Contemporary Issues in Health Well-Being and Social Care - Change4Life Policy in England - Essay Example

?Contemporary Issues in Health Well Being and Social Care Inserts His/Her Inserts Grade Inserts (29 November 2013) Outline Outline 1 Introduction 3 Welfare, policy and well being 3 Policy response to a contemporary well being related issue in health 6 How Change4Life addresses well being 7 Strengths and weaknesses of the policy measure 9 Challenges of the policy response 11 Conclusion 12 References 13 Contemporary Issues in Health Well Being and Social Care Introduction Welfare determines well being and well being is a measure of the success of a welfare system. The ideology that shapes welfare systems in any country can alter the level of life satisfaction or happiness within the population. One can analyse the extent to which a social policy has been successful through its ability to meet the well being goal. This route will be taken in assessing the effectiveness of Change4Life policy in England. The paper will start with a discussion of the definition and relationships among welfare, well being and policy. It will address motivations for the policy, evidence of the strengths and weaknesses and eventually give recommendation on alternatives. Welfare, policy and well being Welfare may be defined in three different ways. It may be interpreted using the economic school of thought, where it is presumed to be a form of utility. Here, people’s interests and well being are determined by the things they need. Alternatively, this parameter may be understood in the form of social protection, where it encompasses all the services that protect people from critical external conditions including sickness, old age, childhood and several other factors (Carpenter, 2009). In this context, the welfare state has often been used as a reference point. Thirdly, one may define welfare as a form of assistance which is granted to the underprivileged. For purposes of clarity, this paper will rely on the second definition which perceives welfare as a form of social protection (Bohan-Baker, 2001). Proponents of the welfare state claim that it is essential in order to accord all citizens with their democratic rights. Furthermore, economic and social evidence exists for provision of social benefits. Statistics indicate that countries which offer social protection tend to exhibit less poverty and are richer (Brown and Duncan, 2002). Even for humanitarian purposes, it has often been stated that tackling poverty is a point of concern for several individuals. Most governments acknowledge the merits of these arguments. However, it is the magnitude of protection that they do not agree on (Boseley, 2009). Welfare may take the form of corporatist or work-based contributions, social democratic regimes and liberal ones. The UK perceives welfare as institutional in that it is meant for all. Need is treated as an ordinary part of social life, so everyone needs social protection. Social democracy has been the predominant paradigm in most UK welfare systems. Most policies have been designed in a manner that promotes equality, fraternity and liberty. However, elements of individualism have been existent in the social democratic model. Stakeholders try to develop rights and maintain individual liberty. Additionally, social democracy has attempted to mitigate effects of inequality rather than to eliminate inequality altogether. This means that the government focuses on dealing with the worst outcomes of a market model. In the provision of health services, this has been the predominant form. However, recent reforms have seen a move towards neoliberalism (Bohan-Baker, 2001). In the neoliberal school, it is held that all individuals have rights. Therefore, the government should respect these rights and not interfere in provision of services by the market. To this end, certain reforms have pervaded the UK health sector in tandem with this school of thought. These include promotion of greater choice and the move towards commissioning. The private sector is now contributing more greatly in the health care system than before. In this regard, people are held responsible for their actions. Less state intervention is the way to go for most advocates of the model. The key hurdle behind implementing such a system is that no health care system in the world exists on a pure competitive basis. This is because people with the greatest need for health care are also the ones in the least position to pay for its market price. Some of them may be too old, young, chronically sick or disabled. Therefore, private health often needs some form of subsidisation (Sointu, 2006). Well being is individual happiness intertwined with social conditions and mutuality. It refers to the exchange of social values through non economic means like culture. The concept focuses on trust, participation, personal relationships and mutual reinforcement (Sointu, 2005). Well being can be both affective and cognitive. The cognitive component refers to the reflections of individual circumstances and experiences in comparison to others while the affective part dwells on the quality of those experiences as interpreted subjectively by the individual. Well being thus stems from the social relations and conditions which bring about positive experiences and create a sense of contribution and belonging for people concerned. Subjective well being and objective well being are two paradigms for understanding this concept. Subjective well being is a reported assessment of the happiness that an individual experiences. Objective well being refers to external social determinants of happiness that may include employment, health, age, and personality (Boseley, 2009). Welfare provision and well being are intertwined because people’s perception of well being is determined by social precursors; of which welfare is part. Government policy may seek to promote well being or positive outcomes within the population. Social policies may thus be prepared in an effort to meet this parameter (Boseley, 2009). The New Labour government began a push for well being in 2000 when it called for the promotion of economic, environmental and social well being. Furthermore, the government in 2006 also advocated for a move towards different measures of national success other than economic ones. Well being was also suggested by the New Economics Foundation as a replacement for GDP in the assessment of government success (Sointu, 2006). Since welfare determines