THE ROLE OF PUBLIC HEALTH IN HEALTH A ND SOCIAL CARE SETTING

Introduction

This essay is going to examine the role be played by public health in health and social care setting. Specifically, the essay will examine role of public health in monitoring and measuring diseases in the community, investigate the implication of diseases and illness in community on health and social care provision and finally, analyse factor that affect individuals health and wellbeing

  • explain the roles of different agencies in identifying levels of health and disease in communities

The foundation of public health is identification of health and diseases in the community. In the UK public health sector, There are three organization that works together to ensure diseases as well as the health condition of the public is identified. This includes the world health organization, department of health and local authorities.

World health is an international body whose mandate is to promote public health of its members’ states. The role of WHO include including diseases monitoring and surveillance, monitoring health situation and trends,   shaping research agenda, and providing technical assistance to countries or region that face diseases epidemic (WHO 2015b).

The role played by department of health is an important one. It is responsible for setting health agenda for the country,  develop public health policy and ensure their implementation.   It is also responsible for monitoring the nation’s health, designing and implementing appropriate programs to tackle public health threats.

Under the health and social care act 2012, local authorities were given major public health to play. They are required to   monitor the diseases and health condition of the local communities as well as commission public health activities to address local health problem. They also play an important role of providing accommodation and financial support to vulnerable people in communities.

  • explain, using statistical data, the epidemiology of one infectious and one non-infectious disease that is widespread in their own country

One essential element of public health is epidemiology. According to Watterson (2003) epidemiology is the study of diseases distribution, incidences and   control method. The epidemiology help understand the trend of a diseases, whether reduction or increase, as well as effectiveness of intervention. Epidemiology provide numerical figures that create a clear picture of a disease, it management and it impacts. Below is an example of epidemiology of two disease one infection (STIs) and other non-infection in UK (diabetes).

Sexually transmitted infection is a term used to refer to number of sexually transmitted diseases from one person to another. According to data from Public Health England, STI are very common in UK. In last year 2014, approximately 440, 000 cases of STI were diagnosed.    Almost all of these cases were recorded in youth under the age of 25 years. The most four common STI diseases are syphilis, gonorrhoea, genital warts and Chlamydia. Out all of the fours Chlamydia is the most common which accounted for 206,774 diagnoses made in 2014. (PHE 2015)

Although STI Impact has been largely recorded in heterosexual youth, the number of diagnosis recorded in men who have sex with men (MSM) has been increasing for the last ten years (see figure below). For instance, in 2014, there was 46% increase in Syphilis and 32 % increases in gonorrhoea in MSM category as compared to new diagnosis recorded in 2013 (PHE 2015)

Figure 1 Diagnosis of STIs among men who have sex with men (MSM)

(Source; Public health England 2015)       

According to PHE (2014) higher cases of STI was recorded among black ethnicity as shown by figure below

Figure 2; STI diagnosis by ethnicity

(Source; PHE 2014)

 

 

Diabetes is a common non-infections disease in UK. According to data from PHE (2014), approximated 6 percent of people over 17 years have been diagnosed with diabetes in UK which is equivalent to 2.7 million people. Due to the relation obesity and diabetes, the cases of diabetes have been increase due to increase in obesity cases. Diabetes is age related diseases with 16.5% percentage of all diagnosed made in 2013 being on those over 75 years old, 14.5% in those between 55-74 years, 5.1% in those between 34-54 years less than 2 % in those below 34 years. Again, the disease is ethnicity related with Bangladeshi or black Caribbean ethnicity and black Africa being at higher risk that white (PHE 2014).

  • evaluate the effectiveness of different approaches and strategies to control the incidence of disease in communities

According to shields and Wycross (2003), incidence of diseases is a term that is used to refer the number of illness reported in a specified population over a given period of time. Incidences of disease help identify the number of new cases of a particular form of illness that has been suffered by a community in a specified period of time.

In UK, incidences of diseases have been an important element of public health as it helps identify the most threatening illness and condition. Incidences of disease are controlled using various approaches which include surveillance, testing, Vaccination among. The approach however depends with diseases. For instance, For STIs, the mostly used approaches to control incidences is by encouraging people to use condom. Evidence has shown that condom is the most effective way of preventing sexually commendable diseases (Steen et al 2009).

While other approach for control incidences of diseases are effective on their own such as use of condom to curb STI incidences, other will need to be combined with clinical intervention for them to be effective, For instance, Testing, cannot be effective on its own, however when combined with early clinical interventions they become more effective in controlling new incidences of a disease (Steen et al 2009). For example, testing would be very effective in identifying and monitoring new cases of STIs, but that does not prevent new   STIs cases from occurring. However, when combined with clinical intervention, STI diagnosis can be reduced.

