Discussing Important Issues around the Health and Well Being of Burnley - Case Study Example

Introduction This case study aims at discussing important issues around the health and well being of Burnley, Lancashire UK. The paper focuses on Coronary Heart Disease as a main health issue affecting adults within the community and that has been a major cause of death. The case study assesses the prevalence and incidence of coronary heart disease as a health issue in Burnley. It looks at the various factors that influence this prevalence and incidence. Identified factors include; socio-economic factors, environmental factors, health and social services, lifestyles, population, political factors among others. Information given is further supported using demographic and epidemiological statistics. The case study also reviews on the different strategies that have been put in place to promote health as well as health education in the selected community and highlights on the possible strategies that need to be put in place to improve or change the current situation. The construction of the case study has been effectively been done using supporting literature and evidence. Discussion A community is defined as a group or collection of people that live together and that share common beliefs, practices, values and resources. Community members are said to be tied together by the common resources that they share. Health and Wellbeing at Burnley Burney, being the selected community for this case study, is located in the Eastern part of Lancashire and covers about 111km2.The community has a total population of close to 85, 600 people. The region’s racial composition includes 7.16 percent non whites (South Asians) and 91.77 percent whites. The south Asians are mainly from Pakistan. The community is that of economic and social deprivation. It obtains significant amounts of European regeneration and national government funds. The health of Burnley’s residents is said to be worse than that of the average England putting into consideration the number of people in hospitals due to alcohol related illnesses and those dying from smoking. The number of adults that are physically active as well as that of those who are obese is however the same as that of England. Inequality is an attribute in Burnley with men living in areas that are least deprived living more than eleven years longer than those in the areas that are most deprived. This duration differs in women with close to seven years (Health Profile, 2010). Coronary Heart Disease as a Major Health Issue within the Adult Community The level of health deprivation in Burnley has been found to be extremely high especially in terms of coronary heart disease and mortality rates. According to findings in the Burnley Health profile from the Association of Public Health Authorities, the region’s health profile is far much worse as compared to that of England with the main issues being high mortality rates as a result of strokes and heart diseases, smoking and mental illnesses. The main health concerns in Burnley as well as in the whole of Lancashire and the entire country as well include circulatory diseases (stroke and CHD), liver and lung diseases (Health Profile, 2010). The incidence and prevalence such long term diseases; circulatory diseases, like coronary heart diseases, and cancer in Burnley has been found to be very high with the life expectancy being lower as compared to the national- average. Life style has been indicated as being one of the major contributors of the high incidence and prevalence of the diseases (Rosamond et al., 1998). Many of these problems are associated with lifestyle. Obtaining knowledge related to the prevalence and incidence of the various health related behaviors allows for discussions on the possible issues of health in Lancashire, Burnley to be held. Reducing the number of smokers in the community is for example one way through which diseases whose occurrence is highly related to smoking, like in the case of coronary heart diseases, are reduced (Fraker et al., 2007). The reduction in the rate of smoking is however met with significant increases in the consumption of alcohol; low physical activity level and poor feeding habits which are in turn leading to an increase in obesity rates as well as of heart diseases. Such behaviors, considering the expanding adult population is likely to result into poor status of health in future (Gaziano et al., 2005) Though the mortality rates from the various diseases has been found to decrease over the previous years, both locally and nationally, as a result of interventions from different organizations related to health, a wide gap exists between the national picture and the sub region with death rates higher than the expected within Lancashire. Though the rates of prevalence and incidence of the mentioned long term diseases has reduced nationally, the