WHAT ARE THE KEY ASPECTS OF PUBLIC HEALTH STRATEGIES?

In this assignment I will be describing the key aspects of Public Health strategies developed by governments to monitor and care for the health of its people.

P1

What is Public Health?

Public health is about helping people to stay healthy and protecting them from threats to their health. Public health activities involve helping individuals and dealing with wider factors that have an impact on the health of many people such as an age-group, an ethnic group, a locality, or a country. They do this mainly by following the three main ‘domains’ which are: health protection, health improvement, and healthcare public health.

What is Public Health England?

They are an executive agency of the Department of Health and Social Care. They provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific expertise and support. They employ 5,500 staff, mostly scientists, researchers and public health professionals. 

What is Health Protection?

This is when you protect people’s health by doing various things such as; ensuring the safety and quality of food, water, air and the general environment, preventing the transmission of communicable diseases, and managing outbreaks and the other incidents which threaten the public health.

What is Health Promotion?

This is the process of enabling people to increase control over, and to improve their health. It is a positive concept emphasising personal, social, political and institution resources, as well as physical capacities. 

What is Health monitoring?

This is a way to check if the health of workers is being harmed from exposure to hazards while carrying out work and aims to detect early signs of ill-health or disease. It shows if control measures are working effectively.

Identifying the health needs of the population

Trends or patterns need to be identified to control any implications. An example of this would be when the government and NHS work together to provide free condoms to the public. This will prevent any sexually transmitted infections or diseases such as HIV.

Monitoring community health

This can be done by discussing any changes in which you believe should be made to the health of public and alerting them to the potential problems that may be around. An example of this would be working with the NHS to find out how many people have HIV. This will allow the NHS to monitor those individuals and act on the situation. 

Controlling communicable disease

This is an infectious disease transmissible from one person to another by direct or indirect contact. Examples of direct contact would be if you make direct contact with someone with body excreta or discharges from an ulcer, open sore, or respiratory tract. Some examples of the non-direct contact would be things such as drinking glasses, sharing toys and bed clothing. However other things would be vectors such as flies, mosquitoes, or other insects capable of spreading the disease.

Promoting health of the population

Promoting health of the population is doing his such as preventing disease which aims to minimise the burden of diseases and associated risk factors.

Develop programmes to reduce the risk and screen for disease early on

This involves the reduction of ill health which can be done by introducing programmes to identify which people are at risk of a condition, then enrol them on programmes which will help prevent the condition such as providing free vaccinations for people who do not have HIV to lower their risk of getting the disease.

P2

19th century

John Snow (1854) – John snow was interested in drinking water in the spread of cholera, he had observed that the people who had drank water by one water company were likely to get the disease than those who didn’t. He took it upon himself to lock the pump at Broad street in Soho London to end an outbreak in cholera in London. In Soho there were 13 pumps supplying water from the wells, cholera outbreak happened very quick.

Edwin Chadwick (1832) – Edwin Chadwick had found that there was a link between poor living standards and the spread of growth disease. Therefore, he had recommended that the government provide clan water, improved drainage systems and allowed the local councils to clear away garbage from streets. It shows the connection between health and hygiene.

The sanitary movement (1842) – This was done with the work of Edwin Chadwick alone. He focused based on the Public Health Act. The report was sponsored by the Poor Law Commission. The report pointed out the correlation between the lack of sanitation and: disease, high mortality rates, low life expectancy.

Poor Law Act (1834) – This was when the poor law was introduced. Some people welcomed it because they believed it would: reduce the cost of looking after the poor, take beggars off the streets, encourage poor people to work hard to support themselves. It also ensured that the poor were housed in workhouses, clothed and fed. The children who were in these workhouses would receive some type of schooling. In return for this care, all workhouses would have to work several hours each day.

First Public Health Act (1848) – The Public Health Act was the first step to improve health in the health in the public, this is where Edwin Chadwick played an important role. The rapid growth of cities during the nineteenth-century led to concerns about environmental problems such as; poor housing, unclean water supplies, bad air and the impact that all of these had on the health of a working population.

20th Century

Beveridge Report (1942) – This report was presented by its author, Sir William Beveridge, to the British parliament which made him part of the war government. He was the man who was given the job to set up a welfare plan for Britain. He had the responsibility to find out what was needed for Britain to take care of the basic needs of people and create a set of reforms that would look after people giving them a basic standard living. Shortly after the Beveridge report was published. He proposed a new system of social security, which would include everyone and provide benefits.

Founding of the NHS (1946) – The NHS was created based on the Beveridge Report. The structure of the NHS in England was established in 1946 and new details was launched two years later. The NHS is to be funded out of general taxation and not through national insurance. The services were still provided by the same doctors and same hospitals apart from the fact that: everyone was eligible for care, services were financed from central taxation, and services were provided free at point of use.

Acheson Report (1998) – This report included three crucial areas which are: all policies that may have an impact on health should be evaluated in terms of their impact on health inequality, families with children should receive a high priority of health, and steps should be taken to reduce income inequalities and improve the living standards of poor households.

Our Healthier Nation (1999) – This report links to the Acheson Report. It proposed to tackle the roots of ill-health such as; air pollution, unemployment, low wages, crime and disorder and poor housing. This Act also focuses on preventing main killers such as; cancer, coronary heart disease, stroke, accidents and mental illness.

