Obesity In London Borough Of Lewisham - Essay Example

? Obesity in London borough of Lewisham Obesity in London borough of Lewisham Introduction Healthcare is very important. This paper is going to discuss some of the healthcare issues in London. It is evident that the poor always have many hardships in life and healthcare is not exceptional. However, there are some healthcare programs that are set by the government that take care of the healthcare of all categories of people (Riegelman 2009). This paper is also going to focus on some of those programs to try and evaluate some of the roles that they play in the healthcare system in London borough of Lewisham. One of the increasing healthcare concerns in Lewisham is increased cases of obesity. The paper will also articulate on how obesity has been a problem to Lewisham residents. After a wide range of research on healthcare literatures and obesity in particular, the paper is going to draw some conclusions that would shade light to important recommendations. Healthcare in London Healthcare delivery system in the London is in crisis due shortage of key health professionals (King's Fund Commission on the Future of London's Acute Health Services 1992). Spending on healthcare has grown fast nearly doubling over the past decade. Given the aging population, healthcare spending will continue increasing. London needs a model that can improve on quality, cost, safety and patient satisfaction. Healthcare is very important to all humans. In London, people have enormous challenges that face them in healthcare matters. Some of them are unable to take care of their health due to high cost of medical facilities (King's Fund Commission on the Future of London's Acute Health Services 1992). Denial of the minority groups in accessing healthcare services, discrimination in matters of treatment by the doctors and nurses, and failure by the government to enroll the minority in the social healthcare programs are some of the challenges they go through. The healthcare problems that are associated with poverty are fostered by the administration (Riegelman 2009). In London, the qualified white physicians are rarely posted to the heavily populated areas that the poor and minorities live. Education of the poor and especially the medical career seem to be politicized with majority of those joining the training being the whites and the rich (King's Fund Commission on the Future of London's Acute Health Services 1992). For any body to be active in any of the activities, his health must be perfect (Riegelman 2009). So the minority groups are denied the healthcare services so that they can be inactive in matters pertaining assuming power from the majority. When it comes to treatment of some illnesses, the poor are discriminated over by the physicians who belong to the majority. In some instances, patients from the minority are neglected when it comes to matters of pain, many stay for a very long time languishing in pain while the nurses and physicians go on with their chores as if everything is okay (Riegelman 2009). This is very different from what happens when the patients from the rich backgrounds is admitted to the hospital. When patients are receiving treatment, the rich are more likely to receive more comprehensive treatment than the poor. Some researches have indicated that white doctors and physicians are more vigorous when treating the whites than when treating the patients from other minority groups (King's Fund Commission on the Future of London's Acute Health Services 1992). It is very important to ensure that in any medical institution, the doctor- patient relationship be improved so that there is no misinterpretation or misunderstanding by either of the parties (Riegelman 2009). Many doctors, who discriminate on the poor fail to pay attention to them, a situation that leads to doctors receiving inappropriate information from the patient and this can result in to the doctor giving wrong medication to the patient. The government has been criticized for failure to establish some laws that would govern on the cultural healthcare. This is a king of healthcare that is sensitive to matters pertaining class, culture, race, and gender oriented (King's Fund Commission on the Future of London's Acute Health Services 1992). This knowledge involves the doctors and the whole healthcare fraternity in understanding the importance of culture and what they believe (Riegelman 2009). In such a situation, the government is expected to come up with mechanism that would ensure that people from the minority and ethnic groups have some representatives in healthcare services that clearly understands their needs well. This is the only surest way that the minorities will receive equal opportunities in the healthcare sector (King's Fund Commission on the Future of London's Acute Health Services 1992). However, the government has ignored these proposals and instead created a one ethnic healthcare institution that only cares about the whites and the rich. To achieve all its goals, the London healthcare programs have the responsibility to ensure that they have skilled, committed and highly motivated workforce (Riegelman 2009). Educating the healthcare beneficiaries becomes fundamental to know their rights; therefore public education becomes one of their key roles. The healthcare system in London has great impact on human health (King's Fund Commission on the Future of London's Acute Health Services 1992). It has helped reduce the number of death rates by controlling the preventable illnesses. This is achieved by ensuring that the public is well informed on various health matters. It also provides government with information on various health matters on the researched areas to make well informed decisions. Through its education, it has helped reduce the spread of AIDS, prevent and control infectious diseases including the environmental hazards. The community is well informed about their rights as