Determinants of Public Health
Public health refers to the health problems where the determinants that evade, undercut and are oblivious to the territorial borders of the state. The challenges connected to public health are enormous due to the complex architecture of the global health. Economic, trade, environment, urbanisation influence the crucial public health related issues (Marmot and Bell 2012). Healthy lives are dependent upon a number of determinants such as the availability of the resources, the ageing rate, accessibility to proper health care services, social support, proper urbanisation, availability of opportunities (Barton and Grant 2013). The increasing health related costs and the degradation of the quality of life and the social values of the people has been a major concern in UK. Hence the government have take up certain policies to address the overall determinants of the public health. The climatic change due to global warming is also a major concern when it comes to public health. Hence, the government has also focussed on the strategies to cope up with the changing climate.
This report draws attention towards the broad range of social, environmental and individual factor that influences the health of the UK population. The report aims to focus on the governmental policies focusing on the wider determinants of health for improving the population health and the mitigating the health inequities. The report aims to discuss about the different determinants such as ageing population, high prevalence of the chronic conditions, using infrastructure and the declining social capital in UK. It also provides an account of the urban policy agenda for the development of healthy cities. The report finally draws the sustainable developmental strategy for the improvement in the health and the social care system of UK.
Public health can be considered as the science of improving the health status of the people and the communities. In overall public health is normally concerned with the protection of the health of the entire population. The population can be a small neighbourhood or a nation (Naylor et al. 2012).
The sustainability of the public health depends upon a number of determinants of health. Example of some of the determinants of health are availability of the resources for meeting the daily needs, admittance to economic and educational job opportunities, access to the health care services, proper housing facilities social safety and support, social norms and attitudes, disclosure to the social disorders, environment and culture.
Top Health Issues in UK population
Some of the top health issues that are prevalent with the UK population are obesity, risk of cardiovascular diseases, cancer, chronic conditions like diabetes. More than four million people in England are faced with long term physical and mental health conditions (Gov.uk, 2018). According to the reports Cardiovascular diseases are the largest cause of death in UK and the cost due to CVD may account to $ 19 billion in 2009. In Wales about 59 % of the adults are overweight and about 64% of the adults are obese in Scotland (Gov.uk, 2018). The prevalence of obesity has almost doubled between the year 1980 and 2008. In UK about 24 percent of the population is now obese. Childhood obesity is an important threat in the 21st century (Karnik and Kanekar 2012).
The amount of the diabetic people has increased from 1.4 to 2.9 million. Mental ill health and musculoskeletal health also contribute to the health issue of UK (Gov.uk, 2018). In UK the ageing population is gradually increasing with time. Over the next 50 years the population of the aged people will double (Gov.uk, 2018). Older age is related to poor health conditions, chronic diseases, falls and injuries, diabetes, obesity, cancer cardiovascular diseases. Due to this reason the health care cost in UK has also raised. It should be noted that age friendly local physical environment are necessary for a healthy ageing.
The effect of urbanisation on health can become double aged due to overcrowding, social deprivation, pollution, stress and crime. Urbanisation may also exacerbate the chance of hypertension, cardiovascular diseases, diabetes and asthma. Communicable diseases like diarrhoeal diseases and pneumonia have been the leading cause of the childhood death globally (Santamouris 2013). Epidemiological transition related to the development of the communicable disease to a non communicable disease. Integrated approach for the planning and health requires consideration of the other dimensions of sustainable development. Climate change can be the ultimate health threat that can affect the determinants of health. The global warming that has occurred since 1970 has caused over 14000 excess deaths per year up to 2004 (Bateman et al. 2013). Extreme high temperatures can contribute directly to mortalities due to cardiovascular and respiratory diseases. Rising temperature and differential rainfalls can impact the production of the staple foods (Wolch et al.2012).
Cities having low residential densities, low connectivity and low employment density is linked with less walking or cycling. Sprawl can lead to long commutes, lack of access to fresh foods increasing the frequency of chronic conditions like asthma, hypertension and diabetes (Allmendinger and Haughton, 2012). People residing in the sprawl areas are more likely to be obese, have low social capital, mental ill health and stress. A research in UK has found that as areas become less sprawling, the qualities of lives of the people improve having greater economic opportunity, less spending in housing and transportation (Allmendinger and Haughton, 2012).
