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Health promotion covers the process which makes people capable of increasing control over their health and improve it. Apart from focusing on individual behavior it reaches to a wide range of social as well as environmental interventions (Health promotion, 2015). This concept is developed upon social and cultural understanding of health and illness. Health promotion is important as it provides a practical approach to achieve greater equity in health. The present report is on health promotion in UK. It provides knowledge and understanding of issues and factors due to which some individuals are not able to access health support. In the report, theories of health behavior have been discussed. An attempt has been made to understand socio- economic influences on health. The report also analyses the factors that influence health promotion. Lastly, a health promotion campaign has been planned.
1.1 There are various effects of socio- economic influences on health in London borough. The various socio- economic factors are unemployment, lifestyle choices, discrimination, access to education, access to health care facilities (Lloyd-Jones and et.al., 2010). These influence health in London borough in various ways. Unemployment leads to reduced income in the family. It also makes the situations stressful for the family members and the person concerned. All these have negative influence on health. As people are not financially stable, they avoid spending money on availing health care services and save it for fulfilling their basic needs such as food and shelter. This hampers their health and care and treatment could not be obtained on time.
Lifestyle choices is another economic factor that influences health of people in London borough. Good choices made by people support their health while unhealthy choices make them prone to diseases. For example, sedentary lifestyle and consumption of fatty foods make people prone to heart diseases, diabetes, blood pressure (Bartholomew and et.al., 2011). In contrast to this, lifestyle choices including daily exercises, consumption of healthy diet, avoidance of smoking and alcohol will influence the health in a positive manner. Discrimination is a socio- economic factor which refers to unjust treatment of different categories of people on grounds of race, age, gender etc. This factor influences health in London borough. If people are discriminated on the basis of their religion, race, ethnicity, caste, creed, color etc., they are not given priority during provision of care and treatment. As a result of this, these people are deprived of health care facilities (Nutbeam, Harris and Wise, 2010). When treatment is not received on time, their health suffers and it is impacted in an adverse manner.
Another socio- economic factor is access to education. It can be analysed that education provides knowledge and information to a person and makes him capable of making better choices regarding his health. When people do not have access to education, they are not aware about the importance of health and factors affecting it. In this situation, they make make lifestyle choices or behave in a manner which harms their health (Richard, Gauvin and Raine, 2011). In contrast to this, when people in London borough have access to education, they are aware about the aspects which will promote their health. Hence, positive actions for promotion of health are taken by them. Also, access to education makes people knowledgeable about their rights to health care services (Weare and Nind, 2011). Therefore, they are able to stand against discrimination and obtain health care on time.
Access to health care facilities is also a socio- economic factor which impacts health of people in London borough. When people have access to health care, the are able to obtain advice as well as care and treatment at the required time. This brings improvement in their health thus impacting it in a positive manner (Korda and Itani, 2013). In contrast to this, when health care facilities are located in a remote area or have a complex process, local people are not able to obtain the required treatment on time. This makes their illness more complicated and impacts the health negatively.
1.2 Relevance of government sources in reporting on inequalities in health can be assessed. There are various government sources for reporting inequalities such as Black Report 1980, Acheson report 1998, Marmot Report 2010, NICE etc. (Thorogood and Coombes, 2010). Black report is a document which was published by the Department of Health and Social Security. This document is relevant in reporting non inequalities in health as it showed in detail the diseases that are unequally distributed among the population of Britain. The Report also provided information on the widening of these inequalities. Along with that, the Black Report also provided detailed information on social inequalities which influence health.
The Marmot Report was published in 2010. it proposed an evidence based strategy with the help of which social determinants of health that lead to inequalities. It can be assessed that Marmot Report 2010 is not much relevant for reporting on inequalities in health. However, it provides useful information on addressing inequalities in health. But, the report contains evidence that many people in England are not living as others who are best off in the society (Marmot Review report - 'Fair Society, Healthy Lives, 2010). But, specific information on health inequalities is not provided by it. Another government source is NICE. The National Institute for Health and Care Excellence (NICE) is an independent organization which provides evidence base health information. It assists the health care professionals in delivery of quality care (National Institute for Health and Care Excellence (NICE), 2015). It can be accessed that NICE is not a relevant government source for information on inequalities in health. Rather, it develops and provides guidance, standards and information on high quality health and social care.
1.3 In London Borough, there are various barriers for accessing health care. These include location, physical disability, employment, income, trust and belief, mental capacity, prejudice etc. Location acts as one of the biggest barrier in accessing health care. Some of the health care facilities may be located in remote areas. For reaching those areas, adequate travel and transport facilities may not b available to the people (Soler and et.al., 2010). As a result of this, they may face barrier in accessing health care. Income impacts access to health care services. If the income of a person is less, he may not be able to obtain health care service due to their high expenses incurred on care and treatment. Hence, it may act as a barrier. Trust and belief are two important aspects in health care. The service users need to have trust and belief in health care professionals and the treatment provided by them. If people lack trust on health care services and consider them as inefficient, they will not use the services (Neiger and et.al., 2012). Hence it may act as a barrier in accessing health care.
