Public health assigment PDF

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Sheffield Hallam University Faculty of Health and Wellbeing

Module Title: Fundamentals of Public Health, Science and Practice

Assignment title: Public Health Assignment Level Four

Your course: BSc (Hons.) Nursing

Your student number: 25039201

Word Count: 3147

Date of submission: 8th September 2017

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In this assignment, key principles of public health will be explored using a case study. This case study is: ‘Zain is a 28-year-old young man who is at University. He is living in shared accommodation with a group of people he is having difficulty getting on with. He has found some part time work but again he is struggling to get on with his work mates. He is homesick and feels very irritable, low and isolated such a long way from home. Often, he cannot get out of bed in the morning and has missed a few lectures and shifts. He is not sleeping well, and relies on fast food as the basis for his diet. On weekends Zain is drinking heavily and partying.’ Key public health concepts will be discussed including how they are relevant nationally and internationally. These will include health and health promotion. Sociological theories and social policy initiatives will be drawn on and it will be examined how these relate to healthcare. Throughout these principles will refer to the case study and health issues and risk associated with lifestyle choices will be discussed, going on to consider strategies which encourage health promoting behaviour in response to this. Health can be defined in many ways, both negatively and positively. In 1946 the World Health Organisation (WHO) defined health as ‘a complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ [ CITATION WHO06 \l 2057 ] At the time of publish this definition moved away from the negative aspect of defining health as the absence of disease and incorporates physical, mental and social factors as contributing to health. Allowing for health to be viewed as interlinking factors in individuals, rather than just a physical cause or physical condition. This definition is useful in providing a global prospective for health,

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allowing for health to be understood not just in terms of our local population but in terms of how health has an impact all over the world. Health issues are transferable across nations and a global perspective provides us with greater possibilities to improve health from a wider population perspective. (Boyd, N.D) However, the WHO definition is outdated and the use of the world ‘complete’ for individual wellbeing is limited and indicates that individuals would be unhealthy most of the time. It is very unlikely that a person has complete physical, mental and social wellbeing everlastingly. Individuals can have underlying health issues but still carry out a normal life and consider themselves healthy. As is the case of rising numbers of people living with chronic illness, it has become the norm for individuals with health conditions such as coronary heart disease and diabetes to age well. (Huber, 2011) In consequence, (Bircher, 2005) offers a more fitting definition of health. Suggesting that wellbeing is characterised by physical and mental potential and that age, culture and personal responsibility are in accord with the demands of life. This recognises that health changes throughout the life cycle, and allows for health and disease to be attributed to individual factors. Therefore, this definition can be used in the case of Zain, to categorise what is healthy or unhealthy about his lifestyle. Zain is transitioning into university, he is struggling to do this and feels isolated and homesick. He has little social networks as he is struggling to get on with his flatmates or work mates. The transition into university can place a lot of pressure and stress on individuals. On top of moving into a new lifestyle of study, students often move into new housing, and create new social networks. This can be difficult for individuals especially if they are moving away from home. Additionally, students now have

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control over their own financial situation and often face financial hardship. (Massey 2005) These life changes can have detrimental effects on health, particularly mental health. This appears to be the case with Zain, he is socially isolated and feels irritable, often struggling to get out of bed in the morning. Due to this he has been missing shifts and lectures. Indicating, that this is affecting his wellbeing; having low mental wellbeing for long periods of time can lead to mental health issues. This is increasingly common in university students, (Gil, 2015) demonstrates this as 78% of students expressed they have experienced mental health problems in a recent survey. In the case of Zain, it appears that he is expression characteristics of depression. Depression is a global problem and according to (WHO, N.D) it affects 121 million people worldwide. Also in 2000, depression affected 2.6 million people nationally in the UK. It is an illness which causes a negative emotional state and the most common type of depression being clinical depression, with core symptoms being depressed mood, loss of interest, decreased energy and irritable mood. (Mcrory, 2012). Highlighting that with feelings of irritability, isolation and struggling to get out of bed in a morning, Zain is expressing similar characteristics. A key principle of public health is the prevention of an illness is better than a cure. Therefore, early intervention is important in doing this. A key organisation which is responsible for such principles are Public Heath England (PHE). (PHE, 2015) states that two of their core functions are ‘to improve the public’s health and wellbeing’ and ‘to improve population health through sustainable health care and services.’ A way they can do this for individuals like Zain is through action plans like the NHS England (2016) Five year forward view for Mental Health. One of the key priority’s set in this plan was to promote good mental health and preventing 4