2.1 Use relevant research to determine current priorities and approaches to the provision of services for people with disease or illness

Priority setting in public health activity is essential. According to Vanessa (2014), priorities setting in the context of public, mean allocation of resources in a manner that the desired health outcome will be achieved. There are several methods that can be used in priority setting but the mostly used method is the Disability adjusted Life years (DALY). This method is based on the premise that available resources should be used to address the most common diseases in the community. DALY method is very useful in assessing magnitude of diseases, health risks and premature death hence providing proper guidance on resources allocation. The use of DALY method is clear in UK. It has not only been used to set priorities but also make case for primary prevention (Groose et al 2009).

Based on the Global burden of diseases as calculated using DALY approach,    seven health Priorities has been set in UK. These Priorities are

  • Tackling Obesity
  • Reducing smoking
  • Reducing harmful drinking
  • Best start in life
  • Reducing dementia risks
  • Tackling antimicrobial resistance
  • Reducing tuberculosis ( PH 2014b)

Obesity has been associated with the increasing cases of cardiovascular diseases, diabetes, cancer and poor mental health. On the other hand evidences have indicated that smoking is the largest killer In UK causing 80000 premature deaths per year. Alcohol drinking has also been found to be the leading risk factor for those between ages 19-45 (PH 2014b). This and more worrying statistics and facts has prompted the UK government through the Public health England to set the seven health priorities that the government will focus

2.2 Explain the relationship between the prevalence of disease and requirements of services to support individuals within the HSC service provision

According to world health organization (WHO 2012), prevalence of a disease is a measure of how many people have a certain disease at any given moment. The prevalence of diseases has direct effects on the requirement for health services to support individual affected by the condition. An increase in prevalence of a disease requires an increase in capacity to offer the high demand for support services. Let take breast cancer for instance. In UK, the prevalence of breast cancer especially among women has been increasing for the last several decades. It is believed to be increasing at a rate between7-7.8% per year (Forman et al 2014).

Breast cancer increases individual over dependence on health and social care services for support. Additionally, the treatment and management of breast cancer requires input of many specialist healthcare professional from doctor to radiotherapist (Chitnis 2014). This indicate that, as prevalence of breast cancer continue to rise, more people will requires health and social cancer services regularly which mean that more doctors, surgeons, radiotherapists among other healthcare professional will be needed to satisfy the high requirement for support among breast cancer patients. Furthermore, there might be the need to increase the   health and social care capacity to accommodate more breast cancer patients.

2.3 Analyse the impact of current lifestyle choices on future needs for health and social care services

People’s lifestyle choices are very important in public health since they are one of the strongest determinants of people’s health (Bury 1997). Some lifestyles choices promote diseases and illness while other promotes health and wellbeing. For instance, smoking, physical inactivity, over consumption of fast food and excessive alcohol consumption are the leading contributor to premature death caused by health problem such as cancers, diabetes, cardiovascular diseases, mental health problem, obesity and overweight. On the other hand, lifestyles choice such as regular medical check-up, consumption of raw food,   an active life through physical exercises etc contribute to healthier and prolonged life (HDA 2003).

The current lifestyles choices in UK are characterized by high level of consumption of unbalanced diets as most people are relying on fast food (bbc.co.uk, 2016). Equally, there are a large numbers of people estimated to be 10 million adult who smoke alcohol (ASH 2015). In addition, majority of UK citizens have adopted a sedentary behaviour with no form of physical activities. These current lifestyles choices have direct impacts on future needs for health and social needs. These needs include more funding, more human resource and more Health and social care infrastructure. As pointed out by PH (2014), the current lifestyle choices especially those relating to unbalanced diet, smoking and lack of physical exercise will continue to led to sharp increase chronic diseases such as cancer, cardiovascular, diabetes, etc. As this happen, the general practice (GP), NHS, nursing, care home, mental health centre and residential homes will need to employ more staffs, invest more in health and social care related infrastructures and require more financial supports.

 

3.1 assess the health and well-being priorities for individuals in a particular health or social care setting

In the current setting, local authorities have the responsibility of setting health and wellbeing priority and commissioning public health activity for their local community. They set priority through Join Strategic Needs Assessment (JNSA). JSNA is an on ongoing process in which the local authorities work together with clinical commissioning group and other local health stakeholders to identify and set health and wellbeing priority for action (Camden 2015).

