Exploring the Development and Scope of Public Health - Coursework Example

Teaching Part nature and scope of the alcohol abuse in West Midlands In the UK, various factors have been pointed to be affecting social health, individual wellbeing and the ultimate health of an individual. These factors include increase in chronic disease such as cancer, diabetes and obesity. The second one is that the population of UK is concentrated the aged and the lone dwellers and finally, the smoking and alcohol abuse. This paper will focus on of alcohol abuse describing the scope and nature of this problem and suggested research approaches to amend the situation (Earle, 2004 pg5). In the British community, consumption of alcohol is a normal practice that contributes significantly to the British economy. Many individuals take alcohol very responsible while as there is the population that are entangled in alcohol abuse. Harmful consumption of alcohol has negative impacts on the economy, the society and the individual’s health. Furthermore, abuse of alcohol has been observed to cause a variety of public health concerns including violence, poisoning, chronic diseases such as cirrhosis and particular cancers and accidents (Morgan, 2012 pg. 428) . The effects of alcohol misuse on the society include lower economic status as a result of reduced productivity, frequent sick days and unemployment. In addition, social harm occur through high rates of divorces and rampant domestic violence cases perpetuated by individuals with high dependence on alcohol. This is because the alcoholics are likely to be motivated to crime and anti-social behaviors in the society. All of these situations consequently result in higher burdens on the National Health System characterized by higher demand for primary care with alcohol related hospital admissions (Unwin, 2007) The Home Office and the Department of Health acknowledged the impact of the alcohol situation through setting up a government alcohol strategy in June 2007. The strategy is mainly focused on promoting sensible Alcohol uptake and to reduce the adverse consequences of the alcohol abuse. It is derived from the Alcohol Harm Reduction Strategy of the year 2004. The Alcohol strategy of June 2007 squares in on the minority of the population who drink alcohol irresponsibly and thereby inflicting harm on themselves, their household members and the community at large ( Chinman, 2011 pg. 181) The Department of Health conducts a survey on the annual volume of alcohol consumption in England to determine the trends. One unit of an alcoholic drink is lawfully defined as 8mg of undiluted alcohol content which relates differently with different quantities of other particular drinks. For instance, a 175 ml of wine which compares roughly to one glass equates to roughly two units of undiluted alcohol. Consequently, the department recommended 21 weekly units for men and 14 weekly units for women (Chinman, 2011 pg. 182). In 2007, uptake of alcohol per capita in United Kingdom escalated to 19% between 1980 and 2007. This contrasts the 13% decrease among the countries of the Organization for Economic Cooperation and Development (OECD). In this study, binge drinking was described as an individual who consumes at least five drinks during a particular week. The United States of America, Canada, Germany and France recorded 17%, 24%, 30% and 33% respectively. On the other hand, the European nations were reported to have higher per capita consumptions. The highest levels of alcohol uptake were reported in Denmark, Finland, Ireland and the UK. Both Austria and Germany had 36% of binge drinking, while as Ireland and Romania reported 44% and 39% respectively. Additionally, the UK reported a 34% of binge drinking (Earle, 2007). In the most recent health survey, 33% of adult men and 24% of adult women are categorized as hazardous drinkers. A further 6% and 2% of adult men and adult women respectively represent the drinkers who are likely to cause hazardous effects on their health from drinking alcohol. The World Health Organization (WHO) identified two aspects of alcohol abuse that could cause harm. These are volume and frequency of episodic alcohol drinking and the volume consumption of an individual’s lifetime (Chinman, 2011 pg. 185). Department of Health identified that most youth engage in binge drinking and drunken disorder in the night. On the other hand, the home drinkers have been identified to be at a higher risk of extended periods of alcohol related health conditions as well as developing higher dependency on alcohol. To prove this, a study was conducted in 2007 by Mintel in England. The findings showed migration away from the pubs. As compared to 2004, extra 1.8 million people take their alcohol at their homes (Mintel, 2007pg 10). Studies conducted in rural Eden, Cambria and Stoke provide necessary evidence that the home is most famous choice as the venue for alcohol consumption. The second option for a venue for alcohol consumption was the friends’ residences. This shows that the alcohol consumed