Analysis of Health Inequalities and Smoking Cessation in England

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Contents
Introduction...................................................................................................................................1
TASK............................................................................................................................................... 1
1.1.............................................................................................................................................. 1
1.2.............................................................................................................................................. 2
1.3.............................................................................................................................................. 4
TASK 2............................................................................................................................................ 5
2.1.............................................................................................................................................. 5
2.2.............................................................................................................................................. 8
2.3.............................................................................................................................................. 9
TASK 3.......................................................................................................................................... 11
3.1............................................................................................................................................ 11
3.2............................................................................................................................................ 12
3.3............................................................................................................................................ 14
TASK 4.......................................................................................................................................... 15
4.1............................................................................................................................................ 15
Smoking cessation campaign................................................................................................... 15
Introduction............................................................................................................................. 15
4.2............................................................................................................................................ 18
References................................................................................................................................... 21
1

Introduction
Health promotion is a process of enabling individuals to increase control over and improve
their health. (WHO, 2018) Health care service providers have to strive to improve the health of
society. Strategies, planning and models of health promotion can help achieve good health.
Health organizations should empower individual and communities to take health as a first
priority. Socioeconomic factors play a major role in health inequalities.
TASK 1
1.1
Socioeconomic factors and poor living conditions like poverty, lack of education,
unemployment and housing can affect health and measures taken to address them can
improve health (Orlowski, 2014). Socioeconomic factors like unemployment, income, access to
education, homelessness, lifestyle etc. influence health massively.
Environmental factor: The area or individual where an individual resides can contribute to
their health. As is seen in case study Ramon was homeless, due to which he was more
vulnerable to diseases. Poor living conditions increase the risk of communicable diseases if no
access to health services. Research in England found that 80% have mental health issues, 73%
of homeless people suffer from physical health problems, 35% have met with emergency or
accident while 26% admitted to hospitals (Homeless Link, 2014).
Education: An educated individual makes better health choices than an uneducated individual.
An educated person can easily access better health services. The high mortality rate can be
strongly related to lack of education. (Institute of Public Health in Ireland, 2008). Employment
and income are linked to education. Poverty is highly linked with poor health. As Ramon may
not have asked for health service facility, his illiteracy can be the reason.
Employment and income: The occupation of an individual helps him earn his basic life
amenities. The type of employment can influence a person’s income. Poor people are many
times unable to obtain the basic needs of food and shelter. Income inequality is correlated to
health problems’ (Rowlingson, 2011). Low income can cause a mental issue due to
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unsatisfaction to happiness. (Williams, 2011). Unemployment factor and no income made
Ramon homeless, resulting in his early death due to a physical or mental issue. Infectious
diseases are more prevalent among homeless people. (Thomason, 2013)
1.2
Various Government sources report on health inequalities. Some well known are Marmot
Report 2010, Black Report 1980, Acheson Report 1998, Health Survey for England (HSE). Also,
House of Commons, Health Committee, Health and Lifestyle Surveys, (HALS), Census data and
many others have established inequalities in health qualities.
Black Report (1980): The report analyzed the factors that show the contribution to health
inequalities which are commissioned in 1977 by a Labor government in 1980. Secretary of
State for Social Services had published the report. It highlighted many socioeconomic
inequalities in society and the failure of NHS policies. Inequalities are due to factors like
income, unemployment, education, diet, the condition of work and housing (Gray, 1982). A
number of recommendations were made. Some important recommendations are an allowance
of infant care, child benefits; maternity grants; housing grants; preventive and primary care
(Oliver, 2010).
Acheson Report (1998): Health inequalities tackled under this report by The Labor
Government in 1997. (The Health Foundation, 1998) Acheson Report concentrated on health
policies and worked on changes for better improvement. New health strategies were
introduced for Saving Lives. A bold statement was made that claimed of safe 300,000 lives over
the next 10 years. It emphasized on health inequalities; and took necessary steps which gave
priorities to a family with children, economic background. (Oliver & Exworthy, 2003).The
report announced that cancer; heart disease and mental illness will be addressed by 2010. The
Acheson report in 1998 showed more impact than black report 1980.
Marmot Review 2010: The report investigated health inequalities post-2010. -It proposed
ways to improve the previous reports. The report found that people living in the poorest area
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are dying early than those living in richer areas. (The Marmot Review, 2018). Further
investigated that government agencies made policies that only focused on a few sectors of
society health inequalities. The review set framework to ensure justice in society regard
health, to increase well being of each individual and community. As analyzed in previous
reports, low socioeconomic factors are linked to health inequalities and are unavoidable. In
the case of the poor health of Ramon, these reports evaluate the factors of health inequalities.
