The roles of public Health in Health and Social Care.

THE ROLE OF PUBLIC HEALTH IN HEALTH AND SOCIAL CARE

Public Health

Introduction

 The concept of public health has grown in importance and stature since its inception in the UK.  The main aim of public health is prevention of illness and diseases in the entire population as well as promoting and sustaining health of the citizens. This is facilitated by recognizing many social factors that contribute to health (WHO, 2015).

This paper aims at investigating the roles of different agencies that work within the community to reduce the incidence of diseases. This paper will investigate both non-infectious and non-infectious diseases which are widespread as well as explore the various strategic approaches and statistical methods applied to evaluate, monitor, and regulate the incidence of the diseases.  The paper will also explore the various effects of illness and diseases in delivery of health care and social care services. The paper will put into consideration the current lifestyle in the community that impacts the delivery of quality health and social care services (Department of Health, 2013).

Roles of different agencies in the UK

Public health refers to science and art of ailment prevention and prolonging of life using planned efforts to help the society make informed choices. The main role played   by the different agencies is to identify incidences of diseases   within various communities. The different agencies involved in  public health include International agencies such as World Health Organization (WHO)  and European Union (EU); National level agencies (Government  and UK Department of Health  (DH) and the local authorities  and local health trusts (Social welfare 2013).

The World Health Organization (WHO) has six core functions. To begin with, they provide strong leadership on critical health issues and engage in partnership especially in areas that are in need joint action. They are also responsible in research agendas that facilitate dissemination of knowledge on health issues. The organization also sets norms and standards that should be used to promote and monitor the effectiveness of specific interventions of public health issues.  The organization facilitates the establishment of evidence based policies that are ethical. This includes provision of technical support by catalyzing change and developing sustainable institutional policies. WHO also monitors the health situation and evaluates the current health trends (Forest & Denis 2014).

 The European Union has the responsibility of complementing the national policies. It does so by helping the EU affiliated governments to achieve the established shared objectives, pool resources so that they can generate the scale of economies as well as tackle the shared challenges. The role of this international organization also includes promotion of healthier lifestyle, and ensuring equitable distribution of resources to tackle the serious health threats that are predominant among EU member countries (Social welfare 2013).

 At the national level, the UK Department of Health (DH) leads the strategy, policy and outcomes of health improvement. The agency leads by establishing policies that protect the citizens from a range of health threats.  It leads in emergency preparedness, providing health programs for Olympics and Paralympics et cetera. It helps the health care providers at the national level to harness the cutting edge in the advancement of medical science to improve health care.  The agency also designs the systems for England public health.  

The Department of Health (DH) helps the UK residents to have better and longer life. The role of the agency is to lead, shape, and provide funds for the healthcare system in the UK.  This ensures that people have adequate support as well as helping to, maintain the dignity of the citizens. The agency also creates national policies and healthcare legislation. It also supports the integrity of the healthcare system by ensuring delivery of quality care and accounting for the funds provided to it by parliament in a way which represents the interests of the patients. The agency also champions innovation and supports research and technology, transparency, openness, and honesty. This improves the out-patient care by establishing the safest and highest quality of healthcare services. Ultimately, the efficiency and productivity of the healthcare system is improved (Department of Health, 2013).

  The local authorities have a convening role and also promote co-existence between the Local authorities and the GP consortia. The key role of the local authorities is to lead joint strategic needs assessments (JSNA) to ensure coordinated and coherent strategies.  The agency also supports local voice and promotes patient’s autonomy. The local agency also leads on local health in order to prevent occurrence of diseases.  The agency promotes the commissioning of the social care and Local NHS services to improve delivery of quality care (Reiner et al. 2013)

Epidemiology of infectious and non-infectious disease

 Epidemiology refers to the study of distribution of infectious and non-infectious diseases, and the determinants of these health related events within a specified population, and application of research studies to control the health issue.  Epidemiology involves studying of global patterns, risk factors, and preventive measures that can be applied to improve the health issue.  

Non infectious disease is also referred to as non-communicable disease. This refers to a health condition that is non transmissible. More often than not,, most of non-communicable diseases are chronic and progress slowly. Examples include asthma, obesity, malignant disease. and cancer. Infectious diseases are highly contagious, which implies that they are transmitted from one person to another. They are often caused by pathogens.  Examples of infectious diseases include HIV/AIDS, tuberculosis, influenza, childhood diseases, MRSA, influenza, food and water borne diseases (Social welfare 2013).