patients. This helps them understand the necessary actions to take if they fall sick (Riegelman 2009). Human health is linked directly to various social environmental conditions that arise in and around people’s homes. Poverty and low education attainment have been proved to go hand in hand with, poor health outcomes manifested by, increased morbidity and mortality. Heart diseases, obesity, elevated blood lead level and low birth weight are more prevalent among individuals with low income and low educational attainment (Riegelman 2009). There is a strong association between socioeconomic status, measured by factors such as level of education, income, and occupational status, access to resources and an individual’s health and wellbeing (Riegelman 2009). These associations have been established and are evident throughout the lifecycle, from childhood to adulthood. Social factors fall in the category of the basic elements that can cause health and disease especially their indirect impact on the early stages of development. Social factors influence the health and wellbeing of children in their present and later years. The Social status of a household determines access to preventive and curative health care as well as availability of healthy living environment for its members (King's Fund Commission on the Future of London's Acute Health Services 1992). Health insurance can be one of the plans to help solve the issue of healthcare in London. Health insurance can be defined as an assurance against any risk incurred on medical bills and expenses (Zellers et al 1992). By making some estimation of the risk of healthcare expenses, the insurers develop a financial plan that is to be paid in monthly premiums. A health insurance is therefore a contract between individuals or their employer and the insurance company (Zellers et al 1992). This contract is renewable either monthly, annually or sometimes can be for life. So far, it is clear that health insurance is a scheme that requires the insured to have some financial sources that the insurer can be drawing premiums from (Zellers et al 1992). Therefore, the poor person in this case may find it hard to acquire one (Riegelman 2009). In most cases, the contract is between the insurer, insured and the employer where by the employer deducts the agreed monthly or annual premiums from the employees wages and pay to the insurance company (Zellers et al 1992). In this case, the poor whom majorities are unemployed would find it difficult to have such a contract. However, some health insurance contracts exist between the insurer and the insured, where the insured uses their own means to pay for the insurance premiums. To the poor, even to those who own some businesses, they may find it hard to pay the premiums due to the nature of their businesses which in most cases are small and inefficient due to lack of capital (Riegelman 2009). Measure taken by the government In December 2006 NHS London invited Professor Sir Ara Darzi to carry out a review of London’s healthcare (Career London Health Observatory 2009). His report set out recommendations of how healthcare in London would change in the next ten years. His recommendations included new services that would see efficient delivery of healthcare services in London. The new services included vision that sees efficient and responsive NHS services in order to cater for the needs of individuals (Career London Health Observatory 2009). This service would ensure delivery of right services, in the right place, at the right time, to the right persons, and by the right persons. One of the initiatives proposed to improve healthcare in England in general was endorsement of a local improvement finance trust (LIFT) (Career London Health Observatory 2009). It is a private partnership introduced to England with the purpose of encouraging public and private investment in the healthcare system. In London, Lewisham, Lambeth and Southwark were chosen as partners of LIFT in building better health (Career London Health Observatory 2009). After introduction of LIFT in these areas, major developments have been completed. One of the notable developments is Waldron primary care centre in Lewisham. These services have also ensured appropriate and patient involvement in provision of new services and facilities (Career London Health Observatory 2009). Health and social care policy Healthcare reforms were summed up by the government in ensuring; standards of quality and provision apply nationally, having a range of approaches that would respond to a wide range of aspirations, expanding choice and equality, and giving responsibility for decision making at local level (Career London Health Observatory 2009). Due to persistent public demands, these policies were formulated in response of public call for increased equality, information, and empowerment of citizens. The importance of empowering citizens was highlighted in the November 2004 white paper- choosing health, which offered new challenges in health maintenance and promotion (Career London Health Observatory 2009). In light with these deliberations, Lewisham has restructured its provider services into two categories- adults and children. These changes have in greater part changed provision of services outside the hospital. They have significant implications for the management of services to individuals (Career London Health Observatory 2009). Patient pathways have been redesigned by practice based commissioning where care giving has been brought nearer to patient’s homes, something that has made sense clinically and economically. However, this move has its own implications in relation to immense workforce requirement in the local community based-services. Obesity in London borough of Lewisham In the UK, 3 in 10 children aged 2-15 years are said to be either overweight or obese (Career London Health Observatory 2009). The issue of children obesity has been an area of concern by many stake holders. Parents, medical practitioners and the government have in the last few years raised concern over the rising cases of obesity in children. Children who are obese are at high risk of becoming obese adults. They also risk attracting obesity related problems which are usually associated with middle age London assembly: (Health and Public Services Committee 2011). Lewisham is the third inner London borough in terms of population (Career London Health Observatory 2009). It is said to have the highest percentage of children indentified at risk of obesity. 