Public Health and Social Care - Essay Example

Social Health Determinants in Hammersmith and Fulham: Obesity By Contents Executive Summary2 Introduction 3 Hammersmith and Fulham’s Review 4 Methodology 5 Background 6 Health Inequalities 6 The need for change 11 Recommendations 14 List of References 15 Executive Summary This report gives the findings and recommendations on the Health Inequalities in London’s Hammersmith and Fulham Borough. The report also talks about obesity as one Social Health Determinant within the Borough. The report is about evaluating the effects of obesity as a social health determinant in a Borough in London called Hammersmith and Fulham. Introduction Obesity is a body condition that is associated with too much body fat. This condition has a series of negative effects to those suffering from it and if not effectively managed, can lead to losses in terms of life and government expenditures. According to National Obesity Observatory, 6 out of 10 men are obese, and 5 out of every 10 women either suffer from obesity or are overweight. This trend causes concerns given the fact that obesity poses great risks of contracting diseases such as diabetes, cancer, heart disease and osteoarthritis. Further estimates from researchers have also indicated that being overweight may lead to the reduction of life expectancy by up to 3 years, and being obese can reduce the same by up to 10 years. In trying to reduce the effects of obesity, the government has initiated several programs aimed at: Changing people’s behaviors to lower the effects of obesity and other related diseases. Improving the number of affected people taking their medications as prescribed to them. Hammersmith and Fulham’s Review Hammersmith and Fulham is estimated to have a total population of about 165, 200. Different groups of people occupy this Borough with about 60% being the white British, 20% include others such as Polish, French and the Irish community. Black African and the Caribbean constitute 10% with the remaining percentage going to various ethnic groups such as Chinese, Pakistani and Indian. The majority of people living here own the houses they live in and constitute 50% of the occupants. Another 22% of the population constitutes unrelated adults living together either as couples or students (Whitting & Faulkner 1965, 20). The Borough has the one of the highest single adults’ proportion compared to other Boroughs, standing at 55% with the unemployment rate just under 5%. The houses here are ranked as the fourth most expensive in the entire country. The Hammersmith and Fulham Borough was chosen for this research as it represents one of the highest numbers of health care inequality cases according NHS. Methodology The following approaches were used in data collection for this research: Visiting and talking to the people about what they think of obesity Interviewing people on what types of diets they follow Questionnaires were also used to get information on how often the people living in Hammersmith and Fulham do exercises. Other questions about general health, including the effects, causes and management of obesity were posed. Discussions of the government initiatives to improve the health care delivery and curb rising cases of obesity and other chronic diseases also took center stage (Hunter, Marks & Smith 2010). In a further discussion, the respondents acknowledged that there are several cases of health inequalities in Hammersmith and Fulham. The report seeks to find out the avoidable health inequalities in the Borough and recommend ways to deal with it, more so on cases of obesity. Background Health Inequalities Health inequalities are the differences that exist in the health status between different socioeconomic groups. In most countries, differences in health are observed across the population (Rees 2001, 56). Variations in genetics and constitution ensure that there is a variation in the health of individuals. Age groups also play a key role in determining the prevalence of ill health. Older people tend to fall sick more often as compared to younger people due to the ageing process (Turpin & Tomkins 2007, 45). In most health systems, inequalities are inevitable and may include: Access to services like health care Lifestyle and health relates behaviors such as smoking, exercising, and diet Health outcomes like differences in life expectancy Socio-economic factor including occupation, income and education. For the effective reduction of health inequalities, plans must be put in place to across all the social health determinants. As it is, the more an individual is economically stable, the better health care he/she will receive and poorer people are likely to receive worse health care (Turpin & Tomkins 2007, 67). This clearly shows that health inequalities affect the whole society and not just the poor. There are several health inequalities that exist in Hammersmith and Fulham, and these include: Premature mortality: some people, both men and women die prematurely, especially those from lower economic class Life expectancy that is not equal: there exists a 7.1 year gap in the males’ life expectancy and 11.7 