Mental capacity refers to the ability of a person to make his own decisions. It acts as a barrier in health care as an individual may take decisions for his health and do not obtain treatment from health care (Netto and et.al., 2010). In contrast to this, if a person lacks mental capacity, then he may not have the knowledge and understanding related to health care services. In such situation, the person lacking mental capacity will not use health care services. Hence, it acts as a barrier in access to health care. Prejudice is another issue that may restrain people from obtaining health care. Prejudgment or an opinion regarding health care service may be formed by the local people and they may decide not to obtain treatment.
2.1 Links between government strategies and models of health promotion can be analysed. There are various strategies of government which help in promoting health. These include Healthy Lives and Healthy People 2010, campaigns such as Smoking Health Harm Campaign, Choosing Health 2005, revised 2010, Change for Life etc. The various models of health promotion are Beattie's model (1991), Caplan and Holland’s Model (1990), Tones and Tilford’s Model (1994), Tannahill and Downie Model (1996) etc. (Valdez and et.al., 2010). Beattiee's Model helps in reflecting on social and political perspectives which lie beneath the health promotion approaches. It consists of four dimensions namely individual, authoritarian, collective focus of intervention and negotiated. In this regard, four types of activities are categorized by this model. They are personal counseling, health persuasion, legislative action and community development. It can be analysed that government strategies are linked to this model of health promotion as both aim to improve the health of individuals. The government strategies are formulated on the basis of the activities which are characterized in this model and they work to control smoking (Rosemarie and Zack, 2011).
Tones and Tilford’s Model (1994) states two sets of processes for health improvement, namely, development of health policy and health education. Both these states are aimed at empowering people to take control of their life (Chou and et.al., 2013). It can be analysed that government strategies are also aimed at empowering the people to take control of their health. These include anti smoking campaigns such as Smoking Health Harm Campaign etc. based on the Tones and Tilford’s Model (1994), these campaigns work to raise awareness about ill effects of smoking.
Caplan and Holland’s Model (1990) is concerned with unpicking the factors that determine health and ill health. Following this, the model provides suggestions regarding activities that can be used for addressing health issues. The model is presented in the form of two axes (Golden and Earp, 2012). One axis refers generation of knowledge in relation to health. The other refers to the ways in which society is constructed. This is linked to the government strategies as they also lead to generation of knowledge about health. Various legislations have been formulated by the government to controlling smoking. It is illegal to smoke in public places. Further, the government also imposes certain taxes on tobacco industries (Shahidi and Zhong, 2010). These raise the prices of cigarettes thus helping in controlling smoking behavior of people.
2.2 Professionals play a significant role in meeting government targets for health promotion. The professionals who are involved in health promotion are health advisers, dentists, health visitors, nutritionists, school nurses, midwives, dietitians, practice nurses, etc. As a smoking cessation officer in a G.P. Practice, the role of a professional would be integral role in reducing the number of patients who smoke (Haber, 2013). They plan to organize seminars in which the patients are informed about smoking and its ill effects. They also provide them information about the ways in which smoking damages body and its various organs. Following this, with the help of interactive sessions, smoking cessation officer initiates discussion among the patients. With these activities, awareness is created among the patients. Further, smoking cessation officer conducts long term follow ups in the G.P. Which involve 3 month and 12 month follow ups. This is accompanied by one – one sessions with the patients (Wong, Zimmerman and Parker, 2010).
The role of the officer consists of the aspects of service delivery and administration. Through this, smoking cessation officer increases the support resources wherever possible. Having trained into counseling skills, the officer works to solve smoking cessation issues by interacting effectively with the clients (Henke and et.al., 2011). Smoking cessation officer also gains information about the patient's degree of addiction and their readiness to cease smoking. Following this, they advise the smokers to quit this ill habit. They work with other health care professionals on a smoking cessation strategy and help in providing behavioral counseling and other therapies to the patients. Moreover, another important area where smoking cessation officer plays an important role is that he encourages the smokers who have relapsed to make efforts for quitting smoking.
2.3 Routines play an important role in promoting healthy living. Routines include personal hygiene, general hygiene, exercise, diet, relaxation etc. As per the case study, the patients in G.P. Practice smoke. Smoking would have exposed their body to a number of harms such as poor vision, suppressed appetite, anxiety and irritability, bronchitis, heart diseases, diabetes complications, risks of cancer etc. The routine of daily Exercise helps in keeping the body and mind healthy. At the G.P. This would promote healthy living by lowering the risk o type 2 diabetes and heart disease. This is because exercise would help in controlling weight. It also boosts up the high density lipoprotein which is considered to be good cholesterol (Exercise: 7 benefits of regular physical activity, 2015). Therefore, in this way the risk of heart disease is minimized. As the patients who smoking would be suffering from anxiety and stress, exercise would help in improving their mood and making them positive about life.
