The Role Of Public Health In Health And Social Care Setting

Introduction

 The health and wellbeing of individual is of key importance not only to individual themselves but also to the government. Furthermore, the Government is under legal duty to ensure it protect its citizens from threat of disease on their health and well being. To fulfill this obligation, the government together with various stages engaged in planned and organized public health activities, aimed at monitoring, preventing and promoting health and wellbeing. This essay aim to explain and evaluate approaches and strategies used to monitor, control and management of incidences of disease in community

1.1explain the roles of different agencies in identifying levels of health and disease in communities

Public health is defined as planned and organized measures put forward to help people stay healthy and also to protect them for threat to their healthy (WHO 2015a). There are different organization and agencies at local and international level that are dedicated to public health. In UK there are a number of agencies that play significant role in ensuring disease are detected and responded to in our communities. These organizations and agencies includes public health England, faculty of public health, department of health, and United Kingdom public health association Public health England is an executive agent of department of health which is mandated to ensure nation‘s health and wellbeing. The function of public health includes monitoring incidences of disease in the wider UK, entering into partnership with other health agencies to improve the health and wellbeing of citizen and to provide guidance develop policies and framework relating to public health in England(DH 2012) Faculty of public health is another agent of public health UK. This is a faculty of royal college of Physician which plays a significant role in setting, monitoring and promoting standard relating to training and qualification of public health specialist in the UK. The faculty is responsible for ensuring that public health special have the proper competencies gained through proper and quality training (FPH, 2015) The department of health also play a significant role in ensuring population is healthy and protect from threat, of disease by developing and implementing government public health policy. The department is also responsible for information gathering and dissemination through guideline, directives, framework all aimed at promoting health and wellbeing of the wider population (DH 2015) Another agent that also plays an essential role in Public health is the United Kingdom public health association (UKPHA). UKPHA encourage partnership working in Public health by bringing together all individual and organizations committed to promotion of public health. It does this by providing platform where individual and organizations committed in promoting public health discuss and developed polices for at all level of government and also for all sector(RCN 2015)  

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

 According to World health organization, epidemiology refers to the study of distribution and determinants of health related event such as diseases, with the aim of applying this study to control and manage diseases and health related problem (WHO 2015). In this section, the epidemiology of breast cancer and HIV is discussed. Breast cancer is one of the leading types of cancer in UK. According to data from Office of national statistic, breast cancer remains the most prevalence type of cancer in UK as compared to other type of cancers. The data also shows that this type of cancer is gender biased as 99 percent of the cases are reported in female. Since 2001-2010, breast cancer has and continues to account for 1 in 3 of all new diagnosis of cancer in female (ONS, 2010).

Table 1: Number of newly diagnosed cancers and age-standardised rates; by sex, 2010, England 1
Males					Females
Site	Number	Percentage	Rate2		Site	Number	Percentage	Rate
Prostate	34,892	25.6	106.4		Breast	41,259	31.2	125.7
Lung	18,738	13.7	55.9		Lung	15,041	11.4	37.9
Colorectal	18,590	13.6	56.5		Colorectal	14,628	11	36.1
Sub-total	72,220	53.04	:5		Sub-total	70,928	53.64	:5
						.
All cancers3	136,372	100	422.6		All cancers2	132,386	100	369.6

(Source; Office of national statistic 2010)   According to Cancer research UK (2014), age, family history, late childbearing, high hormone level and lack of proper breast feeding are the primary risk factor of breast cancers. These Risk factors suggest that breast cancer can be avoided through adaptation of proper lifestyles. It is based on these Risk factors and the facts that the disease is gender biased, that public health activities to curb the disease has focused more on Lifestyles choices and are also more female focused. The several measures put forward for management and control of breast cancer included the NHS breast cancer screening program HIV is an infectious disease which has been one of the major concerns of public health due to its impact on the health of individual. The HIV virus is transmitted from one individual to another when the blood of two individual came into contact. According to PHE (2014), the number of people living with HIV Virus in UK has double over the last ten years. By 2013 an estimated 107,800 people are living with HIV virus in UK. This has mainly been contributed by medical advancement. According to PHE statistic, the Number of new diagnosis has been on steady rise since 1981 up to 2013. In 2012 new diagnosis were 6, 300 while that recorded in 2013 were 6000. The new diagnosis has affected two major groups which includes the gays and the black African heterosexuals. According to PHE (2014), two third of new diagnosis are found on these two group. Due to medical advancement, the numbers of people dying from AIDs and related condition has been on decreased trend. People with HIV virus can live almost near life, however, the Virus do affect the quality of life of the people affected.  