year gap for females between various wards in the Borough Child health inequalities According to World Health Organization, social determinants of health are the situations in which people find themselves in either at birth or during the process of growing up, work and age, and the systems that are set and structured to prevent and treat illness. These circumstances are further shaped by another larger set of factors which include: social, economic and political. In this report, obesity was chosen as a social determinant of health to be discussed in the Borough of Hammersmith and Fulham Obesity is a condition associated with being overweight and having a lot of body fat. This condition affects people across all ages and may be caused by either factors related to heredity and variation in human genetics or the lifestyle one chooses to live. Most cases of obesity in Hammersmith and Fulham are due to the kind of lifestyle. Most people living in the Borough are economically very stable, and this translates to the kind of lifestyle they live. According to National Obesity Observatory, six out of ten men, and five out of every ten women living in Hammersmith are either overweight or obese. The statistics further indicate that the prevalence of obesity among the adults increased from fifteen percent in 1993 to twenty-six percent in 2010. Sixty-seven percent of men and fifty-eight percent of women were overweight in 2010. The Borough has also had many cases of childhood obesity. Going by the recent statistics, there has been a significant reduction in the rate of childhood obesity. The proportion of boys and girls of ages between 11 and 15 who suffered from obesity, increased from 17% in the year 2001 to 25% in 2004. Fluctuations in these numbers have been recorded between 2005 and 2010. Children in the highest income quintiles have the least risk of suffering obesity while the proportion of obesity in children is highest in the lowest quintiles. The causes of obesity in Hammersmith and Fulham were found to similar to other Boroughs, but the victims were highest in this Borough. The causes include, among others: Lifestyle: studies have shown that overeating in conjunction with a sedentary lifestyle contributes massively to obesity in Hammers and Fulham. Most sedentary behaviors occur in different setting, such as workplace, at home, during leisure time and during transport. Most adults in Hammersmith and Fulham are employed in different sectors and spend up to more than seven hours per day sedentary. All these activities pose a great risk of suffering obesity despite being part of daily lifestyle for most people in this Borough. Lack of physical activities: with just under 5% of the total population unemployed, Hammersmith and Fulham have the majority of its population working, and they rarely have enough time to get involved in physical exercise. Exercising helps to keep the body clean and add lean muscles tissues while at the same time losing fat. It also prevents other related illnesses such as blood pressure. It has been proven that muscle tissue has a higher metabolic rate and hence will speed up the rate of losing body weight. Metabolic: the use of energy varies from person to person. The metabolic and hormonal factors may not be the same for every person, but they play a pivotal role in determining how much weight one can gain. Studies have shown that ghrelin levels, appetite-regulating hormone and other peptides found in the stomach are involved in triggering hunger and giving a feeling of being full after meals. Genetics: most studies have indicated that one can inherit the tendency towards obesity. The chances of being overweight are estimated to be at 25% for those whose parents are obese. Heredity and variation also influence very strongly which part of the body will carry weight. Health care professionals in the Hammersmith and Fulham are able to identify the early indications of Type 2 diabetes, diseases related to the cardiovascular system and other obesity related illnesses in both children and adults. People who suffer from obesity for longer periods have higher risks of falling sick from obesity related diseases. Current statistics shows that most adults in Hammersmith and Fulham have higher risks of being overweight due to the kind of activities involved in their workplaces. Most of them spend up to seven hours a day in sedentary activities. This has caused a major health concern to the health experts in this Borough, prompting them quickly to come up with better ways of dealing with the issue. In a Borough where the majority of the population is working class, prevention measures are considered important given the chronic diseases and conditions that are associated with obesity and the fact that obesity is very difficult to treat. Prevention will also play a big role in reducing the chances of children becoming obese at adulthood. Current statistics in Hammersmith and Fulham have shown that the chances of children becoming obese at adult stage have increased from the initial 20% at the age of four years and below to 80% by adolescence. Obesity prevalence among different age groups