rates remain high in Burnley and Lancashire as a whole (Health Profile, 2010). Risk Factors Related To Coronary Heart Disease in Burnley There are various factors which contribute to coronary heart disease, these include alcohol, high blood pressure, smoking of cigarettes, age, raised blood cholesterol, diet, sex, weight, heredity, lack of exercise, birth control pill, other diseases, psychological and personality factors, socio-economic factors (Libby et al., 2007) .Raised blood cholesterol, high blood pressure and cigarette smoking have been well-known to have a greater impact in bringing about coronary heart disease. Risk factors such as poor diets, lack of physical activity, obesity and smoking are more common among people of lower socio-economic status (Levy & Thom, 1998). Poor nutrition, exposure to smoke from tobacco as well as high levels of stress places young children within the low social economic communities at a higher risk of getting CHD. Findings obtained indicate that individuals from low social economic levels, especially men, take longer to identify CHD symptoms and are not aware of the need to change their lifestyles or obtain effective rehabilitation to control, prevent or treat the disease (Morrow & Gersh, 2007). Cigarette smoking has the highest risk involved in causing coronary heart disease. A person who smokes is more likely to suffer from a heart attack than a non smoker. The smoker is two or three times more likely to coronary heart disease. People who smoke pipe or cigar have an elevated risk of getting coronary heart disease hence death occurrence but the risk involved is not as high as for cigarette smokers (Thorax, 1998). Passive or non smokers have a risk of heart attack but this is because of the exposure of those who smokes cigarette. Smoking tends to heave blood cholesterol levels. Cigarette smokers also have amplified fibrinogen levels and platelet counts, which make the blood to become stickier. In conclusion cigarette smokers have twice chance of getting a heart disease than a non-smoker (Fox, 2004). Statistics indicate that close to 30 percent of Burnley residents smoke as compared to about 24 percent residents of the North West. 185 people in this community die from smoking and smoking related diseases every year (Health Profile, 2010). Alcohol is an added issue that leads to coronary heart disease. Too much intake of alcohol raises blood pressure and finally leads to heart failure. It increases the risk of abnormal heart beat and sudden death caused by bloated heart and irregular heart beat (Department of Health, 2004). Individuals from a higher socio-economic status are less likely to drink uncontrollably than individuals from a lower socio-economic status. People of lower socioeconomic status indicate that alcohol gave them self-confidence, relieves tediousness, and forgot their struggle and a more possibility to relax them. The high rates of alcohol intake in Burnley are best brought out by the increased number of deaths resulting from alcohol related illnesses. The region has been ranked as that which consumes extremely high levels of alcohol and as having the highest alcohol related death rates within the country (Department of Health 2005). Lack of exercises causes heart attacks because of poor blood circulation and inactivity of the body (Mosca et al., 2007). Low physical activity especially among older people has been indicated as being a major cause of coronary heart disease and related deaths in Burnley. Almost 32% of women in Burnley and 46% of the men have been found to have excessive weight while 17% of men and 21% of women are obese. In Burnley there is an increased rate of sensitization on community members about the importance of physical activities and sports to reduce the rate of coronary heart disease. Such sensitizations is done by organizations such as the Sport and Physical Activity Alliance (SPAA) that is committed to empowering the people of Burnley to engage in physical activities and sports to curb the problem of cardiovascular diseases (Health Profile, 2010). There are several units in Burnley that are providing help to people who are willing to be educated on the maintenance of good health and to partake substantial activities to ensure that they keep fit. The Healthy Communities Unit of Pendle Leisure Trust is one such unit that is working for the benefit of the community and with an aim of reducing heart related issues. Statistics show that the number of Burnley individuals attending exercise lessons in 2006/7 were 6339 while the individuals attending the fitness classes were 2330 in total. Chai Centre is another unit working towards promoting health and fitness classes in Burnley with their main focus being on women with poor financial backgrounds and who are being empowered in Burnley to take up healthier lifestyle and lead to fitness. These women are offered free