Introduction
In this assignment, I am going to explain the different social determinants of health and how they impact population health, explain the importance of public policies, identify sources of public health knowledge, and talk about social circumstances, health, and individual capacity for self-determination. Public health programs are extremely significant to us, these programs promote and protect the health of everyone. Public health programs are remarkable to families as their general point is to improve public health. The most prevalent and momentous public health programs in the United Kingdom include vaccinations, free school meals, and screening programs such as mammography, and cervical screening. Many public policies such as speed restrictions, drunk driving, wearing masks, and no smoking at work are all in place to help with public health and work alongside public health programs.
Public policy; smoking ban
There are many social determinants of health. These are non-medical factors that influence health (Who. int, 2021). Additionally, the term public policy refers to a set of movements the government takes to report matters within society (Ebscohost.com, pg. 1, 2021). All public policies are created to protect the health and well-being of all individuals in society. An example of this is the smoking ban in workplaces where smoking is not allowed in any enclosed workplace, public building, or on public transport in the UK. This public policy impacts health by improving in overall lung function for individuals who used to work in smoke-filled environments. Researchers have suggested that there was an associated reduction in attendance in the emergency room related to breathing problems, asthma, and heart-related problems since the smoking ban was put in place (Myers, 2011). It is very important that people in the healthcare profession promote the benefits of the smoking ban and educate the population on chronic illnesses related to smoking, this is because 'If you're working in health improvement or healthcare public health, you may be more involved in the longer-term work of interpreting data on heart disease or lung cancer' therefore they will have more knowledge on the subject to educate (Public health knowledge and intelligence professional, 2015). According to the WHO 'More than 170 countries in the world have initiated tobacco control policies and regulations' (Nilan et al. 2017; WHO 2017). It is evident that this public policy takes the pressure off many public services and programs, for example, Asthma UK is a free program developed by asthma clinicians and health psychology experts to help asthma patients (Asthma UK, 2021), however, due to the smoking ban having such a positive impact on asthma this public health program will not be under as much pressure. However on the other hand, we are not fully protected in some social circumstances as people are still allowed to smoke outdoors in public, also how do we protect individuals with no capacity, for example, children cannot stop parents who smoke inside the house when the child is present, 'second-hand smoke increases the risk of infections of the respiratory system, middle ear disease, asthma, breathing-related symptoms and declines in lung function among children' (Tobacco-Free Life, 2016). Nonetheless, further countries need to take crucial steps to decrease tobacco use and save the lives of the billion people who would otherwise die from tobacco-related diseases around the world during this century. Although in the UK most social determinants of health are protected by this public policy, living, and working conditions are not protected from smoking in every country around the world 'twenty-three states, Guam, Northern Mariana Islands, and Palau do not yet have comprehensive smoke free indoor air laws covering all bars, restaurants, and worksites' (Anon, 2021).
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Public policy; free school meals
Another public policy I would like to discuss is free school meals. Free school meals are a public policy that impacts health by protecting children in poverty from starving. Examples of how this is done include the government paying for the meals of children in school if their home income is low, '17.3% of pupils are known to be eligible for free school meals' (Service.gov.uk, 2019). Several schools offer free school meals (FSM) to students at state-maintained colleges if the child is understood to be from a financially deprived background. According to Gorard, 2012, 'there were 624,247 KS4 pupils in England in 2007. Of these 84.3% were not eligible for FSM, 12.4% were eligible and 3.3% were still recorded with no FSM data' (Gorard, 2012). It is essential that schools provide free school meals for those who are in need, to meet the school food standards agency (Department for Education, 2020). However, I am going to discuss how the covid 19 pandemic impacted this public policy. During the pandemic schools had to shut therefore children were missing out on their free school meals, a lot of families were struggling, and a lot of children were starving. It is unfair that different social determinants of health have such a massive impact on children when they are unable to change their social circumstances and living conditions due to their age. It is important that our public figures show the importance of free school meals. Marcus Rashford said: 'This is not politics, this is humanity' (Proquest.com, 2020). 'Marcus Rashford is an ambassador for fare share and has donated 20 million pounds to food, poverty, and community charities to help people fighting with hunger' (FareShare, 2021).