depends on the activities each one is engaged in at each stage of life. Recent scientific researches show that the chances of a baby to become overweight greatly depend on the frequency of breastfeeding. Breastfed babies are less likely to become obese by 15 to 20%. For babies who are breastfed for longer periods, their chances are much higher at around 20 to 40%. For most young people, obesity is, as a result, of lack of enough physical activities in conjunction with poor eating habits. As seen earlier, genetics and lifestyle also greatly determines a child’s weight. The fight against obesity squarely lies with those who suffer from it, with the support of their close relatives and friends. Strategies to produce healthy weight loss will greatly prevent the prevalence of obesity among the people living in Hammersmith and Fulham. Improving the diets by eating healthier foods and increasing the physical activity play a pivotal role in preventing obesity. There has been rising demand for treatment costs in most of the Boroughs across England. According to The Health and Social Care Act 2012, the provision of better health care is imperative and is an equal right to all (Griffiths & Hunter 2007, 78). Everybody, despite the economic status, deserves the best available medical care services possible. Most of the reported health issues in Hammersmith and Fulham relate to poor sanitation in some areas and bad eating habits among the youths and the lack of exercise. There is no doubt that for a long time now, various activities have been initiated by the local authorities to deal with these issues, but a lot more still needs to be done and measures put in place for a successful realization of a healthy population in Hammersmith and Fulham. Much focus has been on the social determinants of health with little concentration on the medical causes of some of these conditions. In their service delivery, which is health services, the local government seems to be concentrated more in dealing with the outcomes of these conditions rather than also focusing on the prevention measures. In ensuring good health, the larger population of the Hammersmith and Fulham needs to be involved not only as patients being treated in hospitals, but also as key decision makers about choosing a healthy lifestyle. One major misconception among most people is that anything to do with health matters is purely the business of health organizations, more so the NHS. This fact has had a major role in undermining the gains made to promote health as part of one’s responsibilities and not entire government’s concern (Schneider & Lilienfeld 2008, 54). As a social health determinant in Hammersmith and Fulham, obesity has several impacts not only to the affected, but also the local government. They include: Low self-esteem: various researches have shown that most people suffering from obesity develop behavioral characters such as low self-esteem and low levels of confidence. Most of them think that their condition can be a hindrance to a achieving what others have achieved. In the school, most obese students have poor social lifestyle as they feel odd among other students. Consequently, poor results have been recorded from such students. Heart diseases: it is a proven fact that those who suffer from obesity have up to 80% chances of suffering heart-related illnesses. As the amount of body fat increases in the body, blockage may occur in the blood vessels leading to high blood pressure. Treatment of such chronic diseases demands a lot of input from the government in terms of resources and facilities required to treat them successfully Psychological effects: in a culture where people always try to keep in shape, as in the case for Hammersmith and Fulham, obese people are very much disadvantaged and have often been blamed for their conditions. The disapproval of obese people by some individuals can escalate to discrimination and eventual torment. The need for change It is evident that Hammersmith and Fulham still face enormous tasks over the next few decades to deal with its health care issues. These challenges range from health inequalities and the ever increasing pressure on the limited financial resources (Detels 1997, 65). The local authorities of the Borough need to work with the communities and ensure that services needed to support the locals are made available. The local government needs also to ensure that all the people affected by various health conditions are assured of full health support necessary and that they can live a healthy and productive life while receiving medical services as close as possible to whenever they may be. The enormity of the problems faced by the Borough is further demonstrated in the variation in life expectancy among those from the areas of least stable and most stable people in the Borough. National figures indicate a gap of 7.9 years and 5.4 years for men and women respectively (Thaler & Sunstein 2008, 63). The gap has been widening over the years and increase in life expectancy is attributed to improvements in the areas occupied by economically stable people while the life expectancy remains almost the same