Public Health in Nursing Practice - Essay Example

Introduction Public characteristics or demographics refer to the characteristics which a certain part or subgroup share as a population. These characteristics include “population size, growth, density, distribution, and vitals statistics” (MacPherso, 2006, p. 25) which furthermore identify the behavior and status of the population such as in the occurrence of a disease, spending, or the use of the public services or even how they take part in substance abuse. Public health, a sector of healthcare which is aimed at providing health services in the community setting, uses these demographics to determine the public health condition and its needs. By collecting reliable data, appropriate sectors of the community will be able to create or improve policies or manipulate other factors in response to threats to the health of the total population. Due to the apparent impact of the demographic trends, this paper will try to analyze the current trends of drug abuse in the United Kingdom and its effects to public health and social policies. To better recognize the relationship of the trend of drug abuse among citizens of UK to its public health, it is deemed important to first define the meaning of public health and recognize its history, the principles that surround it, and its nursing perspective; it is as well necessary to identify the epidemiology of drug abuse in the nation. The related national and international policies and the role of public health in combating its effects will also be discussed. Public Health in Focus Healthcare is not only directed in providing treatment or care to those apparent medical need and are in the clinical setting. Just as according to the World Health Organization (WHO), the leading organization in managing the provision of health services to populations all over the world, health is “state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity” (WHO, n.d.). Hence, it is imperative that healthcare providers also devote on providing healthcare services even outside the clinical setting by not only treating existing diseases but also promoting well-being, preventing disease, and restoring health. Public Health Defined. Although the definition is almost the same worldwide, this paper will take the definition of public health used by the practitioners in the UK. According to Acheson (1988), public health is “the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society” (as cited in Hunter, Marks, & Smith, 2010, p. 19). On the other hand, Wanless (2004) pointed in a government-commissioned review that Acheson’s definition of “the organized efforts of society” lacks some appropriateness and opted to extend it into “...through the organized efforts and informed choices of society, organizations, public and private, communities and individuals” (as cited in Hunter, Marks, & Smith, 2010, p. 19). With this meaning, most, if not all, aspects and sectors of the total population, including the different agencies and subgroups, are also held responsible in playing their own roles in maintaining public health. History of Public Health in the UK. The British authorities had recognized the benefits of maintaining public health only in the nineteenth century. As stated in “History: 19th-century” (n.d.), the United Kingdom in the 19th century was characterized by “overcrowding, poor housing, bad water and disease.” After recognizing the debilitating effect of the existing condition, Sir Edwin Chadwick proposed that the only way to reverse Britain’s poverty was to prevent the spread of diseases and promote health; and with the help of some prominent personalities like Florence Nightingale who stated that environmental manipulation will lead to promotion of health condition among others, and some government measures and legislation, public health was gradually improved (“History: 19th-century,” n.d.). By the 20th century, the public health sector benefited from a series of key improvements. The establishment of the Ministry of Health, the creation of the Welfare State, and the foundation of National Health Service in the first half of the century; and the enactment of several laws showed that authorities have recognized the importance to care for its citizenry which led to the “greater focus than ever before on the health of the nation” (“History: 20th-century,” n.d.). Despite these changes, however, events from the second half of the said century until the present still show existing deficiencies in part of the government with its public measures as well as the public itself. Inequalities in health are still present; and cost and efforts needed to carry out certain health objectives are vehemently escalating. Principles of Public Health. The practice of public health is, as stated in the definition, focused in preventing life, prolonging life and promoting health. To be able to do so, public-health-involved authorities