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

According to Gregory (2014), incidence of disease refers to the number of new diagnosis recorded over a specified period of time in a give population. In Public health, studying incidence of disease is very crucial as it help in developing approaches and strategies to curb new diagnosis. There are several methods of controlling/curbing incidences of disease which include Surveillance and monitoring, testing, health education, Vaccination among other. The suitability of any of these approaches does however depend on the nature and type of the disease. In an effort to control the increasing incidence of breast cancer, the government is using several measure one including health education and screening. According to WHO (2012), health education is one of the most effective way of control disease especially those that are preventable. In health education the government educate females on causes of breast cancer, how to avoid them and also to encourage them to regularly check their status. Additionally, breast cancer is also use to monitor and treats new diagnosis at their earliest stages. This approach help manage new incidence effectives as Scientific evidences have shown that early intervention in breast cancer improves the outcome of the treatment as compared to late diagnosis and treatment. In the management and control of HIV, the government is also using sexual education to encourages individual engages in safe sexual relation. The government not only encourages people at high risk to know their status but also to use protection during sex in order to curb incidence of HIV. Additionally, the government is also using HIV testing to monitor new incidences. This help in identifying new infection as they occurs which help to improve the outcome of intervention taken. According PHE (2014), people with HIV Virus can live a near normal live but only if their condition is diagnosis at it earliest stage and treatment start immediately. These approach has result to continue decrease of number of people dying because of Aids and related condition. The number has fallen and in 2013 only 560 people died out of the virus.

2.1. Use relevant research to determine current priorities and approaches to provision of services for people with disease or illness such as HIV and Breast cancer.

 In public health, it is important to set priorities and determine on the best approaches to use to ensure health and wellbeing of the citizen. In setting priorities, it is important that such priorities are based on well informed choice. To achieve this, the government use the disability-adjusted life years (DALY) techniques. DALY is a method use to calculate the burden of various diseases. It measures the gap between the ideal health conditions and the current health taking into consideration age, disability and illness factors that exist in between (Davis, 2013). The information given by DALY method help the government in setting priorities in Health and social care with regard to where efforts and resources should be concentrated. According to recent research, the most burden of diseases are caused by risk factors such as tobacco use, alcohol consumption, poor dietary, physical inactivity, and uninformed lifestyles choices. Based on the nature of these risk factors, burden of disease can be avoided if risk factors are well address. It is based on this facts that the government through it various public health agencies has set prevention as one of the top priority in 2014/2015 to ensure public remain safe from diseases and health related problem(PHE 2014). In line with this, the government is using several approaches to prevent diseases and reducing their impact on the public. One of such approach includes health education. Public is being constantly being educated on how to life a healthier life and adopt well informed lifestyles. A good example of health education is the change4life campaign that aim at educating and encouraging people to consume proper diet, engage in physical activities. Another example is the Smoking cessation program which give discourages smoking. On top of prevention, the government has also set early intervention as one of it priority in public health. This has mainly been driven by the fact that, when majority of disease are detected and treated at their earliest stage, there is improved outcome. To achieve this, the government is using several approach and initiatives to monitors diseases in our community. One of such initiatives is the NHS breast cancer screening programs which aim at detecting breast cancer at it earliest stages so as to improve the treatment and survival rate.

 2.2 explain the relationship between the prevalence of disease and requirements of services to support individuals within the health and social care service provision

An important connection do exist between prevalence of disease and the services offered by health and social care to offers support to individuals suffering from particular illness/disease. As commented by Gregory and Duck (2014), health and social care should at all time respond appropriately to services user associated with most prevalence disease in the community In UK breast cancer is one of the most common diseases. According to office of national statistic, the incidence rate of breast cancer has continued to rise since 2001 with a rate of about 6.3 to 7 percent per year (ONS 2010). This increase mean that more breast cancer patients continues to seek NHS services to cater for their condition. This increases the demand for Health care which put more pressure on NHS and the entire health and social care to respond appropriately to the needs of breast cancer patients.  As a result, more professional such as Radiologist, pathologist, surgical officer etc and investment such as new equipments, new facilities etc is needed to meet the health needs of breast cancer patients. The relation between prevalence of disease and  health and social care services is important one. The government should at all time keep monitoring the prevalence of disease in our community so as to know how to plan, redesign or modify the health and social care services to meet the health needs of the community.

