Health, Effects and Interventions
Word count or equivalent:
2000 words (plus reference list – Harvard style referencing)
Assessment criteria:
The summative assessment is assessed using a marking rubric that includes how well each of the four learning outcomes have been demonstrated in the essay. ITuses a six-point qualitative scale that goes from very level of achievement to limited
or no demonstration of the learning outcome. The marking rubric also assesses the structure of the essay and quality of writing i.e. grammar and spelling. This rubric will help students to understand what aspects of writing their essay they have done well on and which they need to improve for future modules.
Marking scheme:
The standard achieved is very good and the work provides clear evidence that the knowledge, understanding and skills are at a level appropriate to the level of study.
There is evidence showing that all the learning outcomes appropriate to that level are achieved with many at a very good standard.
This module is designed to help you develop your knowledge and understanding of the environmental and social factors that influence health and wellbeing. These factors are often referred to in the public health literature (books and journal articles) as the determinants of health.
The biological, environmental and social determinants of health include what kind of home you live in, what kind of neighbourhood, the access you have to greenspace, to doctors and other health and social care professionals as well as the quality of the air, water and soil. Having a good quality job, having a home that is dry, spacious and warm as well as having easy access to good quality food and feeling safe walking to school, to work and to the shops all can have a big impact on your health and wellbeing, the health and wellbeing of your family and friends, and of the wider community and society that you live in.
Understand the factors underlying the influences on health status as well as other social determinants of health.
2. Be able to describe health inequities in the context of imbalances related to determinants of health.
3. Understand the concept of lifestyle in terms of its focus on individual behaviours, the limiting effects of structural factors, and in particular structural inequalities.
This module provides one core foundation for you becoming a future public health professional. Key elements of the module include:Have an understanding of the various levels at which determinants of health operate at individual, household, community, national, international levels and also gain insight into the structural factors underlying the impact of health policies and programmes
• Define and describe the range of determinants of health and how they influence health and well-being.
• Be able to develop logic diagrams (causal pathway diagrams) to visualise how determinants influence individual or community health and wellbeing.
• Understand the concept of lifestyle – diet, exercises, sleep, smoking, drinking, sexual health (as one key social determinants of health) – and how lifestyle related determinants of health influences individual and community health.
• Understand the concept of environment – air, water and soil quality, noises, Determinants of Health and Illness – August 2016 Page 9 of 42 housing, transport, greenspace and neighbourhood – and how environmental determinants of health influences individual and community health.
• Understand the concept of social – access to goods and services, gender, ethnicity, culture, power, social class, and social roles – and how social determinants of health influences individual and community health.
• Define and understand health inequalities and health equity, their link to environmental and social factors and the broad strategies that have been developed to tackle them.
• Understand that some determinants of health are modifiable, or more modifiable, than others (environmental and social factors are more modifiable and biological factors are non- or less modifiable).
Health, Effects and Interventions
Introduction
The Essaybegins with the definitions of health, determinant of health and aspect of health; it thenfocuses on explaining the determinants of health in three areas, its impact on individuals and communities. Elaborating on how the factors affect health and also relevant interventions.This is achieved by looking at the determinants of health from the social and economic factors (Education), Life style factors (Alcohol) andenvironmental factors (Housing).
“Determinants of health are factors that have an effect on individuals’ health in addition with environmental and social economic factors.
“The specific features and pathways by which societal conditions affect health are termed the social determinants. The social determinants of health refer to factors determined by social policies which affect health, e.g. working conditions, housing, and the physical environment” (Naidoo, Wills,2016,pg22).
Health is being of sound mind, physically and mentally stable and not just the absence of ill health or disease.
In health determinants there are factors which determine an individual’s vulnerability to disease. These could be through Lifestyle, environment factors and health behaviours which may all contribute to disease.
Naidoo and Wills (2016) say health has two common meanings in everyday use, one negative and one positive.
The negative definition is the absence of disease or illness. This is the meaning of health within the Western scientific medical model.
The positive definition of health is a state of well- being, interpreted by the World Health Organization in its constitution as a state of complete physical, mental and social wellbeing,not merely the absence of disease or infirmity.
The aspects of health could be defined as being the overall wellbeing of an individualin all arears of their lives. This includes the emotional, intellectual, social, physical and spiritual aspect.
Social and Economic:
This model addresses the multicultural concept of health which views health as influenced by economic, social political psychological biological, cultural and environmental factors.
“A model of health based on social sciences which explains variations in health in relation to socio economic factors”.(J. Naidoo, J. Wills, 2016, pg.325)
The model looks at health inequalities in various areas and the way in which an individual’s social condition and beliefs can affect their health. This could be through education/ uneducated, employment/unemployment, poor dieting, poverty,housing, religious beliefs, ethnicity, pollutionor merely living an unhealthy / active lifestyle.