well being and vice versa, it is becoming clear that the ideology which shapes welfare systems in any country can alter the level of life satisfaction or happiness within the population. One can analyse the extent to which a social policy has been successful through its ability to meet goals of well being. This implies that the ideological underpinnings of the policy have a direct effect on the effectiveness of the policy in meeting goals of mutual satisfaction. This will be the case in the assessment of a chosen policy in the country. Policy response to a contemporary well being related issue in health The policy of choice for analysis in this respect is the Change4Life campaign that started in 2009. It was sponsored by the Department of Health but involved a series of other stakeholders in the NHS as part of the Healthy Lives Healthy People Strategy. The Department of Health stated that one of its key components for the “Healthy Lives Healthy People” strategy was to empower individuals by encouraging them, giving partners opportunities to be involved in tackling obesity, involving the government and creating a base for evidence of the same (Department of Health, 2011). Change4life was a mechanism for achieving all these facets of the strategy. Some of the stakeholders involved in Change4Life include PCT CEs, directors of PH, SHA CEs, Children SSs directors, Local Authority CEs, Medical directors, and directors of nursing. All these individuals were to contribute towards the campaign in their own capacity. The campaign was centrally funded by the government through a budget of ?14 Million in 2011 (Mitchell, 2011). Change4Life is a national social marketing strategy launched in England to tackle obesity. Its aim is to promote behaviour change among members of the population who are most at-risk of obesity. The well being issue being tackled is unsatisfactory health that stems from obesity-related illnesses. These interventions emanated from the fact that only one in ten persons in England will be healthy by 2050. The goal for the campaign was to ensure that children under 11 maintain a healthy weight. It would thus minimise obesity before it started through promotion of a healthy lifestyle (Department of Health, 2009). The campaign used social marketing as its main approach through the use of a segmentation model. This would attempt to help people in need by changing their behaviours and attitudes towards weight gain. It would tackle the justifications for these points of view and thus create a communication campaign designed to alter those attitudes (Evans, 2003). The promotion was to provide products to individuals who would take on the challenge. These items included well charts, questionnaires, handbooks and other forms of web content. Change4Life was also supposed to signpost people to certain services like free swimming, cookery classes, walks and breastfeeding cafes. Change4Life may have been government sponsored but it also brought together certain nongovernmental and commercial organisations into the initiative. Some commercial organisations would sell healthy food options in their premises. Alternatively, others would be third party advertisers for the campaign (DH, 2009). How Change4Life addresses well being Health is one of the objective determinants of well being. It is socially determined and also dependent on other risk factors like obesity. This policy response was a preventive measure enacted by government in order to improve people’s health by minimising their exposure to lifestyle risk factors. Since the government and other influential stakeholders currently regard well being as an important parameter for the nation’s success, then it was sensible to promote improvements in health within communities (Jaker, 2000). The “Healthy People, Healthy Lives” call to action set a target for minimising obesity among children and adults. It was realised that increasing physical activity was important but controlling what one ate was the key determinant for weight loss. It was thus imperative to minimise calorific intake across the population. (Local Governement Authority, 2012). Change4Life was thus launched in order to meet the “Health People, Healthy Lives” well being issue of obesity. It was a tool for implementing this strategy. It is likely that this policy was motivated by the need to inform and equip the public on certain matters. The welfare system in the UK is such that it acknowledges how everyone has a need (Boseley, 2009). Therefore, social protection needs to be introduced in order to meet those needs. The form of protection to be offered in this policy is in the form of tools, information and products. It seeks to equip these persons with the right support needed to improve their way of living. As mentioned in the definition, well being encompasses aspects of mutual trust and relationships that cause satisfaction. Change4Life caused the involvement of the public in a health-improvement effort. It fostered participation and trust from the targets of the campaign. This would eventually lead to greater outcome concerning their well being. The campaign also created trust and involvement from local authorities, businesses, schools health professionals and charities in England. As result, even individuals who were not direct recipients of its benefits ended up gaining from it (Brown and Duncan, 2002). Certain policy implications are evident in the latter approach. It may be stated that the involvement of local stakeholders is a social democratic strategy. The Department of Health helped local authorities, community leaders and the National Health Service to reach people who were at risk and thus work towards boosting their well being. Social democratic policies often rely on government sponsored protection, which is the case in Change4Life. (Hogget, 2001). On the other hand, it may also be stated that Change4Life did not operate under this strategy alone. The Department made it an open initiative such that other brands could join them by building on the brand. They had the freedom to use the Change4Life logo to carry out various changes. For instance, a food manufacturing company that creates green products could use the logo to demonstrate to buyers that it is a healthy alternative. Partners are also expected to promote different product categories in order to foster achievement of outcomes. Many of commercial partners were allowed to use their marketing assets in order to foster behaviour change (Department of Health, 