Health Policy on Obesity in Relation to Mental Health Illness - Essay Example

? Health Policy on Obesity in Relation to Mental Health Illness Introduction In human beings, health signifies an individual’s general condition in terms of body and mind, usually denoting that person’s freedom from any apparent pain, injury, or illness (referring to the term ‘healthy’) (Blaxter, 2004, 45-53). According to World Health Organization (WHO) the word heath denotes "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity" (Grad, 2002, 981). Thus, from a holistic viewpoint mental health is an important component of a person’s all round well-being, and includes that person’s capability to lead a quality life, with a strong balance maintained between his daily activities and strivings towards attaining psychological adaptability, irrespective of his race, culture, ethnicity or gender (Ewles, 2005). The World Health Organization defines mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community" (World Health Organisation, 2010). Obesity, where excess fat accumulates in the body, causes serious health problems like diabetes, liver and heart problems, and/or cancer, often also leads to mental illness in the affected person, thus producing an overall negative effect on human health. Data from the latest Health Survey for England (HSE) revealed that “in 2009, 61.3% of adults (aged 16 or over), and 28.3% of children (aged 2-10) in England were overweight or obese, of these, 23.0% of adults and 14.4% of children were obese. The Foresight report, Tackling Obesities: Future Choices project, published in October 2007, predicted that if no action was taken, 60% of men, 50% of women and 25% of children would be obese by 2050” (Department of Health, Obesity, 2011). From these reported figures, it is obvious that obesity is slowly turning into a major public health problem, making it necessary for the UK government to frame effective policies in order to deal with the problem that is affecting the well-being of the entire community. It must make appropriate health policies related to obesity to accord proper healthcare to all sections of the population, to spread awareness and educate the public through various promotions and programmes. In this context, the paper will examine the determinants of health, their relevance to health and well-being, and the impact of inequalities of health on individuals and populations, while analysing the impact of policies on public health and healthcare access, and the structure, organization and delivery of healthcare.  It will also evaluate the role of the nurse in the promotion of health with individuals, families and populations and first contact care, while using a health promotion framework to illustrate role of nurse Discussion The determinants of health, their relevance to health and well-being, and the impact of inequalities of health on individuals and populations: The surrounding environment and circumstances that one faces in his/her daily life, often decides the course of health of that particular individual. Different factors like family income, education, lifestyle, surrounding environment, interpersonal relationships, and genetics, all have a significant effect on health. On the other hand, certain commonly deliberated factors like the availability and use of health care services, tend to produce less impact on an individual’s health (WHO, Health Impact Assessment (HIA) - The determinants of health, 2011). According to WHO the determinants of health comprise of “the social and economic environment; the physical environment; and the person’s individual characteristics and behaviours” (ibid). Thus, we find that often the ambience/surroundings in a person’s life determines this/her health, and some of these determinants are quite beyond the direct control of an individual. Besides the aforementioned factors, others factors also determine an individuals’ health and these are: People belonging to higher income groups and having a higher social status are generally seen to have better health, and the differences in health increase with an increasing gap between the rich and the poor (ibid). Here the problem turns out as what Tudor Hart once referred in his article as 'inverse care law'; where we find that individuals having the worst health, also tend to receive the minimum health services (Tudor, 1971, 405-412). Poor education is related to lack of self-confidence, greater stress and subsequently poor health (ibid). Clean air and water, safe homes and workplace environment, and good roads are important contributing factors towards good health. Strong interpersonal relationships with greater cultural and community bonds support good health (ibid). Genetics often plays a strong role in determining one’s health, as for example certain illnesses are transferred from the parents to their offspring. Besides this, lifestyle behaviour also affects one’s health, like sedentary lifestyle, drinking, or smoking, often produces negative impacts on one’s health. The availability and