Health Promotions - Five Portions a Day - Assignment Example

Health Promotions - Five Portions a Day 2007 Health Promotions - Five Portions a Day A large share of premature deaths in the UK and other developed countries (up to 50 percent) are estimated to be caused by issues related to quality of life (O'Donnel 1989). Many of these deaths can be prevented by addressing the wide range of lifestyle patterns such as physical activity and exercising, tobacco and excess alcohol use, stress behaviour, nutrition, participation in social networks and economic underpinning, adjustment of lifestyle values, etc. Health promotion is a broad framework within which all of these issues are addressed to improve community health and reduce the number of preventable premature deaths. Broadly defined, health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health (Nutbeam 1986: 116). The primary goal of health promotion is to help individuals and groups change their lifestyle to reach a state of optimal health which can be defined as "...a balance of physical, emotional, social, spiritual, and intellectual health" (O'Donnel 1989: 5). The change can be facilitated through a variety of actions to increase the population awareness and create an environment that supports good health practices. Therefore, health promotion is a reflecting approach serving to facilitate physical and emotional well-being of individuals and groups. Although the actions undertaken within this approach may take different forms and employ a variety of tools, the most common form of health promotion efforts is a programme targeting a specific population in a unique setting. Thus, in schools and other educational institutions, health promotion approach may include a range of physical and mental health practices to target to educational goals such as improved cardiovascular fitness, non-utilization of potentially hazardous chemical substances, social skills proficiency, affective development, and enhanced motoric functioning (Zins et al 1985). The available research and evidence collected domestically and internationally suggests that health promotion efforts do result in changed harmful lifestyles and improved social, economic and environmental determinants of health (Perkins, Simnett and Wright 1999; IUHPE 2000). Effectiveness of a health promotion campaign depends upon several factors including correct assessment of health needs in the intervention area, right goals and objectives, and professional development and implementation. The emerging health threats and risks associated with living in the modern globalised technological world require new forms of action to successfully address them. The challenge for the coming years will be to fully realise the potential for health promotion inherent in many sectors of society, among local communities, and within families. One of the most evident and essential needs is to break through traditional boundaries within government sectors, between nongovernmental and governmental organizations, and between the public and private sectors involved in a health promotion effort. Cooperation between these sectors and organisations is required to establish new forms of highly beneficial and equal partnerships for health at all levels of governance in societies to more effectively promote healthy behaviours. With partnership and cooperation in place more community members actively participate in the effort improving quality of life and healthcare. Emergence of the Local Health Care Co-operatives (LHCC) demonstrates that the need for partnership and cooperation is gradually recognised by both central governments and local authorities. These units have made good progress in developing into responsive and inclusive organisations which are now the main focus for planning the development of community health services. LHCCs are expected to gradually evolve into the Community Health Partnerships to reflect their new and enhanced role in planning and delivery of health care services and programmes (NHS 2000). Chronic diseases are those diseases which can only be controlled and not cured. Some of the chronic diseases are asthma, arthritis, diabetes, heart disease, chronic obstructive pulmonary disease, dementia etc. The occurrence of chronic diseases increases with age and significantly affects the quality of a person's life. It is estimated that in the UK 17.5 million suffer from chronic diseases and 6 out of 10 adults suffer from chronic health problems (HPA 2006). Therefore, it is necessary to design and implement a proper strategy to tackle the issues that contribute to high incidence of chronic diseases in the UK population: such diseases are not curable and the resources allocated to control them impose a huge burden on the British health care system. The 5 A DAY is one the first serious countrywide health promotion programmes designed and implemented by the Department of Health to address the growing incidence of chronic diseases associated with nutrition. Basically, the 5 A DAY is a communications programme aiming to increase awareness of the health benefits of fruit and vegetables. It is designed particularly to target those groups and populations with the lowest intakes through providing clear and consistent messages about what counts towards 5 A DAY and portion sizes of fruit or vegetables (DH 2007). Nowadays the 5 A DAY initiative is the core element of the government's framework for prevention of ill health and for the reduction of health inequalities. The promotional materials and all products with no added sugar, salt or fat may carry the 5 A DAY logo including