Impact of Urbanization on Health
Social capitals are normally an economic idea that defines the connection between entities or individuals that can bring about economic values to people (Murzyn-Kupisz and Dzia?ek 2013). Social capital allows the citizens to solve the theories collectively. It is the social capital that actually greases the wheels that helps the community to move smoothly (Blokland 2016). The place where interactions with the fellow citizens can occur smoothly, the business and the transactions will naturally flourish. Furthermore the social capital can widen the awareness of people, to test the variety of their own views. Social capital can even serve as conduits for the movement of the helpful information that assists in achieving the goals (Blokland 2016). Community connectedness is extremely important in improving the quality of life of people. Level of trust between the people of Britain have fallen drastically and have stagnated over the last 60 years, which has got intense implications for the future success and the economic growth of the country (Uphoff et al. 2013). According to the World Values survey it has been found that only 30 % of the people believe that “most of the people can be trusted” and about 70 percent would say that “one needs to be careful”. The head of the Behavioural insights team have confessed that a greater attention is to be paid for rising the trust levels of the society as a vital part of the economic expansion.
According to the researches the reasons behind the declination of the social capital are the changes in the family structure, privatisation of the leisure time because of the onset of televisions, mobiles and other forms of entertainment (Uphoff et al. 2013). It has actually contributed to about 40 % decline in the in the involvement in groups and social capital building activities. The children and the grandchildren of the baby boomers or the ex-generations are less engaged in community life. Blokland (2016) had emphasized in the benefits associated with the social capital. Trust and rules of reciprocity within the family of a child, peer group, school, and the communities which are larger have far reaching effects on their opportunities, choices, and educational achievements as well as in their development of attitudes and behaviour (Murzyn-Kupisz and Dzia?ek 2013). UK is currently facing higher crime rates owing to the fact that they do not participate in community organisations or supervise the young generation. It has to be kept in mind that establishment of social capital and a trustworthy community can also bring about a change in the ill effects of socio-economic disadvantage.
Importance of Social Capital in Health
The key dimension of having a healthy city is the availability of the health care services. The health care provision has undergone significant changes in UK. The delivery of health care in UK is fragmented in to a combination of private, public and non profitable provisions, for example the fragmentation of the NHS services (Rydin et al. 2012). The national health system in UK is one of the largest healthcare systems in the world. NHS has its own structure and organisation that that makes strategies, policies. It covers everything including the antenatal screening, routine checkups, transplants, emergency treatments, palliative care and end of life care.
Public health England (PHE) is an autonomous governmental agency of the UK department of health having scientific and technical expertise in various sectors of the public health. Its main core function is to protect the public from infectious diseases and other health hazards. PHE had developed some global health strategies. It helps to reduce the health inequalities and improve the health and the well being of the UK population. PHE strive to provide sustainable health care services to public by tackling the obesity, smoking, reduction of harmful drinking and chronic diseases.
A health care system that is sustainable works within the social resources and the available environment protecting the health care of present and future generation (Wolch et al. 2014). A sustainable environment to for living is possible by reducing the environmental pollution such as reducing the carbon emission, neutralization of the wastes, making best use of the resources, creating resilience against a continuously changing climate (Wolch et al. 2014). A sustainable development strategy was established for the sake of public health, health and social care system 2014-2020 in January 2014. The strategy looked towards the sustainable development by reducing the amount of carbon emission, preserving the natural resources and preparing the community for the adverse weather events and promoting a healthy environment and lifestyle.
Health is a status of physical, mental and social wellbeing, which to some extent depends upon the environment in which one is living. There are certain aspects of health that influences urban planning (Levy 2016). The need of the urban planning and healthy cities emerged from the need to control disease, which included the initiatives such as garbage collection, sewerage, rodent control and mosquito abatement. It should be noted that Seasonal affective disorder (SAD) is one of the example of illness that is linked with the designs of the building (Kurlansik and Ibay 2013). Building designs that does not allow the entry of any daylight exacerbate the symptoms of this disease (Santamouris 2013). Urban planners had to be careful about the measures that that help to reduce the injuries and the fatalities due to accident (Barton & Grant 2013). Accident reducing policies such as traffic control planning, pavement standards, planning for a proper fire station paved the way for the modern urban planning (Levy 2016). The desire to create safe places has long been one of the agenda of the urban planners (Levy 2016). As crime increases and more the people fear of their safety, a challenge is imposed on the planners. One of the ways to reverse fear is to improve the urban design. In the United Kingdom the planning initiatives and designs are set forth by the local authorities, architectural liaison officers in order to create safe public space (Santamouris 2013).
Healthcare Provision in UK
Lack of adequate planning for the urbanization of the cities can form sprawling environments, limited access to useful services, poor transportation system and connectivity, poor housing structures and opportunities. Well planned cities expand the opportunities of economic growth (Rtpi.org.uk. 2018). Urban areas need extensive planning for reducing the threats to the healthy development. According to the World health organization (WHO), the determinants of a healthy urbanization includes stimulating job creation, lad use policy, settlement policies, community empowerment, better securities and reduction of the vulnerabilities (World Health Organization, Europe 2018). The WHO healthy cities initiative is a global initiative that tends to engage the local government in the development of health by a course of institutional change, political assurance, capacity building, innovative projects and partnership based planning. About 100 cities of Europe are the members of the WHO European healthy cities network and around 1400 hundred cities and towns across 30 national healthy cities are the members of this network (Rtpi.org.uk. 2018). The healthy cities movement provides a systematic and a comprehensive planning for health and emphasizes on the following:-
- The needs for addressing the vulnerable groups
- The needs for addressing the health disparity and urban poverty.
