Breast Cancer as a Public Health Issue - Research Paper Example

? Public Health & Breast Cancer A Report on Breast Cancer as a Public Health Issue School Introduction Public health is an important aspectof the population’s wellness, wellbeing and health. Public health aims to educate and provide a population with the tools that they need to manage and prevent diseases and to promote sanitary behaviours such as hand washing. Public health objectives can range from targeting fairly benign diseases such as the common cold, to life-threatening and devastating types of cancer. Health itself is defined by the World Health Organization as being a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (World Health Organization, 1948, p1), suggesting that public health operatives need to look at the whole picture rather than merely preventing disease. Wellness is more complex to define, as there is no “official” definition provided. However, all definitions involve acknowledgement of the importance of both physical and mental health and it has been described as “an active process of becoming aware of and making choices toward a healthy and fulfilling life” (Schnieder, 2010, p68). Using these wide definitions of health and wellness, public health can therefore target disease and “un-wellness”. The purpose of this report is to explore how public health does this and to identify some of the major issues that are currently a part of public health. The report will focus on the importance of breast cancer public awareness as one of the most common types of cancer (World Health Organization, 2013b). Issues in Public Health Despite the fact that public health is one of the most important aspects of health and wellness, as it can go beyond standard treatment and medical care, there are a number of different issues in contemporary public health. These are usually due to various factors, including cost, availability, public awareness, public uptake and a lack of continual commitment to the directive (Schnieder, 2010). This means that public health needs to be continually aware of the public health issues that currently affect the population in question and keep awareness high (Fleming & Parker, 2008). The issues in public health evidently vary from population to population, with developing countries needing to focus more on infectious disease (Fleming & Parker, 2008), and Western countries suffering more from the diseases of “old age” like cancer, heart disease and dementia (Fleming & Parker, 2008). This line is, however, not clear cut. One of the most recent issues in public health is the link between the MMR (measles, mumps, rubella) vaccine and autism (Schnieder, 2010). Despite this claim being false, many parents refused to immunize their child and a decade later cases of MMR are on the increase (Schnieder, 2010). This has prompted World Health Organization to promote World Immunization Week (World Health Organizationa, 2013). One of the biggest current issues in public health is that of HIV infection, which affects both developed and developing nations alike, although cases and deaths are far higher in places such as Sub-Saharan Africa (CDC, 2013). 34 million people worldwide are currently infected with HIV (World Health Organizationa, 2013), despite the fact that there are a huge range of prevention options available. The HIV virus is transmitted by various bodily fluids (World Health Organizationa, 2013), and therefore sexual behaviours and needle sharing are two of the most common transmission methods (Fleming & Wasserheit, 1999). This can be prevented by using barrier contraceptives and clean needles, although these are not always available to those in the developing world, part of the problem for those working in public health (Love, Love & Laudico, 2004). The easy availability of these items in the Western world does not, however, prevent HIV infection spreading due to the public ignoring some public health advice (Schnieder, 2010). Another major issue in public health, particularly in the developed world, is the high incidence of cardiovascular disease that can lead to heart attack and stroke (Winkleby, Jatulis, Frank, & Fortmannm, 1992). This is not a new public health issue, but does continue to be one of the biggest killers (Winkleby, 1992). Additionally, heart disease can also be a significant problem with respect to wellness, as it can make daily activity difficult (Pate et al, 1993). It can also have a significant effect on mental wellbeing, as the individual with heart disease can have anxiety or depression as a consequence of their diagnosis (World Health Organizationc, 2013). There are a number of public health directives that are in place to help educate the public about prevention of heart disease (exercise and the benefit of a good diet) as well as medical interventions that can extend the lifespan (World Health Organizationc, 2013). However, cardiovascular disease remains the biggest killer worldwide, causing almost 30% of deaths, meaning that it still remains a public health issue (World Health Organizationc, 2013). Breast Cancer Public Health After cardiovascular disease, cancer is one of the biggest worldwide causes of death – it causes 13% of all deaths (World Health Organizationb, 2013). Like cardiovascular disease, a cancer diagnosis does not just affect physical health but takes a toll on mental and spiritual wellbeing and wellness (Burgess et al, 2005). This makes it one of the most difficult diseases to tackle from a public health perspective, particularly as it is so widespread (CDC, 2013). Although the most common types of cancer differ between men and women, breast cancer remains one of the most potent forms and can affect both sexes. According to the World Health Organization, breast cancer is the 5th biggest cancer killer worldwide (World Health Organizationb, 2013), although breast cancer is the most common cancer to develop in countries like the UK (World Health Organizationb, 2013). Evidently, breast cancer is one of the biggest issues in public health, and accordingly there are several different directives aimed at preventing, curing and managing the disease (Jatoi, 1999). As with most cancers, one of the most important factors in avoiding cancer-related death is to get an early diagnosis (Jatoi, 1999). This means that the cancer can be removed with surgery, or targeted with radiotherapy (Jatoi, 1999). The later the diagnosis, the higher the chance that the tumour or neoplasm will have metastasized