PUBLIC HEALTH P1 AND P5

Hey everyone, so this assignment was P1 and P5 for public health!!

Describe key aspects of public health strategies (P1) Explain health promotion and protection (P5).

There are many strategies in public health to ensure that the population stays healthy, and has a longer life expectancy. Public health is now managed by a number of different agencies such as the Department of Health, NHS, Public Health Agency, DHSSPSNI and also GP. The DHSSPSNI has a mission to improve the health and social well-being of the population in NI. They had three main responsibilities including HSC, including policy and legislation for hospitals, family practitioner services and community health and personal services. Public health is another responsibility which covers policy, legislation and administrative action to promote and protect the health and well-being of the population and also public safety, which cover policy and legislation for fire and rescue services.

To ensure the Department of Health achieve their aims, the government needs information about how health the population are. They need to find out the mortality and morbidity rates and often ask individuals to complete surveys rating their own health.  It is important for the government to monitor these as it keeps track of the statistics for both mortality and morbidity rates and also allows them to be able to identify the actions that need to be taken for example if they need to improve on their health campaigns or set up new facilities and undergo more recent research to improve on the statistics.  There are over 41,000 people diagnosed with lung cancer each year (NHS, 2013). A further 3% of lung cancer cases are caused by exposure to second hand smoke in non-smokers. Lung cancer is known to be the second highest cancer to affect the UK. The more you smoke will certainly increase the likelihood of developing lung cancer however it is the length of time that you have been a smoker that is the most important factor (cancer research, 2014). Approximately 2.3 million people in the UK are living with Coronary Heart Disease (CHD) (NHS, 2014). The main causes for CHD are hypertension, diabetes, high cholesterol and also smoking (NHS, 2014). Around 800,000 people in the UK are affected by dementia (NHS, 2015). This risk of developing dementia usually increases as individual age. The mortality rates in Northern Ireland alone, in 2013 were 14,968 (NISRA).

An aspect for strategies of public health is to identify the health needs of the population and to develop programmes to reduce the risk and screen for early onset of disease. When the government have recognised and are aware of the population’s health status, they will then concentrate on their resources on key health issues. One key health issue is cancer and bowel cancer is known to be one of the most common cancers which is diagnose in the UK, with approximately 40,000 new cases each year (NHS, 2014). The Northern Ireland Bowel Cancer Screening Programme is offered to all men and women who are aged 60 to 74 every two years. Individuals within this age group will be sent a screening test so that they are able to do the test at home (HSC, 2011).  This is done by taking a sample of the faeces, and when completed, sent to a laboratory to be tested for any signs of blood. If blood traces are recognised the individual may be then sent for a further colonoscopy. An abdominal aortic aneurysm or (AAA) is when the main artery in the body widens as it passes through the abdomen. The artery balloons out as the walls weaken. This is more common in those who smoke, who have high blood pressure, those with cardiovascular disease and also in older men (HSCNI, 2015). If this is not treated, it can be fatal and 80-100 individuals in Northern Ireland die from a ruptured AAA each year.  The Northern Ireland AAA screening programme was implemented in 2012 and is offered to men in their 65^th year in Northern Ireland. Its aim is to reduce AAA mortality by providing a systematic, population based screening programme which uses a simple ultrasound scan (HSCNI, 2015). For those who undergo the ultrasound screening a reduction in mortality to 45% has been highlighted in men between the ages of 65 and 79 years.

Another key aspect is controlling communicable diseases. Any outbreaks of infectious diseases must be investigated and should be controlled by the DOH to protect the public. The Health Protection Service has a role in protecting the population from environmental hazards and also infections and it is delivered by a multi-disciplinary team (HSCNI, 2015). The DOH make individuals aware of diseases like influenza by having posters and leaflets in for example doctor surgeries and clinics, in which individuals are able look at and take away with them. This can be telling them how disease is spread and what can be done to prevent it. To control seasonal flu the DOH are giving immunisations to those who are at most risk from this disease including, the elderly, young children, asthmatics and diabetics. This reduces the likelihood that these individuals will come in contact with this disease.

A further key aspect is promoting the health of the population. Health promotion is motivating individuals to increase control and responsibility over their own health and improve it by changing their lifestyle and behaviour. The DOH wants to reduce the mortality and morbidity rates of disease/illness in Northern Ireland. This is done by setting out health campaigns which often use the fear approach in order to shock or fear the individuals into changing their behaviour. An example of a health campaign is the, “is your waistline creeping up on you?” poster which was used to support the, “choose to live better” campaign (PHA, 2011). This is also a television advertisement. On the poster it shows a man with a waistline of 37” and ‘cancer’ wrote on the band on his underwear. This shows that if men of a certain age have a waistline of 37” or more then it can be seen as a health risk and could therefore lead to cancer.  During the year of 2011, over 4,000 individuals from across Northern Ireland had been surveyed about a variety of health and wellbeing issues. In relation to obesity, the CMO report stated that 59% of the adults that were measured were either overweight (36%) or obese (23%). Males were seen to be more likely overweight (44%) than females (30%). This therefore make men who have a waistline like this think twice about it, and so may persuade them to change their lifestyle to lose weight as they may have a fear of developing cancer due to being overweight. This can be linked to the victim model. It suggests that people have limited influence over their health and that it may be determined by genes and by social and economic environments.  There is a link between obesity and social class. This suggests that poverty limits choice. Individuals and families who have a lower income have less choice in the food that they are able to buy and therefore eat. This is because processed, junk food tends to be cheaper than it is to eat healthily. A diet that is processed is loaded with the wrong nutrition, for example high in fats and carbohydrates and so leads to obesity. In addition low income individuals often live in areas where there are few facilities for healthy, safe exercise. This model highlights that people who have low income are victims of economic circumstances.

Another campaign is, “every cigarette rots you from the inside out”, which features a father lighting a roll-up cigarette made of rotting flesh (BBC, 2015). The aim of this campaign is to try to shock smokers into giving up. It also highlights the belief that hand rolled cigarettes are just as harmful as normal, packed cigarettes. The statistics for those who smoked hand rolled cigarettes in 1990 was 18% for males and 2% for females. In 2011 this had a big increase to 40% males and 26% females (action on smoking and health, 2015). In 2013, the opinions and lifestyle survey highlighted that 40% male and 23% females smoked hand- rolled cigarettes. These figures are almost still the same as they were in 2011. This can be linked to the empowerment model which suggests that individuals are empowered and have a free choice, meaning that they are free to choose between a healthy and unhealthy lifestyle. They are the ones who decide what they are going to spend their money on whether it be cigarettes or not.

The fifth key aspect is planning and evaluating the national provision of health and social care. The DOH sets out plans each year for health and social care and they must measure how successful they have been by carrying out an evaluation. It is beneficial to set targets as it gives you a laser focus, so that all the attention is set on one area at a time. This means that the DOH can put attention on to one key area at a time to give it a better chance of being achieved. Targets will also help make good decisions as they will help to identify and establish priorities and make right choices based on long term views and in this case what’s important for the population. This is when the evaluation comes into play in that, if the targets have not been met the DOH are able to look back on them along with statistics and therefore see where they have gone wrong and what needs to be changed and improved. 

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