- Participatory governance
- The social, environmental and the economic health determinants.
The fair society , Healthy lives report (The marmot Review) 2010 has showed the presence of a social grade of health, which shows that those living in the deprived neighbourhood die earlier and deprived neighbourhood are again exposed to environmental factors that affects the health negatively (Marmot 2015). Transport patterns, housing quality, access to the green space, community participation and isolation are structured by the social inequality. These economic and the social inequalities highlight the health determinants. Furthermore there is a large disparity in the physical activity between the people which leads to the physically inactive neighbourhood (Marmot 2015). Neighbourhoods having low socio economic background have very few resources of physical activities compared to the ones belonging to high or medium socioeconomic background.
Health White Paper, Healthier Lives, Healthier People have proposed that arranging transport, environment and housing should be fully integrated for addressing the social determinants of health. In Scotland, Good Places, Better Health implementation plan have encouraged a rationale that is system based for action for reducing the health inequalities and associating with other governmental agencies related to this domain (Apps.who.int, 2018). The main proposal of this strategy is to involve the local communities at the heart of handling the public health complications. In this proposal charge has been given to the local government instead of the central government to fund and innovate their own ways to improve the public health care area (British Medical Association, 2013). The proposal also proposes the importance of the clinicians in improving the population health. The NHS commissioners the GP consortia should have the responsibility of the whole population in the area. The NHS would prepare a crucial role in the emergency preparedness, response and promotion of health and prevention of the avoidable illness (Apps.who.int, 2018).
The most important problem perceived was overcrowding and poor housing standards. Hence there was a need for a large scale of housing clearance program as well as redesigning of the older housing patterns. Therefore an urban program took its cue from the social pathology approach and provided additional resources for initiatives in education, health, housing and well fare is selected geographical areas (Marmot and Bell 2012). The significance of the urban policy was the remediation of the land and the property which would help in the re-establishing of the markets.
The impact of place on health and well being of a person is an important thread of both policy development and conceptualization. The environment has always been a social determinant of health (Gov.uk, 2018). Promoting good health is associated to the fundamental reassessment of the methods of spatial planning and physical development (Aldridge 2017). Urban planning of the towns and the cities has a profuse impact on the health of the population (Corburn 2005). The nature of the multiple effects of the human settlement on human health has been described in the settlement health maps (McCrone 2017). The urban planning initiative has been taken by WHO and the objective mainly included promotion of a healthy life style, facilitating the social cohesion, promotion of access to good quality of housing , access to the job opportunities, accessibility to good quality facilities, encouraging the local production of food and health food outlets, promotion of safety and security, promotion of equality in the development of the social capital, promotion of the conservation of the land and minerals, reducing the carbon emissions to threaten the stability of the climate (Gov.uk, 2018).
WHO has adopted thee distinct levels of urban planning. The first level is basic which involves the availability of shelters, access to potable water and food, pure and fresh air and effective sewage management. It should be noted that sprawling shanty towns have high chance of prevalence of the communicable diseases (Corburn 2005). The second level of planning moves beyond the environmental health and refers to those facets that affect the health and the well being of people such as parks for opportunity to do physical activities and enables contact with the nature, aesthetic delight and social cohesion. More space would encourage cycle networks reducing the car reliance and thus combat the green house emission (Tallon 2013).
In the third level the health is fully integrated in to the urban planning process for the health and the well being of the public. The third level collaborates with the other core themes of the sustainability of the environment, economic development and the social justice (Corburn 2005).
UK government is taking up different approaches for defining the social capital both within the government and academia of UK. Nationally the government is engaging with the young people to investigate about the capacity of the social capacity for addressing specific areas of the policy (Tallon 2013). In 2003 the government had announced the setting up of the Children and Families Directorate. The Directorate brings about several working areas such as the Children and the Young people’s unit (CYPU), whose aim is to research and evaluate the policies that are child centred and for the disadvantaged young population (McCrone 2017).
Conclusion
It can be said that Public health is dependent upon a large number of social determinants such as the socio-economic status, diseases, housing and the social capital. The population of UK is gradually ageing rapidly contributing to an overall poor health condition increasing the health care costs. The rate of chronic diseases like obesity, diabetes has also increased in UK. Furthermore the impact of urbanisation has also increased due to overcrowding, as overcrowding may increase the risk of communicable diseases. Climatic change that UK has been facing has been an ultimate health threat. Rising temperature due to global warming has brought about a differential rainfall affecting the production of crops. The report also focuses on the fact that the social capital in UK has been declining with the new generation, which is hampering the lifestyle, attitudes and the behaviours of the new generation.