in licensed premises was much lower than those consumed at home. A 31% drop in alcohol sold for consumption outside the home was observed between 2001 and 2007. Further research indicated that the decrease can be due to more women getting more managerial jobs and limited time availability for the higher income earners. For this reason, the domestic alcohol consumption has become a public health issue due to its consequences on health and the rise of chronic diseases. Alcohol is supposedly correlated domestic violence, social crimes and breaking of traffic laws. From 1984 to 2008, alcohol related deaths amounted to 9000 (Lane, 2011 pg. 363). Locally, in West Midlands, as evidenced in the Public Health of England, alcohol specific outcomes conditions have very high direct standardization rates (DSR). These outcomes include liver infections, ethanol poisoning, unspecified poisonous content of alcohol, alcohol induced pancreatic and the cognitive disorders. They reported 79.9, 34.8, 11.9, 11.8 and 247.1 DSR per 100000 alcohol consumers respectively. For the year 2007, alcohol related deaths in West Midlands decreased to 25.4 DSR per 100, 000 as compared 29.7 DSR for the year 2006 and 2005. Wolver Hampton had the highest levels of alcohol related deaths with 41.0 DSR per 100, 000 while as the lowest was 14.3 in Warwick. To add on that, West Midlands reported 25.4 DSR per 100, 000 consumers of alcohol (Lawder, 2011 pg. 35) Part 2: Researching the Alcohol Abuse in West Midlands Comparison of Qualitative and Quantitative Research In quantitative research design, independent and dependent variables need to be identified. The research designs in this approach are either descriptive or experimental. Descriptive quantitative research design is only conducted once while as the experimental quantitative research design studies the established measures before and after the intervention. Generally, the quantitative research design is the standard method for a variety of scientific studies. Here, statistical and mathematical approaches are employed to analyze data (Carr, 2007). These studies employ only one variable as the primary focus to enhance accuracy. Hypotheses are identified as either null or alternative. The alternative hypotheses proves interdependence among the independent and dependent variables while as the null hypotheses rejects association. An example of this research design is that done in 2007 in Pakistan, Ali et al. the study was focused on identifying profile of drug abusers in the locality as well as to recommend for preventive measures (Ali, 2011 pp.41). On the other hand, the qualitative studies employs diverse variables for an individual study. The most common qualitative research design involve the survey designs and the case studies. Because of its high degree of flexibility in handling various variables, it is considered the appropriate approach when the subject is diverse and would not be adequately settled through yes or no hypotheses. The advantages of using this design is the ease of operation and planning and its lack of dependence on sample size contrary to the quantitative studies. an example of this research design is that done by Chinman, M., Burkhart, Q., Ebener, P., Fan, C., Imm, P., Osilla, K.C., Paddock, S.M. and Wright, A about understanding off- and on-premises alcohol sales outlets to improve environmental alcohol prevention strategies ( Chinman, 2011 pg. 181). Stages of Research The procedures for a particular research is highly influenced by its design. Generally, a researcher starts by identifying a particular issue or problem in the society and those it affects either directly or indirectly. Secondly, identify research questions whose answers should be suggesting possible solutions to the identified problem. Thirdly, determine whether you study would be quantitative or qualitative (Hanlom, 2012). From all the above, the researcher can set broad and specific objectives for the study to be conducted. The objectives are expectations of the results of the study. Hypotheses will then be stated to enable empirical testing of independent and dependent variables identified if the quantitative research design will be used. Also, the researcher will need to identify, modify and design the appropriate data collection tool for his study. Moreover, the data analysis approaches should be identified before the study. Upon completion of all the above, the researcher is required to train the personnel involved in the study on their expectations and value of the study. Finally, an ethical compliance permission should be obtained prior to the study (Carlisle, 2012). Research Project Sample Study of Alcohol Abuse among Individuals with Intellectual Disabilities One of the effects of alcohol misuse is the development of mental instability among the drinkers. In the U.S it is estimated that 8 million citizens suffer from this particular condition. The consumption of alcohol is relatively higher in individuals with intellectual disability as compared to the population at large. The