Education: The process of learning or gaining general knowledge or skills, developing of ones reasoning and judgement.
“Education is a very general term used to refer in very different ways to the experience and/or results of learning undertaken primarily in institutional setting such as schools and colleges. The very breadth of this term often conceals a number of important distinctions of meaning that are important for a consideration of the health impacts of education…
distinction between education as a context and education as a process because the two elements of education have different types of implication for health. Some of the benefits and/or risks of education for health result from the membership or participation in a learning institution, others from the explicit experience of the process of learning…
(Fienstein, et al. 2006, p. 189)
The aspectof education ispersonal growth, knowledge in making healthier choices, self-esteem, better paid jobs, higher income, and improving social status. Improving ones knowledge/ understanding, develop life skills which assist in living a healthier lifestyle.
Inspires an individual physically, mentally, emotionally, medically, socially, and vocational potential of which he/ she is able to function independently. It enables an individual to increase control over their health and environment. This could be seen as an important factor that can serve an individual in many areas.
According to Higgins et al. (2008) Gaining information, knowledge, skills and experience can lead to: Improved employment prospects and better career opportunities, less unemployment, higher incomes, higher quality work and working conditions.Improve socialisation, social cooperation and participation in local communities and the wider society e.g. voluntary community activities, political engagement, less likely to engage in criminal and anti-social activity.Personal psychological growth and development, enhance psychological resilience and coping with difficult life events e.g. loss of job, bereavement.Greater likelihood of developing knowledge, attitude and behaviour conducive to good health.
The effect of Education on an individual may include having a choice, chance of employment, gaining experience and skills, good income, security, Confidence , motivated , healthy lifestyle, awareness, better health, communication, prevention, focus, may live longer.
Without Education the individual may face a higher level of Unemployment, lower paid jobs, lack of security, unawareness, limited income, low self-esteem, poor environment, decision making and poverty.
“Less education is linked to deaths at an earlier age. Life expectancy difference of many years depending on the country e.g. 5 year plus in the UK
Less is linked to poorer general health and physical functioning e.g. increased risk of some cancers, cardiovascular disease.
Higher education is linked with increased engagement with healthy lifestyles – more physical activity, less alcohol drinking and smoking.
Level of parental education influences child and family health behaviours.
However, Health scares e.g. Measles, Mumps Rubella vaccine (MMR), educated women less likely to get their children immunised because of what turned out to be incorrect/wrong claims that the immunisation could lead to autism.
Also some groups with high education can drink and smoke more in certain context e.g. young single men and women at university.” (Higgins, et al.2008)
Intervention:
To combat lack of education may include having rules in the society such as free education from Primary school age up to college years, making it compulsory for all children to be education. Introducing government programmes providing substantial education and life skills aiming to develop self-esteem, social and communication skills for adults. Working with individuals to identify realistic goals to empower them to take health related decisions by developing health literacy and self-efficacy.
Devising health educational activities and overcoming language barriers by providing evening classes for non-English speaker.
Environmental-Housing
This determinant may be beyond the individuals control and can have a positive or negative effect on health and wellbeing. “Living in a cold, damp and dirty environment can contribute to illness, infections and stress. And poor quality housing is usually within a deprived neighbourhood.
“The issues of housing stock, dampness, inadequate heating and energy efficiency are recognized as key determinants of health” (Parliamentary office of science and Tecnology2011).
“Healthy housing” covers the provision of functional and adequate physical, social and mental conditions for health, safety, hygiene, comfort and privacy. A healthy home therefore is not a specially designed house but a residential setting for a household that includes all standards and “best practice” knowledge of dwelling construction and immediate environment design.”(WHO, 2004).
Characteristics of poor housing include cold, damp & mould, falls, sound insulation, carbon monoxide, noise, air pollution, waste management, indoor air quality, water quality, smell, nuisance, inadequate lighting, domestic hygiene, facilities, greenspace, safety &security, crowd and space.
Furthermore to the characteristics are the effects of poor quality housing which consist of mental health, respiratory and cardiovascular conditions, infections, depression, allergies, anxiety, hazards and deaths.
According to Naidoo and Wills (2016) cold and damp housing has been shown to contribute to illness. Children living in damp housing are likely to have higher rates of respiratory illness, symptoms of infection and stress…..Psychological and practical difficulties accompany living in a high-rise flats and isolated housing estates, which may adversely affect the health of women at home and older people.
Inequalities: This is the changes between people due to geographical, social and other factors. Some of these factors are that of very low or no income which in turn affects thehousing conditions they find themselves in which then affects their health and wellbeing.
“Avoidable and unfair differences in health status between groups of people who share the same socio-economic status or gender”(Naidoo,Wills,2016, pg.322).