  UK is reported to have the highest level of obesity in the Western Europe. Obesity is a non-infectious disease and it refers to body mass index (BMI) that is between 25 and above.  According to the Health and Social Care Information Centre, 24.9% of the population is obese and approximately 61.7% is overweight. The levels have increased in the past three decades, and it is projected that if intervention measures are not put in place, half of the population will be obese by 2050. This trend is attributed to the fact that most people have adopted modern lifestyles which includes unhealthy dietary and physical inactiveness. Obesity is the biggest health crisis in the UK because it is also associated with other health complications such as diabetes, cancer, and cardiovascular disorders (National Obesity Forum n.d).

 The most common type of infectious diseases is influenza. The latest epidemiological reports indicate that influenza has continued to increase considerably.  The influenza virus is the leading cause of respiratory tract infections, which is associated with severe complications which lead to hospital admission and mortality.  The internet based surveillance indicates that influenza affects 18.4 per cent out of a population of 1000 people. However, 20-44 people report higher rates of infection which is reported at 23.1 per cent out of a population of 1000 people   (Social welfare 2013).

The effectiveness of different approaches as well as strategies of diseases control

There are various approaches being utilized by the Department of health in controlling obesity and influenza in the UK.  Some of these approaches include screening, vaccination, legislation, education, and creating awareness and surveillances (Social welfare 2013).

The Department of health has established interventions that will help people make healthier choices by ensuring that they are in a position to make healthy dietary and to become more active. This includes programs such as Change4life. The department has established strategies that will help effective labeling of drinks and food which will help people to make informed choices. The legislation requires the factories to include ingredients such as calories.  The National institute of Health and Care Excellence (NICE) has established a series of initiatives that aims at reducing obesity. This includes improving the physical environment and leisure parks to improve the amount of physical activeness among the population (Public Health England 2014).

The departments at national and community level encourage the use of school based programs as the main strategy to tackle obesity. For example, the Croydon Healthy Schools program was established in order to ensure that local schools support healthy food programs and promote physical activeness. The public health agencies at the national level deal with four specific networks including food, physical activity, alcohol, and health safety at the workplace.  These initiatives have helped people to adopt healthy lifestyles.  In addition, regular education has helped to reduce discrimination as well as enhance self confidence among people with obesity (Social welfare 2013).

 The Public health of England also conducts surveillances of the Influenza after every week to monitor the influenza activity at community and national level. Influenza is the leading cause of hospitalization in the UK. For this reason, the healthcare agencies at the government level (Department of Health) supported by the local authorities have developed annual a flu program that seeks to vaccinate individuals at high risk of developing influenza. The high risk individuals include the older people, infants and toddlers, pregnant women, immune-suppressed, and those suffering from cardiac diseases. In addition, the program provides training to help the citizens in detecting signs and symptoms of influenza. The public health department also requires that any suspected case of avian flu must be reported to the nearest animal and Plant Health agency. This helps the agencies to effectively control the infection. A recent case of low severity (H5N1) avian flu was reported in Dunfermline early this year, but the agencies managed to control the infection by using restricted movement (Public Health England 2014).

The current priorities and approaches

The priorities for delivery of health services are influenced by evaluating the burden of a disease. The analysis of the community burden of disease provides comparable assessment of the cost of health, injuries, risk factors and mortality rates. This is normally done using the disability-adjusted life year (DALY). DALY that normally evaluates the number of years lost as a result of premature deaths within a certain time (Social welfare 2013).

According to DALY report in the UK, the leading health burden is mental illness, heart complications, cancers diseases and respirational diseases respectively. In 2010, the leading causes of DALY were cardiovascular disease, chronic osteoporosis (back pain), as well as chronic obstructive pulmonary disease (COPD). Most of these disorders are associated with unhealthy lifestyles such as poor dietary, alcoholism, smoking, and lack of exercises. Therefore, the current healthcare priorities in the UK include preventive services for mental health, smoking, diet control, alcoholism as well as promoting physical activeness.  The second priority is to improve the clinical services by providing adequate support for mental health services, respiratory disorders, and cardiovascular disorders (Public Health England 2014).

 The approaches being used to provide healthcare include primordial prevention. This involves   identification of legislation that aims at delivering quality services. Other approaches include education and awareness, environmental controls and social welfare.  The second approach is through primary prevention. This primarily focuses on health promotion interventions such as health education on immunization, chemoprophylaxis, and serophaylaxis. Environmental modifications will help to protect the community from various hazards in the environment. The nutritional interventions and behavioral changes will ensure that people adopt healthy lifestyles (Social welfare 2013).