cavities in previous researches on this aspect of alcohol misuse are likely to demand attention for individuals with re occurring mental instability, those who are incarcerated and individuals with mild intellectual disability. The aim of this study is to identify strategies for prevention of this condition and identify possible methods to meet the needs of these individuals (Chapman, 2012 pg.1147). The study methodology would be quantitative where various tools would be used for data collection. Using a stratified cluster random technique for sampling, this study would conduct a cross sectional survey that would focus on the characteristics of the patient and the addiction history. The sample size would be determined using this formula; n= (Z 2 pq)/d 2 ). n is the ultimate sample size, Z is set as 1.96 as the standard normal deviate with 95% confidence level, p is the proportion that is believed to have a particular characteristic in the target population. Finally, q = 1.0 – p and d is the desired degree of accuracy usually at 0.05 (Coles, 2009. pg. 345). The study population would involve those who attend rehabilitative care for alcoholics and those that have alcohol related hospital admissions in West Midlands. The data collection would be conducted though face to face interviews and retrospective data collection from the patient files of those in the sample size. Quantitative analysis would be conducted on the findings which will be used to develop recommendations (Coles, 2009. pg. 345). Previous researches would be to justify the study and also to build up on its literature review. One of these studies include the study done in Pakistan by Karachi. In his study, he identified various possible reasons for alcohol misuse which were marital problems, breakup from romantic relationships and family problems. Alcohol amongst other drugs are viewed as a medium for shifting away from the reality of disturbing life situations. The findings noted that alcohol misuse is rooted in negative social pressures and socio economic hurdles. The study identifies the need for measures to prevent addictions (Ali, 2011 pg. 41). Benefits of an interdisciplinary approach to the problem The benefits of tackling the alcohol abuse situation through an interdisciplinary approach is well elaborated through a health impact assessment. The health impact assessment is a universal too that can be applied in every politically administrative realms. This is because it can be used as a tool that aids in decision making as well as predicting possible impacts of implementing certain options. The World Health Organisation that the tool is quite effective in determining inequalities in healthcare (Chinman 2011, pg.181). The alcohol consumption in the UK has resulted in health inequalities. Fortunately, the health impact assessment (HIA) tool can be used to counter these inequalities due the sensitivity and applicability of the tool towards inequities. The study conducted by Dahlren & Whitehead 2006, using a HIA identified the determinants of health to include biological factors such as hereditary factors, age, and sex, individual lifestyle behaviours such as eating patterns and smoking and alcohol consumption. Others include networks and individuality in a society, living and working environments such as sanitation and water, housing and availability of health services. The last one involves the cultural, environmental and socioeconomic conditions (Dahlren & Whitehead 2006 pg.45). Health determinants are interrelated with complex causal relations that impact on health therefore they should not be studied in isolation. For example, the binge drinking problem is highly likely to have been caused by influenced by other determinants through the causal pathways like social individuality. The lack of supportive networks in the society could be attributed to poverty which could have been due to economic factors in general. The peer pressure to indulge in alcohol drinking can be greatly related to the intense marketing strategies which have been modified in this 21st century to digital and internet advertising and social media advertising. This explains the high rate of alcohol consumption amongst the youth which results in harm to themselves or those close to them. Advertising of alcohol creates social norms that lead to normalisation of alcohol drinking in the society. This is because exposure to these adverts is linked to alcohol consumption especially to the youth (Rodgers, 2012, pg. 428). In health promotion health inequalities are believed to be widespread since health status of individuals vary considerably. Sociological factors such as poverty, gender, race and social class have a direct impact on an individual’s health status. Regional variances have been witnessed in health, differences in gender and patterns of health as well as increased incidence of a particular diseases. Promoting public health through health education is likely to be effective in encouraging behaviour change. A study conducted by McQueen in 1987 identified vital