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

The choices people make can have long term effect on their health. According to NHS choice (2015), people eating habit and preferences, drinking and smoking habit, and their physical activities do have significant impacts on their healthy. Poor dietary, alcohol consumption, tobacco smoking and lack of physical activities all do have negative effect on individual health. According to NHS choice (2015), poor dietary is one of the leading causes of obesity and overweight, diabetes and cardiovascular disease. Recent research has shown that these diseases have been on the rise in UK for the last decades. According to health survey for England 2013, the cases of obesity and overweight has increased year by year since 1993 -2013. Similar trend has also been recorded in diabetes. Since 1994 to 2013, the prevalence of diabetes has increased from 2.9 % to 6.9 % among men and from 1.9 % to 5.6 % among women (HSCIC 2015). Tobacco smoking, alcohol consumption and lack of physical activities have also been blamed for the increase in preventable disease such as cancer, cardiovascular disease, diabetes, hypertension and related condition. As researches indicate, preventable disease continues to rise in UK. This show the lifestyle choices of majority population can be term bad or poor. Bad lifestyles increase the prevalence of disease in our community which in turn continues to put more pressure on the NHS and the entire Health and social care. If more people continue to make bad lifestyles choice as it is today, then the NHS and all other health and social care players will have to be ready for increased demand of their services from people suffering from diseases termed as preventable. More resource and investment will be need for treatment of these conditions. However, the Government can reverse the trend by allocating more funds to health education to encourage people adopt healthier lifestyles. 

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

The major aim of health and social care agencies is to ensure individual health and wellbeing remains intact. However, the health and wellbeing need is not always the same in different group of people or region. This calls for a decentralized approach in setting health priorities. In UK, this has been made possible by empowering local health and wellbeing agencies such as clinical commissioning group, local authorities and other stakeholder to assess and set priorities for the local community. Through Joint strategic need assessment (JSNA), health and wellbeing priorities have been set for different community based on their health care needs. In west minister, the local authority together with the central London clinical commission group has identified the health issue challenges and needs of people in the Westminster borough. These issues and challenges includes,

• an drastic rise in number of birth putting the pressure on maternity and early life services
• high rate of Child obesity in the borough which is above the national average
• 1 percent of 5 year school going children has a dental issue in the borough
• Misuse of substance among the youth is above national average
• Sex exploitation among the young is at alarming rate
• High rate of isolation and unemployment contributing to poor physical, mental and social health
• Dementia, HIV, cancer and other related disease has been on rise in the borough robbing the victim an opportunity to live independently (city of west minister 2013)

In order to address this issue, the local authority together with the central London clinical commissioning group has set five health care priorities as contained in the Westminster’s joint health and wellbeing strategy for 2013-2016. These priorities are;

• Ensuring every child has the best start in life
• Enabling youth to have healthier adulthood
• Supporting economical and social wellbeing and opportunity to find social isolation and unemployment
• Ensuring access to appropriate care at the right time
• Supporting people to live longer independent live(city of west minister 2013)