should perform the public health activities such as (1) surveillance and monitoring of the population’s health status; (2) prevention and control of epidemics; (3) environmental and occupational protection; food, water, and workplace safety practices; (4) assurance of quality and accessibility of services; (5) disaster preparation and response; (6) public health research to develop innovative solutions; (7) community mobilization and development; and (8) public health policy development (Porche, 2004, p. 5). Figure 1 in Appendix A shows the main determinants of health. Essentially, they dictate the formulation and implementation of public health policies as they provide link to the true situation of the public. Drug Abuse in United Kingdom: An Alarming Trend There are several characteristics of the population of the United Kingdom that can draw attention as they pose threat to the public health. Among these is the increasing concern that the population’s abusive patterns with regard to drug abuse is drawing. In a report of the UK Drug Policy Commission (UKDPC), the people of UK were identified to be the highest consumer of prohibited drugs in all Europe. This has also resulted to the increase of drug-related deaths which pushed it to the second spot among the European countries with high drug-related deaths statistics as well. Such deaths have been identified to be due to “poisoning, drug abuse, or drug dependence” (as cited in Steele, 2007). Despite this, British behaviors toward drug use made the professionals declare that “drugs have become an increasingly common feature in British life” (as cited in Steele, 2007). Blood-borne infections like HIV and hepatitis C have also become common among intravenous drug users who share needles during drug use; such an alarming shift in addition to the persistence of drug-related crimes in the nation. Despite the government efforts to increase social awareness and amplify justice system policies to counter the negative effects of illegal drug use to health and public safety, the abusive trends toward drug use have led to crime costs reaching to £13 billion a year and damages to health of those who continue with it in both England and Wales only (as cited in Steele, 2007). In another related article, Wormack and Fleming (2007) reported that 128, 000 secondary pupils, who are aged between 11 and 15 years from varied regions in UK, have “tried class A drugs.” This class of drugs include ecstacy, lysergic acid diethylamide or commonly known as LSD, heroin, cocaine or crack, magic mushrooms, and amphetamines. The National Centre for Social Research (NCSR) and the National Foundation for Educational Research (NFER) (2010) recently published a survey about the substance abuse patterns of the young people of England in the years 2006 to 2008. Although “the prevalence of drug use has declined since 2001,” it is still upsetting to know that 15 of every 100 young people in England who only belong to the 11 to 25 year age group are into the use of drugs mentioned earlier (NCSR & NFER, 2010, p. 4). As projected in Figure 2 found in Appendix A, the youngest age group of 16-24 also shows the highest consumption rate of Class A drugs from the year 1996 to 2004 in the UK. The answer to what causes this trend is still unclear. However, some experts blame it on the British culture for having a “binge mentality when it comes to recreational drugs” (“Gauging the UK’s,” 2005). Prominent people like Mike Linnell, Director of Communication of the Manchester-based drugs agency called Lifeline, and Petra Maxwell, member of the DrugScope -- a drug information organization, both agreed to the “cultural” claim (“Gauging the UK’s,” 2005). Implications of Drug Abuse to Individual and Public Health In addition to the dangers it poses to public safety, the increase in drug abuse cases in the United Kingdom have also resulted to the increase in health threat to the individual drug users and the public as they are part of the bigger community. Drug addiction does not only lead to increase in crime rate due to the users’ impaired social behaviors, effects also come in an array of physical, emotional and mental health problems such as paranoia, damage to nose and lungs, heart problems, depression, mental upsets, seizures, strokes, and damage to blood, bone marrow and other vital body organs among others (“Drug Abuse,” 2010, p. 330). Aside from the debilitating consequences of some of these illnesses to the functional ability of a person throughout his or her life, drug use can also cost them their lives. In fact, yearly record of drug-related casualties are said to reach more or less 2000 deaths as reported by the National Health Service. In addition, nine of every ten and six of every 100 people affected by hepatitis C and HIV respectively were found to have contracted these condition through intravenous drug use as shown in the records of the Department of Health (“Drug Misuse,” 