fresh, frozen, cooked, chilled, canned and dried fruits and vegetables as well as 100% fruit and vegetable juice. A set of nutritional criteria for composite foods to enable products that contain non-harmful levels of added sugar, salt or fat to carry the logo was published by the Department of Health in 2004 (DH 2007). The potential benefits of improved diet to the health have been recognised since long ago and there are abundant evidences to support this stance. Therefore, 5 A DAY programme relies upon a solid body of credible research emphasising the role of food in securing and maintaining good health. Diet and nutrition are significant factors in the promotion and preservation of good health right through the whole life course of a human being. Their positions as determinants of chronic non-communicable diseases are well known and occupy a significant role in prevention activities. The chronic diseases which are related to diet and nutrition are the largest public health burden. These include diabetes, obesity, cardio vascular diseases, osteoporosis, cancer and dental diseases. The burden of chronic diseases is alarmingly increasing world wide mainly because of the drastic changes in the food habits. It has been estimated that chronic diseases resulted around sixty percentages of 56.5 million total deaths in the world and 46% of the global diseases (WHO 2002). Cardio vascular diseases cause almost half of the deaths resulting from chronic diseases. Obesity and diabetes also affect a large section of the population and people get these diseases earlier in life. It is estimated that by 2020 chronic diseases will contribute to almost three quarters of all deaths world wide (WHO 2002). Research demonstrates that coronary heart disease, diabetes and cancer cause approximately 60 percent of all premature deaths. In order to tackle some of the chronic diseases such as coronary heart diseases, diabetes etc the best method are diet and nutrition. The preventive measures include reduction of fat, sugar, and salt in the diet and increase in the intake of fruit and vegetables consumption. Moreover, people should be encouraged to eat 5 Portions of variety fruit and vegetables each day to reduce the chances of chronic diseases. Thus, eating more than five portions of fruit and vegetables per day can cut the risk of stroke by 26%: researchers examined data from eight studies (four from the US, three from Europe and one from Japan) that tracked the diets and occurrence of stroke among a total of 257,551 adults, followed for an average of 13 years. During that time, 4,917 of the subjects suffered a stroke (Steffen 2006). Proper diet which account for lowering plasma cholesterol and blood pressure level can reduce the chances of cardio vascular diseases. In order to keep the cardio vascular diseases under control, one has to take more fruits and vegetables and less saturated fat. In the past, under-nutrition and chronic diseases were perceived as two separate problems, and such stance seriously thwarted effective action to control chronic diseases because safe, sufficient and different food supplies clearly reduce the risk of chronic diseases. The existing evidence supporting such point of view is abundant, and, furthermore, a number of studies are available to demonstrate that nutrition deficiency as opposed to healthy diet not only increases vulnerability to cardio-vascular adversities but also raises the risk of common infectious diseases too (Tompkins and Watson 1989). Both over nutrition and under nutrition causes chronic diseases, and it is estimated that 79% of death causes by chronic a diseases are taking place in developed countries (WHO 2002a). Chronic diseases of childhood and teenage years such as, type one diabetic, some childhood cancers, inflammatory bowel diseases are connected with child feeding on breast milk substitutes and short time breast feeding (Davis 2001). It is empirically demonstrated that taking 5 portions of fruit and vegetables can reduce the risk of premature death by 20 per cent (DH 2000). Moreover, it will decrease the possibility of colorectal and breast cancer as the intake of fruits and vegetables increases. These cancers represent in 18 per cent men and nearly about 30 per cent women in UK (DH 1998). Another advantage of higher consumption of fruit and vegetables is that it reduces coronary heart disease and chances of stroke. Moreover, it is also very helpful in reducing blood pressure (Appel, Moore and Obarzanek 1997). Other benefits of increasing intake of fruit and vegetables are delaying the development of cataracts, reducing symptoms of asthma and very helpful in managing diabetes (Taylor, Jacques and Epstein.1995). Availability of convincing evidences forced public health policy makers pay adequate attention to controlling and preventing chronic diseases with 5 A DAY programme being at the core of the effort. The programme brought some positive results already in the short-term perspective. Thus, in the beginning of this decade awareness of the 5 A DAY message was gradually increasing. The Expenditure and Food Survey shows that total fruit and vegetable consumption increased 2.5% by volume from 2001/2 to 2002/3, with consumption of fresh fruit up by 5.8% (Marriott and Buttriss 2004). However, the room for further improvement is huge because many members of the targeted population still lack encouragement to eat 5 portions of a fruit and vegetables a day. For example, a survey by the Food Standards Agency into consumer attitudes to food found that almost 60% of people said they knew they should eat 5 portions a day compared to 43% in 