1.3
No access to health services may have led to the death of ill Ramon at a very young age. Some
important barriers to assessing healthcare are time, location, employment, income, physical
disability, belief, education level, culture, mental capacity, transport and many. The most
important reason for barriers to assessing healthcare is physical, cultural, psychological,
financial, geographical and other resources.
Financial barrier: NHS finances healthcare through taxation, but all services are not free like
dental, optician care etc. (NHS, 2018). Financial inability to access transport to health services,
nursing home, the hospital is a huge barrier. In a case study of homeless Ramon, his inability to
access health services may be due to his poor financial condition.
Psychological barriers: Fear, anxiety, stress, depression, a mental disorder can be leading to
the inability of an individual to take benefit of effective health care or approach to help the
organization. Due to fear to make necessary changes in lifestyle some individuals do not access
healthcare. (Paxman, et al.,2017). Ramon can be suffered by some kind of psychological barrier
when seeking health services; he may not want to change his addiction to alcohol or smoking.
Racism barrier: Ramon may be feared of being discriminated due to racism to seek health
services. Racism can be a reason for health inequalities. For instance, in UK racial abuse is
faced by 63% Gypsie travellers experience attacks or bullying. (Atterbury, 2010). The UK
legislation policies help to decrease inequalities related to health. To reach optimum health
care to users various Act and guideline against racism are framed. The Equality Act 2010 help
to reduce inequalities but experiences failure for minority groups (Salway, et al., 2016).
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TASK 2
2.1
Some famous health promotion models like Tannahill, Becker and Beatie give ways to
approach government in strategies to fight health issues. The strategy of the government
currently is to establish a smoke-free generation Smoking is one of the biggest cause of death
(Global and Public Health, 2017).
Tannahill developed three crucial points to health promotion. They are Health Education,
prevention and Health Protection (Downie, et al., 1996). All three approaches are overlapping
as seen in the image below.
Health education is communicating knowledge, facts, information about components that
improve health. For instance, facts about smoking can be distributed on leaflets for the public
to read and understand how it harms to lungs. Prevention methods are to help avoid health
problems. It motivates people to follow a healthy lifestyle. Health protection by government
services guide the public from current health problems and encourage preventive initiative.
Recent government protection measures include smoke-free places, an initiative to prohibit
tobacco. The overlapping method of Tannahill’s model is that each component does not exist
without another element and all three are important in health promotion. (WHO, 2018)
Becker’s health belief model based on the psychological approach is used to explain and
predict health behaviour (Becker, 1974). The model uses incentives and deterrents to promote
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health facts. The model has a broad range of scope in promoting health like preventive
measures- diet exercise or preventing health risk like smoking, contraception etc. The model
focus on identifying an individual's different perception and beliefs(Hayden,2009) and
incorporate strategies are used to cue steps to make a healthy change. Socio-psychological
variables are considered and further evaluation of modifying factors is screened. Depending on
the impact, needed action is decided.
Beatie model (1991) of health promotion focuses on four prototypes, which are 1.Legislative
action, which will focus on issues, make act, policies and ensure availability of resources;
2.Community development takes interest in promoting health at the community level. It
empowers community skills 3.Personal counselling for health works on improving health
quality. 4. Lastly, Health persuasion is techniques carried out by health professionals which
needs to focus on why change is happening. (Global and Public Health, 2017). Health
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promotion based on Beatie's model is authoritative, collaborative, negotiated an individual-
centric effort.
2.2
The main role of health professionals is to achieve both local and national targets. All
professional will work in collaboration to promote health such strengthening community,
developing individual skills, creating supporting and healthy environments. Health education
that encourages individual and community towards healthy lifestyle like a good diet, exercise,
meditation etc. Health professionals are health policy lawyers. They follow laws, rules and
guideline made by legislation to achieve local and national government targets. Health
professionals provide support, reasoning, answers to questions asked, give effective advice
initiative, ideas, and guidance, in relation to individuals and media. For instance, an officer of
the smoking cessation should be well updated with current facts and policies about smoking.