lifestyle behaviours that directly influence an individual’s health status. They include sedentary lifestyle, smoking, alcohol abuse and poor nutrition (McQeen, 1987 pg. 180). For this purpose, a national guideline for harmful alcohol use and alcohol dependence by the National Institute for Health and Clinical Excellence (NICE) in 1997. These guidelines aim to improve access to health care for individuals in health misuse practices, determine role of interventions in treating alcohol dependence and integrate the preceding two aims to provide advice on best- practice (Fone, 2012 pg. 428). In conclusion, the alcohol misuse is a global concern both in the developing and developed countries. various governmental support have been invested in curbing the problem this is because, not only does alcohol misuse affect the health of the individual but it also affects the nation at large thorough decreased productivity at work, high mortality and morbidity with alcohol correlated situations. It has also been observed that dependence on alcohol abuse could be attributed to the intellectual disability such as mental illnesses and psychological disorders. Various studies have been done to determine the variables that promote alcoholism with little impact in the society. This is because most of these recommendation are not implemented as it is expected. This therefore proves that studies in these field have been deemed redundant. More research should be conducted and the recommendations should be employed in developing policies on alcohol consumption (Ritcher, 1995 pg. 679). References: Ali, H., Bushra, R. and Aslam, N. (2011) Profile of drug users in Karachi City, Pakistan. Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ṣiḥḥīyah li-sharq al-mutawassiṭ [online], 17(1), pp. 41 Brook, D.W., Brook, J.S., Rubenstone, E., Zhang, C. and Morojele, N.K. (2011) Environmental stressors, low well-being, smoking, and alcohol use among South African adolescents. Social science & medicine [online], 72(9), pp. 1447-1453. Carroll Chapman, S.L. and Wu, L. (2012) Substance abuse among individuals with intellectual disabilities. Research in developmental disabilities [online], 33(4), pp. 1147-1156 Chinman, M., Burkhart, Q., Ebener, P., Fan, C., Imm, P., Osilla, K.C., Paddock, S.M. and Wright, A. (2011) The Premises is the Premise: Understanding Off- and On-premises Alcohol Sales Outlets to Improve Environmental Alcohol Prevention Strategies. Prevention Science [online], 12(2), pp. 181-191 Cartwright, A.K.J. and Shaw, S.J. et al . (1978) ‘The relationships between per capita consumption drinking patterns and alcohol related problems in a population sample 196 –1974, Part 1, Increased consumption and changes in drinking patterns’, British Journal of Addiction, Vol. 73, No. 3, pp. 237–46 Coles, L. and Porter, E. (2009) Public Health Skills: A Practical Guide for Nurses and Public Health Practitioners . [online] US: Wiley-Blackwell. Earle, S., Lloyd, C. and Sidell, M. (2007) Theory and Research in Promoting Public Health . EuroHealthNet (2004) Promoting Social Exclusion and Tackling Health Inequalities in Europe: An Overview of Good Practice from the Health Field, Brussels, EuroHealthNet. Fawcett, S., Paine-Andrews, A., Franisco, J., Schultz, J., Lewis, R., Williams, E., Harris, K., Berkley, J., Lopez, C., Fisher, J. and Richter, K. (1995) ‘Using empowerment theory in collaborative partnerships for community health and development’, American Journal of Community Psychology, vol. 23, no. 5, pp. 677–97. Fone, D., Brennan, I., Sivarajasingam, V., Morgan, J., Fry, R., Lyons, R., Dunstan, F., White, J., Webster, C., Rodgers, S., Lee, S., Shiode, N., Orford, S. and Weightman, A. (2012) Change in alcohol outlet density and alcohol-related harm to population health (CHALICE). BMC public health [online], 12(1), pp. 428-428 . Hanlon, P., Carlisle, S., Hannah, M. and Lyon, A. (2012) The Future Public Health . Open University Press. Lane, D.C. and Simmons, J. (2011) American Indian youth substance abuse: community-driven interventions. The Mount Sinai journal of medicine, New York [online], 78(3), pp. 362-372 Lawder, R., Grant, I., Storey, C., Walsh, D., Whyte, B. and Hanlon, P. (2011) Epidemiology of hospitalization due to alcohol-related harm: Evidence from a Scottish cohort study. Public health Lipsky, S. and Caetano, R. (2009) Epidemiology of Substance Abuse Among Latinos. Journal of Ethnicity in Substance Abuse [online], 8(3), pp. 242-260 Unwin, N., Carr, S. and Pless-Mulloli, T. (2007) Introduction to Public Health and Epidemiology. [online] Open University Press. Watanabe-Galloway, S., Ryan, S., Hansen, K., Hullsiek, B., Muli, V. and Malone, A.C. (2009) Effects of methamphetamine abuse beyond individual users. Journal of psychoactive drugs [online], 41(3), pp. 241 Zuccato, E., Chiabrando, C., Castiglioni, S., Bagnati, R. and Fanelli, R. (2008) Estimating community drug abuse by wastewater analysis. Environmental health perspectives [online], 116(8), pp. 1027-1032 http://www.wmpho.org.uk/localprofiles/alcoholdeaths.aspx Read More