poor mental health. They aim by 2020/21 that 1.5 million people suffering with mental health problems have access to services. Subsequently, helping individuals like Zain to access services to help with his mental health. Despite this many student don’t seek advice or help about their mental health. A survey by the National union of students (NUS) into mental health found that 54% of students who needed mental health support did not seek it. (Sherriff, 2015) Showing that whilst health incentives are in place, it is not always as easy as it seems to get people to take the initiatives on board. This appears to be even more apparent in males suffering from mental health problems. (Patrick & Robertson, 2016) proposes that men are reluctant to seek help for mental health and wellbeing. It is challenging to engage men in conversations which tackle stigma around mental health as it is shaming for men and viewed as being weak. Nevertheless, campaigns are in place to promote good mental health and wellbeing. One such being Student Minds who empower students to look after their mental health and support others. (Student Minds, 2017) One way in which they are promoting this is through the national campaign ‘University Mental Health Day’ which addressed the barriers to participation that students with mental health difficulties at university face. The most recent campaign in 2017, 7800 people took part in the campaign and 81 universities ran events on the day. (Student Minds, 2017) This campaign can help Zain to seek active support with his mental health problems and learn to overcome them and have good wellbeing. Determinants of health are factors that contribute to whether a person is healthy or not. (CDC, N.D) There are 3 main factors considered. (WHO, N.D) highlight that the 3 factors are ‘the social and economic environment’, the physical environment and ‘the persons individual characteristics and behaviours’ however there are many more 5

factors which can be considered. One factor which could be influencing Zain’s health is his personal behaviour. Zain relies on fast food and this is the majority of what his diet consists of. (Livestrong, 2015) reports that unhealthy diets can lead to weight gain and malnutrition. If Zain continued to eat fast food he would not be getting the adequate nutrients he needs and is at risk of gaining weight which could lead to obesity. This can lead to other health conditions which can be damaging to Zain’s health. (NHS Choices, 2016) state that obesity can lead to serious health issues like type 2 diabetes, coronary heart disease, strokes and certain cancers like breast and bowel cancer. Accordingly, if Zain persists eating an unhealthy diet he is putting himself at risk of developing this life-threating conditions. In 2015, 63% of adults in England were classed as being overweight. (PHE, 2017) In addition, the prevalence of getting obesity is similar between men and women but men are more likely to be overweight, meaning Zain is more likely to be at risk of health inequalities. Reducing obesity is a priority of PHE and it aims to change individual’s behaviour in relation to healthier eating and increase physical activity. Policies like this will help individuals like Zain adjust his diet and maintain a healthier lifestyle. A major government initiative which aims to improve diet and fitness levels is Change4Life. The campaign aims to encourage individuals to address areas in their lifestyle which could be unhealthy. It intends to create an understanding of basic nutrition, allowing individuals to make positive decisions towards diet and exercise. Government initiative like this will help individuals like Zain greatly as they will educate him on how to improve his diet, so he can take the steps necessary to improve his health. (Change for Life, N.D.)

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Another risk to Zain’s health is that he has been drinking heavily on the weekends. Alcohol unit guidance recommends that both men and women should not regularly drink more than 14 units a week. And that if individuals choose to drink they should spread their drinks evenly throughout the week. (Drinkaware, 2016). Zain isn’t spreading his drinks out through the week and is putting his health at risk by drinking large amounts of alcohol in a short space of time. The NHS refers to this as binge drinking. Drinkaware (2016) indicates that Zain is at risk when being drunk as accident and falls are more likely which could lead to injuries or broken bones. Binge drinking can affect your mood and memory and if continued long term it can lead to mental health problems. So, Zain is further putting himself at risk by binge drinking as he could be making his already present mental health problems more prominent. (NHS Choices) suggest there are lots of benefits to cutting down alcohol intake. Lowering your alcohol intake can improve your mood greatly and can help you feel more refreshed, as alcohol can disrupt sleep. This would benefit Zain, he would get a better night’s sleep so he could concentrate better on his studies and if his mood is improved he is more likely to find motivation to go to lectures and work. It has been found that alcohol is one of the biggest behavioural risks for disease and death. (Department of Health, 2015) In response to this, from the years 2010-2015 the government released a policy paper on harmful drinking and set several objectives to reduce the amount of alcohol misuse. They action to have a reduction in the number of adult’s drinking above the lower risk guidelines and a reduction in the number of adult’s binge drinking. This policy will help individuals like Zain and prevent them from risking their health by drinking regularly. Department of Health (2015) are helping individuals to change drinking behaviour, through the Change4Life campaign 7

they are informing people about the risks of drinking excessively and providing them with tools and advice on how to reduce their drinking. Zain will benefit from this campaign as it provides him with the information to reduce his alcohol intakes and therefore improve his health. There are a variety of health promoting strategies in place in the UK. One of which is campaigns. Zain is struggling with his mental health and one campaign which would help Zain tackle this is Time to Change. This is a growing movement of people, changing how people think and act about mental health. Since the campaign began in 2007, 4.1 million adults have improved attitudes to mental health. (Time to change, 2017) This campaign helps tackle stigma and discrimination surrounding mental health allowing Zain to feel comfortable to open-up about his mental health and gain the support he needs. Similarly, the Heads Together Campaign aims to change the national conversation around mental health and wellbeing. This campaign is being run by Prince Harry and the Duke and Duchess of Cambridge. (Heads together, N.D) This could encourage people to change their attitudes to mental health as the campaign is being run by role models to the public, even more so the case as it is royalty spearheading the campaign as the royal family are viewed in very high ground. In an interview, ‘William highlighted the importance of role models opening up about their mental health.’ (Morley, 2017) Thus, illustrating the positive effect this will have, with high profile individuals supporting this campaign, the health promoting messages are more likely to influence the public. Another way to promote health is through charities. In the case study, Zain is drinking heavily and a charity which could help him is Drinkaware. This is an independent UK