He should be aware of the hazards of smoking in different variables like pregnancy, children
etc. (Wilkinson, et al., 2004). Thus, any professional working on a particular health scheme or
7

project, need to be efficient enough with thorough knowledge about the field. Addressing
problems of the public, making important observations and creating solutions to question
raised should be done.
Research from England on Obesity showed that it affects 2/3 of adults and 1/3 of children and
is a second preventable hazard to health after smoking (Bernard & Hogarth, 2015). Targets
achieved at both local and national level help reduce obesity in children through the
promotion of healthy measures at schools, families, and community level. We need to tie up
with local GP's, to ensure local health. Effective health and social care services run at schools,
college and community level can help to tackle obesity. (Department of Health and Social Care,
2016)
Professionals such as midwives, GP’s, health visitors, school nurses, nursery nurses, dieticians
are required in meeting local targets. For instance, midwives can help tackle obesity from
antenatal care. The care through pregnancy, labour and postnatal care will help generate
quality of health for both child and mother. Nutrition suggestions by dieticians during
antenatal, pregnancy and postnatal period are very helpful. It brings positive maternal and
infant outcomes (Yeatman &Williamson, 2017).
2.3
A routine such as diet, exercise for physical well being, meditation for mental well being
Personal hygiene also plays a vital role in maintaining balance in the human body and ensures
a positive mental feeling. Personal hygiene, relaxation routine helps to keep mind refreshing.
Healthy Routine marks an important place in health promotion. Establishing a healthy routine
is the need of the hour to avoid lifestyle diseases.
Exercise can be beneficial to tackle child obesity. Children should engage each day in regular
exercise. Exercise benefits children as it helps to promote healthy growth like building bones,
muscles, reduces cardiovascular concerns, enhances energy level and positivity. Playing
outdoor games helps boots sportive mentally of children. Today, technology ill effects like
excess smartphone usage are keeping children busy indoors. This has become a social issue as
it will lead lack of physical activity and overall performance of any individual. (Pippig, 2016)
8

Regular exercise has proven to reduce the risk of heart disease, type2 diabetes, some cancers.
It is studied that stroke and heart disease reduces by 35% in people who engage in physical
activity (NHS Choices, 2018). Children are advised to practice healthy eating as eating poor
diets like junk food with excess fat, sugar will eventually contribute to obesity (Gaynor, 2018)
The routine which include regular exercise, healthy nutrition, and a balanced diet, some
meditation exercises bring a good quality of life and can extend the life span of an individual. A
lot of diet programs are being run in schools and colleges to ensure a healthy generation
ahead. Managing lifestyle with healthy and good habit will reduce diseases in future.
Obesity, oral unhygienic conditions are common among children who eat more unhealthy
foods, excess fatty and sugary diet. Regular brushing is encouraged to prevent tooth decay,
halitosis. and reduction of sugar intake and fatty junk food to avoid young age obesity which
will also reduce cardiovascular disease risk. Stress is an important factor for mental disorder. It
also hampers physical well being of the individual. Managing excess working hours and
removing sometimes to focus on your health can make a person more productive. Hence, in
many workplaces, we see that extracurricular activities are an advantage to reduce work
pressure. A power nap can also help refresh the mind. Nurturing your body, mind and soul
brings a sense of positive energy. A less active lifestyle and excessive technology usage, a
sedentary lifestyle is greatly hampering children's both mental and physical health. Stress can
be avoided by regular meditation. Mediation brings positive energy and refreshes the mind. A
study done by UCLA concluded that smokers who are having 3 servings of vegetables/fruits
and drinking herbal tea (black or green) are protecting themselves from lung cancer (Irwin,
2008).
Thus, by making simple changes in routine habits we can avoid health problems, promote good
health and energy levels. Making changes in daily routine like personal hygiene, good food,
regular exercise, following a circadian rhythm that involves following proper time to get up and
sleep, following meal timings, managing stress levels by extracurricular activities can benefit an
individual with excellent health and productive life. Health promotion holds a crucial place in
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every health organization. A healthy routine can promote a good quality of life and a good
span of life.
TASK 3
3.1
Health is a state or condition which every individual needs to achieve because implementing
healthy behavior in life will bring about positive changes in a person's life. healthy behavior
refers to the habits of a person which are healthy for example healthy eating habits, exercising
regularly etc. healthy behavior of an individual depends on their health beliefs which means
the attitude of people towards health. Some people believe health to be an important factor in
life and that it will bring positive changes in life while others feel healthy lifestyle can restrict
them from doing what they live.
