A Health Promotion Approach to Substance Abuse - Research Paper Example

A Health Promotion Approach to Substance Abuse Introduction Health disparities are the differences in availability and/ or access to services and facilities. Health status disparities is however the variation in the rates of occurrence of disabilities and diseases between the geographically and/ or socioeconomically defined group population. On the other hand, health inequality refers to the circumstances where the health of various distinct demographic groups is different in spite of the comparative access to the services of health care. For instance the existence of higher mortality and morbidity rates among those populations in lower social and occupational classes than their counterparts in higher social and occupational classes. Health equity however is the study of the variations in the healthcare and health quality across different populations (Anderson, 2004). This may include differences in health outcomes, presence of disease, and healthcare access across sexual orientation, ethnic, racial, and socioeconomic groups. This paper hence seeks to discuss the inequalities and disparities based on the health care system when referring to the biomedical model and the asset based approach to the health care systems in relation to substance abuse. In relation to substance abuse, the health biomedical model is used in lowering the number of premature mortality and morbidity. This model encourages the examination of the body parts that may work together to ensure that the population attains good health. The model looks at the wrong thing about the individual in relation to substance abuse and then that part is fixed. If an individual is not feeling well then he or she would seek examination from a doctor. The doctor will offer diagnosis and eventually treatment if the individual in not well to better his or her life. This model hence look at the body as a machine where by if any part of it is wrong, then it is fixed so that it may function well again (Bacon, 2010). The biomedical approach is popular in the western world and this is because of the cheap care and treatment of people, it applies the scientific methods, uses expert knowledge in obtaining the results, and has improved public health. Biomedical model has a single focus. That is the actual person and not the emotional and the social process of the individual. The model seeks to identify individuals at risk of a disease resulting from substance abuse and then focuses on their treatment and not the prevention of the disease. Biomedical health model focuses attention on the physical symptoms and the emotional aspect of the health state of the service user which is secondary with exemption of the psychiatric services. According to this model, in order to promote health in relation to substance abuse, the effective doctor to patient communication is very significant for the patient to master what the doctor expects from them in order to comply with the directions like taking medication and adhering to the regimen among other instructions. There is not a single universal health model of health provider to user interactions. They have variations depending on the knowledge between the two parties and the consultation nature. For instance a single encounter with a radiographer is particularly different from an encounter with a familiar general practitioner. On the other hand, the critics of the model have always cited the nature of the de-personalized objectifying practice of biomedicine like putting focus not on the individual but on the disease (Barkauskas, 1983). Supported by technology, the biomedical model enhances the interest of the reductionist in the body that learns much about less. This conventional risk has also resulted into various concerns. The biomedical model is characterized by the theory of the scientific underpinnings of the medicine and has been replaced by the bio-psychosocial model as it characterizes the contemporary western health care delivery in the best manner. However, biomedical model in response to substance abuse has always responded to questions such as: why an individual exhibits a particular behavior, what the survival value of a particular behavior is, how an individual grew to respond in such a way, and how the behavior has generally evolved phylogenetically. The model has also diverted attention on how an individual learns to show the symptoms in order to obtain survival value. These symptoms of substance abuse according to the model are shaped depending on their survival value and communication. For example, symptoms like the components of language illness are dependent on the capability of considering the view of other people on them. On the same note, medical practice becomes mind full medicine when there is knowledge of how patients developed their symptoms and how they should be responded to. The biomedical model hence is effective in promoting health in relation to substance abuse (Bartley, 2006). Another approach that can be applied for the same purpose in the community is the asset based approach. Asset based approach to health care system can be described as the combined resources that communities and individuals have within their reach to protect themselves against negative outcomes of health and to promote the status of their health. However, health assets are not often used mindfully or purposefully although they are part of every individual. In relation to substance abuse, an asset based approach values and makes visible the knowledge, skills, connections, and community potential. It aids the promotion of the connectedness, social capital and capacity of the community in tackling substance abuse. The approach also put emphasis on the need to rectify the balance that exists between nurturing the strengths and resources and meeting the needs of the community and people. Asset based approaches are primarily concerned with recognizing and identifying the protective factors supporting wellbeing and health (Bobel, 2010). These approaches offers the potential to promote both the longevity and quality of life via putting focus on the resources that enhance coping abilities and self esteem of the community and individuals. The approach is practically not a substitute for investing in the improvement of service or making efforts to address the structural causes of the inequalities in health. Therefore measuring the effects of the asset based approach on the outcome of health is complex. At present, the evidence of the efficiency and the effectiveness of the approach largely results from small scale explanatory research and case studies on substance abuse. Including the approaches like an integral section of mainstream delivery service is a move that requires transformation of organizational and individual values, attitude, and practice (Kristen, 2010). The asset based approach is characterized with health asset that enhances the capability of communities, individuals and populations to sustain and maintain wellbeing and health and minimize the inequalities