2009). The use of these illicit drugs is indeed a public health concern for causing a great health inequality. This is specifically evidenced in the recently-published study sponsored by the University of Hertfordshire which concluded that the fatality rates among the young drug users is alarmingly increasing despite their excellent health status (“Fatality Rates,” 2010). The growing number of users in the 11-15-year-old age group is also another threat the UK public health authorities must deal with. Due to these events, the Government, along with the private and even with some international organizations, has created several programs and policies to counter this public health problem. Initiatives versus Drug Abuse and Its Effects to Public Health As it conveys negative effects to public health, the Government has initiated several policies and measures to reduce the harm of drug use through the initiatives of the Department of Health which is also in line with the existing international programs initiated by the World Health Organization among others. The local and national initiatives founded by the UK Government include providing financial programs to support awareness campaigns and treatment services through rehabilitation and residential detox centers provided by FRANK and National Treatment Agency along with their local agency counterparts respectively; creating anti-drug policies such as the Drug Strategy; providing suitable guidelines and even initiating information centers using websites for public access (“Drug Misuse,” n.d.). Budget for drug treatment directed to several agencies, both in local and national levels, has reached more than half a billion pounds in the year 2008 to 2009. Although measures are still on-going, substantial data show that this project has lead to the catering of the treatment needs of much greater number of drug-using populations (“Drug Treatment Funding,” 2008). FRANK, one of the government-initiated drug abuse or misuse campaigns, was made to accommodate the demands of information-seeking public. The site provides details about “the risks and dangers of drugs and their use” as well as to where or whom to go to for help and advice. According to a survey, awareness related to the negative effects of drug use among young people has increased since the campaign started (“Drug Misuse Campaigns,” 2008). With the help of this campaign, many inquiries have also been responded to. This initiative is expected to positively influence the behavior of the population from choosing not to use illicit drugs for recreational purposes. The Drug Strategy, on the other hand, is one of the government’s campaigns against illicit drug consumption which is arranged into a ten-year schedule (2008-2018). According to the Department of Health, it is aimed at interfering with the supply and thus controlling the use of the illegal drugs. With the different agencies including the Home Office, the Department of Children, Schools and Families, and the Department of Health, working hand in hand and through proper management, monitoring and evaluation, the program is expected to protect families and strengthen communities (“Drug Strategy: UK Government,” n.d.). Table 1 in Appendix B shows the four strands of work of the Drug Strategy. A number of international organizations, especially the World Health Organization and the United Nations through the United Nations Office on Drugs and Crime (UNODC), have also initiated a joint program in the fight against drug abuse and its negative health and social effects called UNODC-WHO Joint Programme on Drug Dependence Treatment and Care ("UNODC-WHO Programme," n.d.). The general objectives of the said program are contained in Table 2 in Appendix B. This program create linkages even with the local and municipal level in the effort of “improving coverage and quality treatment and care services for drug use disorders in low- and middle-income countries ("UNODC-WHO Programme," n.d.). Conclusion Drug abuse and dependence is indeed a public health concern that does not only affect the United Kingdom but the rest of the world as well. As a result, local, national and even international programs to respond to its negative threats are needed. The demographic trends and the behavior of the British people towards the use of recreational drugs which is identified to be “cultural” in origin is indeed alarming since it has been related to many severe health conditions and even risks to security that puts the health of the community as a whole in jeopardy. Although improvement is now apparent, the Government, health organizations and other related agencies must not only make policies to fight drug abuse as public a concern but also continue to monitor and evaluate these policies for the purpose of public health maintenance and improvement through the use of indicators such as demographic trends. .     