Concepts of Public Health

Assignment 1- what is public health?

This assignment will be based on public health and the criteria I am going to meet within this is describing key aspects of public health strategies, describe the origins of public health policy in the UK from the 19^th century to the present day and comparing historical and current features of public health.

P1- Describe key aspects of public health strategies

There are 6 different types of public health strategies these are identifying health needs of the population, monitoring community health, developing programmes to reduce the risk and promote screening, controlling communicable disease, promoting health of the population and planning and evaluating the health and social care provision.

The key aspects of public health is that it defines good practice in 4 aspects, and the first one is being population based which means that it is based within the population and specific groups within the population. The second one is emphasising collective responsibility for health protection and disease prevention which is making sure that they are responsible for the health of people and making sure things are put into place in order to prevent people from getting diseases and illness that can spread. The third one is recognising the key role of the state, linked to a concern for the underlying socio-economic and wider determinants of health, as well as disease which is when they look at the society based and the environment and they look into concerns based around these factors. The fourth one is emphasising partnerships with all those who contribute to the health of the population which means that they are making sure that people work together to contribute to the health and making sure that if a person becomes ill everyone works together in order for that person to get better.

Developing programmes to reduce risk and promote screening

This is when an attempt is made to reduce levels of ill health by introducing new programmes which identify a person of being ‘at risk’ of a condition and getting them to do preventing programmes. An example for this is when a person is obese and the doctor notices that they have a higher chance of getting obese they will refer them to a weight management programme which will help give them support in losing weight and doing things to help prevent the cause of diabetes. This key aspect of developing programmes which promote screening is emphasising collective responsibility for health protection and disease prevention as they are using this in order to look for diseases so that they can reduce a person’s chance on contracting the disease, this then links to health protection as if people are seen ‘at risk’ then they can send them to start a new programme which can help their understanding and help them reduce their chances even more by doing this certain programme.

This has an importance to the government as if all of their professionals are working correctly and providing the people with the correct programmes to attend then it means less of the population are uneducated and can try and improve ill health of the population. This is important to the service user as they are using the service and they are getting good advice and education out of it to help them to improve with the condition and learn more about it, it also gives them the chance to change and make a difference in their life due to that certain condition. These is important to the authority because they get to promote these things and help make a difference to a person’s life and can prevent other people from being at risk of getting the same thing.

Controlling communicable diseases

This is reducing the impact of infectious diseases through immunisations and other control measures. This can be things such as injections which help prevent a person getting MMR which is measles, mumps and rubella but it can also include things such as hygiene measures in restaurants and take-away places to prevent the spreading of food poisoning. The key aspect is emphasising collective responsibility for health protection and disease prevention as this is trying to prevent a person from getting it such as if an asthmatic has the flu jab then this reduces the chances of them getting the flu and becoming really unwell whereas it might not affect a healthy person as bad. It also can look into the concerns for the underlying socio-economic and wider determinants of health as well as disease because if a person has HIV which can be spread to another person they might look into how they can stop this from spreading within the society.

This is important to the government as it prevents more people within the world contracting diseases and potentially dying, and if people are getting these free vaccinations then it doesn’t look bad for the government as they are putting things into place to try and control these things from happening. This is important to the service user as it gives them a chance of having things put into place to control the likeliness of getting a disease and for most people these things are free, which is a great opportunity for a person to get the vaccination if it’s going to make a difference for that person. It is important for the local authority as when they are giving people things to control these diseases they are getting less people dying from these things because they have done something in order to prevent it. 

Promoting health of the population 

This is when there are activities put into place where they are promoting health and trying to reduce ill-health within the population. If a person has obesity and they go to the doctors and they notice that they have a really high chance of getting diabetes, then they might try and engage them into doing things such as being more active and doing more exercise and eating healthier foods such as fruits and vegetables. The key aspect links into the population based as it links into the population sector and promotes health for the population with activities which can reduce the risk of ill health for the population and it also links into partnerships who contribute to the health of the population because if the professionals who help a person get better aren’t doing it properly then it is only going to give more of the population ill-health and the activities won’t work. Some of the activities can be things such as a person educating other people on healthy eating when they have diabetes.

This is important to the government as they can promote health in order for people to focus on the good side of health rather than the ill health which will mean that the numbers of deaths will decrease and will look good for the government if people are listening to the promotions. The importance to the service user is that they are having health promoted to them so that they can change things and get advice and good help so that if they are unsure about something they can get information on it and learn more about a certain condition or ill-health.  The importance to the local authorities is that they can be the ones to promote health such as in health care settings or social settings or in the GP surgery and dentists and all different places within the community.