Health believes of a person can be explained through implementing healthy behavior which is
described through three different models which describe the attitude of people towards
health. They are health belief model, health action model and stages of change model, these
theories describe attaining healthy behaviors in the life of an individual.
Health believes model: it is described through 4 stages perceived susceptibility, perceived
severity, perceived benefit and perceived barrier, self-efficacy, and cue to action. Perceived
susceptibility describes an individual's perception towards the behavior being bad or a matter
of concern. Next stage is perceived severity which describes a person perceiving the severity or
seriousness of the issue on behavior. Once the threat is perceived, the perception of the
benefit comes into play where a person assesses the benefit of changed behavior. The
perceived barrier is the next stage which describes the barriers that come with changes
behavior. Self-efficacy refers to the confidence of a person towards changing behavior and
reflects their self-desire. In order to bring changes in the behavior acting on these stages is
necessary which is done with the help of health professionals through the psychological
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process in the form of the cue to action that helps a person slowly imbibe healthy habit
(Green, 2014).
Health action model refers to the readiness of a person towards changing behaviour. It
depends on the self-esteem and motivation of a person. People with high self-esteem are
likely to have a strong attitude towards changing behavior because of self-confidence in them
and motivation towards change helps them build self- confidence and act on the change. Locus
of control is another factor of the health action model which describes a successful attribute of
an individual towards changing behavior. It can be external and internal, internal is based on
self-esteem and confidence of a person in bringing out change while external refers to external
factors that restrict the person for change like time, financial conditions, family etc.
(LEVENTHAL, 2012).
Stages of change: it is also known as the Trans theoretical model which describes the change
of behavior through different stages and each stage pushes a person to the next stage. The
pre-contemplation stage is the first stage where an individual is not ready for the change in
behavior. Contemplation stage is where the person is ready for a change in behavior. In the
preparation stage, an individual works on changing behavior by preparing to act on changed
behavior. Next is the action stage where an individual works on changing behavior and
maintenance stage is when the person works to maintain the changed behavior. Next stage is
the termination stage where an individual has succeeded in changing behavior and lives by it
while the relapse stage is that going back to the previous habit or behavior of a person. The
termination and relapse stage decide the failure and success of the person in changing
behavior (Norcross et al, 2011).
3.2
Health promotion helps to in stil good healthy behavior in a person but possess conflicts in
various industries as it lowers the revenue of these industries. The three major industries that
are affected with a healthy lifestyle are alcohol, tobacco, and food industries. It is the
responsibility of the government to promote health among individuals but this affects
revenues of this industry and somewhere affects the economy of government as well.
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The alcohol industry is wide and is successful in bringing out good revenues. It has been
observed that the profit attained by the government through alcohol was £10.4 million where
maximum individuals possess risk due to excessive consumption of alcohol leading to the
development of diseases. Alcohol consumption leads to a number of diseases of which heart
disease, liver dysfunction, cancer are just a few. Health promotion against alcohol involves
aiming to reduce alcohol consumption by removing alcohol advertisements, banning of
discounts on alcohol, raising prices and not making it easily available to the public. Because of
this reason alcohol industries have a conflict with health promotion because it demotes their
industry and affects their revenue.
The tobacco industry also increases revenue by providing £12 billion to the government but it
should be noted that 100,000 people die of smoking every year and smoking has a very bad
impact on health. It not just affects and causes coronary artery disease, blood pressure,
cancer, COPD but it affects many body parts and their functioning with lung cancer is common.
To restrict this, smoking cessation campaigns should be done to spread awareness among
youth about the dangers of smoking. This affects the smoking industries and the revenue that
they bring. It leads to unemployment and reduction in overall revenue which affects the
industry and in turn the government as well (Moodie et al, 2013).
The food industry is also affected by health promotion because it endorses processed food,
sugary drinks and fatty foods which are not good for health. Excessive sugar consumption
leads to diabetes which has become common among the youth. Every sugar drink contains
enough sugar to put a person at risk of developing the disease. This is also influenced by other
factors like environmental factors, genetic factors, lack of physical activity etc. all of this
influences the health of a person and thus health promotion campaigns are necessary to
restrict people from consuming unhealthy food. This can be achieved by a restriction on the
selling of unhealthy food, restriction on sugar drinks, restriction on food outlets that delivers
fast food But this affects the revenue of the food industry and also leads to unemployment of
3.9 million people while the revenue is £203 billion, this suggest the effect on the food industry
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