regular use of health services for treatment and prevention of diseases also indirectly affects health. Gender differences also affect health, as men and women tend to have varying illnesses at varying ages. Given below are the determinants of health within a community: Fig 1: The determinants of Health- G Dahlgren and M Whitehead Policies and Strategies to Promote Social Equity in Health (Institute of Futures Studies Stockholm 1991) (Source: Healthy together, Determinants of Health, 2005). Fig 2: The determinants of health factor in case of obesity and the relationship with mental illness. Here we find that all factors attributed by WHO as determinants of heath (fig 1) are also determine obesity factor in an individual, which in turn also cause mental health disorders in obese individuals (Source: NHS and National obesity observatory, 2011, 5). Impact of policies on public health and healthcare access, and the structure, organization and delivery of healthcare:  Public health is defined “The science and art of promoting and protecting health and wellbeing, preventing ill health and prolonging life through the organised efforts of society” (HM Government, 2011, 11). Within the arena of public health there are three main aspects, which include: the general improvement of public health like elevating lifestyles, alleviating health inequalities in terms of educational, social class, or gender differences, and other broader socio-economic and cultural determinants of health); health protection (which includes readiness for dealing with sudden appearances of epidemic/infectious diseases, natural hazards and other medical emergencies); and the accorded health services that encompasses efficiency of the services rendered, proper planning, and appropriate evaluation (ibid). Thus, to tackle obesity the UK government must focus on educating its citizens into leading a more quality life (like eating ‘healthy’ food and regular exercising, in order to lose weight and keep ‘fit’), while also making provisions for the psychological treatment of obese people, or counselling them in order to avoid the development of mental illnesses. Health policies are defined as "decisions, plans, and actions that are undertaken to achieve specific health care goals within a society"(WHO, Health policy, 2011). Here World Health Organization further explains that a well-planned and comprehensive health policy gives “a vision for the future; it outlines priorities and the expected roles of different groups; and it builds consensus and informs people” (ibid). Health policies are of different types and vary from ones that deal with personal health care, to ones related to public health policies, like anti-smoking promotion policy or vaccination policy. Health care policies also include monetary aspects (often removing a part of the financial load from citizens, with governmental subsidies in healthcare), the structure, organization, quality, delivery of healthcare, and healthcare equity (HM Government, 2011, 4). Besides the aforementioned ones, the UK government in their healthcare policies also aim to be more “responsive – owned by communities and shaped by their needs; resourced – with ring-fenced funding and incentives to improve; rigorous – professionally-led, focused on evidence, efficient and effective; and resilient – strengthening protection against current and future threats to health” (ibid, 6). While some countries do not have any specific health policies and leave it to the private sector to plan and work on medical researches in order to better the arena of healthcare; other countries have clear and comprehensive policies that ensure healthcare equity, funding of researches, and an adequate promotions and plans for the health workers to achieve the desired healthcare objectives. However, such extensive policies also require large-scale governmental funding, often leading to debates on public policies and their actual effects on the community health care, with critics claiming that the policies in actuality fail to remove the income, gender or social class disparities that still exist within healthcare (McClean, 2003). The role of nurses in the process of health promotion with individuals, families and populations and first contact care: Health promotion is defined in the Ottawa charter as follows: "not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being" Allowing for a favourable “political, economic, social, cultural, environmental, behavioural and biological” atmosphere that supports ‘good’ health" It "focuses on achieving equity in health" It "demands coordinated action by all concerned: by governments, by health and other social and economic sectors, by nongovernmental and voluntary organization, by local authorities, by industry and by the media" Health promotions "should be adapted to the local needs and possibilities of individual countries and regions to take into account differing social, cultural and economic systems" (WHO, The Ottawa charter for health promotion, 2011). Health promotions also include the