in deprived areas. The projected increase in the number of old people in the next two decades in conjunction with relatively low rate of unemployment is expected to impact heavily on the demand for health services. Common illnesses associated with old age will increase. Going by the current values which stand at 1,250 patients in Hammersmith and Fulham suffering from dementia, the number could increase to around 1,500 patients by 2015. Many other health concerns for older people are also likely to become more common such as reduced mobility, disabilities in both sensory and physical conditions. With all these challenges looming, it is up to the people also to change most of their lifestyle activities to cut down on risks of falling ill. Unless a change in behavior is embraced by the people not only from the Borough, but also from across the whole country, disabilities resulting from conditions such as obesity may still be on the rise. The Hammersmith and Fulham, collectively with Well-being Board need to work together in offering a new approach to health issues facing the Borough. The new engagement that ensures opportunities in the health sector will require properly designed structures for its success (Donaldson & Scally 2009, 29). A good strategy for this project will provide a benchmark against which the positive outcomes of the project will be measured. It will also act as a framework that will guide commissioning across all health sectors, both public and private, for both children and adults. The Joint Strategic Needs Assessment (JSNA) has also been involved in trying to shape the priorities locally and has been well represented in the Health and Well-being Strategy. Despite the fact that the health of most people in Hammersmith and Fulham have shown some variations compared with the England average, levels of smoking for pregnant women and breastfeeding initiation are better. Levels of drug abuse, alcohol related crimes and other violent crimes are worse (Holland, Detels & Knox 1991, 30). The estimates provided by various health sector shows that the GCSE achievement and physically active children are better than the England average. However, the levels of childhood obesity and poverty in most children of at least five years old are worse. Recommendations The recommendations were based on the current issues in the health sector associated with the social health determinants. In dealing with cases of obesity, the following were recommended: The local government in Hammersmith and Fulham needs to create and develop a culture of engaging in physical activities among the people. Lack of physical activity like sitting for long hours greatly boost the chances of being overweight or obese. Walking over shorter distances needs for example to workplaces will improve the blood flow, thereby reducing any chances of being overweight. The government also needs to promote healthy diets among the people of Hammersmith and Fulham. Foods that are low on calories are very vital in keeping body weight in check. One needs to choose wholegrain foods such as brown bread and rice and avoid foods that are highly refined with high levels of sugar and saturated fats. Eating between five to six servings of fruits or fruit salads and vegetables on a daily basis is greatly encouraged for adults. Eat the right amount of food that the body needs. Weighing and measuring foods helps to achieve the correct quantity that the body requires. In caring for those suffering from obesity, the local government needs to initiate a program that will seek to monitor them throughout their medications. The program will aim to follow them so as to ensure that they strictly follow to the prescriptions. A program like this will ensure that those who suffer from obesity and other related illnesses also help in the fight for a healthy population in Hammers and Fulham. List of References Detels, R. (1997). Oxford textbook of public health. 1 1. Oxford, Oxford University Press. Donaldson, L. J., Scally, G., & Donaldson, L. J. (2009). Donaldson’s essential public health. Oxford, Radcliffe. Griffiths, S., & Hunter, D. J. (2007). New perspectives in public health. Abingdon, Radcliffe. Holland, W. W., Detels, R., & Knox, E. G. (1991). Oxford textbook of public health. Oxford [England], Oxford University Press. Hunter, D. J., Marks, L., & Smith, K. E. (2010). The public health system in England. Bristol, Policy Press. Informal professional (Firm). (1845). Medical directory. London, Churchill Livingstone. Rees, R. (2001). Poverty and public health, 1815-1948. Oxford, Heinemann. Schneider, D., & Lilienfeld, D. E. (2008). Public health: the development of a discipline. New Brunswick, N.J., Rutgers University Press. Thaler, R. H., & Sunstein, C. R. (2008). Nudge improving decisions about health, wealth, and happiness. New Haven, Yale University Press. Turpin, C., & Tomkins, A. (2007). British government and the constitution: text, cases and materials. Cambridge, Cambridge University Press. Whitting, P. D., & Faulkner, T. (1965). A history of Hammersmith, based upon that of Thomas Faulkner in 1839. London, Hammersmith Local History Group. Read More