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wide alcohol education charity. They help reduce alcohol related harm by helping people make better choices about their drinking. (Drinkaware, N.D) One way they are doing this is through the ‘cut back and feel better’ campaign. This a campaign which encourages people to moderate their alcohol consumption through a mobile app. It allows users to set personal goals based on drinking habits and unlock achievements when making positive changes. (Drinkaware, N.D) This campaign will help Zain as it is an easy accessible tool to help him limit and monitor his alcohol intake. By having an application dedicated to the moderation of alcohol consumption then Zain can use this and may be less likely to drink in excessive amounts. In addition, in the case study Zain is binge drinking. To educate people about the consequences of binge drinking, The Home Office launched a series of adverts. These portrayed young people being violent, injuring themselves and making poor decisions. The campaign says, ‘you wouldn’t start your night like this, so why end it like it?’. The aim of the campaign was to challenge people to think twice about binge drinking and educate people about the consequences of losing control. (BBC News, 2008) This is an effective strategy in promoting health as advertisements are broadcast frequently and viewed by a large audience, therefore the health promotion message is being effectively communicated with the public. (Giddens, 2013, p4) states that sociology is ‘the scientific study of human life, social groups, whole societies and the human world.’ There are many theories regarding sociology. One of these is functionalism. This focuses upon the idea that society is a system with various parts working together to produce stability. This has an organic analogy, comparing the operation of society to a living organism. Indicating, that institutions of society work together just as the human body does. For society to 9

function all institutions play a necessary part. (Giddens, 2013, p18) these institutions include family, media, government, economy, education and religion. Working together interlinkingly, these institutions provide stability in society. (Crossman, 2017) For example, the government provides education, children go to school to gain skills which will allow them to gain employment and therefore supporting the family. In the case study Zain is attending university to gain an education, so he is meeting his function in society. Functionalism is a good theory in explaining why society hold together, yet they say little about conflict and racial social change. Therefore, another sociological theory which focuses upon this is Marxism. (Denny & Earle, 2005) states Marxism focuses upon the conflicts in society between two social classes, the bourgeoise and the proletariat. The relationship between these classes is exploitive with the proletariat creating more wealth for the bourgeoise than the wealth they make for themselves. Keeping the rich richer and the poor poorer. In the case study, Zain is attending university. Marxism would suggest that he is being exploited as he is being put in debt from his student fees by the government. Many inequalities exist in society, health and illness is not distributed evenly. More affluent social classes tend to have better health and better access to healthcare provisions than the lower class creating health inequalities. Health inequalities exist between genders also. Women tend to live longer than men in almost every country in the world. (Giddens & Sutton, 2013, p461) In the years 2-13-2015 the life expectancy for women was 82.8 years and for men it was 79.1. (Office for National Statistics, 2016) Therefore, Zain is much less likely to have as the same life expectancy as his female counterparts. Furthermore, men suffer from higher rates of death from accidents and violence than women and are more likely to be prone to 10

drug and alcohol dependency than women. (Giddens & Sutton, 2013, p461) it has also been fund by (Lupton, 2013) that men engage in more risk-taking behaviour, like drug taking and getting drunk than women do. As seems relevant in the case of Zain, who is risking his health by drinking heavily on the weekends. To meet the needs for welfare and wellbeing in society, social policy is the development of services for people through the actions of society. (Alcock, 2014) According to (Blakemore & Warwick, 2013) Beveridge is the main architect of Britain’s welfare system. In 1942, Beveridge report was published which proposed to demolish five ‘giants’ of want. These included, squalor, disease, ignorance, idleness and want. Following this in 1946, the Labour Government began the introduction of the welfare state. They introduced the National Insurance Act and the National Assistance Act 1948, this implemented sickness and unemployment benefits and retirement pensions. This will help Zain as he is provided with a pension from his earnings and if he ever needed to take time off work for sickness he will not enter poverty due to the benefits provided. In 1948, the labour government found the National Health Service (NHS) where medical care became based on need and not ability to pay. (The National Archives, N.D) This was a major public health movement to reduce health inequalities and prolonging life. In conclusion, this assignment has highlighted key public health concepts including health promotion, early intervention and determinants of health and how these concepts relate to the case study of Zain have been discussed. Risks associated with Zain’s lifestyle choices have been identified and how these are damaging to health has been recognised. Any strategies and social policies which were introduced that

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are in place to promote health promoting behaviour and help Zain make better choices that are beneficial to his health have been explored. Functionalism and Marxism have been considered and how these theories apply to Zain and his lifestyle.

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References 

Alcock, P. (2014) Social Policy in Britain (4th ed.) Basingstoke, Hampshire: Palgrave Macmillan

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BBC News. (2008) Binge-drinking adverts launched. Retrieved from: http://news.bbc.co.uk/1/hi/uk/7457746.stm

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Bircher, J. (2005) Towards a Dynamic Definition of Health and disease, Medicine, Health Care and Philosophy, 8(3), 335...