enforcement of certain basic health strategies, which aim at alleviating the risk of spreading any infectious disease by containing the already infected, and educating others on how to avoid being infected (Merrill, 2010). The basic forms of health promotion takes place when the government designs a comprehensive and strategic public health policy that takes into account the determinants health (as outlined by WHO), like food, house, and job security at individual levels, and quality living and safe working conditions at an overall community level (Naidoo and Wills, 2009). While deciding on policies for obesity, the government must necessarily also focus on mental health promotions, as obesity and mental illness are very closely related (Barry & Jenkins, 2007; Cattan M & Tilford). Nurses are an integral part of any health promotion policies as they come in more frequent and direct contacts with the individual patient, patient’s families, and the overall community. They are able to closely monitor and note all individual patients and their families from a very close level, and with their role as ‘informer’ they are able to strategically connect this knowledge at a much wider community level and spread awareness in health promotions (fig 3). Besides working towards creating a general awareness while working on health promotions, nurses can also test the theories learnt into practice and gain first-hand experience, thus gaining further experience and competence. Given below is a pictorial representation of the role of a nurse within the framework of health work promotion (as designed by Dr. Stewart Piper): Fig 3: Health promotion framework showing the importance of a nurse within its domain (Source: Piper, The nurse practitioner as empowerment facilitator: Individual action perspective, 2009, 5). Conclusion Since it is the living and working conditions that form the most important factors in determining health of an individual, the government in its health policies must create strategies and promotions that aim at erasing the various health inequities that exist in the UK society. It must aim to educate and create a social awareness on various ways to tackle the problem of obesity, and avoiding means that help to develop the problem. Since nurses play the important role of an ‘informer’ who holds all relevant knowledge on patients, their families, and various medical ailments, it is necessary that they are made a part of the entire framework, so that can lend their expertise and knowledge, to achieve success in the health promotion package on obesity. References Blaxter, M., 2004. Health. Cambridge: Polity Press. Barry, M., & Jenkins, R., 2007. Implementing Mental Health Promotion. London: Churchill Livingstone.  Cattan, M., & Tilford, S., (eds), 2006. Mental health promotion – A lifespan approach. Maidenhead: Open University Press.  Department of Health, 2011. Obesity. Retrieved from, http://www.dh.gov.uk/en/Publichealth/Obesity/DH_078098 Ewles, L., 2005. Key topics in public health: Essential briefings on prevention and health promotion. London: Churchill Livingstone.  Grad, F., 2002. The Preamble of the Constitution of the World Health Organization. Bulletin of the World Health Organization 2002, 80 (12), 981-984. Healthy together, 2005. Determinants of Health. Administration of Occupational Health and Safety- Iceland. Retrieved from http://www.heilsuefling.is/heilsuefling/h2g/whp_in_general/determinants_of_health/ HM Government, 2011. Healthy Lives, Healthy People Our strategy for public health in England. Retrieved from, http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_127424.pdf   Linsley P., Kane, R., and Owen S., (eds), 2011. Nursing for Public Health – Promotion, principles and practice. Oxford: Oxford University Press.  McClean, 2003. “Globalisation and health.” In, Orme, J., et al (eds.) Public health for 21st Century – New perspectives on policy, participation and practice [2nd edn]. Maidenhead: Open University Press. Merrill, R., 2010. Introduction to Epidemiology (5th edn.). London: Jones & Bartlett.  Naidoo, J. & Wills, J., 2009. Foundations for Health Promotion (Public Health and Health Promotion) (3rd ed). Edinburgh : Bailliere Tindall. NHS and National obesity observatory, 2011. Obesity and mental health. Retrieved from,  http://www.noo.org.uk/gsf.php5?f=9777&fv=10266. Piper, S., 2009. The nurse practitioner as empowerment facilitator: Individual action perspective. Retrieved from, http://www.rcn.org.uk/__data/assets/pdf_file/0005/286880/Stewart_Piper.pdf. Tudor, H., 1971. The inverse care law. Lancet 1 (7696), 405-412. World Health Organisation, 2010. Mental health: strengthening our response. Retrieved from, http://www.who.int/mediacentre/factsheets/fs220/en/ WHO, 2011. Health Impact Assessment (HIA) - The determinants of health. Retrieved from http://www.who.int/hia/evidence/doh/en/ WHO, 2011. Health policy. Retrieved from, http://www.who.int/topics/health_policy/en/ WHO, 2011. The Ottawa charter for health promotion. 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