in health. The health assets mentioned can possible operate at an individual, community, population or family level as a promotion and protective factors to buffer against the stresses of life resulting from substance abuse. The asset based approach include the skills such as: the practical skills, knowledge and capacity of the local residence; the connections and networks in a community; the interests and passions of the local people that drive change; the local community effectiveness and their voluntary associations; the economic and physical resources of a place which enhances health and wellbeing; and the third sector organizations and the public and private resources available for supporting the community. In tackling substance abuse and health inequalities, asset based approaches value the knowledge, skills, capacity, and the connections between the community and the individual. The approaches put focus on the positive individual and community capacity and not on their need problems or deficits solely. The assets can actually act like foundation where by a positive future can be built (Meredith, Alcoholics Anonymous, 2005). The challenges resulting form health disparities and inequality can be overcome through the identification and mobilization of the assets of an individual and/ or the assets of the community. Most of the existing literature recognizes both the acquired and innate health asset antecedents as individual values, genes, life experiences and beliefs. This infer that there is a possibility of identifying health protecting and promoting assets from the domains of the determinants of health such as individual and personal characteristics, the working environmental conditions, social circumstances, health services, and the behavioral choices and lifestyle. In relation to substance abuse and health promotion, asset based approaches focus on the identification of the factors that protect and support wellbeing and health. The approach provides the potential to promote both the longevity and quality of life via putting focus on the resources tat can help in promoting the coping abilities and self esteem of the communities and individuals (Meredith, Narcotics Anonymous, 2005). The case of a working asset rests on accomplishing better balance between the response to the needs, offering the services that only government and public services can, and obeying the individuals and communities’ potential asset and their resources. Although the asset based approach may not tackle disparities and health inequality on its own, various principles of asset may offer support to the achievement of the goal together with the efforts in place. These efforts may include: targeting the appropriate communities and areas to work in; using asset based techniques and methods allowing the local people to have the lead; providing time to the communities to acknowledge and realize their own collective and individual assets in order to rebuild their networks and confidence; and rebuilding trust with individuals and communities through making changes in the services. In handling substance abuse through health promotion, asset based approach adds value to the health promotion deficit through the following: identifying a wide range of health promoting and protective factors supporting wellbeing and health; strengthening the community and individual capacity to realize their contributing potential to the development of health; promoting the population to the level of the health co-producer and not just as a simple health care services consumer; and contributing to a sustainable and equitable economic and social development. Adopting the asset based approach is something that is long term, open ended and community led action which has unpredictable and less certain outcomes which in the long run are likely to emerge. The asset based approach is not something that fits all. This is because it requires building of trust between the professional staff and the members of the community as well as a careful negotiation on the basis of individuals who work with the communities. This approach is a bottom up means of working through the community (Messer, 2002). Every community combines and recognizes their assets and defines their ambitions in a local manner. The approach also shows significance in differentiating the needs that can basically be met by friends, family, and social networks as well as those needs that will only be met in the best way via cooperation between communities and services, and those needs that can be delivered only through the mainstream services. This will need planning, mapping and commissioning as it cannot happen alone. Therefore as asset based approach is likely to promote health as far as substance abuse is concerned. The two mentioned models, the biomedical model and the asset based approach address disparities and health inequalities in health care system in relation to substance abuse. In addressing inequalities in healthcare and socioeconomic status, race and gender are very important factors to be considered especially in America. Socioeconomic status at an individual level is a determining factor of healthcare access. It is not surprising therefore that those individuals in the low classes of socioeconomic status have limited insurance coverage, health and inadequate access to healthcare. In addition, such socioeconomic classes have minimal education level and usually do their work without health and benefits plan significantly catered for, while those in the higher classes of socioeconomic standing have their jobs providing medical insurance. The differences in socioeconomic factors have variations between groups of races and the impact on their status of health. In America, the Hispanics and African Americans have the rate of poverty at 33.29% significantly higher than the poverty rate among whites which is 11%. Sad enough, the disparities in the mentioned socioeconomic status contribute to up to three times higher rates of deaths resulting from the diseases of the heart among the low income whites and blacks compared to their counterparts in the middle income class. Generally, black men and women experience higher death rates from heart coronary diseases in each income level compared to the whites, hence the blacks inferably tend to be poorer in health status (Meredith, Community Organizing ang Community Building for Health, 2005). Nevertheless, the mortality due to cancers is at a higher rate among the blacks compared to the whites because of the delays in treatments and diagnostics and inadequate preventive health screenings. Other factor leading to health disparity is the influence from the environment. The environmental influence is directly related to the health inequality. The populations of the minority have an increased exposure to the hazards of the environment including lack of resources in the neighborhood, community and structural factors, and the residential separation that leads to a cycle of stress and disease. The environment surrounding us influences our behavior and can result