According to Camden’s joint health and wellbeing strategy for 2012-2013, the major health and wellbeing priorities for Camden borough include tackling the biggest killers, addressing the most common diseases, dealing with health condition where Camden borough is doing poorly as compared to other borough and finally deal with obesity

In Camden, majority of the death are caused by cardiovascular disease, respiratory diseases and cancer and as such the local authority has set this as priority areas to reduce the number of premature death caused by these diseases. In the whole borough there are those health conditions that are more common and present a health challenge. These include high blood pressure, depression, diabetes and asthma. In order to improve the health of general public, addressing these diseases is one of the priorities of the local authority. Additionally, there are those areas in which Camden is doing poorly when compared with other borough. These include children poverty, deprivation, mental illness, alcohol and substance misuse and premature death from heart diseases and stroke. Finally,   obesity has been on the rise in the borough especially among children and as such the Camden authority has set obesity as one of the priority areas to prevent associated health problem and premature death (Camden 2013).

3.2 evaluate the effectiveness of strategies, systems and policies in a health or social care setting.

There are several systems, strategies and policies put forward by the government to promote the health of the general public. Some of them include the NHS compliant policy, Partnership working, Involvement of family in care planning and implementation among others.

National Health Service complaints Policy is a policy that come into forces in 2009. The objective of this policy is to ensure dissatisfaction with services and customer complaint are well handled. According to this policy, all the NHS organizations are required to develop and implement internal compliant procedure for service users. The compliant procedure introduced by NHS organizations need to be easily accessible and responsive to service user complaints. Since it introduction, there has been an increases in numbers of complaint cases successfully handled by NHS organization estimated to be 162,000 complaints 2013 (HSCIC 2013) as well as the Local Government ombudsman office. However, according to recent inquiries conducted, the NHS complains policy has not fully achieved it objective. In the Robert Francis (2013) Inquiry into Mid Staffordshire NHS Foundation Trust in 2013, it was found out the care organization in question did not listen to or respond to customer complains despite it having the complaint procedure. In another inquiry, conducted by Clwyd and Hart (2013), it was found that most of care organizations have Patient Advice and Liaison Service (PALS) which they combine with compliant management. This creates a conflict of interest since the people employed to advice and counsellor the patient were the same people handling customer complaint.

3.3 discuss changes that could be made to improve the health and well-being of individuals in a health or social

There are significant numbers of changes that can be done to improve people health. As mentioned by HDA (2003), most of the current health related challenges being faced in our country is as a result of   Lifestyles diseases. In order to achieve public health goals, the public perception, attitude and behaviour will therefore need to be change so that they can start adopting healthy behaviours. People will needs to be discouraged, against smoking, alcohol misuses, fast food and sedentary behaviour in order to reduce the high number of lifestyle disease and premature death.  In top of discouraging them against these behaviours, the public will also need to be educated to acquire knowledge and skills that will help them take greater control over their lives.

According to Bury (2007) People lifestyles behaviour is directly affected by their social and economical condition. For instance, due to low income level, most people result to consumption of packaged food/fast food as they are relatively cheaper when compared to raw food. The government will therefore needs to addresses the wider social economical factors as part of the wider and long term scheme to improve people health. Fighting poverty, unemployment, social and domestic violence etc are some of the social economical changes that need to be addressed for healthy improvement.

3.4 evaluate an activity that has been implemented to encourage behaviour change for maximizing health for individuals in a health or social care setting

Changing people   unhealthy behaviour is very essential in reduction of lifestyle behaviour related diseases which have been on the rise in UK in the recent years. The UK government continues to influence people behaviour through number of activities including the NHS smoking cessation services. The NHS smoking cessation services was introduced specifically to help reduced   cigarette smoking rate in UK hence setting people free from highly likely health problem such as oral and lung cancer, stroke among other tobacco-related diseases.  According to Bauld, Judge, and Platt (2007), people who seek NHS smoking cessation program are four time likely to be successful in quitting.

A recent research by Bauld et al (2009) found out that, intensive NHS treatment for smoking cessation to contribute up to 53 % reduction on smoking. This is clear evidences that show NHS smoking cessation to be effective in reducing   smoking rate. They study also found out that group intervention   was more effective than one-on one support. The biggest challenges with NHS smoking cessation services are motivating people to seek the services. As mentioned by West, McNeill and Raw (2000), it is only two percent of the active smoker who seek NHS smoking cessation services.

Despite evidences showing NHS smoking cessation to be effective it reach is minimal and for it to be more effective in reducing the  number of smoker, NHS smoking cessation activity will need to increases their accessibility to the over 11 million smoker in England.

Conclusion

It is very crucial that healthcare professional understand the role of public health in health and social care setting. This is because the role played by public health help in measuring, monitoring, preventing, and controlling diseases is important one and as such healthcare professional needs to have skills and knowledge about techniques, model, strategies and best practices used for public health activities.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reference

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