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According to Wanless (2004, p.27 [online]), the concept of public health involves the science and art of preventing disease, prolonging life, and promoting health through organized efforts and informed choices made by society, organizations, communities, and individuals. This definition highlights the focus of public health in reducing health inequalities by safeguarding the public from transmissible diseases, enhancing service provision, and advancing population health (Naidoo and Wills, 2005, p.8).
Health promotion is closely intertwined with public health as it aims to empower individuals to exert more control over decisions that impact their overall well-being.
Health is a challenging concept to define as it differs for each individual depending on their lifestyles.
In 1948, the World Health Organisation (WHO) established a widely accepted definition which states that health encompasses not only the absence of illness or weakness but also comprehensive well-being in terms of physical, mental, and social aspects. It highlights the importance of being physically fit and mentally stable. Nevertheless, due to individual variations, people may have diverse interpretations of health that can evolve over time.
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Health inequalities, also known as the 'health gap', refer to variations in health status among different socio-economic classes. Extensive research has confirmed a link between health and wealth, with individuals in higher socio-economic classes having better chances of avoiding illness and living longer compared to those in lower socio-economic classes (Marmot, 2010, p.16 [online]; Acheson, 1998 [online]).
As a result, mortality rates are higher for individuals in lower social classes compared to their counterparts in higher social classes.
Mortality rates are a significant measure for assessing health inequalities as they reflect the impact of social conditions. Despite overall improvements in life expectancy, there remains a disparity in life expectancy across various social classes (Marmot, 2010, p.45 [online]). Factors contributing to this discrepancy include inadequate diet, obesity, smoking habits, and increased drug and alcohol consumption (Marmot, 2010,p.37 [online]). Despite previous efforts to reduce these disparities,the health gap between society's wealthiest and poorest segments continues to widen (Triggle ,2010[online]).
The text emphasizes that healthcare access may vary (Acheson, 1998 [online]). However, various factors beyond the availability of healthcare can negatively impact an individual's health. These factors encompass gender, ethnic groups, religion, age, geographical location, residential deprivation, education, occupation, and economic conditions (Marmot, 2010,p.39 [online]). While each factor can independently affect health outcomes, individuals in lower socio-economic classes tend to face disadvantages related to most or all of these factors. Consequently, the combination of these factors can lead to a significantly higher health burden for people living in poverty (DoH, 2010,p.15).
Poverty encompasses a lack of income necessary for a basic standard of living, including both relative and absolute measures (Alcock, 2006, p.64). Relative poverty occurs when income falls below the country's average, resulting in limited access to necessary goods and services compared to society as a whole. On the other hand, absolute poverty refers to having an income below the minimum required for a decent life or survival, leading to only being able to afford basic levels of food, clothing, and shelter (Alcock, 2006,p.64). Insufficient finances hinder individuals and families from obtaining adequate housing,nutrition,clothing,and heating. Moreover,lack of transportation means that people living in poverty may struggle to reach specialized clinics or hospitals,resulting in reduced attendance at appointments and missed health screening opportunities (Kozier , 2008,p .133).
According to the World Health Organization (WHO, 2011 [online]), obesity is defined as having an excess of body fat. This problem is prevalent and complex in modern society, with implications both on a personal and economic level. In the United Kingdom, dealing with obesity, including prevention, management, and consequences like premature death and work absenteeism, costs up to £4.2 billion per year (DoH, 2010, p.20). As a result, public health has placed significant emphasis on combating obesity, particularly among children (DoH, 2008,p.27).
Children who are obese face various negative health effects in the short and long term. These include increased blood pressure and hyperlipidaemia (NOF, 2011 [online]). They also have a higher risk of developing diabetes, coronary heart disease, or metabolic syndrome at an early age (WHO, 2011 [online]), which can lead to a shorter life expectancy (DoH, 2008, p.2). Additionally, obese and overweight children are more vulnerable to poor psychosocial health such as emotional stress, stigmatization, discrimination, and prejudice (NOF, 2011 [online]). As a result, these factors increase the likelihood of children experiencing low self-esteem , depression , and eating disorders (BMA , 2005,p.8 [online]). Importantly , childhood obesity often persists into adulthood (Coleman ,2007,p.71), making it a significant concern.
The education model plays a crucial role in preventing obesity as it is more effective to prevent rather than treat the condition. This approach aims to provide individuals with essential information and knowledge about obesity, empowering them to make informed decisions about their lifestyles (Ewles and Simnett, 2003, p.44). School health education programs demonstrate this strategy by not only increasing children's awareness but also cultivating their skills for maintaining a healthy lifestyle (Ewles and Simnett, 2003, p.44).