Interventions:
Addressing each individual /family needs and with early interventions this can helpchange a person’s lifestyle and improve their wellbeing. By also creating policies that may help tackle inequalities in housing and reduce health inequalities, particularly in disadvantagedcommunities and isolated estates. Providing greenspace, a high standard of social housing in this communities andimplementing housing standards and invest in building more high standard and affordable homes, tackling homelessness.
“Natural environments such as neighbourhood parks, trees, gentle slopes, and water features have been considered promising determinants of both quality of life and community sustainability. Many scholars found that natural environments in neighbourhoods improve physical activity levels; emotional, mental, and physical health; and social interactions among neighbours—factors which, apart from improving residents’ quality of life, are considered supportive of community sustainability. For this reason, access to different kinds of natural amenities (e.g., parks, trees, water) are often mentioned as sustainability indicators for community development in its environmental, economical, and social aspects” (Kim and Woo,2015).
Lifestyle-Alcohol
Thisfactor has a great impact on health no matter your age, gender or race. Alcohol drinking can affect your body, lifestyle and metal health. Individuals are advised to drink no more than 14 units per week as this may help keep the side effects of alcohol low. Alcohol in large quantity (binge drinking) has a damaging effect to an individual.
“Alcohol is a prominent commodity in the UK marketplace. It is widely used in numerous social situations. For many, alcohol is associated with positive aspects of life; however there are currently over 10 million people drinking at levels which increase their risk of health harm. Among those aged 15 to 49 in England, alcohol is now the leading risk factor for ill-health, early mortality and disability and the fifth leading risk factor for ill health across all age groups” (Public health England 2016)
Individuals drink for various reasons, such as curiosity, by copying, for the effect, to relieve stress, culture, to get the experience, self-exploration, anxiety and depression.
Short-term side effects are induced anxiety, sleep, diarrhoea, weight gain, stress, blackouts, vomiting, drowsiness, and alcohol poisoning and stomach problems.
But there are long-term side effects such as Brain damage, dementia, cancer, heart disease, liver disease, mental health problems, blood pressure, stroke, ulcers and osteoporosis (thinning of the bone).
As stated by Taylor (2012) Alcohol consumption can be strongly influenced by social and cultural factors, such as the behaviour of family and peers and social income (social and community factors).
Intervention on Alcohol/binge drinking may improve by starting an earlier intervention and treatment on the individual, putting firm policies on bars, clubs and licenced shops.
Educating the individual, friends, and families and supplying them with information.
Also educating teenagers and young adults and restricting alcohol advertisements.
Encouraging and motivating the individual to make changes, eat healthily and exercise regularly to improve their lifestyle.
References
Fienstein, L., Sabates, R., Anderson, T. M., Sorhaindo, A. and Hammond, C. (2006) What are the effects of education on health’, in Desjardins, R. and Schuller, T. (2006) Measuring the effects of education on health and civic engagement: proceedings of the Copenhagen Symposium. Copenhagen: OECD CERI.
Health matters: Harmful drinking and alcohol dependence (2016a) Available at: https://www.gov.uk/government/publications/health-matters-harmful-drinking-and-alcohol-dependence/health-matters-harmful-drinking-and-alcohol-dependence (Accessed: 8 November 2016).
Higgins, C., Lavin, T. and Metcalfe, O. (2008) Health impacts of education: a review. Dublin: Institute of Public Health in Ireland. Available at: https://www.publichealth.ie/files/file/Health%20Impacts%20of%20Education.pdf .
Housing facts and figures: The impact of bad housing – shelter England (2015) Available at: http://england.shelter.org.uk/campaigns_/why_we_campaign/housing_facts_and_figures/subsection?section=the_impact_of_bad_housing (Accessed: 8 November 2016).
Kim, Y. & Woo, A. (2015) “Estimating Natural Environmental Characteristics of Subsidized Households: A Case Study of Austin, Texas”, Sustainability, vol. 7, no. 10, pp. 13433-13453.
Naidoo, J, Wills, J. (2016)Foundation for health Promotion, 4th Edition, London, Elsevier.
Public Health England, (2016)‘The public health burden of alcohol and the effectivenessand cost-effectiveness of alcohol control policies’: an evidence review.Available at
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/583047/alcohol_public_health_burden_evidence_review.pdf (Accessed: 29th January 207).
Scriven, A., Ewles, L. and Simnett, I. (2010) Promoting health: A practical guide, 6th edition, Edinburgh: Baillière Tindall/Elsevier.
Taylor, V., (2012) Leading for health and Wellbeing, London: Sage.
The chartered institute of environmental health (2016) Available at: http://www.cieh.org/policy/housing/poor-housing.html (Accessed: 8 November 2016).
WHO, (2011) ‘Housing and health’. Available at: http://www.who.int/hia/housing/en/ (Accessed: 8 November 2016).
