHS under the
Health and Social Care Act 2012: evidence from a qualitative study of four clinical
commissioning groups. BMJ open, 7(2), p.e011745.
Bellew, W., Bauman, A., Kite, J., Foley, B., Reece, L., Thomas, M., Mihrshahi, S. and King,
L., 2019. Obesity prevention in children and young people: what policy actions are needed?.
Public health research & practice, 29(1).
cqc.org.uk 2019. Our strategy for 2016 to 2021, Available at: https://www.cqc.org.uk/about-
us/our-strategy-plans/our-strategy-2016-2021 [Accessed on: 1st Jan, 2019]
Cqc.org.uk. 2019. Public Health England. [online] Available at:
https://www.cqc.org.uk/directory-care/providers/public-health-england [Accessed 14 May
2019].
Ells, L.J., Hancock, C., Copley, V.R., Mead, E., Dinsdale, H., Kinra, S., Viner, R.M. and
Rutter, H., 2015. Prevalence of severe childhood obesity in England: 2006–2013. Archives of
disease in childhood, 100(7), pp.631-636.
GOV.UK. 2019. Health matters: public health issues. [online] Available at:
https://www.gov.uk/government/collections/health-matters-public-health-issues#obesity-and-
the-food-environment [Accessed 14 May 2019].
Green, J. and Thorogood, N., 2018. Qualitative methods for health research. Sage.
Hanson, M., Mullins, E. and Modi, N., 2017. Time for the UK to commit to tackling child
obesity. Bmj, 356, p.j762.
Harris, C., Allen, K., King, R., Ramsey, W., Kelly, C. and Thiagarajan, M., 2017.
Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: Identifying
opportunities for disinvestment in a local healthcare setting. BMC health services research,
17(1), p.328.
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