Vaccines
Another public health program is vaccinations. Vaccinations not only protect your child from deadly diseases, such as polio, tetanus, and diphtheria, but they also keep other children safe by eliminating or greatly decreasing dangerous diseases that used to spread from child to child (Stanfordchildrens.org, 2019), This does not only protect the public, but it also takes the pressure off health services as there will be fewer sick people. On-time vaccination throughout childhood is essential because it helps 'provide immunity before children are exposed to potentially life-threatening diseases', (Centers for disease control and Prevention, 2019) so why should some children miss out on this opportunity because of their parents? A lot of parents have reservations about letting their children get the vaccines they are being offered, therefore it is very important that the principal sources of public health knowledge such as doctors and nurses, promote how important it is for everyone to get vaccinated, 'If you're working within health protection you may be involved in work on infectious diseases requiring a rapid response for example, providing information to inform the advice given to the public about pandemic flu or norovirus' (Public health knowledge and intelligence professional, 2015). Some diseases that once injured or killed thousands of children have been eliminated completely and others are close to extinction, primarily due to safe and effective vaccines. According to the CDC parents can protect their children younger than 2 years of age from 14 potentially severe illnesses by getting them vaccinated (The Childhood vaccine-preventable diseases, and vaccine safety: Immunization Schedule, n.d.) Vaccine hesitancy is one of the top 10 biggest threats to global health (WHO, 2019). Vaccine hesitancy is where people with access to vaccines delay or refuse vaccination. Studies show that 'In 2012, there was a large outbreak of measles, initially concentrated in the Liverpool area, which subsequently spread to surrounding communities in the Northwest of England. Most cases occurred in older unvaccinated children, or infants too young for vaccination' (Proquest.com, 2017). People who are born and live in more deprived areas have health inequalities and have a lower life expectancy and a lot of this is due to not having vaccinations that are offered to people in non-deprived areas. According to Dahlgren and Whitehead (1991) 'The broad social and economic circumstances that together determine the quality of the health of the population are known as the 'social determinants of health' (Public Health England, 2017). Although the government must spend money on vaccinations every year this is a lot more cost-effective than people not getting vaccinated and the NHS being overwhelmed with people suffering from these preventable diseases. There is an increasing need now for all nurses to become agents of public health and promote health as part of their clinical practice (While 2014).
Government funding
Furthermore, a lot of public health programs would not be able to function if we did not have the government to provide us with the funds. However, it is very important that the public health programs that are available to us are promoted and advertised so that people are aware of them. This can be done through nurses and doctors or even television advertisements. Health experts from the Nuffield Trust, Health Foundation, and King's Fund say tight spending in recent years and increasing demand for services have been 'taking a mounting toll on patient care'. They add that there is 'growing evidence that access to some treatments is being rationed and that quality of care in some services is being diluted' (Full Fact, 2019). 'Public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole' (The Royal College of Nursing, 2020). On the other hand, in 2014, the commonwealth fund declared that in correlation with the medical services frameworks of 10 different nations, the NHS was the best. For example, according to the NHS funding 'in 201819 prices, health expenditure in England increased from £30.2 billion in 197980 to £130.3 billion in 201819'. Although the government and health services provide us with public health programs to help the health of the population, some diseases are obtained from genetic reasons and cannot be prevented.
However, not all public health programs are supported by the government. According to the King's Fund, Jo's Cervical Cancer Trust is the only UK charity that supports people afflicted by cervical cancer and anomalies, and it focuses its efforts on raising awareness and recognition of the condition, as well as ways to avoid it (The King's Fund, 2015). There is now a vaccine to help protect women from cervical cancer (The man who saved a million lives, pg.25) This vaccine is called the HPV vaccine, and up until 2018 this vaccine was only offered to females 'In July 2018, it was announced that the HPV vaccine would be extended to boys aged 12 to 13 years in England (NHS Choices, 2021). Jo's cervical cancer trust states that their Public Health Engagement Coordinators work to increase screening coverage by educating and collaborating with healthcare providers, as well as hiring neighborhood volunteers coverage through preparation and collaboration with healthcare practitioners, recruitment of community volunteers, and close engagement with community organizations. Cervical cancer is entirely preventable, with cervical tests preventing 75 percent of cases. However, what good is cervical screening programs if not every woman avail of them? Some women feel embarrassed to attend these appointments, therefore it is extremely important for not only healthcare professionals to promote the importance but public influencers too. Rebecca Vardy is one of the many women who has been promoting cervical screening in the hope that others will follow in their example, she posted a picture on social media to her 110k followers of her attending her appointment talking about the benefits it will bring (Cervical Screening, 2019). Every year in the United Kingdom, an unprecedented 5,000 lives are saved because of the nationwide cervical screening program saves an estimated 5,000 lives in the UK per year, but participation is declining (Jo's Cervical Cancer Trust, 2021). In women aged 35-64 years, regular screening is associated with a 95% reduction in cervical cancer (Landy et al., 2016). On the other hand, there is controversy about whether younger females should be offered cervical screening as the programs are only offered to women aged 25, although 'In the UK, per 100,000 women about 4 people are diagnosed with cervical cancer under the age of 25' (ClaireCohen, 2014).
Conclusion
Overall public health programs are to help the population in as many ways as possible. Public health professionals try to help the public by educating people on things such as vaccinations. Many people hear false information about vaccinations, for example, many parents think that vaccines can cause autism therefore they do not get their children vaccinated for the many diseases that they could get throughout their childhood. However public health professionals make sure to educate as many people as they can by explaining that studies have shown that there is no link between receiving vaccines and developing Autism. It is evident that we need government funding to avail public health programs for everyone, and without this funding, there would be a lot more people with serious diseases. Furthermore, during my research, I became more aware of how important public policies like free school meals are. Free school meals save so many families in poverty in England and without this public policy, there would be so many children who would starve. There is a public health program out there for nearly everything and we as individuals and as a society benefit from them.
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