 The other approach is the secondary prevention which mainly focuses on halting the progression of the disease and prevents complications. The main activities in this stage include screening tests, laboratory findings, and adequate treatment programs. The fourth approach is through tertiary prevention. This involves use of all interventions to limit disabilities and impairments associated with the health event and help promote a patient’s health condition. This mainly focuses on interventions that prevent disability limitation as well as rehabilitative services.  Rehabilitative services are coordinated through medical, vocational, educational, and social training measures to help the patient retain their functional ability to the highest level (Public Health England, 2014).

The approaches being used include monitoring and surveillances. Monitoring is used to describe the performance and analysis of measurements that are aimed at evaluating the environmental changes such as water quality and other forms of pollution, dietary intake et cetera. Monitoring also entails all other forms of measurements of health services and the extent to which patients adhere to the advice provided by healthcare professionals.  On the other hand, surveillance is the inspection of the determinants of health, and the distribution of   the other health related illnesses (Public Health England, 2014).

Relationship that exists between the prevalence of disease and the service requirements

There are considerably adequate healthcare resources including hospital, community health services, personal medical services, and community health services.  The community health services providers (HCHS) and dental staffs are about 105,000. There are bout 41 300 healthcare providers who provide consultation services and an additional 53,000 who provide training services.  There is about 971,000 non-medical staff whereby 319,000 are qualified nurses, 136,000 are technical and therapeutic professionals, 187,000 in infrastructure support, and 36,000 are managers.  In the new health and social care setting, these healthcare providers consist of clinical commissioning groups (Department of Health, 2013).

The UK health and well-being board brings together organizations to work in partnership in order to deliver powerful that advocate for the needs of communities and patients.

 These healthcare professionals have combined efforts to help people lead healthier lives.  This involves ensuring that people have adequate support, care and treatment as needed, and in the most compassionate, respectful, and dignified manner.  The specialists are working together to ensure that they provide evidence based care. This is achieved by bringing in the multidisciplinary teams together in health and social care to manage healthcare efficiently and effectively.  This facilitates timely referrals which are important in reducing time for making diagnosis. Although there have been massive improvements in healthcare, the public health of England continues to be burdened by diseases such as obesity and influenza.  This often calls for strategic frameworks and policies (Department of Health, 2013).

Impact of current lifestyle choices on the health care future needs

The UK people’s health is determined by their lifestyle choices.  This is attributed to the increased globalization and   busy schedules that make it difficult for people to engage in healthy lifestyle.  For instance, obesity is associated with poor dietary and increased physical inactiveness.  The food available in the UK today is just refined ingredients mixed with some chemicals. These food products are cheap, and taste very good that one cannot have enough. This makes the food to become hyper-palatable which makes people eat them in high quantity due to food addiction.  Food addiction is a complex issue that can be very difficult to overcome. This often leads to mental disorders and increases a person’s susceptibility to other infectious diseases such as influenza (Health Protection Agency 2010).

 Obesity is associated with energy imbalance. The main variable factor and one that can be modified is physical activity. Most people are not active. Physical activity has continued to decline in developed countries. The pattern is being reflected in developing countries. Over the past decades, each household in the UK own second hand carts and appliances that help to cut on labor. Outdoor activities have also reduced considerably; consequently, one in every four people in the UK is at risk of becoming obese. The impact of physical inactivity affects the   future of the healthcare industry because increases cardiovascular disease burden through the increased cost of preventive care (Department of Health 2013).

Most of the health complications are associated with behavioral risk factors.   Chief among the behavioral risk factors includes smoking and binge drinking. It has been hypothesized that smoking helps in reduction of weight gain. However, these beliefs are over-simplistic. Both smokers and non-smokers are at risk of becoming obese if they feed on unhealthy foods and are physically inactive. The impact of tobacco smoking and alcohol affects the   future of the healthcare industry because it increases the cost of preventive care (Enfield 2013).

Priorities for people in specific health setting

 The well-being and health of the populace in this community are highly related to each other. According to WHO, health has a great influence on the nation’s economic development. The healthier a community is the more productive it becomes.  The healthcare settings of a community are influenced by many factors such as communication, poverty and social services. These determinants can be categorized by many physical factors such as the individual health factors which include hormonal imbalance, genetic disorders, and immune system.  These factors increase people’s risks of cardiovascular and metabolic disorders. These factors also affect the behavioral, cultural and psychological factors. For instance, stress is a psychological factor whereas unsafe sexual behavior, abuse of alcohol, and smoking are behavioral factors that have an impact on an individual’s health. (Public Health England, 2014).