Diet is another routine which promotes healthy living. As provided in the case study, smoking would have exposed the patients to the risk of poor vision and suppressed appetite. A healthy diet would help in improving the appetite of the clients. This would also provide them with the required energy. Moreover, a health and balanced diet also plays a significant role in improving the visions of the patients. Further, the routine pf relaxation is equally important for the patients (Black and et.al., 2010). As the patients suffer from irritability and anxiety due to smoking, relaxation will help in soling this issue. It would lead to reduction of stress and will support the patients in their efforts to quit smoking. Lastly, the routine of personal and genera hygiene would also promote healthy living by preventing the patients from developing any infection or disease by protecting them from harmful pathogens.
3.1 Health beliefs are related to the theories of health behavior. Health beliefs are defined as personal convictions which influence health behaviors. The various theories of health behavior are Theory of Reasoned Action, Health action Model and Stages of Change Model. Theory of Reasoned Action is concerned with developing an understanding of the voluntary behavior of an individual (Heller and et.al., 2011). Therefore, it would define an individual's basic motivation to smoke. According to the theory the actual behavior is preceded by intention to perform a certain behavior. It can be assessed that health beliefs is related to it as behavioral intention to smoke will only come from a belief that smoking will give a certain positive outcome. With stronger intentions to smoke, a person would make increased efforts to indulge in smoking.
The Heath Action Model provides a comprehensive framework and incorporates major variables that influence health choices and actions. It comprises of two major sections. The first section is known as behavioral intention and contributes to the the intention of an individual to act. This comprises of three parts namely, cognitive, affective and normative. The second section includes all those factors which determine whether an intention will be translated into practice. Health beliefs are related to this mode in the following way (Leichter, 2014). The decision to smoke, which is taken by a person, is influenced by a peculiar cluster of beliefs, social pressures and motives. These create the state of readiness for undertaking the action of smoking. Stages of Change Model assess the readiness of an individual to at on a new healthier behavior. This also provides strategies and processes of change which guide an individual through the stages of change. The health beliefs of an individuals are related to the model as the person becomes ready to adopt a new healthier behavior and quit smoking only on the basis of his belief (Lloyd-Jones, D. M. and et.al., 2010). These beliefs pass the individual through the various stages and in this way, control on smoking can be brought about.
3.2 Potential conflicts with the local industry has various effects on health promotion. The local industries like tobacco industries work with the motive of obtaining profits and expanding their operations. These are involved in providing smoking options to the general public. Heath promotion which aims at stopping smoking seems to hinder the progress of these industries. This is because both have purposes which are contradictory to one another. As a result of this, there may be potential conflicts with the local tobacco industry (Richard, Gauvin and Raine, 2011). This would impact health promotion. Health promotion would encourage people to stop smoking thus leading to loss to the industry. In response to this, the industry may undertake promotional campaigns to attract the people to by their products. They would also lower their prices so as to retain their existing customers and gain new customers. The effect of this would be that the pace of health promotion would be hindered as the people would be influenced by then efforts made by tobacco industry (Weare and Nind, 2011). Some of the smokers who are in the middle of a smoking cessation program would quit the program. Thus, the efforts made in the direction of controlling smoking behavior may fail. Also, it would become very difficult to bring behavior change in the smokers and initiate the smoking cessation program again.
However, there can be certain positive effects also. Conflicts with the local tobacco industry may also lead to the development of stricter policies, norms and regulations regarding smoking. Therefore, the tobacco industry may find it difficult to operate under the new norms and policies (Korda and Itani, 2013). This would strengthen health promotion and it would be easy to bring behavior change in the people. Smoking cessation programs can also be implemented without any interference from the local tobacco industry.
3.3 It is important to provide relevant health related information to the public. This is because it helps in reducing sickness and dependency thereby increasing personal responsibility. When people have information pertaining to their health, there are less chances of getting sick. Also, they become self dependent and consider health as their personal responsibility rather than that of the government (Soler and et.al., 2010). Further, provision of relevant health related information also assists in removing health inequalities. This is because with the information, people would be encouraged to seek care and treatment and remain healthy. Control of communicable diseases is another reason due to which it is important to provide health information to the public. With it, the people become aware the communicable diseases in the locality. Further, they also gain knowledge about the concepts such as infection and cross contamination. All these will help in controlling communicable diseases (Netto and et.al., 2010).
From the essay it can be concluded that health promotion is concerned with individual as well as community health aspects. Socio- economic factors such as lifestyle choices, unemployment, income, access to health care etc. influence health of people in London borough. Location, mental capacity, trust and beliefs, prejudice etc. act as barriers to accessing health care. Government strategies are linked to the models of health promotion. Routines such as personal hygiene, exercise, healthy diet, relaxation etc. play an important role in promoting healthy living. Health beliefs are associated with theories of heath behavior. Provision of health related information to the public is important because it helps in reducing sickness, controlling communicable diseases, removing health inequalities etc.
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