Educational programs should prioritize the promotion of breastfeeding and delaying the introduction of solid foods to infants. Parents should also receive education on the range of available foods at home. Parental education should focus on enhancing a child's self-esteem and providing guidance on addressing psychological issues. Early childhood education should include information on healthy diets, workshops that may involve food tasting, and physical activity (NICE, 2006, p.75 [online]).
The rise in obesity rates and increased public awareness have driven the implementation of new public health initiatives. The white paper 'Healthy weight, healthy lives' and guidance from the National Institute for Clinical Excellence (NICE) have been instrumental in addressing obesity (DoH, 2008; NICE, 2006 [online]). Policies and strategies based on these recommendations have been introduced with a primary focus on preventing and managing obesity, as well as promoting healthy eating and physical activity (NICE, 2006 [online]). These strategies include school-based education programs, physical activity initiatives, and public health messages disseminated through various media channels such as television, radio, posters, and leaflets.
Local authorities have implemented local strategies to address obesity, such as Medal Motion in the northeast. This initiative encourages children to walk or bike to school and aims to prevent obesity (Local Motion, 2011 [online]). These local strategies have been developed in collaboration with government initiatives and are influenced by national policy, including healthy schools.
The aim of national interventions is to promote healthy eating habits and raise awareness about the importance of fruit and vegetables. The five a day scheme encourages individuals to incorporate more fruits and vegetables into their diets. The school fruit and vegetable scheme extends this initiative, specifically targeting children to educate them on the benefits of consuming these foods. Change4life is another nationwide effort that focuses on improving children's diets, increasing their physical activity levels, and enhancing their overall well-being.
Furthermore, the national child measurement programme involves regular weighing and measuring of four to five year olds and ten to eleven year olds by school nurses. This program helps monitor obesity prevalence and assesses the effectiveness of strategies for reducing it. Other nationwide initiatives include Sure Start, school sports programmes, simplified food package labelling, and regulations on advertising targeting children on television channels.
The World Health Organization (WHO) has initiated a significant consultation on diet-related diseases and emphasized their global strategy's focus on diet, physical activity, and health (WHO, 2004 [online]). This worldwide preventative approach involves decreasing children's energy intake and enhancing their consumption of nutritious foods, increasing physical activity, and reducing sedentary behavior like watching television (WHO, 2004 [online]). To oversee and assess their 'Global Strategy on Diet, Physical Activity, and Health,' the WHO devised a framework and implementation toolkit (WHO, 2008 [online]). Building upon this framework, the WHO urged governments to address children's food marketing practices and regulate marketing messages that promote unhealthy diets (WHO, 2007, p.9 [online]).
The recent white paper 'Healthy Lives, Healthy People' (DoH, 2010) provides guidelines for healthcare professionals to assist individuals in making their own decisions and choices about their health. Nurses can play a role in promoting health for individuals seeking help with obesity, while also advocating for healthy lifestyles and creating an environment that encourages children to make healthy choices. School nurses are well-positioned to identify overweight children and should regularly implement screening, parental support, and health promotion activities. It is important to offer support to children and families in managing weight sensibly by discussing small changes in family behaviors and making appropriate referrals for specialized investigation, psychological assistance, or specific dietitian advice (NICE, 2006, p.49 [online]).
The nurse must possess the necessary skills and knowledge on healthy eating to educate children and their families (NICE, 2006, p.44 & p.101 [online]). Additionally, resources like advice leaflets should be readily available to give to parents for communication and teaching purposes. Evidence suggests that problem-solving techniques can be successful when discussing obesity and food behaviors with children and families (Ewles, 2005, p.95). Nurses can use this information to identify when eating patterns become problematic and provide advice on how to manage difficult situations (NICE, 2006, p.148 [online]).
Access to healthcare can be impeded by various factors such as language, age, attitudes towards healthcare, disabled access, financial barriers, and geographical location (Kozier, 2008, p.133). Geographical obstacles may require patients to travel long distances for specific services or treatments, resulting in high travel expenses and limited transportation options. The provision of healthcare services also varies depending on the region, creating disparities in access known as the "postcode lottery," as exemplified by the case of the "Herceptin postcode lottery" (Kozier, 2008, p.133).
The cost of healthcare can significantly impact individuals as certain services, such as dental treatment and eye tests, are not provided for free. Additionally, prescription charges can create a barrier to receiving necessary medications if they are unaffordable. Consequently, untreated illnesses may arise. Moreover, limited income can hinder individuals from accessing the internet, thereby impeding their ability to use online services like 'Choose and Book' for appointment booking purposes. Other factors that can obstruct healthcare access include the expense of health insurance, lack of knowledge and awareness, and absence of a support network.
Health Inequalities and Poverty: A Public Health Perspective. (2019, Aug 19). Retrieved from https://studymoose.com/what-is-public-health-health-essay
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