services to allow them lead a healthy life and become fit and free from coronary heart diseases. Lack of exercise and physical activity has been found to be a major cause of increased body weight among individuals which may in turn result into coronary heart diseases. There is a high chance of developing heart attack among obese and over weight individuals (Awtry & Loscalzo, 2004). People who are flabby are directly linked with raised blood pressure and sensitive blood cholesterol which are in cooperation significant risk factors for coronary heart disease. High blood pressure increases the heart workload causing weakening overtime enlarges, thickening of the heart and becomes stiffer (Morrow & Gersh, 2007). When heart blood pressure occurs and combines with obesity, smoking and diabetes the risk of heart attack and failure increases. It is important that people become aware on how, and be able to regulate on the quantity and type of fat taken in to reduce the consequence of too much magnitude of fat in the body that causes heart disease (Williams et al., 1998). The committee on the medical aspect of food and nutrition policy (COMA) in Burnley suggests a reduction of fat intake, salt reduction intake and increased in vegetable, fruit, bread. Diabetes badly increases the risk of mounting cardiovascular diseases. There is a larger risk involved when the blood level is not well constrained. It has been found that persons with diabetes like two-thirds die of blood vessel disease (Department of Health, 2004). Stress is another causal of coronary heart disease. Stress causes other deviant behaviors like smoking, overeating and alcohol taking which are factors that contribute to heart diseases (Kannel et al., 1998). Being a community whose socio economic status of individuals is low and with the high smoking and alcohol drinking rates, Burnley records is likely to record high levels of stress and frustrations among the residents. Strategies, Policies and Recommendations Identifying the risk factors and contributors of the rise in Coronary heart Diseases has been one and is one effective way through which effective strategies have been and can be, put in place to help in reducing the incidence and prevalence of the disease. One effective strategy entails improving treatment for the disease (Boon et al., 2006). This as an already implemented strategy has reduced mortality rates in East Lancashire by 42 percent between the years 1981-2000.the North West Strategic Health Authority (SHA) has shown support to the delivery plan aimed at reducing cardio vascular related deaths and preventing patients at risk from developing cardiovascular diseases (Unal et al., 2003). Reduction of alcohol intake could be of help to individuals who over drink. Research suggests that alcohol protects one against getting coronary heart disease. Though alcohol is said to be important for ones health, it is important for individuals to limit their intake level to 1-2 drinks per day (Tunstall-Pedoe,et al., 2000). Large amounts of alcohol causes blood pressure, heart beat disorder, and damages ones heart muscle. Smoking is another factor that contributes to coronary heart diseases hence individuals should stop smoking to curb the numerous diseases caused by smoking (Thomas et al., 1999). The Burnley, Pendle and Rossendale is one organization playing a great role in reducing alcohol intake in Burnley. The organization offers free services to individuals above 18 years living in Burnley, Rossendale and Pendle and who have problems with alcohol consumption or who are aware of people who do. Other organization working towards the eradication of alcoholism and smoking in the community include Burnley Community Alcohol Service, Multi-Agency Alcohol Support Team and NHS East Lancashire Stop Smoking Centre. Educating community members on the importance and ways of maintaining good health through proper nutritional and feeding habits as well as through physical exercise is an important way of reducing mortality from coronary heart diseases (Department of Health, 2002). Eating balanced meals that have low fat and cholesterol and including a fruit and vegetables should be encouraged. People should eat food high in fiber, low in fat and exercise regularly. A care health provider should be consulted in case one wants to start a weight loss program (Capewell, 2004). Physical exercise is considered to be of great advantage to people. People should get regular exercises every time and then. It is recommended that at least 30 minutes of exercises daily should be well designed by a normal person while at least 60-90 minutes on daily basis for an obese person (Department of Health, 2004). Physical exercise aid in lowering blood pressure, increase the level of healthy cholesterol and control ones weight. Examples of the exercises could include swimming, aerobics, walking among others. It is always advisable