40% of Lewisham residents are of black and minority ethnic origin (Career London Health Observatory 2009). However, although Lewisham has varying propositions of different ethnic groups, local analysis of the NCMP indicates that there is no statistically major difference in the prevalence of obesity all the groups that reside in Lewisham. Nevertheless, obesity is linked to socio-economic status with higher obesity prevalence in more deprived areas. Some studies have showed that a child is likely to be obese if their parents are obese, and if they live in deprived area (Bray and Bouchard 2004). Most of Londoners consume high contents of energy in their diets and have little physical activities, something that results to excessive wait gain. In a study carried out by Health and Public Services Committee in April 2011, the consumption of healthy food and participation in physical activities among young Londoners is lower than it should be (Career London Health Observatory 2009). Due to increased cases of obesity in the recent years, some researches have proved that children have become physically inactive. Behind inactiveness in children physical activity, are complex factors such as cultural, social, and gender sensitivities in the society that pay contribution to this effect. Children and teens are very fond of fast foods and the ones with high levels of calories for that matter. Physical activities play a major role in burning the level of calories in our bodies (Bray and Bouchard 2004). What the government ought to do is to include a community awareness program alongside other healthcare programs. The community awareness program should clearly educate the community on the risks involved in eating foods with high contents of calories (Bray and Bouchard 2004). It is also important to indicate alternative kinds of foods that children need to take. However, researches have indicated that taking foods with high contents of calories is not the only contributing factor to the increased number of obesity cases. Physical activities should always accompany high levels of calories taken (Bray and Bouchard 2004). It is believed that physical activities does not only help burn the high contents of calories but is also good for human health. Many parents and caregivers fail to realize this fact and it’s the major cause of obesity cases. On the other hand, even if the foods were clearly labeled with the correct amounts of calories in the foods sold in the fast food restaurants; this would not reduce the level of consumption by the children and teens (Bray and Bouchard 2004). For example, some children and teens are fond of buying snacks by themselves. In this regard, a child or a teen would definitely go for the most appealing snack regardless of the labeled level of calories in it. Therefore, unless the government comes out clear and stipulate the levels of calories children need to be taking, it will be difficult to control obesity. In order to address the issue of obesity, it is necessary to tackle all the underlying issues of obesity. Most effective interventions includes multi-faceted with supporting children and their families to adapt to healthy eating habits being the major concern (Career London Health Observatory 2009). However, the issue approached in a wider spectrum including involving health service providers, schools and the food industry. In total, it is estimated that around 240, 000 children aged 2-15 in London are obese (Career London Health Observatory 2009). The problem is said to be more severe in London than in any other part of the country. Health survey for England results indicates that between 1995 and 2008, obesity prevalence in London increased from 15 to 18 per cent among girls (Career London Health Observatory 2009). However, although diet and physical activity are the major causes of obesity, not all obese individuals are victims of these causes as every person has his or her own varied causes. These variations in causes are as a result of different lifestyles of different social groups and much more on variations on individual lifestyle. In this regard, this calls for various solutions to obesity. During public commissioning strategic plan for Lewisham 2009-2015, childhood obesity reduction was identified as the key priority areas (Health and Public Services Committee 2011). This was endorsed by the government through the department of health and DCSF, with specific focus directed to healthy growth and development of children, building physical activity into people’s lives, promotion of healthier food choices, creation of incentives for better health, and intensified personalized advice and support to all people (Career London Health Observatory 2009). In this regard, the government initiated programs which impacted on obesity prevention. In earlier years, the healthy child program looked into issues related to obesity prevention and it’s now updated to provide greater emphasis on nutrition, breastfeeding and physical activity. In Lewisham and other boroughs in London, 2009-2015 children and young people’s plan (CYPP) indentified how different partnerships agencies working with children and their parents would focus on reduction of obesity in London. The promoting healthy weight in children and families group is a strategy that encompasses prevention and treatment of obesity as one of the strategies of promotion of healthy lifestyles