References Class A use in the past year, by age group. (n.d.). BBC News. Retrieved from http://news.bbc.co.uk/2/shared/spl/hi/pop_ups/05/uk_drug_trends/html/3.stm Drug abuse. (2010). In Encyclopedia of Health (4th Ed.). Tarrytown, NY: Marshall Cavendish. Drug misuse. (2009, January 6). Retrieved from http://www.nhs.uk/conditions/Drug- misuse/Pages/Introduction.aspx?url=Pages/What-is-it.aspx Drug misuse campaigns. (2008, September 15). Retrieved from http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publichealth/Healt himprovement/Drugmisuse/DH_085889 Drug strategy: UK government. (n.d.). Retrieved from http://webarchive.nationalarchives.gov.uk/20100419081707/http://drugs.homeoffi ce.gov.uk/drug-strategy/uk-government/?view=Standard Drug strategy. (n.d.). Retrieved from http://webarchive.nationalarchives.gov.uk/20100419081707/http://drugs.homeoffi ce.gov.uk/drug-strategy/ Drug treatment funding. (2008, July 11). Retrieved from http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Publichealth/Healt himprovement/Drugmisuse/DH_085890 Fatality rates among young drug users a cause for concern. (2010, February 1). Science Daily. Retrieved from http://www.sciencedaily.com/releases/2010/01/100129092633.htm Gauging the UK’s drug use. (2005, October 7). BBC News. Retrieved from http://news.bbc.co.uk/2/hi/uk_news/4229470.stm History: 19th-century public health. (n.d.). BBC Bitesize. Retrieved from http://www.bbc.co.uk/schools/gcsebitesize/history/shp/modern/indrevpublichealth rev1.shtml History: 20th-century public health. (n.d.). BBC Bitesize. Retrieved from http://www.bbc.co.uk/schools/gcsebitesize/history/shp/modern/twentiethcenturyp ublichealthrev1.shtml Hunter, D. J., Marks, L., & Smith, K. E. (2010). The public health system in England.Bristol, UK: The Policy Press.  National Centre for Social Research (NCSR) & National Foundation for Educational Research (NFER). (2010). Smoking, drinking and drug use among young people in England: findings by region, 2006 to 2008. Retrieved from http://www.ic.nhs.uk/webfiles/publications/Health%20and%20Lifestyles/sdd0608r egion/SDD_Regional_Findings_v2.pdf MacPherso, G. (2006). Migration, medicine and health: principles and practice. Hamilton, Ontario: BC Decker Inc. Porche, D. J. (2004). Public & community health nursing practice: a population-based approach. Thousand Oaks, CA: Sage Publications.Steele, J. (2007, April 19). Steele, J. (2007, April 19). Britain has worst drug addiction rate in Europe. Retrieved from http://www.telegraph.co.uk/news/uknews/1549028/Britain-has-worst-drug-addiction-rate-in-Europe.html UNODC-WHO joint programme on drug dependence treatment and care. (n.d.). Retrieved from http://www.unodc.org/docs/treatment/09- 82847_Ebook_ENGLISH.pdf World Health Organization (WHO). (n.d.). Reproductive health. Retrieved from http://www.who.int/topics/reproductive_health/en/ Wormack, S., & Fleming, N. (2007, March 30). 128, 000 pupils have tried class A drugs. Telegraph. Retrieved from http://www.telegraph.co.uk/news/uknews/1547068/128000-pupils-have-tried- class-A-drugs.html Appendix A Figure 1. Class A use, by age group; England and Wales only (British Crime Survey 2003/04, as cited in BBC News, n.d.). Figure 2. The main determinants of health (as cited in Hunter, Marks, & Smith, 2010, p. 26). Appendix B Table 1. The Four Strands of Work of the Drug Strategy 2008-2018 Protecting communities through tackling drug supply, drug-related crime and anti-social behavior Preventing harm to children, young people and families affected by drug misuse Delivering new approaches to drug treatment and social reintegration Public information campaigns, communications and community engagement Table 1. The Four Strands of Work of the Drug Strategy 2008-2018 ("Drug Strategy," n.d.). Table 2. UNODC-WHO Joint Programme on Drug Dependence treatment and care: The Objectives The promotion and support worldwide (with a particular focus on low- and middle-income countries) of evidence-based policies, strategies and interventions that are based on a public health and human rights approach, in order to reduce drug use and the health and social burden it causes. The widespread recognition of drug dependence as a preventable and treatable multifactorial health disorder, and recognition of the social advantages of investing in treatment, such as lowering health-related costs, improving security and contributing to social cohesion and development. Drug dependence treatment should become a part of the mainstream health care and social welfare system, without discrimination with respect to other chronic general and mental health disorders. Nothing less than what is provided for other diseases. The investment in comprehensive and result-oriented programmes for drug dependence treatment care, particularly community-based interventions, including the skill set of their human resources. Table 2. Objectives of the UNODC-WHO Programme on Drug Dependence Treatment and Care ("UNODC-WHO Programme," n.d.) Read More