into poor health outcomes due to the poor health choices that we make. It has been noted among the minority neighborhood many kinds of fast food chain and less stores of groceries than the predominant neighborhoods (Anderson, 2004). This affects the families of the minority population and minimizes their ability to obtain easy access to the nutritious foods necessary for their young ones. The environmental factors hence pose social consequences that has been projected in America that the current generation has a short life to live compared to their predecessors. Additionally, the neighborhoods of the minority possess multiple health hazards resulting from their tendency to live in close proximity to toxic waste factories and highways and in a generally dilapidated streets and structures. These conditions of the environment results into varying health risk degrees from exposures to carcinogenic toxics such as radon and asbestos, to noise pollution that eventually leads to mortality, morbidity, and increased chronic illnesses. The residential environmental quality like damaged housing has been indicated to heighten the risk of adverse outcomes of birth reflective in the health of the communities. Conditions of housing create different degrees in the risks of health leading to birth complications and consequences in the long term in the aging population. In addition, the hazards related to occupation add the detrimental impacts of the poor housing conditions (Barkauskas, 1983). From different studies, it has been reported that a big number of the minorities are in jobs where the rates of toxic chemical exposure, fumes and dust is higher. Segregation of races also an environmental factor occurring through action that are discriminatory in the organizations working in the industry of the real estate in housing rentals or markets. In spite of all minority groups being segregated, there is a tendency to segregate the blacks regardless of their level of income as compared to the Asians and Latinos. Hence, the act of segregation leads to the clustering of the minorities in the poor neighborhoods with limited medical care, employment and resources of education associated with criminal behavior of higher rates. Because the environment in such areas cannot be conducive for physical exercise, segregation affects the health of the residence of individuals in such unsafe neighborhoods. Ethnic and racial discrimination is an additional element in the individual environment that people have to interact with. Individuals reporting discrimination have been pointed to have increased hypertension risks apart from other effects that are related to the physiological stress. The magnitude of socioeconomic, structural, and environmental stressors results into the conciliation of the physical and psychological being that leads to adverse health and disease (Meredith, Community Organizing ang Community Building for Health, 2005). According to the discussed biomedical model and the asset based approach to health care system, there are particular reasons that will definitely lead to disparities in health care. Some of these reasons include: Lack of health insurance coverage: patients are likely to have their medical acre postponed if they lack insurance coverage. They are likely to live without prescription of medicines and the necessary medical care. In America, the minority groups lack the insurance coverage than the whites. Inadequate source of care: with limited access to medical care, there is great difficulty in getting health care and obtaining prescription medicine. Minority groups lack doctors to visit frequently for basic medical care. Insufficient financial resources: lack of finances is generally a barrier to the access of the healthcare services and this is common among the minority groups in America. Existing legal barriers: the legal barriers can block the low income minority immigrants to the insurance programs for the public. For instance in America, the federal law prevents the state from offering coverage of the Medicaid to the immigrants with less than five years in the country. The structural barriers: such as excess waiting time spent, inability to arrange quick appointments, poor transportation affects the willingness of getting health care. The system of financing health care: the delivery and financing system of healthcare is a barrier in itself to health care access. The ethnic and racial minorities are often enrolled in insurance plans with limits on the services covered and provide few health care providers. Language barrier: the differences in language may restrict the minority groups to the access of medical care especially those who are not proficient in English. Lack of health care providers: scarcity of medical specialists and practitioners as well as the facilities for diagnosis can limit access to health care in rural areas and inner cities where minority populations are concentrated. Health literacy: especially where the patient experiences problems of understanding health information. This results into challenges of mastering their health status hence bar access to care. Insufficient diversity in the workforce of health care: cultural differences are a major reason for disparities in health especially where the difference exists between the minority patient and the physicians. Age: older people existing on fixed incomes make settling expenses of health challenging. Such people may have problems with mobility ad transportation making health care services access a challenge. On the other hand, the disparities in the quality of health care can result from the problems with the provider patient communication, discrimination on the part of the provider, and lack of preventive care to the patients (Bobel, 2010). Conclusion In summary, health disparities are specific population differences in the occurrence of disease, access to the health care, and health outcomes. This happens due to the measures among the populations of health outcomes, access to care and chronic disease rates. The disparities can be eliminated through persistent ethnic and racial data collection by the providers of health care, minimum cultural and linguistic standards for competent health services, effective disparities reduction program evaluation, greater representation of minority in the workforce of health care, expanded health care access for racial and ethnic groups, enhancement and establishment of offices of the government for the health of the minority, and participation in the efforts of health improvement by the minority representative (Bartley, 2006). On the other hand, health inequalities deal with the differences between the statuses of health of a given population in comparison to the other. References Anderson, P. (2004). Disparities in health. London: Routledge. Bacon, N. (2010). The Shape of Happiness in Health. London: The Young Foundation. Barkauskas, V. (1983). Effectiveness of public health nurse home visits. American Journal of Public Health , 573-580. Bartley, M. 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