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

To ensure health and social care services are effective, accessible, are of high quality and affordable several system, policies and procedures have been established. These includes the NHS complaint policy, decentralization of health and social care responsibility to local agencies, healthcare partnership, user and their family involvement, choice and preferences of servicer user. The NHS complain policy requires all the health and social care organizations under the NHS system to establish a complaint procedure in their organization that is easy to use, accessible and effectives to provide a platform to servicer user to air their grievances or issue relating to services delivery. Since establishment of this policy, the level of servicer user satisfaction and confidences has gone up according to data from local government ombudsman (LGO 2014) The decentralization of health and social care responsibility to local agencies including local authorities, clinical commissioning group and others is another arrangement meant to improve the quality and provision of health and social care services. Under the health and social care Act 2012, local authorities in collaboration with other stakeholder are under legal and professional obligation to assess and provide health and social care services that meet the health and wellbeing needs of local community. This arrangement has not only make services more accessible at local level but has contributed a lot to effectiveness of health and social care services since services are designed and provided according to need of local community. Several recent government policies and legislation has put emphasis on the need for partnership working in the health and social care. According to health and social care Act 2012, local authorities are required to collaborate with other health agencies including NHS organization, clinical commissioning group, health and wellbeing board among other to assess and meet the health and wellbeing need of local community. Equally, the government SENDS green paper requires local authorities; family and health care organizations to work together in Assessing and responding are earliest stage to special education needs of children. These policies on partnership working have enabled health care agencies to take a unified approach toward public health. This help in reducing equality in health and social care as well as improving on service delivery In matter of quality of services, the care standard Act 2000 was developed. The Care standard act 2000 establishes a national system of inspecting, regulating and licensing health care organization including nursing home, care home, domiciliary services, and hospital among other. Care quality commission is the organizations mandated by the acts to ensure provider of health and social care services are meeting the national minimum standard applicable in the sector. The establishment of this system has contributed to improvement of quality of healthcare services since only care organization that meet the standard are allowed to operate. 

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

There are several changes that can be made to improve the health and well being of individual in health and social care setting. According to recent researches, individual behavior has been found to major contributor to burden of disease in UK. This call for a raft of measure and activities to changes people behaviors. Although the government is implementing several programs to achieve this such as change4life campaign, NHS smoking cessation program, better outcome can be achieved by widening the scope and reach of this activities. Education on lifestyles should be introduced in school syllabus to equip the younger generation with the necessary skill and knowledge that will help them make wiser lifestyle choices in their future life. Equally, Smoking cessation program should be widen in scope to not only help smoker quitting, but should also educate the general public about the danger associated with smoking. This would be very helpful especially discouraging young generation from starting smoking In additional to widen the scope and reach of health education, the government should also deal with factors that are contributing to bad lifestyles choice. For instance, Bad dietary is mainly contributed by easy accessibility of fast food which is also more affordable than organic food. Equally, more people are consuming alcohol and smoking tobacco due to their available, ease of access and affordability. The government should therefore introduce or enhances regulation relating to sale of these products to make them not only prohibitively expensive but also hard to get. Policy should be introduces to discourage, manufacturing and sale of all products and services contributing to bad lifestyles choice. Equally, the government policies should also encourages manufacturing/production and sales of goods and services that promote healthier lifestyles. Otherwise, if this is not done, health education such as changes4life and other will continue to achieve minimal milestone and may fail to complete achieve their target. For instance, the government continues to encourage people to adopt healthier eating habit, this message may reach to the target but the target may fail to act on it due to unavailability and un-affordability of healthier foods as compared to fast food and the likes.  

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

Bad lifestyle choice and behavior has been blamed for the increase in preventable disease and burden of diseases (NHS choice 2015). In response to this, the UK Government have continues to promote and encourages healthier lifestyles behaviors. Despite this a significant number of UK populations continue to smoke tobacco. According to HSCIC (2014) tobacco smoking has been found to be a major cause of cancer, diabetes, hypertension and cardiovascular disease. In order to curb and reduce the impact of tobacco on people health, NHS Smoking cessation program was introduced by the government. This program aims to encourage and help smoker quit smoking so as to minimize the risk factors of disease on them. Since its introduction, the program has continued to achieve major milestone. According to HSCIC (2014), the program has enabled 156,570 people quit smoking. The achievement achieve by NHS smoking cessation program has demonstrated that increase in government efforts can help changes people bad lifestyle behaviors hence improving the health of the general public. The Government should therefore continue and increase the funding meant for such activity. 

Conclusion

 The role played by public health in promoting health and wellbeing of population can ever be underemphasized. Public healths activities not only enable the government and other public health to understand the heath status of the population, but also to devise appropriate response measures all aimed at preventing and promoting the wellbeing of the population. It is therefore important that, all stakeholder of public health including aspiring public health professional to understand how approach and strategies are used in public health to promote the wellbeing of the population.  

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