In order to address these social determinants of heath government has take up several policies and procedures. The report had discussed about the distinct levels of urban planning taken by WHO, required to prevent overcrowding. ‘The Healthier lives and the healthier people’ have proposed the planning for transport and housing. Finally it can be said that the increase in the social awareness and social capital in the UK community can bring about sustainability in the environment, social and economic condition of the country.
References
Aldridge, M., 2017. The British New Towns: A programme without a policy. Routledge.
Allmendinger, P. and Haughton, G., 2012. Post?political spatial planning in England: a crisis of consensus?. Transactions of the Institute of British Geographers, 37(1), pp.89-103.
Apps.who.int. (2018). HEALTHY CITIES AND THE CITY PLANNING PROCESS. [online] Available at: https://apps.who.int/iris/bitstream/10665/108252/1/E67843.pdf [Accessed 6 Feb. 2018].
Barton, H. & Grant, M. J Urban Health (2013) 90(Suppl 1): 129. https://doi.org/10.1007/s11524-011-9649-3
Barton, H. and Grant, M., 2013. Urban planning for healthy cities. Journal of Urban Health, 90(1), pp.129-141.
Bateman, I.J., Harwood, A.R., Mace, G.M., Watson, R.T., Abson, D.J., Andrews, B., Binner, A., Crowe, A., Day, B.H., Dugdale, S. and Fezzi, C., 2013. Bringing ecosystem services into economic decision-making: land use in the United Kingdom. science, 341(6141), pp.45-50.
Blokland, T., 2016. Networked urbanism: social capital in the city. Routledge.
British Medical Association, 2013. Health and environmental impact assessment: an integrated approach. Routledge.
Corburn, J., 2005. Urban planning and health disparities: implications for research and practice. Planning Practice & Research, 20(2), pp.111-126.
Euro.who.int. (2018). Activities. [online] Available at: https://www.euro.who.int/en/health-topics/environment-and-health/urban-health/activities [Accessed 6 Feb. 2018].
Gov.uk. (2018). Global Health Strategy 2014 to 2019. [online] Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/354156/Global_Health_Strategy_final_version_for_publication_12_09_14.pdf [Accessed 6 Feb. 2018].
Hall, P. and Pfeiffer, U., 2013. Urban future 21: a global agenda for twenty-first century cities. Routledge.
Karnik, S. and Kanekar, A., 2012. Childhood obesity: a global public health crisis. International journal of preventive medicine, 3(1), p.1.
Kurlansik, S.L. and Ibay, A.D., 2013. Seasonal affective disorder.
Levy, J.M., 2016. Contemporary urban planning. Taylor & Francis.
Marmot, M. and Bell, R., 2012. Fair society, healthy lives. Public health, 126, pp.S4-S10.
Marmot, M., 2015. The health gap: the challenge of an unequal world. Bloomsbury Publishing.
McCrone, G., 2017. Regional policy in Britain. Routledge.
Murzyn-Kupisz, M. and Dzia?ek, J., 2013. Cultural heritage in building and enhancing social capital. Journal of Cultural Heritage Management and Sustainable Development, 3(1), pp.35-54.
Naylor, C., Parsonage, M., McDaid, D., Knapp, M., Fossey, M. and Galea, A., 2012. Long-term conditions and mental health: the cost of co-morbidities.
Rtpi.org.uk. (2018). [online] Available at: https://www.rtpi.org.uk/media/1119674/rtpi_promoting_healthy_cities.pdf [Accessed 6 Feb. 2018].
Rydin, Y., Bleahu, A., Davies, M., Dávila, J.D., Friel, S., De Grandis, G., Groce, N., Hallal, P.C., Hamilton, I., Howden-Chapman, P. and Lai, K.M., 2012. Shaping cities for health: complexity and the planning of urban environments in the 21st century. Lancet, 379(9831), p.2079.
Santamouris, M., 2013. Environmental design of urban buildings: an integrated approach. Routledge.
Tallon, A., 2013. Urban Regeneration in the UK. Routledge.
Uphoff, E.P., Pickett, K.E., Cabieses, B., Small, N. and Wright, J., 2013. A systematic review of the relationships between social capital and socioeconomic inequalities in health: a contribution to understanding the psychosocial pathway of health inequalities. International journal for equity in health, 12(1), p.54.
Wolch, J.R., Byrne, J. and Newell, J.P., 2014. Urban green space, public health, and environmental justice: The challenge of making cities ‘just green enough’. Landscape and Urban Planning, 125, pp.234-244.
Gov.uk. (2018). Public Health England – GOV.UK. [online] Available at: https://www.gov.uk/government/organisations/public-health-england [Accessed 6 Feb. 2018].
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