2000, but despite the noticeable increase in awareness, in 2003 only 28% actually achieved this target, which is only a 2% increase as compared with 2000 (FSA 2003). Evidently, some of the barriers which prevented UK population from increasing the consumption of natural healthy food (e.g. poverty, unavailability of good quality fresh fruits and vegetables) can barely be addressed within the framework of the 5 A DAY initiative. However, the programme itself seems to lack some essential features that distinguish a highly effective health intervention from a moderately effective or ineffective one. Adequate level of attention paid to cooperation and partnership on the lower levels is one of such features. The 5 A DAY initiative employs a combination of strategies focusing primarily on the partnership with the food industry partners and large media organisations in order to generate and communicate the information related to the programme. As a result, the 5 A DAY effort nowadays bears more resemblance to an average advertising campaign that to an accurately planned and implemented health promotion initiative. Despite effectiveness of this approach (the power of mass media in shaping public opinion and lifestyles is well known and universally recognized), overwhelming attention to 5 A DAY logos, posters, newsletters, booklets and other instruments for the arsenal of advertiser shadows several other important aspects. Firstly, the volume of pro-5 A DAY information broadcasted via countrywide channels is often unreasonably huge and sometimes even contradictory which seriously undermines its influential power. Secondly, eating pattern change is a highly difficult task (especially in older people) which can, perhaps, be compared with making a life-time smoker quit the habit. The difficulty of this task suggests that something more than aggressive continuous advertising campaign is required to encompass it. In order to reach the target population the most effective manner, the best method is establishing a lasting good faith partnership between local healthcare organisations, local governments and media, voluntary organisations, and public. In the local community level such a concerted effort in partnership, with highly specialised agencies, is the best option in order to face the menace of chronic diseases and boost the results of such initiatives as 5 A DAY. Therefore, it is advisable to develop and implement a technology supported care management programme that directly addresses the needs of the local healthcare community. They should also set up a project board, a medical advisory board and a project team to provide high standard health care services. In order to oversee all the activities mentioned above, a committee comprising of representatives of the local community, governments and health care professional should be formed. It must be understood that in any society, the success of any healthcare policy or programme would basically depend on creating awareness in the local community about the health problems and their outcomes. Healthcare organisations alone cannot wage a war so effectively against any large scale menace. Therefore, a partnership between various agencies and the public becomes imperative in controlling and preventing the problem of chronic disease through health promotion programmes such as 5 A DAY. References Appel, L., Moore, T. and, E. Obarzanek 1997. 'A clinical trial of the effects of dietary patterns on blood pressure'. New England Journal of Medicine, 336: 1117-23 Davis, K. M. 2001. 'Breastfeeding and chronic disease in childhood and adolescence' Pediatric Clinics of North America, 48: 125-14 Department of Health 2000. The NHS Plan. London [available online at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4002960] Department of Health 1998. Report on Health and Social Subjects 48. Nutritional Aspects of the Development of Cancer. Report of the Working Group on Diet and Cancer of the Committee on Medical Aspects of Food and Nutrition Policy. Stationary Office, London Department of Health 2007. 5 A DAY. Retrieved April 10, 2007 from http://www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/FiveADay/index.htm. Food Standards Agency 2003. Consumer attitudes survey 2003. Retrieved April 10, 2007 from http://www.food.gov.uk/news/newsarchive/2004/jul/cas2003enforcers Health Protection Agency (2003). Annual Report and Accounts 2006. Fact sheet [available online at http://www.hpa.org.uk/publications/2006/annual_report/pdf/Annual_Rpt_2006_Part2.pdf] International Union for Health Promotion and Education, 2000. 'The Evidence of Health Promotion Effectiveness: Shaping Public Health in a New Europe. A report for the European Commission'. Health Education Research, 15(3): 243-248 NHS Scotland 2003. Partnership for care. Scotland's health white paper. Edinburgh: Scottish Executive [available online at http://www.scotland.gov.uk/Publications/2003/02/16476/18730] Marriott, H. and Buttriss, J 2004. 'Estimates of food consumption and energy and nutrition intakes in the UK 2002/03: results from the latest Expenditure and Food Survey'. Nutrition Bulletin, 29(4): 344-349 Nutbeam, D. 1986. 'Health Promotion Glossary'. Health Promotion 1(1): 113-127 O'Donnell, M. 1989. 'Definition of health promotion: Part III'. American Journal of Health Promotion, 3(3): 5 Perkins, E. R., Simnett, I. and Wright, L. (Eds.) 1999. Evidence-Based Health Promotion. John Wiley & Sons, Chichester Steffen, L.M. 2006. 'Eat your fruit and vegetables'. The Lancet, 367(9507): 278-279 Taylor, A., Jacques, P., and E. Epstein 1995. 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