in the borough (Health and Public Services Committee 2011). Some of the policies that intervene on healthy lifestyle in Lewisham include sustainable community strategy, the Lewisham food strategy, physical activity strategy, and play and recreation strategy. However, these strategies can not come without underlying challenges in this borough. Lewisham is considered to have wide with no consistent pattern in rates of obesity (Career London Health Observatory 2009). These become a biggest challenge in prevention and treatment of the affected areas. Nonetheless, a performance dashboard for the promoting healthy weight in children and families group has in the recent past been implemented to facilitate a systematic sharing of knowledge and information to aid delivery of the actions plan. There has been a conduction of needs assessment which highlights the gap in terms of service delivery for children and individuals who need support beyond what is provided by general preventive measures (Health and Public Services Committee 2011). However, obese remains to be the most health problem since no specific services exist for children who are extremely obese. On the other hand, psychotherapy approach can be used by the counselors to influence conscious thought and eating behavior (Benjamin and DeBerry 1982). It is an approach that includes cognitive techniques like reverting negative thoughts, anxiety, problem solving and general eating behavioral techniques (Benjamin and DeBerry 1982). Psychotherapy approach has developed a process of counseling people with obese problems. The process involves exploring the patient’s problem, assisting the client set goals, motivating the client, and helping them to maintain the changes they gain in the recovery process (Benjamin and DeBerry 1982). It is believed that counseling process can change the individual eating behavior. In this approach, counselors need to look at the broader framework of the patient lives. This initiative highlights the critical significance of efficient care forecasting and case management. For a counselor to have ultimate goal he or she should apply certain techniques while dealing with the clients. These techniques include but not limited to; incentive drive which addresses client in changing his or her eating habit by cheering them to consider the good and not so good feature of weight gain (Benjamin and DeBerry 1982). Another technique is goal setting. This technique paves therapy direction which provides a tool by which growth can be revised and gives client substantial facts of upgrading. The third technique is predicament unraveling. In this context the technique of predicament unraveling oral instructions are incised as well as written information and skill rehearsal. Besides involving counselors in the treatment process, it is equally important to use this method in preventing cases of obesity (Benjamin and DeBerry 1982). Qualified counselors are involved in group counseling where collective counseling is offered to a group. With increased technology, many people get influence from the media and social networks over many social issues. The health practitioners may decide to use them to educate the youths on dangers of unhealthy eating habits. Nowadays, social networking has become very common especially with the youths. Some programs can be designed to encourage them on how they can continue being healthy. At the same time, persons in treatment can get some assistance on how to continue with treatment. Written sources can also be used by the counselors to enrich their services after oral counseling which put the patient glued to the guidance offered by the counselors, as they may make some reference to the written instructions and guidance. In obesity treatment, outpatient management is very important. Patients with moderate obesity problem need people to monitor their progress as they offer some psychological support. Conclusion It’s very important to have laws and regulations governing the healthcare industry. The physicians and the patients must all feel comfortable and secure when carrying out their duties or when being treated. One of these laws is the physician-patient law. There has been a great loss or deterioration of patient- physician relationship. This law requires that the physicians should maintain good rapport and communication with the patient. There is also the law of the physicians refusing to provide professional services to patients because of their race, color, class or nationality. This is punishable by the law. All persons are supposed to be treated equally regardless of their background, race, color, nationality or status of their illness. The government should ensure that all patients get equal healthcare attention regardless of whether they are poor or rich. In regard to increased cases of obesity in London, it would be wise if the government introduces a law that controls and educates people on obesity issues alongside other eating habit problems. However, it doesn’t matter how strict the law of obesity control would be, what matters is how well the law incorporates other factors that contribute to the increased cases of obesity. Even if the law stipulated the amounts of calories children need to take in order to reduce cases of obesity, children and teens are the most adventurous people and they will always want to have a taste of what they are forbidden to eat. Therefore, it is always important to ensure that there is enough civic education on what people need to do in order to reduce the increasing number of obesity cases in London. Bibliography: Benjamin, B Wolman and DeBerry, S 1982. Psychological aspects of obesity: a handbook. New York: Van Nostrand Reinhold. Bray, A. George and Bouchard, C 2004. Handbook of obesity: clinical applications. Sydney: University of Sydney. Career London Health Observatory 2009. Ethnic Health Intelligence Overview. 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