P2- describe the origins of public health policy in the UK from the 19^th century to the present day

Timeline of public health policies

19^th century

The poor law act 1834

 This act is originated with the nineteenth-century poor law system and the Victorian sanitary reform movement. The poor law had changes made in response to the 1832 royal commission of inquiry into the operation of the poor laws. Within the report that was made the commissioners made several recommendations to the parliament and as a result of this the poor law amendment act 1834 was passed which said that no able-bodied person was to get any money or help from the poor law authorities apart from people in a workhouse. The workhouse conditions were made very harsh and this was to discourage people from wanting to receive help even though the harsh conditions the act made sure that the poor had shelter, they had clothes and they was fed. Children who entered the workhouses would receive some sort of education and schooling. In return the care all the paupers received in the work house they had to work several hours in the day in order to get the help and care.                 

Edwin Chadwick and the sanitary movement

A man who did a report on injury into sanitary conditions of the population of Great Britain published in 1842. Edwin Chadwick got evidence of the relationship between environmental factors, poverty and ill-health. It recommended the establishment of a single local authority, which is supported by an expert medical and civil- engineering advice to administrator all sanitary matters. Six years later the national public health act 1948 was passed and the first board of health was established. Edwin Chadwick wrote a report on sanitary matters about the conditions on ill health and things such as poverty and he looked into recommendations to improve these kind of conditions that was taking place. He then found out that there was a link with poor living standards and the spreading and growth of diseases. He then made a recommendation that the government should get involved and start providing clean water, improving the standards of the drainage systems and for local councils to go and take away rubbish off the streets and from people’s homes. He argued that the poor conditions were preventing people from working effectively.

John snow and the broad street pump (1854)

John snow was a man who was interested in the role of drinking water with the spread of cholera and he did observations on the people who drunk water provided by a company who were more than likely to get the disease than the people who had not drunk the water. He plotted cases of cholera on a map he learnt that the people who were falling ill was the people getting their water from the single pump, which got its supplies from a sewage- contaminated river Thames. Other people getting their water from a nearby well never caught the infection. A connection between cholera and water that was contaminated was established and this was before bacteriology was able to identify the causative organism. Once identifying the source of infection as polluted water, John Snow removed the handle of the Broad Street water pump and halted the outbreak of cholera in Soho, London.

The first public health act (1848)                                                                                                                                                                                 

This is industrialisation and rapid growth in cities in the nineteenth centuries which then led to concerns about environmental problems and these was poor housing, water supplies which wasn’t clean, the bad air and how it impacted the health of the working population. Edwin Chadwick was a member of sanitary movement and looked into several public health issues like poor housing and the working conditions. He did a report on an inquiry into the sanitary conditions of the labouring population of Great Britain in 1842 which contained evidence which linked to the factors of ill health and poverty, it also recommended a single local authority which was supported by an expert in medical and civil engineering advice, and this was to look into all sanitary matters. After this six year later this act was passed and established. 

The 20^th century

The Beveridge report, 1942

This is a report on the fact that British people should be rewarded for their sacrifice and resolution after the second world war had taken place. After this the government then promised that they would create an equal society which is why they asked sir William Beveridge to write a report on the best ways to support people who are earning a low income. A report was published by Beveridge in December 1942, which was a report about everyone who works has to pay a weekly contribution, which meant that in return of this benefits would be given and paid to the people who are sick, unemployed, retired or widowed which will help them out as they are barely earning anything.

Founding of the NHS (1948)

Clements Attlee’s government created the NHS which was due to the Beveridge report. The NHS structure in England and wales was made by the National health service act in 1946 but then new arrangements was made to this and was launched on the 5^th July 1948. This was due to the Minister called Aneurin Bevan, the NHS was then calling for it to be funded through taxation and not through the national insurance. The NHS services was to be provided by the same professionals and hospitals, but the services were provided free at the point of use, that the services were financed from central taxation and that everybody was eligible for care which meant even people who was only temporarily living here or was visiting the country.  The NHS has 3 different parts to the structure the first one is the hospital structures and the second one is primary which meant family doctor services and the last one is community services such as maternity and child welfare clinics, health visitors, midwives, health education, vaccination and immunisation ambulance services.

Acheson report into inequalities in health, 1998

In July 1997, Donald Acheson was asked to look into the inequalities in health in England and identify areas that could be developed and have policies in place to reduce them from happening. This was then followed by two famous reports from sir Douglas Black in 1980 and the updated version from 1987 called the health divide. These reports were always kept quiet because they painted a picture of improving the health inequality in a developed country. When he wrote the report he wrote it with a list of 39 recommendations which addressed the health inequality, on a scale which was being put in order from their impact on the evidence. The main three areas which was identified during the report in terms of their impact was that ‘all policies likely to have an impact should be evaluated in terms of their impact on health inequality’ and the second one was ‘a high priority should be given to the health of families with children’ and the third one was that ‘further steps should be taken to reduce income inequalities and improve the living standards of poor households’.

Saving lives: our healthier nation, 1999

This is a health strategy which was released by the labour government not long after it came into power in 1997. It was linked with Acheson’s report which was to look into and find the reason of ill health which included the air pollution, the unemployment, the low wages, the amount of crimes and disorder and the last thing was poor housing. This also focused on the main things that kill people which are cancer, coronary heart disease and strokes, accidents and mental illness.