 The environmental factors involve all factors that affect the wellbeing of humans. These include safe water and a clean environment. Other factors include chemical factors, biological and physical environment. The socioeconomic factors such as income affect the well-being of an individual. For instance, in the UK, health disparities are evident between the high income and low income earners. The high income households get better medication and education, and are less likely to be affected by infectious and non-infectious diseases (Social welfare 2013).

Priorities of elderly people’s health should be based according to the health issues facing the age group, and are projected to face the age group if not addressed adequately.  Infectious diseases such as Influenza affects the elderly people especially those living in low economic zones. Such diseases are associated with long term effects; hence, they need immediate and appropriate health solutions such as preventive management. Abuse of the elderly people is another issue that must be prioritized. The elderly people are abused physically, emotionally and psychologically. The protection agency must ensure that they are adequately prepared to help the frail human beings.  This is to ensure that they are housed, fed, and their healthcare is taken care of (Paterson 2014).

Effectiveness of strategies systems and polices

The effectiveness of the policies that are implemented in taking care of the elderly involves enactment of policies by the various agencies of the public health. There are various agencies that contribute towards the enhancement of children’s health and are all working to meet the same goal. The partnerships established by these institutions are designed to facilitate incorporation of effective healthcare services. These services include involvement of the PCTs, CCCs and other local authorities. Due to the modifications conducted in the white paper, these policies and systems have been found to be very effective in delivering care .However; there are some areas where the ground level implementation has not been successful. In such instances, there is need to establish more interventions to help implement the policies more effectively (Stewart, Cutler, & Rosen 2009)

 Changes that could be established to improve the healthcare

 The changes that are needed in the UK healthcare system are changes that will influence positive behavior. For example, there are limited opportunities that promote physical activity. In this context, the public health agencies should respond to the private sector to ensure that recreational facilities are not interfered with to ensure that there is enough space for physical activity. This includes maintaining of the cycle routes, sports areas, children play ground areas and pedestrianisation (Social welfare 2013).

 The second priority is to change the local culture and beliefs of physical activity. Most people in the UK do not value physical activity. The public health agencies must put in place awareness programs that will help to ensure physical activity is valued by everybody in the community.  The public health is also responsible for community safety. There have been few worries regarding personal security especially when exercising. The public health must liaise with the community groups and the police to help restore a safe community (Public Health England 2014).

 The public health community must work in partnership with the groups such as educational institutions and communities to increase awareness on preventive measures such as healthy foods, physical activeness, and vaccination programs.  The commissions should improve access to organic food at affordable prices especially among the socially marginalized people (Public Health England, 2014).

Task 3.4 Evaluation of an activity that have been implemented to promote behavior change

 Under the Health and Social Care Act 2012, the main agency in charge of improving the health of the populace is the local authorities. They have a statutory function to improve public health by providing advice to the clinical commissioning groups. The local authorities are entrusted to deliver National Child Measurement Program.  One of such program is “cooking from scratch”. This is an initiative established by NHS and Bristol    county council. The scheme targets to teach the low household income on ways to make simple healthy foods that can be achieved at specific budget.  The program also trains the community on importance of physical activeness and adhering to vaccination programs. The program has been successful as it trains people from diverse settings including the elderly in community day care centers, staff working in these centers, youth clubs, and new mothers. This has helped to reduce the rates of obesity in this county (Public Health England 2014)

References

Department of Health, 2013. “Making mental health services more effective and accessible.”

Einfield, 2015. Health and wellbeing strategy.

Forest, PG., & Denis, JL. 2014. Real reform in health systems: An introduction. Journal of health Politics, policy and Law 37(4).

Health Protection Agency, 2010. What the Health Protection Agency Does? [Online].

National Obesity Forum, n.d. Welcome to the National Obesity Forum [Online].

Public  Health England. 2014. Public health training for health protection and allied professionals.

Paterson, J. (2014). Strategies for enhancing the delivery of person –centered care. Nursing standard 28(39); 37-43.

Reiner, M., Et al. (2013) Long term health benefits of physical activity- a systematic review of longitudinal studies. BMC Public Health 13; 813

Stewart,S., Cutler, D. & Rosen, A., 2009. The New England Journal of Medicine. Forecasting the Effects of Obesity and Smoking on U.S. Life Expectancy [Online]. 361, p.2252-2260.

Social welfare. 2013. “The state of health care and adult social care in England.”

WHO (2015). An introduction to the World Health  Organization.

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