2009). It was mentioned earlier that the neoliberal school is slowly taking root in the healthcare system in the UK. This is also true for the public health system in the country. Partnering with commercial enterprises injects a different dimension into the campaign strategy (DH, 2003). It means that utilitarian values may take root, and thus undermine the altruistic nature of the program. Strengths and weaknesses of the policy measure The Healthy People, Healthy lives strategy was designed in order to get more food industry stakeholders to contribute towards minimisation of obesity by reducing calorific intake. It was also supposed to bring together a series of partners who would support people in maintaining healthy weight (Association for the study of Obesity, 2011). This was to be done across whole continuum of age groups. It appears Change4life has contributed to all the above key areas of the overall policy. The strategy has led people to take personal responsibility for their health, which was a chief aim of the “Healthy People, Healthy Lives” strategy (AOMRC, 2012) Statistics indicate that brand awareness is quite high. Preliminary research showed that after the first two years of the campaign, 88% of mothers could recognise the Change4Life logo and what it meant in their lives. There was a steady rise of brand recognition from 40% in 2009 when it started, to 70% three months later, and 80% by the end of 2009. The number increased to 85% brand recognition and subsequently 88% in 2011. This testifies to the fact that partners working with the Department of health are working hard to get information about the brand out there (DH, 2011). The general attitudes towards the campaign are also positive. A large number of people claim that they trust the campaigns. Some even go as far as reporting that their families have changed their behaviour because of information from the campaign (Lally, 2000). About 400,000 families entered the campaign. 1 million mothers also reported that they implemented behaviour designed to change their children’s behaviour. This finding is not conclusive but could imply that the campaign has done a relatively good job of achieving a well-being goal of health. If those families truly take to heart the messages, then they will have fewer incidences of obesity. As a result, there will be even less obesity-related diseases. The policy response thus achieved a positive effect on this regard (Henry and Gordon, 2001). Indications of support for the campaign may also be assessed through the number of people who joined Change4life at a professional level. Local professionals and supporters reached 25,000 according to the Department’s last survey. These individuals were community representatives who wanted to cause change in people’s lives. The initiative created several sub brands like Walk4Life and Cook4Life by partners. Well being can also be measured by the degree of trust and mutual relationships that prevail in a community. This positive response in number of partners is indicative of the degree of well being achieved even among people who were not the target of the campaign (Department of Health, 2009). Commercial partnerships also soared in the subsequent years. 7.5 million pounds worth of media related value was added by these individuals. Additionally, support grew to 12 million pounds in the next year. This was manifested through increased brand recognition even after a government freeze on non essential health expenditure. Challenges of the policy response Perhaps one of the greatest criticisms against the campaign was the use of commercial partners. Some individuals feel that their presence in the campaign undermined the altruistic nature of Change4Life. For instance, some of them used the logo on their products even though they had exceeded recommended levels of healthy nutrient intake for the population. Additionally, some of these commercial partners may simply be motivated by the need to make more profit. Therefore, they have cut corners and eventually undermine the essence of the campaign. Too much proliferation of the logo by mainstream brands has diluted the level of trust that the public feels towards the strategy (Costello and Haggart, 2003). This means that fewer people will be willing to follow through on the recommendations in the Change4Life campaign. The use of commercial partners is indicative of the neoliberal approach to health. Here, it is assumed that competiveness and market-based interventions are sufficient to meet the needs of the population (DH, 2004). However, the Change4Life campaign has shown that this may not always be possible. Excessive competition may cause companies to engage in unethical behaviour (Jordan, 2008). Since profit-making is their main goal, then public health will always be second place to this drive. Many critics feel that the spirit of the campaign has been lost by the use of the brand in mainstream channels. Perhaps another challenge that has been faced by the department is the fact that it mostly focused on intangible incentives or information. The campaign also dealt with all families as though they had the same financial capability. Only a few low income communities were targeted for special support but most of them were not. It is likely that the welfare ideology of neoliberalism may have caused this focus. The people who are most at risk for obesity may not have the financial capability to afford healthy meals (Hamlin, 2000). Therefore, since the campaign left families to make their own food choices based on recommendations, it was only the financially capable who could engage in the practice. The move towards holding all individuals responsible for their choice has left out the underprivileged (Carpenter, 2009). Conclusion Change4Life was inspired by the move towards promotion of well being as an outcome measure by the government. Key strengths of the campaign include better lifestyle choices among participants and information within the target groups. On the other hand, the program has no strategy for dealing with low income groups. It also caused confusion through involvement of commercial companies. Perhaps elimination of these profit making entities would have made a bigger difference. Furthermore, the plan should have included the underprivileged. Therefore, a return to social democratic principles would have been preferable to this move towards individual choice. References AOMRC, 2012. 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