Choosing health: making healthier choices easier (2004)

This was produced when it was taking into interest about the health increasing and recommending a new approach towards public health which looked on the society and how it was increasing. It looked into social justice and tackling ill health and the bigger causes of this also looking into empowering people to change their lives. Within the document it had 3 principles which was an informed choice which was to protect children and not allowing a person’s choice to affect another person’s, the second one was named personalisation and it was to support the needs of individuals and the last one was to work together and it looked into the partnerships between communities and making sure that they are working together effectively. With these three things put into place the main priorities of these was to try and decrease the number of people who smoked, try to decrease the statistics of obesity whilst trying to promote healthy eating and nutrition, try and increase people to do more exercise, try and support people to drink sensibly and healthily, try and improve the sexual health of people and to improve the mental health of people.

The actions that this paper tried to put into place was that by 2010 all children and young people in England should be in schools where active travel plans were put into place for example to put a plan together to show how it will encourage people to do active forms of transport such as cycling and riding a bike to school. It also wanted the local authorities to work with a national transport charity in order to get new cycle lanes and tracks put into place. It wanted health to be a way of life and to have health trainers to give people healthy choices and to commit to them properly. The other thing it wanted was an NHS that was health promoting which meant that the staff working for the NHS trained staff to deliver health messages effectively whilst doing their day to day job when working with patients. The very last thing was that the NHS will become a model.

The health promotion agency (HPA)

This is an organisation which is independent and is very dedicated on protecting the health of people within the UK. It provides advice and information for health protection to the public, professionals and to the government. It combines two things together which are public health and scientific expertise which does research and does some emergency planning all together within one organisation. This organisation can work as an international, national and regional and it also has links with lots of other organisations around the world.

The national institute for health and clinical excellence (NICE)

This is an organisation which works independently and guidance to people on things such as good health and how to prevent it and things such as treatment of ill-health. They develop guidance which helps people in certain practices such as the clinical practice which the correct treatment and care for people who have specific types of diseases and conditions with the NHS. They give guidance for public health which is when good health is promoted and preventing ill-health from occurring for the people who work within the NHS, the local authority and people who have bigger contact with the wider public which is voluntary sector. The last one is health technologies which is about the new and the things that already exist such as medicines, treatments and procedures within the NHS as they are always developing and advancing so the staff always need to be aware of these new things that can have changes made to them.

M1- compare historical and current features of public health

The system has had a lot of changes since the 19^th, 20^th and the 21^st century as we now have more policies and procedures and legislations put into place to protect the people of the community and the population around the world. Since the 19^th century the water supply, housing and poverty have all improved although they aren’t the best that they can be as there is still homeless people and other people who are struggling financially over the world. In the 19^th century when the poor law act 1834 come into place it helped a lot of people and it does still in the 21^st century as people still receive this and they can also access other benefits which in the 19^th century didn’t exist which help a lot of people out nowadays. There was the first public health act 1848 which was about poverty and the water supplies being contaminated and causing people to become ill whereas in the 21^st century now we have better water supplies and they are clean and we don’t get diseases and illnesses from drinking tap water or the water we are supplied with. It looked into the bad air which was affecting the working population in the 21^st century we have a lot of factories and cars and things that are polluting the air which is bad because back in the 19^th century there wouldn’t have been many cars on the roads. From the 19^th century till now we have better living conditions and things to help us keep improving them because when the people worked within the work houses they got treated really badly and was stripped of their needs as they weren’t allowed breaks or anything.

The old system didn’t really benefit anyone especially the population and the government as there was more people falling ill and contracting diseases which would have been more hard work to explain to people why this was happening. In the 20^th century the founding of the NHS 1948 was discovered and this was good as people could access health services whereas now in the 21^st century the NHS has improved the NHS is more advanced and we now have more medicines and treatments to cure more diseases then they did back in the 19^th and 20^th centuries. The technology is more reliable and the equipment that is now used that it makes really easy to do procedures and make diagnosis. In the 19^th century there was no help from anyone to help get a job if you were unemployed you would be made to look yourself or work in a workhouse whereas in the 21^st century there is a job centre and online resources which people can access in order to try and get help looking for employment. In the 21^st century there is a lot of things come into place which wasn’t invented in the earlier centuries such as the health protection agency which is an organisation looking into health. In the 21^st century there is more people looking into new ideas and trying to make things much better whereas in the 19^th century there wasn’t the resources to help people the way we can in today’s society. In the 20^th century more things came into power which followed on from the 19^th century as our healthier nation 1999 was produced which looked into the report of Acheson and tried to look for the causing root of ill health, including air pollution, unemployment, low wages, crime and disorder and poor housing this helped to develop into the 21^st century to make society safer than it was before.

References

• https://www.slideshare.net/jessejess29/miss-krystian-p1-public-health
• https://navigator.health.org.uk/content/edwin-chadwicks-report-sanitary-conditions-labouring-population-great-britain-was-published
• https://ebookcentral.proquest.com/lib/sandwell-ebooks/reader.action?docID=4191375&query=health+and+social+care+book+1