to other areas of the body, making treatment more difficult and more dangerous for the patient (World Health Organizationb, 2013). Chemotherapy is another treatment for cancer, but causes significant damage to wellbeing as it is cytotoxic and can therefore damage healthy cells causing nausea and other symptoms (McCaul, Branstetter., Schroeder, & Glasgow, 1996). Many countries do provide early screening programs to groups most at risk, although mammogram screening is expensive (McCaul et al, 1996). The expense of such programs does mean that there are limitations placed with make it difficult to catch cancer in low-risk groups, and there may be low availability in some areas. It also requires involvement from many different individuals in the public health sector, including advertisers, GPs, nurses and administrators. However, a reduction in breast cancer deaths will reduce cancer death numbers overall, fitting into broader public health objectives (Schnieder, 2010). Another issue with breast cancer is that treatment and diagnosis can be extremely difficult processes for the patient (Anotni et al, 2001). Depression and anxiety are found to be higher in those living with breast cancer (Burgess et al, 2005) than those without a diagnosis. Even early screening can cause mental stress for the individual (Lerman et al, 1991). This is something that can often be overlooked in public health when the focus is on such a difficult disease to treat, but mental wellbeing is an important part of the World Health Organization definition of health (World Health Organization, 1948). There are suggestions that stress management interventions for those with breast cancer can decrease the number of individuals World Health Organization have depression, as well as potentially increasing the number of survivors (Antoni et al, 2001). Whilst the very nature of depression may mean that some individuals are unlikely to participate (Antoni et al, 2001), health providers should consider the use of schemes such as the one identified by Antoni et al (2001) to improve the health and wellbeing of breast cancer patients. This would help promote overall wellness rather than focusing on the disease. Elements of stress prevention and spiritual wellness can also be promoted in the patient’s own home, making it easier for them to comply with the requirements. This method would also make it cheaper, and therefore more appropriate for a wider number of breast cancer patients worldwide. Finally, a combination of stress management classes and at-home advice would require the services of a variety of public health staff, including promoters, psychologists and specialists, fitting in well with the holistic approach to health. Conclusions In conclusion, it seems that public health and wellness should incorporate several elements of human well-being, including mental and physical health as well as spiritual and environmental where appropriate. This should apply to all of the current issues in public health when working in the sector. There are a number of issues which vary dependent on population, but HIV is one of the most important preventable issues in the developing and developed world. Cardiovascular disease continues to be the biggest issue worldwide, causing more deaths than any other disease group and causing a significant amount of stress and mental health issues for some individuals. Cancer, including breast cancer, continues to affect both mental and physical health worldwide. Breast cancer can be cured more easily when caught early, and screening programs are and should continue to be a high priority for public health professionals. However, these screening programs do come with their own problems, including stress and anxiety as well as their prohibitive costs. Additionally, a focus should be made on promoting the mental well-being of breast cancer patients, World Health Organization may benefit from stress prevention courses. Again, these can be costly but do provide benefit for both mental and physical well-being, core elements of a successful public health program. References Antoni, M. H., Lehman, J. M., Kilbourn, K. M., Boyers, A. E., Culver, J. L., Alferi, S. M., … Carver, C. S. (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20–32. doi:10.1037/0278-6133.20.1.20 Burgess, C., Cornelius, V., Love, S., Graham, J., Richards, M., & Ramirez, A. (2005). Depression and anxiety in women with early breast cancer: five year observational cohort study. Bmj, 330(7493), 702. CDC - Blogs - CDC Works For You 24/7 Blog – CDC Looks Ahead: 13 Public Health Issues in 2013. (2013). Retrieved April 30, 2013, from http://blogs.cdc.gov/cdcworksforyou24-7/2013/01/cdc-looks-ahead-13-public-health-issues-in-2013/ Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually transmitted infections, 75(1), 3–17. Fleming, M. L., Parker, E. Public Health. (2008). Elsevier Australia. Jatoi, I. (1999). Breast cancer screening. The American journal of surgery, 177(6), 518–524. Lerman, C., Trock, B., Rimer, B. K., Jepson, C., Brody, D., & Boyce, A. (1991). Psychological side effects of breast cancer screening. Health psychology, 10(4), 259. Love, R. R., Love, S. M., & Laudico, A. V. (2004). Breast cancer from a public health perspective. The breast journal, 10(2), 136–140. McCaul, K. D., Branstetter, A. D., Schroeder, D. M., & Glasgow, R. E. (1996). What is the relationship between breast cancer risk and mammography screening? A meta-analytic review. Health Psychology, 15(6), 423. Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C.,King, A. C. (1995). Physical activity and public health. JAMA: the journal of the American Medical Association, 273(5), 402–407. Schnieder, M.J. Introduction to Public Health. (2010). Jones & Bartlett Learning. World Health Organization, A new health sector agenda for HIV/AIDS. (2013a). WHO. Retrieved April 30, 2013, from http://www.who.int/hiv/pub/advocacy_brochure/en/index.html World Health Organization , Cancer. (2013b). WHO. Retrieved April 30, 2013, from http://www.who.int/mediacentre/factsheets/fs297/en/index.html World Health Organization , Cardiovascular diseases (CVDs). (2013c). WHO. Retrieved April 30, 2013, from http://www.who.int/mediacentre/factsheets/fs317/en/index.html World Health Organization, Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948. Winkleby, M. A., Jatulis, D. E., Frank, E., & Fortmann, S. P. (1992). Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. American journal of public health, 82(6), 816–820. Read More