that before beginning a physical exercise the person should consult a health care provider (Becker et al., 2008). The empowering women projects (Building Bridge in Burnley) and Chai Center have come up with activities for women who are financially poor, who can`t afford services like going to the gym and partaking developmental courses. The women have been encouraged to take up developmental courses that will educate them to live healthy and exercise regularly to make their body fit. Other projects within Burnley have also been funded by the Community for Health with their objectives consisting of raising awareness and educating community members through national campaigns on important health issues such as high blood pressure, diabetes, coronary heart disease among others. The campaign are effectively being conducted to ensure that community members adopt a healthy lifestyle through which they will keep free from these and other related diseases. Through active participation where all community members are encouraged to take active roles in the campaigns, the various projects are highly successful as more and more community members depict a positive response towards the various recommendations given. References Awtry, H. & Loscalzo, J. (2004). "Coronary Heart Disease". Cecil Essentials of Medicine . Philadelphia, PA: Saunders. Becker, R. et al. (2008) The primary and secondary prevention of coronary artery disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, Chest 133(6 Suppl):776S-814S. Boon, A., Colledge,R. , Walke, R. & Hunter, A. (2006) Davidson's Principles & Practice of Medicine, 20th Edition. Churchill Livingstone Capewell, S., (2004) CHD event of Challenge-intervention to Maximize Life Expectancy. Department of Health (2002) Tackling Health Inequalities: Summary of the 2002 Cross Cutting Review. London: DOH Department of Health (2004). Choosing health: making healthy choices easier. London: The Stationery Office. Department of Health (2004). Delivering Choosing Health: Making Healthier Choices Easier. London: Department of Health. Department of Health (2005) National Standards, Local Action: Health and Social Care Standards and Planning Framework 2005/6- 2007-8. London: The Stationery Office. Department of Health. (2004) Prevention and reduction of alcohol intake. Alcohol needs assessment research project. Director of Public Health (2007) Annual Report. Retrieved 07June, 2011 Fox, C. (2004) Heart Disease and South Asians: Delivery the National Service Framework for Coronary Heart Disease. London: British Heart Foundation & NHS. Fraker, T. et al. (2007) “Guidelines for the management of patients with chronic stable angina.” Circulation, 4: 116(23):2762-72. Gaziano, J, Manson, J. & Ridker, M. (2005) Primary and secondary prevention of coronary heart disease. London: Saunders Publishing. Health Profile (2010). Retrievd 23 May, 2011 http://www.apho.org.uk/resource/view.aspx?RID=91977 Kannel, B., Wilson W., D’Agostino B. et al. (1998) “Sudden coronary death in women.” Am Heart J., 136: 205–212. Levy, R. & Thom, J. (1998) “Death rates from coronary disease: progress and a puzzling paradox.” N Engl J Med, 339: 915–917 Libby, P., Bonow, R., Mann, L. & Zipes, D. (2007) Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed.London: Saunders. Morrow, D. & Gersh, B. (2007) Chronic coronary artery disease. 8th ed. Philadelphia: Saunders Elsevier. Mosca, L., Banka, L., Benjamin, J., et al. (2007) “Evidence-based guidelines for cardiovascular disease prevention in women.” Circulation, 115(11):1481-501. Myerburg, J., Kessler, M., Castellanos, A. (1993) “Sudden cardiac death: epidemiology, transient risk, and intervention assessment.” Ann Intern Med, 119: 1187–1197. Rosamond, D., Chambless , E., Folsom, R., et al. (1998) “Trends in the incidence of myocardial infarction and in mortality due to coronary heart disease, 1987 to 1994. “ N Engl J Med, 339: 861–867. Thomas, C., Knapman, A., Krikler , M.& Davies, J. (1999). "Community study of the causes of "natural" sudden death". BMJ 297 (6661): 1453–6 Thorax (1998) Recommendation for smoking cessation interventions. Thorax, 53 (Suppl. 5), 1- 19. Tunstall-Pedoe, H., Vanuzzo, D., Hobbs, M., et al. (2000) “Estimation of contribution of changes in coronary care to improving survival, event rates, and coronary heart disease mortality across the WHO MONICA Project populations.” Lancet, 355: 688–700. Unal, B., Critchley, J. & Capewell, S. (2003) Explaining the Decline in Coronary Heart Disease Mortality in England and Wales Between 1981 and 2000. England: Department of Public Health. Williams, J., Restieaux, J. & Low,J. (1998). "Myocardial infarction in young people with normal coronary arteries". Heart 79 (2): 191–4. Appendix Comparison of CHD related deaths between East Lancashire and England and Wales among adults below 75 years: 1993 to 2005. Source: Public Health Annual Report for 2007 Read More