21ST Century

Choosing Health: Making Healthier Choice Easier (2004) – The white paper had recognised that the interest in health was increasing so a new approach was recommended to public health with the intent to: reduce the amount of people that smoke, reduce obesity by improving diet, promote exercise, and encourage sensible drinking.

Health Protection Agency (HPA) – The Health protection agency is an organisation which protects people’s health in the UK by: giving advice and authoritative information on health protection issues, identifying responds to health hazards and emergencies caused by infectious disease, hazardous chemicals, poisons or radiation, preparing for emergency or future threats, improving the knowledge about health protection through education and training.

National Institute for Health and Clinical Excellence (NICE) – The NICE is an organisation which provides national guidance on the promotion of good health and the prevention of ill-health. This develops guidance to inform practice in: chemical practice which is the correct treatment and care or those with specific diseases and conditions, public health which the promotion of good health and prevention of ill-health for those who work in the NHS, local authorities, the wider public and voluntary sector, and health technologies in the use of existing and new medicines, treatments and procedures within the NHS.

 COMPARING THE HISTORICAL AND CURRENT FEATURES OF PUBLIC HEALTH

In this article I will be comparing the similarities and differences in historical and current health issues, for example the persistence of health inequalities and the reasons for this.

M1

What is cholera?

Cholera is an infectious and often fatal bacterial disease of the small intestine, typically contracted from infected water supplies and causing severe vomiting and diarrhoea.

What are the causes/signs and symptoms?

The most common symptoms of cholera include; the dehydration caused by cholera is usually severe and can cause tiredness, moodiness, sunken eyes, dry mouth, shrivelled skin, extreme thirst, reduced urine output, irregular heartbeat, and low blood pressure.

How can it be prevented?

There are five main ways in which cholera could be prevented which is to;

1)      Drink and use safe water – you could do this by boiling it or treating it with a chlorine product or household bleach and if you are boiling you should boil for at least 1 minute.

2)      Wash your hands with soap and safe water – you should do this before you eat or prepare food, before feeding your children, after using the latrine or toilet, after cleaning your child’s bottom, and after taking care of someone ill with diarrhoea.

3)      Use latrines or bury your feces and not to defecate in any body of water – use latrines or other sanitation systems, like chemical toilets to dispose of feces, wash hands with soap and safe water after defecting, and clean latrines and surfaces contaminated with feces using a solution of 1-part household bleach to 9 parts water.

4)      Cook food well (especially seafood), keep it covered, eat it hot – you should do this by boiling it, cooking it, peeling it, or leaving it. You should be sure to cook shellfish (like crabs and crayfish) until they are very hot all the way through. Always avoid raw foods other than fruits and vegetables which you have peeled yourself.

5)      Peel fruits and vegetables, and to clean up safely in the kitchen and in places where the family bathes and washes clothes – you should wash yourself, your children, diapers, and clothes 30 metres (98 feet) away from drinking water sources.

In the 21st century, people have started to use technology which has increased science making medical systems more effective and efficient.

Public Health has transformed dramatically over the past 84 years since the Poor Law Act of 1834. The many laws and policies slowly updated and improved over the years, bringing us to the most recent body of change being created: NICE.

The Historical features of Public Health include a very Capitalist view on society. The Poor Law (1834), was designed specifically to build even more capital for the Bourgeoisie; leaving the poorer people behind. This started to change when Sir William Beveridge took a more collectivist approach and wrote the Beveridge Report of 1942. This resulted in the beginning of taxation where the public would put money into public services. Public health then became much more inclusive after the NHS was created in 1948. The NHS provided healthcare services across the country for free; meaning despite an individual’s income, they still had the right to access this service. Every person had an obligation to contribute to these services via taxes, therefore nobody was meant to have the upper hand. However, people in living in higher income households could still afford to go private; this involves quicker service, revolutionary treatment and better quality care – this still exists today.

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Current features of Public Health seem to be much more civilized and take a much more modern approach to health and ill-health in the public domain. The fact that individuals in the UK are now given the ‘choice’ on whether they want to be healthy (Choosing Health: Making Healthier Choices Easier, 2004) is a distant reality from the dominant approach of the Poor Law Act (1834). Public Health across the UK seems to be effective in its aim to improve the overall health of the nation, as it is now listening to the wants and needs of its patients. Public Health Strategies are now much more tailored and appropriate for its target groups as it follows the demands that are displayed in statistical data. There are no surveys and public consultations being made on a more regular basis to really grasp the real needs of the people. Historically in Public Health, this was not seen as a priority as the people in power had their own circumstances prioritized. For example, when the Conservative Government released the Black Report, they only released a few copies and did not invest in its findings. This suggests that the Conservatives wanted to hide the reality of health inequalities and push the gap between higher and lower classes even wider. The people in charge in this case, wanted to profit as much as they can from this situation.

Public Health has also become more effective in its delivery. For example, Preterm Birth Complications and HIV/AIDS were in the top ten causes of death around the world in 2000, which was not in the top ten causes of death in 2016 (WHO, Top Ten Causes of Death). This is likely to be because Public Health promotion campaigns around HIV/AIDS and Preterm Birth Complications were displayed across the country. A lot of money and effort was ploughed into this project in target areas after a shocking increase of these incidences were reported. As a result of this, more sexual health centres were opened; this helped the public by providing information, support and relevant resources. There has also been more research and medical improvements in the maternity sector of the NHS.

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